hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|CO,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Pagosa Springs Medical Center,10/24/2025,2.0.0,Pagosa Springs Medical Center,"95 S Pagosa Blvd Pagosa Springs, CO 81147",840866061,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,code|3,code|3|type,setting,drug_unit_of_measurement,drug_type_of_measurement,standard_charge|gross,standard_charge|discounted_cash,modifiers,standard_charge|AETNA|COMMERCIAL|negotiated_dollar,standard_charge|AETNA|COMMERCIAL|negotiated_percentage,standard_charge|AETNA|COMMERCIAL|negotiated_algorithm,estimated_amount|AETNA|COMMERCIAL,standard_charge|AETNA|COMMERCIAL|methodology,additional_payer_notes|AETNA|COMMERCIAL,standard_charge|AETNA_MEDICARE_ADVANTAGE|MEDICARE|negotiated_dollar,standard_charge|AETNA_MEDICARE_ADVANTAGE|MEDICARE|negotiated_percentage,standard_charge|AETNA_MEDICARE_ADVANTAGE|MEDICARE|negotiated_algorithm,estimated_amount|AETNA_MEDICARE_ADVANTAGE|MEDICARE,standard_charge|AETNA_MEDICARE_ADVANTAGE|MEDICARE|methodology,additional_payer_notes|AETNA_MEDICARE_ADVANTAGE|MEDICARE,standard_charge|ANTHEM_BCBS|HMO|negotiated_dollar,standard_charge|ANTHEM_BCBS|HMO|negotiated_percentage,standard_charge|ANTHEM_BCBS|HMO|negotiated_algorithm,estimated_amount|ANTHEM_BCBS|HMO,standard_charge|ANTHEM_BCBS|HMO|methodology,additional_payer_notes|ANTHEM_BCBS|HMO,standard_charge|CIGNA|COMMERCIAL|negotiated_dollar,standard_charge|CIGNA|COMMERCIAL|negotiated_percentage,standard_charge|CIGNA|COMMERCIAL|negotiated_algorithm,estimated_amount|CIGNA|COMMERCIAL,standard_charge|CIGNA|COMMERCIAL|methodology,additional_payer_notes|CIGNA|COMMERCIAL,standard_charge|COLORADO_ACCESS|MEDICAID_HMO|negotiated_dollar,standard_charge|COLORADO_ACCESS|MEDICAID_HMO|negotiated_percentage,standard_charge|COLORADO_ACCESS|MEDICAID_HMO|negotiated_algorithm,estimated_amount|COLORADO_ACCESS|MEDICAID_HMO,standard_charge|COLORADO_ACCESS|MEDICAID_HMO|methodology,additional_payer_notes|COLORADO_ACCESS|MEDICAID_HMO,standard_charge|COLORADO NETWORK|MEDICARE|negotiated_dollar,standard_charge|COLORADO NETWORK|MEDICARE|negotiated_percentage,standard_charge|COLORADO NETWORK|MEDICARE|negotiated_algorithm,estimated_amount|COLORADO NETWORK|MEDICARE,standard_charge|COLORADO NETWORK|MEDICARE|methodology,additional_payer_notes|COLORADO NETWORK|MEDICARE,standard_charge|COVER COLORADO|COMMERCIAL|negotiated_dollar,standard_charge|COVER COLORADO|COMMERCIAL|negotiated_percentage,standard_charge|COVER COLORADO|COMMERCIAL|negotiated_algorithm,estimated_amount|COVER COLORADO|COMMERCIAL,standard_charge|COVER COLORADO|COMMERCIAL|methodology,additional_payer_notes|COVER COLORADO|COMMERCIAL,standard_charge|FIRST_HEALTH|COMMERCIAL|negotiated_dollar,standard_charge|FIRST_HEALTH|COMMERCIAL|negotiated_percentage,standard_charge|FIRST_HEALTH|COMMERCIAL|negotiated_algorithm,estimated_amount|FIRST_HEALTH|COMMERCIAL,standard_charge|FIRST_HEALTH|COMMERCIAL|methodology,additional_payer_notes|FIRST_HEALTH|COMMERCIAL,standard_charge|HUMANA_CHOICECARE|COMMERCIAL|negotiated_dollar,standard_charge|HUMANA_CHOICECARE|COMMERCIAL|negotiated_percentage,standard_charge|HUMANA_CHOICECARE|COMMERCIAL|negotiated_algorithm,estimated_amount|HUMANA_CHOICECARE|COMMERCIAL,standard_charge|HUMANA_CHOICECARE|COMMERCIAL|methodology,additional_payer_notes|HUMANA_CHOICECARE|COMMERCIAL,standard_charge|MEDICAID|MEDICAID|negotiated_dollar,standard_charge|MEDICAID|MEDICAID|negotiated_percentage,standard_charge|MEDICAID|MEDICAID|negotiated_algorithm,estimated_amount|MEDICAID|MEDICAID,standard_charge|MEDICAID|MEDICAID|methodology,additional_payer_notes|MEDICAID|MEDICAID,standard_charge|MEDICAID ADVANTAGE|MEDICAID|negotiated_dollar,standard_charge|MEDICAID ADVANTAGE|MEDICAID|negotiated_percentage,standard_charge|MEDICAID ADVANTAGE|MEDICAID|negotiated_algorithm,estimated_amount|MEDICAID ADVANTAGE|MEDICAID,standard_charge|MEDICAID ADVANTAGE|MEDICAID|methodology,additional_payer_notes|MEDICAID ADVANTAGE|MEDICAID,standard_charge|MEDICAID_NEW_MEXICO|MEDICAID|negotiated_dollar,standard_charge|MEDICAID_NEW_MEXICO|MEDICAID|negotiated_percentage,standard_charge|MEDICAID_NEW_MEXICO|MEDICAID|negotiated_algorithm,estimated_amount|MEDICAID_NEW_MEXICO|MEDICAID,standard_charge|MEDICAID_NEW_MEXICO|MEDICAID|methodology,additional_payer_notes|MEDICAID_NEW_MEXICO|MEDICAID,standard_charge|MEDICARE|MEDICARE|negotiated_dollar,standard_charge|MEDICARE|MEDICARE|negotiated_percentage,standard_charge|MEDICARE|MEDICARE|negotiated_algorithm,estimated_amount|MEDICARE|MEDICARE,standard_charge|MEDICARE|MEDICARE|methodology,additional_payer_notes|MEDICARE|MEDICARE,standard_charge|MEDICARE ADVANTAGE|MEDICARE|negotiated_dollar,standard_charge|MEDICARE ADVANTAGE|MEDICARE|negotiated_percentage,standard_charge|MEDICARE ADVANTAGE|MEDICARE|negotiated_algorithm,estimated_amount|MEDICARE ADVANTAGE|MEDICARE,standard_charge|MEDICARE ADVANTAGE|MEDICARE|methodology,additional_payer_notes|MEDICARE ADVANTAGE|MEDICARE,standard_charge|MULTIPLAN|COMMERCIAL|negotiated_dollar,standard_charge|MULTIPLAN|COMMERCIAL|negotiated_percentage,standard_charge|MULTIPLAN|COMMERCIAL|negotiated_algorithm,estimated_amount|MULTIPLAN|COMMERCIAL,standard_charge|MULTIPLAN|COMMERCIAL|methodology,additional_payer_notes|MULTIPLAN|COMMERCIAL,standard_charge|PINNACOL_ASSURANCE|COMMERCIAL|negotiated_dollar,standard_charge|PINNACOL_ASSURANCE|COMMERCIAL|negotiated_percentage,standard_charge|PINNACOL_ASSURANCE|COMMERCIAL|negotiated_algorithm,estimated_amount|PINNACOL_ASSURANCE|COMMERCIAL,standard_charge|PINNACOL_ASSURANCE|COMMERCIAL|methodology,additional_payer_notes|PINNACOL_ASSURANCE|COMMERCIAL,standard_charge|PRESBYTERIAN_HEALTH|COMMERCIAL|negotiated_dollar,standard_charge|PRESBYTERIAN_HEALTH|COMMERCIAL|negotiated_percentage,standard_charge|PRESBYTERIAN_HEALTH|COMMERCIAL|negotiated_algorithm,estimated_amount|PRESBYTERIAN_HEALTH|COMMERCIAL,standard_charge|PRESBYTERIAN_HEALTH|COMMERCIAL|methodology,additional_payer_notes|PRESBYTERIAN_HEALTH|COMMERCIAL,standard_charge|ROCKY_MOUNTAIN_HEALTH|COMMERCIAL|negotiated_dollar,standard_charge|ROCKY_MOUNTAIN_HEALTH|COMMERCIAL|negotiated_percentage,standard_charge|ROCKY_MOUNTAIN_HEALTH|COMMERCIAL|negotiated_algorithm,estimated_amount|ROCKY_MOUNTAIN_HEALTH|COMMERCIAL,standard_charge|ROCKY_MOUNTAIN_HEALTH|COMMERCIAL|methodology,additional_payer_notes|ROCKY_MOUNTAIN_HEALTH|COMMERCIAL,standard_charge|ROCKY_MOUNTAIN_HEALTH|MEDICAID|negotiated_dollar,standard_charge|ROCKY_MOUNTAIN_HEALTH|MEDICAID|negotiated_percentage,standard_charge|ROCKY_MOUNTAIN_HEALTH|MEDICAID|negotiated_algorithm,estimated_amount|ROCKY_MOUNTAIN_HEALTH|MEDICAID,standard_charge|ROCKY_MOUNTAIN_HEALTH|MEDICAID|methodology,additional_payer_notes|ROCKY_MOUNTAIN_HEALTH|MEDICAID,standard_charge|THREE_RIVERS|COMMERCIAL|negotiated_dollar,standard_charge|THREE_RIVERS|COMMERCIAL|negotiated_percentage,standard_charge|THREE_RIVERS|COMMERCIAL|negotiated_algorithm,estimated_amount|THREE_RIVERS|COMMERCIAL,standard_charge|THREE_RIVERS|COMMERCIAL|methodology,additional_payer_notes|THREE_RIVERS|COMMERCIAL,standard_charge|TRIWEST|COMMERCIAL|negotiated_dollar,standard_charge|TRIWEST|COMMERCIAL|negotiated_percentage,standard_charge|TRIWEST|COMMERCIAL|negotiated_algorithm,estimated_amount|TRIWEST|COMMERCIAL,standard_charge|TRIWEST|COMMERCIAL|methodology,additional_payer_notes|TRIWEST|COMMERCIAL,standard_charge|UHC|COMMERCIAL|negotiated_dollar,standard_charge|UHC|COMMERCIAL|negotiated_percentage,standard_charge|UHC|COMMERCIAL|negotiated_algorithm,estimated_amount|UHC|COMMERCIAL,standard_charge|UHC|COMMERCIAL|methodology,additional_payer_notes|UHC|COMMERCIAL,standard_charge|WESTERN_SKY_COMMUNITY_CARE|COMMERCIAL|negotiated_dollar,standard_charge|WESTERN_SKY_COMMUNITY_CARE|COMMERCIAL|negotiated_percentage,standard_charge|WESTERN_SKY_COMMUNITY_CARE|COMMERCIAL|negotiated_algorithm,estimated_amount|WESTERN_SKY_COMMUNITY_CARE|COMMERCIAL,standard_charge|WESTERN_SKY_COMMUNITY_CARE|COMMERCIAL|methodology,additional_payer_notes|WESTERN_SKY_COMMUNITY_CARE|COMMERCIAL,standard_charge|WORK COMP|MEDICARE|negotiated_dollar,standard_charge|WORK COMP|MEDICARE|negotiated_percentage,standard_charge|WORK COMP|MEDICARE|negotiated_algorithm,estimated_amount|WORK COMP|MEDICARE,standard_charge|WORK COMP|MEDICARE|methodology,additional_payer_notes|WORK COMP|MEDICARE,standard_charge|min,standard_charge|max,additional_generic_notes
Stool for Occult Blood Card POC,49182274,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,24.2,19.36,,26.33,75,,,percent of total billed charges,75% of total billed charges,9.68,40,,,percent of total billed charges,40% of total billed charges,19.17,79.2,,,percent of total billed charges,79.2% of total billed charges,20.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,22.99,95,,,percent of total billed charges,95% of total billed charges,19.36,80,,,percent of total billed charges,80% of total billed charges,20.57,85,,,percent of total billed charges,85% of total billed charges,21.78,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.68,40,,,percent of total billed charges,40% of total billed charges,9.68,40,,,percent of total billed charges,40% of total billed charges,21.78,90,,,percent of total billed charges,90% of total billed charges,18.39,76,,,percent of total billed charges,76% of total billed charges,9.68,40,,,percent of total billed charges,40% of total billed charges,20.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,19.36,80,,,percent of total billed charges,80% of total billed charges,9.39,38.8,,,percent of total billed charges,38.8% of total billed charges,20.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,26.33,
Urine Dipstick POC,49181002,CDM,307,RC,81002,HCPCS,OUTPATIENT,,,35.1,28.08,,,,,,other ,not separately reimbursable,14.04,40,,,percent of total billed charges,40% of total billed charges,27.8,79.2,,,percent of total billed charges,79.2% of total billed charges,29.84,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,33.35,95,,,percent of total billed charges,95% of total billed charges,28.08,80,,,percent of total billed charges,80% of total billed charges,29.84,85,,,percent of total billed charges,85% of total billed charges,31.59,90,,,percent of total billed charges,90% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,3.61,100,,,fee schedule,100% of CO APG rates,3.27,100,,,fee schedule,100% of NM fee schedule,14.04,40,,,percent of total billed charges,40% of total billed charges,14.04,40,,,percent of total billed charges,40% of total billed charges,31.59,90,,,percent of total billed charges,90% of total billed charges,26.68,76,,,percent of total billed charges,76% of total billed charges,14.04,40,,,percent of total billed charges,40% of total billed charges,29.84,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rate,28.08,80,,,percent of total billed charges,80% of total billed charges,13.62,38.8,,,percent of total billed charges,38.8% of total billed charges,29.84,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of APG fee schedule,6.96,200,,,fee schedule,200% of CMS fee schedule,3.27,33.35,
Urine Pregnancy Test POC,49181025,CDM,307,RC,81002,HCPCS,OUTPATIENT,,,54.1,43.28,,40.58,75,,,percent of total billed charges,75% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,42.85,79.2,,,percent of total billed charges,79.2% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,51.4,95,,,percent of total billed charges,95% of total billed charges,43.28,80,,,percent of total billed charges,80% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,3.61,100,,,fee schedule,100% of CO APG rates,3.27,100,,,fee schedule,100% of NM fee schedule,21.64,40,,,percent of total billed charges,40% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,41.12,76,,,percent of total billed charges,76% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rate,43.28,80,,,percent of total billed charges,80% of total billed charges,20.99,38.8,,,percent of total billed charges,38.8% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of APG fee schedule,6.96,200,,,fee schedule,200% of CMS fee schedule,3.27,51.4,
Antepartum Care 4-6 Visits - 59425,49159425,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1572.9,1258.32,,1179.68,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1245.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1336.97,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1494.26,95,,,percent of total billed charges,95% of total billed charges,1258.32,80,,,percent of total billed charges,80% of total billed charges,1336.97,85,,,percent of total billed charges,85% of total billed charges,1415.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1572.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1415.61,90,,,percent of total billed charges,90% of total billed charges,1195.4,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1336.97,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1258.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1336.97,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1572.9,
Antepartum Care 7 or More Visits - 59426,49159426,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2874.1,2299.28,,2155.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,2276.29,79.2,,,percent of total billed charges,79.2% of total billed charges,2442.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,2730.4,95,,,percent of total billed charges,95% of total billed charges,2299.28,80,,,percent of total billed charges,80% of total billed charges,2442.99,85,,,percent of total billed charges,85% of total billed charges,2586.69,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2874.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,2586.69,90,,,percent of total billed charges,90% of total billed charges,2184.32,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,2442.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,2299.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,2442.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2874.1,
Office/Outpatient Visit Level 1 Es,49199211,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,21.2,16.96,,15.9,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,16.79,79.2,,,percent of total billed charges,79.2% of total billed charges,18.02,85,,,percent of total billed charges,85% of total billed charges,21.2,100,,,fee schedule,100% of CO APG rates,20.14,95,,,percent of total billed charges,95% of total billed charges,16.96,80,,,percent of total billed charges,80% of total billed charges,18.02,85,,,percent of total billed charges,85% of total billed charges,19.08,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,21.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,19.08,90,,,percent of total billed charges,90% of total billed charges,16.11,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,18.02,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,16.96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,18.02,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,424.6,100,,,case rate,pays based on per visit rate,15.9,424.6,
Office/Outpatient Visit Level 3 Established - 99213,49199213,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,158.9,127.12,,119.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,125.85,79.2,,,percent of total billed charges,79.2% of total billed charges,135.07,85,,,percent of total billed charges,85% of total billed charges,158.9,100,,,fee schedule,100% of CO APG rates,150.96,95,,,percent of total billed charges,95% of total billed charges,127.12,80,,,percent of total billed charges,80% of total billed charges,135.07,85,,,percent of total billed charges,85% of total billed charges,143.01,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,158.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,143.01,90,,,percent of total billed charges,90% of total billed charges,120.76,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,135.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,127.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,135.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,700,100,,,case rate,pays based on per visit rate,119.18,700,
Postpartum Care only - 59430,49159430,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,753.6,602.88,,565.2,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,596.85,79.2,,,percent of total billed charges,79.2% of total billed charges,640.56,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,715.92,95,,,percent of total billed charges,95% of total billed charges,602.88,80,,,percent of total billed charges,80% of total billed charges,640.56,85,,,percent of total billed charges,85% of total billed charges,678.24,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,753.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,678.24,90,,,percent of total billed charges,90% of total billed charges,572.74,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,640.56,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,602.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,640.56,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Preventive Medicine 1-4 years Established - 99392,49199392,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,231.7,185.36,,173.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,183.51,79.2,,,percent of total billed charges,79.2% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,231.7,100,,,fee schedule,100% of CO APG rates,220.12,95,,,percent of total billed charges,95% of total billed charges,185.36,80,,,percent of total billed charges,80% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,208.53,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,231.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,208.53,90,,,percent of total billed charges,90% of total billed charges,176.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,185.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,845.6,100,,,case rate,pays based on per visit rate,173.78,845.6,
Preventive Medicine 1-4 years New - 99382,49199382,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,309.4,247.52,,232.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,245.04,79.2,,,percent of total billed charges,79.2% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,309.4,100,,,fee schedule,100% of CO APG rates,293.93,95,,,percent of total billed charges,95% of total billed charges,247.52,80,,,percent of total billed charges,80% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,278.46,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,309.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,278.46,90,,,percent of total billed charges,90% of total billed charges,235.14,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,247.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1001,100,,,case rate,pays based on per visit rate,232.05,1001,
Preventive Medicine 12-17 years Established - 99394,49199394,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,231.7,185.36,,173.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,183.51,79.2,,,percent of total billed charges,79.2% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,231.7,100,,,fee schedule,100% of CO APG rates,220.12,95,,,percent of total billed charges,95% of total billed charges,185.36,80,,,percent of total billed charges,80% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,208.53,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,231.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,208.53,90,,,percent of total billed charges,90% of total billed charges,176.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,185.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,845.6,100,,,case rate,pays based on per visit rate,173.78,845.6,
Preventive Medicine 12-17 years New - 99384,49199384,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,309.4,247.52,,232.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,245.04,79.2,,,percent of total billed charges,79.2% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,309.4,100,,,fee schedule,100% of CO APG rates,293.93,95,,,percent of total billed charges,95% of total billed charges,247.52,80,,,percent of total billed charges,80% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,278.46,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,309.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,278.46,90,,,percent of total billed charges,90% of total billed charges,235.14,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,247.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1001,100,,,case rate,pays based on per visit rate,232.05,1001,
Preventive Medicine 18-39 years Established - 99395,49199395,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,231.7,185.36,,173.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,183.51,79.2,,,percent of total billed charges,79.2% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,231.7,100,,,fee schedule,100% of CO APG rates,220.12,95,,,percent of total billed charges,95% of total billed charges,185.36,80,,,percent of total billed charges,80% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,208.53,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,231.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,208.53,90,,,percent of total billed charges,90% of total billed charges,176.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,185.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,845.6,100,,,case rate,pays based on per visit rate,173.78,845.6,
Preventive Medicine 18-39 years New - 99385,49199385,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,309.4,247.52,,232.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,245.04,79.2,,,percent of total billed charges,79.2% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,309.4,100,,,fee schedule,100% of CO APG rates,293.93,95,,,percent of total billed charges,95% of total billed charges,247.52,80,,,percent of total billed charges,80% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,278.46,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,309.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,278.46,90,,,percent of total billed charges,90% of total billed charges,235.14,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,247.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1001,100,,,case rate,pays based on per visit rate,232.05,1001,
Preventive Medicine 40-64 years Established - 99396,49199396,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,231.7,185.36,,173.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,183.51,79.2,,,percent of total billed charges,79.2% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,231.7,100,,,fee schedule,100% of CO APG rates,220.12,95,,,percent of total billed charges,95% of total billed charges,185.36,80,,,percent of total billed charges,80% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,208.53,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,231.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,208.53,90,,,percent of total billed charges,90% of total billed charges,176.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,185.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,845.6,100,,,case rate,pays based on per visit rate,173.78,845.6,
Preventive Medicine 40-64 years New - 99386,49199386,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,309.4,247.52,,232.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,245.04,79.2,,,percent of total billed charges,79.2% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,309.4,100,,,fee schedule,100% of CO APG rates,293.93,95,,,percent of total billed charges,95% of total billed charges,247.52,80,,,percent of total billed charges,80% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,278.46,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,309.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,278.46,90,,,percent of total billed charges,90% of total billed charges,235.14,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,247.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1001,100,,,case rate,pays based on per visit rate,232.05,1001,
Preventive Medicine 5-11 years Established - 99393,49199393,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,231.7,185.36,,173.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,183.51,79.2,,,percent of total billed charges,79.2% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,231.7,100,,,fee schedule,100% of CO APG rates,220.12,95,,,percent of total billed charges,95% of total billed charges,185.36,80,,,percent of total billed charges,80% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,208.53,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,231.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,208.53,90,,,percent of total billed charges,90% of total billed charges,176.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,185.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,845.6,100,,,case rate,pays based on per visit rate,173.78,845.6,
Preventive Medicine 5-11 years New - 99383,49199383,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,309.4,247.52,,232.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,245.04,79.2,,,percent of total billed charges,79.2% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,309.4,100,,,fee schedule,100% of CO APG rates,293.93,95,,,percent of total billed charges,95% of total billed charges,247.52,80,,,percent of total billed charges,80% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,278.46,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,309.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,278.46,90,,,percent of total billed charges,90% of total billed charges,235.14,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,247.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1001,100,,,case rate,pays based on per visit rate,232.05,1001,
Preventive Medicine 65+ years Established - 99397,49199397,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,231.7,185.36,,173.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,183.51,79.2,,,percent of total billed charges,79.2% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,231.7,100,,,fee schedule,100% of CO APG rates,220.12,95,,,percent of total billed charges,95% of total billed charges,185.36,80,,,percent of total billed charges,80% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,208.53,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,231.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,208.53,90,,,percent of total billed charges,90% of total billed charges,176.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,185.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,845.6,100,,,case rate,pays based on per visit rate,173.78,845.6,
Preventive Medicine 65+ years New - 99387,49199387,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,309.4,247.52,,232.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,245.04,79.2,,,percent of total billed charges,79.2% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,309.4,100,,,fee schedule,100% of CO APG rates,293.93,95,,,percent of total billed charges,95% of total billed charges,247.52,80,,,percent of total billed charges,80% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,278.46,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,309.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,278.46,90,,,percent of total billed charges,90% of total billed charges,235.14,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,247.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1001,100,,,case rate,pays based on per visit rate,232.05,1001,
Preventive Medicine < 1 year Established - 99391,49199391,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,231.7,185.36,,173.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,183.51,79.2,,,percent of total billed charges,79.2% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,231.7,100,,,fee schedule,100% of CO APG rates,220.12,95,,,percent of total billed charges,95% of total billed charges,185.36,80,,,percent of total billed charges,80% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,208.53,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,231.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,208.53,90,,,percent of total billed charges,90% of total billed charges,176.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,185.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,196.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,845.6,100,,,case rate,pays based on per visit rate,173.78,845.6,
Preventive Medicine < 1 year New - 99381,49199381,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,309.4,247.52,,232.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,245.04,79.2,,,percent of total billed charges,79.2% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,309.4,100,,,fee schedule,100% of CO APG rates,293.93,95,,,percent of total billed charges,95% of total billed charges,247.52,80,,,percent of total billed charges,80% of total billed charges,262.99,85,,,percent of total billed charges,85% of total billed charges,278.46,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,309.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,278.46,90,,,percent of total billed charges,90% of total billed charges,235.14,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,247.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,262.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1001,100,,,case rate,pays based on per visit rate,232.05,1001,
Carcinoembryonic Antigen,40082378,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145,116,,108.75,75,,,percent of total billed charges,75% of total billed charges,58,40,,,percent of total billed charges,40% of total billed charges,114.84,79.2,,,percent of total billed charges,79.2% of total billed charges,123.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,137.75,95,,,percent of total billed charges,95% of total billed charges,116,80,,,percent of total billed charges,80% of total billed charges,123.25,85,,,percent of total billed charges,85% of total billed charges,130.5,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58,40,,,percent of total billed charges,40% of total billed charges,58,40,,,percent of total billed charges,40% of total billed charges,130.5,90,,,percent of total billed charges,90% of total billed charges,110.2,76,,,percent of total billed charges,76% of total billed charges,58,40,,,percent of total billed charges,40% of total billed charges,123.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116,80,,,percent of total billed charges,80% of total billed charges,56.26,38.8,,,percent of total billed charges,38.8% of total billed charges,123.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,137.75,
Digoxin Level,40080162,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,112.4,89.92,,84.3,75,,,percent of total billed charges,75% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,89.02,79.2,,,percent of total billed charges,79.2% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,106.78,95,,,percent of total billed charges,95% of total billed charges,89.92,80,,,percent of total billed charges,80% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,101.16,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,44.96,40,,,percent of total billed charges,40% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,101.16,90,,,percent of total billed charges,90% of total billed charges,85.42,76,,,percent of total billed charges,76% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,89.92,80,,,percent of total billed charges,80% of total billed charges,43.61,38.8,,,percent of total billed charges,38.8% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,106.78,
Gamma Glutamyl Transferase,40082977,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,75.6,60.48,,56.7,75,,,percent of total billed charges,75% of total billed charges,30.24,40,,,percent of total billed charges,40% of total billed charges,59.88,79.2,,,percent of total billed charges,79.2% of total billed charges,64.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,71.82,95,,,percent of total billed charges,95% of total billed charges,60.48,80,,,percent of total billed charges,80% of total billed charges,64.26,85,,,percent of total billed charges,85% of total billed charges,68.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,30.24,40,,,percent of total billed charges,40% of total billed charges,30.24,40,,,percent of total billed charges,40% of total billed charges,68.04,90,,,percent of total billed charges,90% of total billed charges,57.46,76,,,percent of total billed charges,76% of total billed charges,30.24,40,,,percent of total billed charges,40% of total billed charges,64.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,60.48,80,,,percent of total billed charges,80% of total billed charges,29.33,38.8,,,percent of total billed charges,38.8% of total billed charges,64.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,71.82,
Hemoglobin A1c,40083036,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,84,67.2,QW,63,75,,,percent of total billed charges,75% of total billed charges,33.6,40,,,percent of total billed charges,40% of total billed charges,66.53,79.2,,,percent of total billed charges,79.2% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,79.8,95,,,percent of total billed charges,95% of total billed charges,67.2,80,,,percent of total billed charges,80% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,75.6,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,33.6,40,,,percent of total billed charges,40% of total billed charges,33.6,40,,,percent of total billed charges,40% of total billed charges,75.6,90,,,percent of total billed charges,90% of total billed charges,63.84,76,,,percent of total billed charges,76% of total billed charges,33.6,40,,,percent of total billed charges,40% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,67.2,80,,,percent of total billed charges,80% of total billed charges,32.59,38.8,,,percent of total billed charges,38.8% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,79.8,
Hepatitis Panel (4),40080074,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,367.6,294.08,,275.7,75,,,percent of total billed charges,75% of total billed charges,147.04,40,,,percent of total billed charges,40% of total billed charges,291.14,79.2,,,percent of total billed charges,79.2% of total billed charges,312.46,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,349.22,95,,,percent of total billed charges,95% of total billed charges,294.08,80,,,percent of total billed charges,80% of total billed charges,312.46,85,,,percent of total billed charges,85% of total billed charges,330.84,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,147.04,40,,,percent of total billed charges,40% of total billed charges,147.04,40,,,percent of total billed charges,40% of total billed charges,330.84,90,,,percent of total billed charges,90% of total billed charges,279.38,76,,,percent of total billed charges,76% of total billed charges,147.04,40,,,percent of total billed charges,40% of total billed charges,312.46,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,294.08,80,,,percent of total billed charges,80% of total billed charges,142.63,38.8,,,percent of total billed charges,38.8% of total billed charges,312.46,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,349.22,
Iron  TIBC 1,40083540,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,70.4,56.32,,52.8,75,,,percent of total billed charges,75% of total billed charges,28.16,40,,,percent of total billed charges,40% of total billed charges,55.76,79.2,,,percent of total billed charges,79.2% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,66.88,95,,,percent of total billed charges,95% of total billed charges,56.32,80,,,percent of total billed charges,80% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,63.36,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,28.16,40,,,percent of total billed charges,40% of total billed charges,28.16,40,,,percent of total billed charges,40% of total billed charges,63.36,90,,,percent of total billed charges,90% of total billed charges,53.5,76,,,percent of total billed charges,76% of total billed charges,28.16,40,,,percent of total billed charges,40% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,56.32,80,,,percent of total billed charges,80% of total billed charges,27.32,38.8,,,percent of total billed charges,38.8% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,66.88,
Prothrombin Time,40085610,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,59.9,47.92,,44.93,75,,,percent of total billed charges,75% of total billed charges,23.96,40,,,percent of total billed charges,40% of total billed charges,47.44,79.2,,,percent of total billed charges,79.2% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,56.91,95,,,percent of total billed charges,95% of total billed charges,47.92,80,,,percent of total billed charges,80% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,53.91,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,23.96,40,,,percent of total billed charges,40% of total billed charges,23.96,40,,,percent of total billed charges,40% of total billed charges,53.91,90,,,percent of total billed charges,90% of total billed charges,45.52,76,,,percent of total billed charges,76% of total billed charges,23.96,40,,,percent of total billed charges,40% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,47.92,80,,,percent of total billed charges,80% of total billed charges,23.24,38.8,,,percent of total billed charges,38.8% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,56.91,
Partial Thromboplastin Time,40085730,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,71.4,57.12,,53.55,75,,,percent of total billed charges,75% of total billed charges,28.56,40,,,percent of total billed charges,40% of total billed charges,56.55,79.2,,,percent of total billed charges,79.2% of total billed charges,60.69,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,67.83,95,,,percent of total billed charges,95% of total billed charges,57.12,80,,,percent of total billed charges,80% of total billed charges,60.69,85,,,percent of total billed charges,85% of total billed charges,64.26,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,28.56,40,,,percent of total billed charges,40% of total billed charges,28.56,40,,,percent of total billed charges,40% of total billed charges,64.26,90,,,percent of total billed charges,90% of total billed charges,54.26,76,,,percent of total billed charges,76% of total billed charges,28.56,40,,,percent of total billed charges,40% of total billed charges,60.69,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,57.12,80,,,percent of total billed charges,80% of total billed charges,27.7,38.8,,,percent of total billed charges,38.8% of total billed charges,60.69,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,67.83,
Thyroid Stimulating Hormone,40084443,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,124,99.2,,93,75,,,percent of total billed charges,75% of total billed charges,49.6,40,,,percent of total billed charges,40% of total billed charges,98.21,79.2,,,percent of total billed charges,79.2% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,117.8,95,,,percent of total billed charges,95% of total billed charges,99.2,80,,,percent of total billed charges,80% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,111.6,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,49.6,40,,,percent of total billed charges,40% of total billed charges,49.6,40,,,percent of total billed charges,40% of total billed charges,111.6,90,,,percent of total billed charges,90% of total billed charges,94.24,76,,,percent of total billed charges,76% of total billed charges,49.6,40,,,percent of total billed charges,40% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,99.2,80,,,percent of total billed charges,80% of total billed charges,48.11,38.8,,,percent of total billed charges,38.8% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,117.8,
Vitamin B12 Level,40082607,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,128.2,102.56,,96.15,75,,,percent of total billed charges,75% of total billed charges,51.28,40,,,percent of total billed charges,40% of total billed charges,101.53,79.2,,,percent of total billed charges,79.2% of total billed charges,108.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,121.79,95,,,percent of total billed charges,95% of total billed charges,102.56,80,,,percent of total billed charges,80% of total billed charges,108.97,85,,,percent of total billed charges,85% of total billed charges,115.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,51.28,40,,,percent of total billed charges,40% of total billed charges,51.28,40,,,percent of total billed charges,40% of total billed charges,115.38,90,,,percent of total billed charges,90% of total billed charges,97.43,76,,,percent of total billed charges,76% of total billed charges,51.28,40,,,percent of total billed charges,40% of total billed charges,108.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,102.56,80,,,percent of total billed charges,80% of total billed charges,49.74,38.8,,,percent of total billed charges,38.8% of total billed charges,108.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,121.79,
Colposcopy Cervix/Upper Vag w/Bx Cervix Charge,49157455,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,466.4,373.12,,349.8,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,369.39,79.2,,,percent of total billed charges,79.2% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,443.08,95,,,percent of total billed charges,95% of total billed charges,373.12,80,,,percent of total billed charges,80% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,419.76,90,,,percent of total billed charges,90% of total billed charges,354.46,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,396.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,373.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,396.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Hepatitis A Adult Vaccine,49190632,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,130.5,104.4,,97.88,75,,,percent of total billed charges,75% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,103.36,79.2,,,percent of total billed charges,79.2% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,123.98,95,,,percent of total billed charges,95% of total billed charges,104.4,80,,,percent of total billed charges,80% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,117.45,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,130.5,100,,,fee schedule,100% of NM fee schedule,52.2,40,,,percent of total billed charges,40% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,117.45,90,,,percent of total billed charges,90% of total billed charges,99.18,76,,,percent of total billed charges,76% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,104.4,80,,,percent of total billed charges,80% of total billed charges,50.63,38.8,,,percent of total billed charges,38.8% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,130.5,
Hepatitis A Peds/Adol Vaccine 2 Dose Sched Charge,49190633,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,78.5,62.8,,58.88,75,,,percent of total billed charges,75% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,62.17,79.2,,,percent of total billed charges,79.2% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,74.58,95,,,percent of total billed charges,95% of total billed charges,62.8,80,,,percent of total billed charges,80% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,70.65,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,78.5,100,,,fee schedule,100% of NM fee schedule,31.4,40,,,percent of total billed charges,40% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,70.65,90,,,percent of total billed charges,90% of total billed charges,59.66,76,,,percent of total billed charges,76% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,62.8,80,,,percent of total billed charges,80% of total billed charges,30.46,38.8,,,percent of total billed charges,38.8% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,30.46,78.5,
"DTaP Diphtheria/Pertussis, acellular/Tetanus Vaccine DTaP Under 7 yrs POC",49190700,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,91.2,72.96,,68.4,75,,,percent of total billed charges,75% of total billed charges,36.48,40,,,percent of total billed charges,40% of total billed charges,72.23,79.2,,,percent of total billed charges,79.2% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,86.64,95,,,percent of total billed charges,95% of total billed charges,72.96,80,,,percent of total billed charges,80% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,82.08,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,91.2,100,,,fee schedule,100% of NM fee schedule,36.48,40,,,percent of total billed charges,40% of total billed charges,36.48,40,,,percent of total billed charges,40% of total billed charges,82.08,90,,,percent of total billed charges,90% of total billed charges,69.31,76,,,percent of total billed charges,76% of total billed charges,36.48,40,,,percent of total billed charges,40% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,72.96,80,,,percent of total billed charges,80% of total billed charges,35.39,38.8,,,percent of total billed charges,38.8% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.39,91.2,
MMR Measles/Mumps/Rubella Virus Vaccine POC,49190707,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,137.9,110.32,,103.43,75,,,percent of total billed charges,75% of total billed charges,55.16,40,,,percent of total billed charges,40% of total billed charges,109.22,79.2,,,percent of total billed charges,79.2% of total billed charges,117.22,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,131.01,95,,,percent of total billed charges,95% of total billed charges,110.32,80,,,percent of total billed charges,80% of total billed charges,117.22,85,,,percent of total billed charges,85% of total billed charges,124.11,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,137.9,100,,,fee schedule,100% of NM fee schedule,55.16,40,,,percent of total billed charges,40% of total billed charges,55.16,40,,,percent of total billed charges,40% of total billed charges,124.11,90,,,percent of total billed charges,90% of total billed charges,104.8,76,,,percent of total billed charges,76% of total billed charges,55.16,40,,,percent of total billed charges,40% of total billed charges,117.22,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,110.32,80,,,percent of total billed charges,80% of total billed charges,53.51,38.8,,,percent of total billed charges,38.8% of total billed charges,117.22,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,137.9,
Varicella Virus Vaccine POC,49190716,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,226.9,181.52,,170.18,75,,,percent of total billed charges,75% of total billed charges,90.76,40,,,percent of total billed charges,40% of total billed charges,179.7,79.2,,,percent of total billed charges,79.2% of total billed charges,192.87,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,215.56,95,,,percent of total billed charges,95% of total billed charges,181.52,80,,,percent of total billed charges,80% of total billed charges,192.87,85,,,percent of total billed charges,85% of total billed charges,204.21,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,226.9,100,,,fee schedule,100% of NM fee schedule,90.76,40,,,percent of total billed charges,40% of total billed charges,90.76,40,,,percent of total billed charges,40% of total billed charges,204.21,90,,,percent of total billed charges,90% of total billed charges,172.44,76,,,percent of total billed charges,76% of total billed charges,90.76,40,,,percent of total billed charges,40% of total billed charges,192.87,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,181.52,80,,,percent of total billed charges,80% of total billed charges,88.04,38.8,,,percent of total billed charges,38.8% of total billed charges,192.87,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,226.9,
"Diphth/HepB/Pertussis,Acel/Polio/Tetanus Vaccine POC",49190723,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,190.9,152.72,,143.18,75,,,percent of total billed charges,75% of total billed charges,76.36,40,,,percent of total billed charges,40% of total billed charges,151.19,79.2,,,percent of total billed charges,79.2% of total billed charges,162.27,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,181.36,95,,,percent of total billed charges,95% of total billed charges,152.72,80,,,percent of total billed charges,80% of total billed charges,162.27,85,,,percent of total billed charges,85% of total billed charges,171.81,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,190.9,100,,,fee schedule,100% of NM fee schedule,76.36,40,,,percent of total billed charges,40% of total billed charges,76.36,40,,,percent of total billed charges,40% of total billed charges,171.81,90,,,percent of total billed charges,90% of total billed charges,145.08,76,,,percent of total billed charges,76% of total billed charges,76.36,40,,,percent of total billed charges,40% of total billed charges,162.27,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,152.72,80,,,percent of total billed charges,80% of total billed charges,74.07,38.8,,,percent of total billed charges,38.8% of total billed charges,162.27,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,190.9,
Pneumococcal  23-Valent Adult Vaccine POC,49190732,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,140,112,,105,75,,,percent of total billed charges,75% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,110.88,79.2,,,percent of total billed charges,79.2% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,133,95,,,percent of total billed charges,95% of total billed charges,112,80,,,percent of total billed charges,80% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,126,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,140,100,,,fee schedule,100% of NM fee schedule,56,40,,,percent of total billed charges,40% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,126,90,,,percent of total billed charges,90% of total billed charges,106.4,76,,,percent of total billed charges,76% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,112,80,,,percent of total billed charges,80% of total billed charges,54.32,38.8,,,percent of total billed charges,38.8% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,140,
"Hepatitis B Vaccine, Pediatric 3 Dose Sched POC",49190744,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,32.9,26.32,,24.68,75,,,percent of total billed charges,75% of total billed charges,13.16,40,,,percent of total billed charges,40% of total billed charges,26.06,79.2,,,percent of total billed charges,79.2% of total billed charges,27.97,85,,,percent of total billed charges,85% of total billed charges,32.9,100,,,fee schedule,100% of CO APG rates,31.26,95,,,percent of total billed charges,95% of total billed charges,26.32,80,,,percent of total billed charges,80% of total billed charges,27.97,85,,,percent of total billed charges,85% of total billed charges,29.61,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,32.9,100,,,fee schedule,100% of NM fee schedule,13.16,40,,,percent of total billed charges,40% of total billed charges,13.16,40,,,percent of total billed charges,40% of total billed charges,29.61,90,,,percent of total billed charges,90% of total billed charges,25,76,,,percent of total billed charges,76% of total billed charges,13.16,40,,,percent of total billed charges,40% of total billed charges,27.97,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,26.32,80,,,percent of total billed charges,80% of total billed charges,12.77,38.8,,,percent of total billed charges,38.8% of total billed charges,27.97,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,12.77,35.65,
"Hepatitis B Vaccine, Adult",49190746,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,119.8,95.84,,89.85,75,,,percent of total billed charges,75% of total billed charges,47.92,40,,,percent of total billed charges,40% of total billed charges,94.88,79.2,,,percent of total billed charges,79.2% of total billed charges,101.83,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,113.81,95,,,percent of total billed charges,95% of total billed charges,95.84,80,,,percent of total billed charges,80% of total billed charges,101.83,85,,,percent of total billed charges,85% of total billed charges,107.82,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,119.8,100,,,fee schedule,100% of NM fee schedule,47.92,40,,,percent of total billed charges,40% of total billed charges,47.92,40,,,percent of total billed charges,40% of total billed charges,107.82,90,,,percent of total billed charges,90% of total billed charges,91.05,76,,,percent of total billed charges,76% of total billed charges,47.92,40,,,percent of total billed charges,40% of total billed charges,101.83,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,95.84,80,,,percent of total billed charges,80% of total billed charges,46.48,38.8,,,percent of total billed charges,38.8% of total billed charges,101.83,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,119.8,
"EKG 12 Lead, Tracing Only Charge",49193005,CDM,730,RC,93005,HCPCS,OUTPATIENT,,,158.4,126.72,,118.8,75,,,percent of total billed charges,75% of total billed charges,63.36,40,,,percent of total billed charges,40% of total billed charges,125.45,79.2,,,percent of total billed charges,79.2% of total billed charges,134.64,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,150.48,95,,,percent of total billed charges,95% of total billed charges,126.72,80,,,percent of total billed charges,80% of total billed charges,134.64,85,,,percent of total billed charges,85% of total billed charges,142.56,90,,,percent of total billed charges,90% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,34.77,100,,,fee schedule,100% of CO APG rates,57.48,100,,,fee schedule,100% of NM APC rate,63.36,40,,,percent of total billed charges,40% of total billed charges,63.36,40,,,percent of total billed charges,40% of total billed charges,142.56,90,,,percent of total billed charges,90% of total billed charges,120.38,76,,,percent of total billed charges,76% of total billed charges,63.36,40,,,percent of total billed charges,40% of total billed charges,134.64,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rate,126.72,80,,,percent of total billed charges,80% of total billed charges,61.46,38.8,,,percent of total billed charges,38.8% of total billed charges,134.64,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of APG fee schedule,13.34,200,,,fee schedule,200% of CMS fee schedule,13.34,150.48,
Allergy Injection Professional Service Charge,49195115,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,32,25.6,,24,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,25.34,79.2,,,percent of total billed charges,79.2% of total billed charges,27.2,85,,,percent of total billed charges,85% of total billed charges,32,100,,,fee schedule,100% of CO APG rates,30.4,95,,,percent of total billed charges,95% of total billed charges,25.6,80,,,percent of total billed charges,80% of total billed charges,27.2,85,,,percent of total billed charges,85% of total billed charges,28.8,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,32,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,28.8,90,,,percent of total billed charges,90% of total billed charges,24.32,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,27.2,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,25.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,27.2,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,446.2,100,,,case rate,pays based on per visit rate,24,446.2,
"Allergy Injection Multiple, Professional Service Charge",49195117,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,38.6,30.88,,28.95,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,30.57,79.2,,,percent of total billed charges,79.2% of total billed charges,32.81,85,,,percent of total billed charges,85% of total billed charges,38.6,100,,,fee schedule,100% of CO APG rates,36.67,95,,,percent of total billed charges,95% of total billed charges,30.88,80,,,percent of total billed charges,80% of total billed charges,32.81,85,,,percent of total billed charges,85% of total billed charges,34.74,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,38.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,34.74,90,,,percent of total billed charges,90% of total billed charges,29.34,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,32.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,30.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,32.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,459.4,100,,,case rate,pays based on per visit rate,28.95,459.4,
Admin Hepatitis B Vaccine Medicare POC,49100060,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,41.9,33.52,,31.43,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,33.18,79.2,,,percent of total billed charges,79.2% of total billed charges,35.62,85,,,percent of total billed charges,85% of total billed charges,41.9,100,,,fee schedule,100% of CO APG rates,39.81,95,,,percent of total billed charges,95% of total billed charges,33.52,80,,,percent of total billed charges,80% of total billed charges,35.62,85,,,percent of total billed charges,85% of total billed charges,37.71,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,41.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,37.71,90,,,percent of total billed charges,90% of total billed charges,31.84,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,35.62,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,33.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,35.62,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,466,100,,,case rate,pays based on per visit rate,31.43,466,
Cervical/Vaginal CA Screen; Pelvic/Breast Exam Medicare Charge,49100017,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,208.9,167.12,,156.68,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,165.45,79.2,,,percent of total billed charges,79.2% of total billed charges,177.57,85,,,percent of total billed charges,85% of total billed charges,208.9,100,,,fee schedule,100% of CO APG rates,198.46,95,,,percent of total billed charges,95% of total billed charges,167.12,80,,,percent of total billed charges,80% of total billed charges,177.57,85,,,percent of total billed charges,85% of total billed charges,188.01,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,208.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,188.01,90,,,percent of total billed charges,90% of total billed charges,158.76,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,177.57,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,167.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,177.57,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,800,100,,,case rate,pays based on per visit rate,156.68,800,
Depo-Provera Injection 150 mg Charge,49100038,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,81.6,65.28,,61.2,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,64.63,79.2,,,percent of total billed charges,79.2% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,81.6,100,,,fee schedule,100% of CO APG rates,77.52,95,,,percent of total billed charges,95% of total billed charges,65.28,80,,,percent of total billed charges,80% of total billed charges,69.36,85,,,percent of total billed charges,85% of total billed charges,73.44,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,81.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,73.44,90,,,percent of total billed charges,90% of total billed charges,62.02,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,69.36,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,65.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,69.36,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,545.4,100,,,case rate,pays based on per visit rate,61.2,545.4,
Rapid Strep POC,49187880,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,56.2,44.96,QW,42.15,75,,,percent of total billed charges,75% of total billed charges,22.48,40,,,percent of total billed charges,40% of total billed charges,44.51,79.2,,,percent of total billed charges,79.2% of total billed charges,47.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,53.39,95,,,percent of total billed charges,95% of total billed charges,44.96,80,,,percent of total billed charges,80% of total billed charges,47.77,85,,,percent of total billed charges,85% of total billed charges,50.58,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,22.48,40,,,percent of total billed charges,40% of total billed charges,22.48,40,,,percent of total billed charges,40% of total billed charges,50.58,90,,,percent of total billed charges,90% of total billed charges,42.71,76,,,percent of total billed charges,76% of total billed charges,22.48,40,,,percent of total billed charges,40% of total billed charges,47.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,44.96,80,,,percent of total billed charges,80% of total billed charges,21.81,38.8,,,percent of total billed charges,38.8% of total billed charges,47.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,53.39,
Hemoglobin A1c POC,40083036,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,44.6,35.68,QW,33.45,75,,,percent of total billed charges,75% of total billed charges,17.84,40,,,percent of total billed charges,40% of total billed charges,35.32,79.2,,,percent of total billed charges,79.2% of total billed charges,37.91,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,42.37,95,,,percent of total billed charges,95% of total billed charges,35.68,80,,,percent of total billed charges,80% of total billed charges,37.91,85,,,percent of total billed charges,85% of total billed charges,40.14,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,17.84,40,,,percent of total billed charges,40% of total billed charges,17.84,40,,,percent of total billed charges,40% of total billed charges,40.14,90,,,percent of total billed charges,90% of total billed charges,33.9,76,,,percent of total billed charges,76% of total billed charges,17.84,40,,,percent of total billed charges,40% of total billed charges,37.91,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,35.68,80,,,percent of total billed charges,80% of total billed charges,17.3,38.8,,,percent of total billed charges,38.8% of total billed charges,37.91,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,42.37,
Hemoglobin POC,49185018,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,40.3,32.24,QW,30.23,75,,,percent of total billed charges,75% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,31.92,79.2,,,percent of total billed charges,79.2% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,38.29,95,,,percent of total billed charges,95% of total billed charges,32.24,80,,,percent of total billed charges,80% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,16.12,40,,,percent of total billed charges,40% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,30.63,76,,,percent of total billed charges,76% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,32.24,80,,,percent of total billed charges,80% of total billed charges,15.64,38.8,,,percent of total billed charges,38.8% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,38.29,
10060 Incision And Drainage Of Abscess Simple,49110060,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,360.2,288.16,,270.15,75,,,percent of total billed charges,75% of total billed charges,144.08,40,,,percent of total billed charges,40% of total billed charges,285.28,79.2,,,percent of total billed charges,79.2% of total billed charges,306.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,342.19,95,,,percent of total billed charges,95% of total billed charges,288.16,80,,,percent of total billed charges,80% of total billed charges,306.17,85,,,percent of total billed charges,85% of total billed charges,324.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,144.08,40,,,percent of total billed charges,40% of total billed charges,144.08,40,,,percent of total billed charges,40% of total billed charges,324.18,90,,,percent of total billed charges,90% of total billed charges,273.75,76,,,percent of total billed charges,76% of total billed charges,144.08,40,,,percent of total billed charges,40% of total billed charges,306.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,288.16,80,,,percent of total billed charges,80% of total billed charges,139.76,38.8,,,percent of total billed charges,38.8% of total billed charges,306.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,139.76,342.19,
10061 Incision And Drainage Of Abscess Complicated Or Multip,49110061,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,624.3,499.44,,468.23,75,,,percent of total billed charges,75% of total billed charges,249.72,40,,,percent of total billed charges,40% of total billed charges,494.45,79.2,,,percent of total billed charges,79.2% of total billed charges,530.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,593.09,95,,,percent of total billed charges,95% of total billed charges,499.44,80,,,percent of total billed charges,80% of total billed charges,530.66,85,,,percent of total billed charges,85% of total billed charges,561.87,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,249.72,40,,,percent of total billed charges,40% of total billed charges,249.72,40,,,percent of total billed charges,40% of total billed charges,561.87,90,,,percent of total billed charges,90% of total billed charges,474.47,76,,,percent of total billed charges,76% of total billed charges,249.72,40,,,percent of total billed charges,40% of total billed charges,530.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,499.44,80,,,percent of total billed charges,80% of total billed charges,242.23,38.8,,,percent of total billed charges,38.8% of total billed charges,530.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,593.09,
"Remove Lesion, Trunk/Arm/Leg <.5 cm Charge",49111400,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,374.8,299.84,,281.1,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,296.84,79.2,,,percent of total billed charges,79.2% of total billed charges,318.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,356.06,95,,,percent of total billed charges,95% of total billed charges,299.84,80,,,percent of total billed charges,80% of total billed charges,318.58,85,,,percent of total billed charges,85% of total billed charges,337.32,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,374.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,337.32,90,,,percent of total billed charges,90% of total billed charges,284.85,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,318.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,299.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,318.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1131.8,100,,,case rate,pays based on per visit rate,281.1,1131.8,
"Remove Lesion, Trunk/Arm/Leg .6 to 1.0 cm Charge",49111401,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,465.5,372.4,,349.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,368.68,79.2,,,percent of total billed charges,79.2% of total billed charges,395.68,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,442.23,95,,,percent of total billed charges,95% of total billed charges,372.4,80,,,percent of total billed charges,80% of total billed charges,395.68,85,,,percent of total billed charges,85% of total billed charges,418.95,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,465.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,418.95,90,,,percent of total billed charges,90% of total billed charges,353.78,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,395.68,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,372.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,395.68,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Trunk/Arm/Leg 1.1 to 2.0 cm Charge",49111402,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,511.8,409.44,,383.85,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,405.35,79.2,,,percent of total billed charges,79.2% of total billed charges,435.03,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,486.21,95,,,percent of total billed charges,95% of total billed charges,409.44,80,,,percent of total billed charges,80% of total billed charges,435.03,85,,,percent of total billed charges,85% of total billed charges,460.62,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,511.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,460.62,90,,,percent of total billed charges,90% of total billed charges,388.97,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,435.03,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,409.44,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,435.03,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Trunk/Arm/Leg 2.1 to 3.0 cm Charge",49111403,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,585.1,468.08,,438.83,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,463.4,79.2,,,percent of total billed charges,79.2% of total billed charges,497.34,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,555.85,95,,,percent of total billed charges,95% of total billed charges,468.08,80,,,percent of total billed charges,80% of total billed charges,497.34,85,,,percent of total billed charges,85% of total billed charges,526.59,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,585.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,526.59,90,,,percent of total billed charges,90% of total billed charges,444.68,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,497.34,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,468.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,497.34,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Trunk/Arm/Leg 3.1 to 4.0 cm Charge",49111404,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,651.3,521.04,,488.48,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,515.83,79.2,,,percent of total billed charges,79.2% of total billed charges,553.61,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,618.74,95,,,percent of total billed charges,95% of total billed charges,521.04,80,,,percent of total billed charges,80% of total billed charges,553.61,85,,,percent of total billed charges,85% of total billed charges,586.17,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,651.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,586.17,90,,,percent of total billed charges,90% of total billed charges,494.99,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,553.61,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,521.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,553.61,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Trunk/Arm/Leg >4.0 cm Charge",49111406,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,917.5,734,,688.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,726.66,79.2,,,percent of total billed charges,79.2% of total billed charges,779.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,871.63,95,,,percent of total billed charges,95% of total billed charges,734,80,,,percent of total billed charges,80% of total billed charges,779.88,85,,,percent of total billed charges,85% of total billed charges,825.75,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,917.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,825.75,90,,,percent of total billed charges,90% of total billed charges,697.3,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,779.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,734,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,779.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Scalp/Neck/Hand/Foot < .5 cm Charge",49111420,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,380.9,304.72,,285.68,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,301.67,79.2,,,percent of total billed charges,79.2% of total billed charges,323.77,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,361.86,95,,,percent of total billed charges,95% of total billed charges,304.72,80,,,percent of total billed charges,80% of total billed charges,323.77,85,,,percent of total billed charges,85% of total billed charges,342.81,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,380.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,342.81,90,,,percent of total billed charges,90% of total billed charges,289.48,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,323.77,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,304.72,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,323.77,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1144,100,,,case rate,pays based on per visit rate,285.68,1144,
"Remove Lesion, Scalp/Neck/Hand/Foot .6 to 1.0 cm Charge",49111421,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,474.8,379.84,,356.1,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,376.04,79.2,,,percent of total billed charges,79.2% of total billed charges,403.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,451.06,95,,,percent of total billed charges,95% of total billed charges,379.84,80,,,percent of total billed charges,80% of total billed charges,403.58,85,,,percent of total billed charges,85% of total billed charges,427.32,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,474.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,427.32,90,,,percent of total billed charges,90% of total billed charges,360.85,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,403.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,379.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,403.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Scalp/Neck/Hand/Foot 1.1 to 2.0 cm Charge",49111422,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,531.9,425.52,,398.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,421.26,79.2,,,percent of total billed charges,79.2% of total billed charges,452.12,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,505.31,95,,,percent of total billed charges,95% of total billed charges,425.52,80,,,percent of total billed charges,80% of total billed charges,452.12,85,,,percent of total billed charges,85% of total billed charges,478.71,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,531.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,478.71,90,,,percent of total billed charges,90% of total billed charges,404.24,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,452.12,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,425.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,452.12,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Scalp/Neck/Hand/Foot 2.1 to 3.0 cm Charge",49111423,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,605,484,,453.75,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,479.16,79.2,,,percent of total billed charges,79.2% of total billed charges,514.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,574.75,95,,,percent of total billed charges,95% of total billed charges,484,80,,,percent of total billed charges,80% of total billed charges,514.25,85,,,percent of total billed charges,85% of total billed charges,544.5,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,605,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,544.5,90,,,percent of total billed charges,90% of total billed charges,459.8,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,514.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,484,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,514.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Scalp/Neck/Hand/Foot 3.1 to 4.0 cm Charge",49111424,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,691.6,553.28,,518.7,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,547.75,79.2,,,percent of total billed charges,79.2% of total billed charges,587.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,657.02,95,,,percent of total billed charges,95% of total billed charges,553.28,80,,,percent of total billed charges,80% of total billed charges,587.86,85,,,percent of total billed charges,85% of total billed charges,622.44,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,691.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,622.44,90,,,percent of total billed charges,90% of total billed charges,525.62,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,587.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,553.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,587.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Scalp/Neck/Hand/Foot >4.0 cm Charge",49111426,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1031,824.8,,773.25,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,816.55,79.2,,,percent of total billed charges,79.2% of total billed charges,876.35,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,979.45,95,,,percent of total billed charges,95% of total billed charges,824.8,80,,,percent of total billed charges,80% of total billed charges,876.35,85,,,percent of total billed charges,85% of total billed charges,927.9,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1031,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,927.9,90,,,percent of total billed charges,90% of total billed charges,783.56,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,876.35,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,824.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,876.35,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Face/Lid/Ear/Nose/Lip <.5 cm Charge",49111440,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,428.4,342.72,,321.3,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,339.29,79.2,,,percent of total billed charges,79.2% of total billed charges,364.14,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,406.98,95,,,percent of total billed charges,95% of total billed charges,342.72,80,,,percent of total billed charges,80% of total billed charges,364.14,85,,,percent of total billed charges,85% of total billed charges,385.56,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,428.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,385.56,90,,,percent of total billed charges,90% of total billed charges,325.58,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,364.14,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,342.72,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,364.14,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1239,100,,,case rate,pays based on per visit rate,321.3,1239,
"Remove Lesion, Face/Lid/Ear/Nose/Lip .6 to 1.0 cm Charge",49111441,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,517.5,414,,388.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,409.86,79.2,,,percent of total billed charges,79.2% of total billed charges,439.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,491.63,95,,,percent of total billed charges,95% of total billed charges,414,80,,,percent of total billed charges,80% of total billed charges,439.88,85,,,percent of total billed charges,85% of total billed charges,465.75,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,517.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,465.75,90,,,percent of total billed charges,90% of total billed charges,393.3,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,439.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,414,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,439.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Face/Lid/Ear/Nose/Lip 1.1 to 2.0 cm Charge",49111442,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,572.4,457.92,,429.3,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,453.34,79.2,,,percent of total billed charges,79.2% of total billed charges,486.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,543.78,95,,,percent of total billed charges,95% of total billed charges,457.92,80,,,percent of total billed charges,80% of total billed charges,486.54,85,,,percent of total billed charges,85% of total billed charges,515.16,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,572.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,515.16,90,,,percent of total billed charges,90% of total billed charges,435.02,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,486.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,457.92,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,486.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Face/Lid/Ear/Nose/Lip 2.1 to 3.0 cm Charge",49111443,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,672.7,538.16,,504.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,532.78,79.2,,,percent of total billed charges,79.2% of total billed charges,571.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,639.07,95,,,percent of total billed charges,95% of total billed charges,538.16,80,,,percent of total billed charges,80% of total billed charges,571.8,85,,,percent of total billed charges,85% of total billed charges,605.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,672.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,605.43,90,,,percent of total billed charges,90% of total billed charges,511.25,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,571.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,538.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,571.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Arthrocentesis Intermed Joint, Wrist, Elbow, Ankle Charge",49120605,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,159.5,127.6,,119.63,75,,,percent of total billed charges,75% of total billed charges,63.8,40,,,percent of total billed charges,40% of total billed charges,126.32,79.2,,,percent of total billed charges,79.2% of total billed charges,135.58,85,,,percent of total billed charges,85% of total billed charges,159.5,100,,,fee schedule,100% of CO APG rates,151.53,95,,,percent of total billed charges,95% of total billed charges,127.6,80,,,percent of total billed charges,80% of total billed charges,135.58,85,,,percent of total billed charges,85% of total billed charges,143.55,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,159.5,100,,,fee schedule,100% of NM APC rate,63.8,40,,,percent of total billed charges,40% of total billed charges,63.8,40,,,percent of total billed charges,40% of total billed charges,143.55,90,,,percent of total billed charges,90% of total billed charges,121.22,76,,,percent of total billed charges,76% of total billed charges,63.8,40,,,percent of total billed charges,40% of total billed charges,135.58,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,127.6,80,,,percent of total billed charges,80% of total billed charges,61.89,38.8,,,percent of total billed charges,38.8% of total billed charges,135.58,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,61.89,217.66,
"Arthrocentesis Major Joint, Shoulder, Hip, Knee Charge",49120610,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,188.9,151.12,,141.68,75,,,percent of total billed charges,75% of total billed charges,75.56,40,,,percent of total billed charges,40% of total billed charges,149.61,79.2,,,percent of total billed charges,79.2% of total billed charges,160.57,85,,,percent of total billed charges,85% of total billed charges,188.9,100,,,fee schedule,100% of CO APG rates,179.46,95,,,percent of total billed charges,95% of total billed charges,151.12,80,,,percent of total billed charges,80% of total billed charges,160.57,85,,,percent of total billed charges,85% of total billed charges,170.01,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,75.56,40,,,percent of total billed charges,40% of total billed charges,75.56,40,,,percent of total billed charges,40% of total billed charges,170.01,90,,,percent of total billed charges,90% of total billed charges,143.56,76,,,percent of total billed charges,76% of total billed charges,75.56,40,,,percent of total billed charges,40% of total billed charges,160.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,151.12,80,,,percent of total billed charges,80% of total billed charges,73.29,38.8,,,percent of total billed charges,38.8% of total billed charges,160.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,73.29,217.66,
"Shave (Epi)Dermal Lesion, Single, Trunk, Arms or Legs; Diam 0.5 cm > Charge",49111300,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,301.3,241.04,,225.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,238.63,79.2,,,percent of total billed charges,79.2% of total billed charges,256.11,85,,,percent of total billed charges,85% of total billed charges,301.3,100,,,fee schedule,100% of CO APG rates,286.24,95,,,percent of total billed charges,95% of total billed charges,241.04,80,,,percent of total billed charges,80% of total billed charges,256.11,85,,,percent of total billed charges,85% of total billed charges,271.17,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,301.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,271.17,90,,,percent of total billed charges,90% of total billed charges,228.99,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,256.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,241.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,256.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,984.8,100,,,case rate,pays based on per visit rate,225.98,984.8,
"Shave (Epi)Dermal Lesion, Single, Trunk, Arms or Legs; Diam 0.6 to 1.0 cm Charge",49111301,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,359.4,287.52,,269.55,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,284.64,79.2,,,percent of total billed charges,79.2% of total billed charges,305.49,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,341.43,95,,,percent of total billed charges,95% of total billed charges,287.52,80,,,percent of total billed charges,80% of total billed charges,305.49,85,,,percent of total billed charges,85% of total billed charges,323.46,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,359.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,323.46,90,,,percent of total billed charges,90% of total billed charges,273.14,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,305.49,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,287.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,305.49,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1101,100,,,case rate,pays based on per visit rate,269.55,1101,
"Shave (Epi)Dermal Lesion, Single, Trunk, Arms or Legs; Diam 1.1 to 2.0 cm Charge",49111302,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,406.2,324.96,,304.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,321.71,79.2,,,percent of total billed charges,79.2% of total billed charges,345.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,385.89,95,,,percent of total billed charges,95% of total billed charges,324.96,80,,,percent of total billed charges,80% of total billed charges,345.27,85,,,percent of total billed charges,85% of total billed charges,365.58,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,406.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,365.58,90,,,percent of total billed charges,90% of total billed charges,308.71,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,345.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,324.96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,345.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1194.6,100,,,case rate,pays based on per visit rate,304.65,1194.6,
"Shave (Epi)Dermal Lesion, Single, Trunk, Arms or Legs; Diam 2.0+ cm Charge",49111303,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,447,357.6,,335.25,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,354.02,79.2,,,percent of total billed charges,79.2% of total billed charges,379.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,424.65,95,,,percent of total billed charges,95% of total billed charges,357.6,80,,,percent of total billed charges,80% of total billed charges,379.95,85,,,percent of total billed charges,85% of total billed charges,402.3,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,447,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,402.3,90,,,percent of total billed charges,90% of total billed charges,339.72,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,379.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,357.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,379.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Shave (Epi)Dermal Lesion, Single, Scalp, Neck, Hands, Feet, Genital; Diam 0.5 cm",49111305,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,315.1,252.08,,236.33,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,249.56,79.2,,,percent of total billed charges,79.2% of total billed charges,267.84,85,,,percent of total billed charges,85% of total billed charges,315.1,100,,,fee schedule,100% of CO APG rates,299.35,95,,,percent of total billed charges,95% of total billed charges,252.08,80,,,percent of total billed charges,80% of total billed charges,267.84,85,,,percent of total billed charges,85% of total billed charges,283.59,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,315.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,283.59,90,,,percent of total billed charges,90% of total billed charges,239.48,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,267.84,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,252.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,267.84,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1012.4,100,,,case rate,pays based on per visit rate,236.33,1012.4,
"Shave (Epi)Dermal Lesion, Single, Scalp, Neck, Hands, Feet, Genital; Diam 0.6 to",49111306,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,361.2,288.96,,270.9,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,286.07,79.2,,,percent of total billed charges,79.2% of total billed charges,307.02,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,343.14,95,,,percent of total billed charges,95% of total billed charges,288.96,80,,,percent of total billed charges,80% of total billed charges,307.02,85,,,percent of total billed charges,85% of total billed charges,325.08,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,361.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,325.08,90,,,percent of total billed charges,90% of total billed charges,274.51,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,307.02,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,288.96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,307.02,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1104.6,100,,,case rate,pays based on per visit rate,270.9,1104.6,
"Shave (Epi)Dermal Lesion, Single, Scalp, Neck, Hands, Feet, Genital; Diam 1.1 to",49111307,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,412.5,330,,309.38,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,326.7,79.2,,,percent of total billed charges,79.2% of total billed charges,350.63,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,391.88,95,,,percent of total billed charges,95% of total billed charges,330,80,,,percent of total billed charges,80% of total billed charges,350.63,85,,,percent of total billed charges,85% of total billed charges,371.25,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,412.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,371.25,90,,,percent of total billed charges,90% of total billed charges,313.5,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,350.63,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,330,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,350.63,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1207.2,100,,,case rate,pays based on per visit rate,309.38,1207.2,
"Shave (Epi)Dermal Lesion, Single, Face/Ears/Eyelids/Nose/Lips/Mucous Membrane; D",49111310,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,342.9,274.32,,257.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,271.58,79.2,,,percent of total billed charges,79.2% of total billed charges,291.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,325.76,95,,,percent of total billed charges,95% of total billed charges,274.32,80,,,percent of total billed charges,80% of total billed charges,291.47,85,,,percent of total billed charges,85% of total billed charges,308.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,342.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,308.61,90,,,percent of total billed charges,90% of total billed charges,260.6,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,291.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,274.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,291.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1068,100,,,case rate,pays based on per visit rate,257.18,1068,
"Shave (Epi)Dermal Lesion, Single, Face/Ears/Eyelids/Nose/Lips/Mucous Memb; Diam",49111311,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,403,322.4,,302.25,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,319.18,79.2,,,percent of total billed charges,79.2% of total billed charges,342.55,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,382.85,95,,,percent of total billed charges,95% of total billed charges,322.4,80,,,percent of total billed charges,80% of total billed charges,342.55,85,,,percent of total billed charges,85% of total billed charges,362.7,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,403,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,362.7,90,,,percent of total billed charges,90% of total billed charges,306.28,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,342.55,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,322.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,342.55,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1188.2,100,,,case rate,pays based on per visit rate,302.25,1188.2,
"Shave (Epi)Dermal Lesion, Single, Face/Ears/Eyelids/Nose/Lips/Mucous Memb; Diam",49111312,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,455.8,364.64,,341.85,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,360.99,79.2,,,percent of total billed charges,79.2% of total billed charges,387.43,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,433.01,95,,,percent of total billed charges,95% of total billed charges,364.64,80,,,percent of total billed charges,80% of total billed charges,387.43,85,,,percent of total billed charges,85% of total billed charges,410.22,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,455.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,410.22,90,,,percent of total billed charges,90% of total billed charges,346.41,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,387.43,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,364.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,387.43,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Shave (Epi)Dermal Lesion, Single, Face/Ears/Eyelids/Nose/Lips/Mucous Membrane; D",49111313,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,529.7,423.76,,397.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,419.52,79.2,,,percent of total billed charges,79.2% of total billed charges,450.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,503.22,95,,,percent of total billed charges,95% of total billed charges,423.76,80,,,percent of total billed charges,80% of total billed charges,450.25,85,,,percent of total billed charges,85% of total billed charges,476.73,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,529.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,476.73,90,,,percent of total billed charges,90% of total billed charges,402.57,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,450.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,423.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,450.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Other Benign Lesion w/Margins , Face/Ears/Eyelids/Nose/Lips; Diam 3.1 to",49111444,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,708.9,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,708.9,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Other Benign Lesion w/Margins , Face/Ears/Eyelids/Nose/Lips; Diam 4.0+ cm",49111446,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1130.3,904.24,,847.73,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,895.2,79.2,,,percent of total billed charges,79.2% of total billed charges,960.76,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1073.79,95,,,percent of total billed charges,95% of total billed charges,904.24,80,,,percent of total billed charges,80% of total billed charges,960.76,85,,,percent of total billed charges,85% of total billed charges,1017.27,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1130.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1017.27,90,,,percent of total billed charges,90% of total billed charges,859.03,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,960.76,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,904.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,960.76,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Trunk, Arms, or Legs; Diam 4.0+ cm Charge",49111606,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1282.6,1026.08,,961.95,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1015.82,79.2,,,percent of total billed charges,79.2% of total billed charges,1090.21,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1218.47,95,,,percent of total billed charges,95% of total billed charges,1026.08,80,,,percent of total billed charges,80% of total billed charges,1090.21,85,,,percent of total billed charges,85% of total billed charges,1154.34,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1282.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1154.34,90,,,percent of total billed charges,90% of total billed charges,974.78,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1090.21,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1026.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1090.21,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1282.6,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 0.5 cm >",49111620,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,591.1,472.88,,443.33,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,468.15,79.2,,,percent of total billed charges,79.2% of total billed charges,502.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,561.55,95,,,percent of total billed charges,95% of total billed charges,472.88,80,,,percent of total billed charges,80% of total billed charges,502.44,85,,,percent of total billed charges,85% of total billed charges,531.99,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,591.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,531.99,90,,,percent of total billed charges,90% of total billed charges,449.24,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,502.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,472.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,502.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 0.6 to 1.",49111621,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,679.9,543.92,,509.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,538.48,79.2,,,percent of total billed charges,79.2% of total billed charges,577.92,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,645.91,95,,,percent of total billed charges,95% of total billed charges,543.92,80,,,percent of total billed charges,80% of total billed charges,577.92,85,,,percent of total billed charges,85% of total billed charges,611.91,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,679.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,611.91,90,,,percent of total billed charges,90% of total billed charges,516.72,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,577.92,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,543.92,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,577.92,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 1.1 to 2.",49111622,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,746.1,596.88,,559.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,590.91,79.2,,,percent of total billed charges,79.2% of total billed charges,634.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,708.8,95,,,percent of total billed charges,95% of total billed charges,596.88,80,,,percent of total billed charges,80% of total billed charges,634.19,85,,,percent of total billed charges,85% of total billed charges,671.49,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,746.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,671.49,90,,,percent of total billed charges,90% of total billed charges,567.04,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,634.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,596.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,634.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 2.1 to 3.",49111623,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,871.1,696.88,,653.33,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,689.91,79.2,,,percent of total billed charges,79.2% of total billed charges,740.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,827.55,95,,,percent of total billed charges,95% of total billed charges,696.88,80,,,percent of total billed charges,80% of total billed charges,740.44,85,,,percent of total billed charges,85% of total billed charges,783.99,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,871.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,783.99,90,,,percent of total billed charges,90% of total billed charges,662.04,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,740.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,696.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,740.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 3.1 to 4.",49111624,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,990.1,792.08,,742.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,784.16,79.2,,,percent of total billed charges,79.2% of total billed charges,841.59,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,940.6,95,,,percent of total billed charges,95% of total billed charges,792.08,80,,,percent of total billed charges,80% of total billed charges,841.59,85,,,percent of total billed charges,85% of total billed charges,891.09,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,990.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,891.09,90,,,percent of total billed charges,90% of total billed charges,752.48,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,841.59,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,792.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,841.59,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 4.0+ cm C",49111626,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1191.5,953.2,,893.63,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,943.67,79.2,,,percent of total billed charges,79.2% of total billed charges,1012.78,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1131.93,95,,,percent of total billed charges,95% of total billed charges,953.2,80,,,percent of total billed charges,80% of total billed charges,1012.78,85,,,percent of total billed charges,85% of total billed charges,1072.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1191.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1072.35,90,,,percent of total billed charges,90% of total billed charges,905.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1012.78,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,953.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1012.78,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Diam 2.1 to 3.0",49111643,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,925.7,740.56,,694.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,733.15,79.2,,,percent of total billed charges,79.2% of total billed charges,786.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,879.42,95,,,percent of total billed charges,95% of total billed charges,740.56,80,,,percent of total billed charges,80% of total billed charges,786.85,85,,,percent of total billed charges,85% of total billed charges,833.13,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,925.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,833.13,90,,,percent of total billed charges,90% of total billed charges,703.53,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,786.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,740.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,786.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Repair Simple  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.5 cm >",49112001,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,277,221.6,,207.75,75,,,percent of total billed charges,75% of total billed charges,110.8,40,,,percent of total billed charges,40% of total billed charges,219.38,79.2,,,percent of total billed charges,79.2% of total billed charges,235.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,263.15,95,,,percent of total billed charges,95% of total billed charges,221.6,80,,,percent of total billed charges,80% of total billed charges,235.45,85,,,percent of total billed charges,85% of total billed charges,249.3,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,110.8,40,,,percent of total billed charges,40% of total billed charges,110.8,40,,,percent of total billed charges,40% of total billed charges,249.3,90,,,percent of total billed charges,90% of total billed charges,210.52,76,,,percent of total billed charges,76% of total billed charges,110.8,40,,,percent of total billed charges,40% of total billed charges,235.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,221.6,80,,,percent of total billed charges,80% of total billed charges,107.48,38.8,,,percent of total billed charges,38.8% of total billed charges,235.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,107.48,263.15,
"Simple Repair  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.6 cm t",49112002,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,332.3,265.84,,249.23,75,,,percent of total billed charges,75% of total billed charges,132.92,40,,,percent of total billed charges,40% of total billed charges,263.18,79.2,,,percent of total billed charges,79.2% of total billed charges,282.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,315.69,95,,,percent of total billed charges,95% of total billed charges,265.84,80,,,percent of total billed charges,80% of total billed charges,282.46,85,,,percent of total billed charges,85% of total billed charges,299.07,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,132.92,40,,,percent of total billed charges,40% of total billed charges,132.92,40,,,percent of total billed charges,40% of total billed charges,299.07,90,,,percent of total billed charges,90% of total billed charges,252.55,76,,,percent of total billed charges,76% of total billed charges,132.92,40,,,percent of total billed charges,40% of total billed charges,282.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,265.84,80,,,percent of total billed charges,80% of total billed charges,128.93,38.8,,,percent of total billed charges,38.8% of total billed charges,282.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,128.93,315.69,
"Simple Repair Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 7.6 cm to",49112004,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,377.2,301.76,,282.9,75,,,percent of total billed charges,75% of total billed charges,150.88,40,,,percent of total billed charges,40% of total billed charges,298.74,79.2,,,percent of total billed charges,79.2% of total billed charges,320.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,358.34,95,,,percent of total billed charges,95% of total billed charges,301.76,80,,,percent of total billed charges,80% of total billed charges,320.62,85,,,percent of total billed charges,85% of total billed charges,339.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,150.88,40,,,percent of total billed charges,40% of total billed charges,150.88,40,,,percent of total billed charges,40% of total billed charges,339.48,90,,,percent of total billed charges,90% of total billed charges,286.67,76,,,percent of total billed charges,76% of total billed charges,150.88,40,,,percent of total billed charges,40% of total billed charges,320.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,301.76,80,,,percent of total billed charges,80% of total billed charges,146.35,38.8,,,percent of total billed charges,38.8% of total billed charges,320.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,146.35,358.34,
"Simple repair of superficial wounds of scalp, neck, axillae,",49112005,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,508.6,406.88,,381.45,75,,,percent of total billed charges,75% of total billed charges,203.44,40,,,percent of total billed charges,40% of total billed charges,402.81,79.2,,,percent of total billed charges,79.2% of total billed charges,432.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,483.17,95,,,percent of total billed charges,95% of total billed charges,406.88,80,,,percent of total billed charges,80% of total billed charges,432.31,85,,,percent of total billed charges,85% of total billed charges,457.74,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,203.44,40,,,percent of total billed charges,40% of total billed charges,203.44,40,,,percent of total billed charges,40% of total billed charges,457.74,90,,,percent of total billed charges,90% of total billed charges,386.54,76,,,percent of total billed charges,76% of total billed charges,203.44,40,,,percent of total billed charges,40% of total billed charges,432.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,406.88,80,,,percent of total billed charges,80% of total billed charges,197.34,38.8,,,percent of total billed charges,38.8% of total billed charges,432.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,483.17,
"Repair Simple  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 20.1 cm",49112006,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,593.5,474.8,,445.13,75,,,percent of total billed charges,75% of total billed charges,237.4,40,,,percent of total billed charges,40% of total billed charges,470.05,79.2,,,percent of total billed charges,79.2% of total billed charges,504.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,563.83,95,,,percent of total billed charges,95% of total billed charges,474.8,80,,,percent of total billed charges,80% of total billed charges,504.48,85,,,percent of total billed charges,85% of total billed charges,534.15,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,237.4,40,,,percent of total billed charges,40% of total billed charges,237.4,40,,,percent of total billed charges,40% of total billed charges,534.15,90,,,percent of total billed charges,90% of total billed charges,451.06,76,,,percent of total billed charges,76% of total billed charges,237.4,40,,,percent of total billed charges,40% of total billed charges,504.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,474.8,80,,,percent of total billed charges,80% of total billed charges,230.28,38.8,,,percent of total billed charges,38.8% of total billed charges,504.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,563.83,
"Repair Simple  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 30.0+ cm",49112007,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,665.8,532.64,,499.35,75,,,percent of total billed charges,75% of total billed charges,266.32,40,,,percent of total billed charges,40% of total billed charges,527.31,79.2,,,percent of total billed charges,79.2% of total billed charges,565.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,632.51,95,,,percent of total billed charges,95% of total billed charges,532.64,80,,,percent of total billed charges,80% of total billed charges,565.93,85,,,percent of total billed charges,85% of total billed charges,599.22,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,266.32,40,,,percent of total billed charges,40% of total billed charges,266.32,40,,,percent of total billed charges,40% of total billed charges,599.22,90,,,percent of total billed charges,90% of total billed charges,506.01,76,,,percent of total billed charges,76% of total billed charges,266.32,40,,,percent of total billed charges,40% of total billed charges,565.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,532.64,80,,,percent of total billed charges,80% of total billed charges,258.33,38.8,,,percent of total billed charges,38.8% of total billed charges,565.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,632.51,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112011,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,324.5,259.6,,243.38,75,,,percent of total billed charges,75% of total billed charges,129.8,40,,,percent of total billed charges,40% of total billed charges,257,79.2,,,percent of total billed charges,79.2% of total billed charges,275.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,308.28,95,,,percent of total billed charges,95% of total billed charges,259.6,80,,,percent of total billed charges,80% of total billed charges,275.83,85,,,percent of total billed charges,85% of total billed charges,292.05,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,129.8,40,,,percent of total billed charges,40% of total billed charges,129.8,40,,,percent of total billed charges,40% of total billed charges,292.05,90,,,percent of total billed charges,90% of total billed charges,246.62,76,,,percent of total billed charges,76% of total billed charges,129.8,40,,,percent of total billed charges,40% of total billed charges,275.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,259.6,80,,,percent of total billed charges,80% of total billed charges,125.91,38.8,,,percent of total billed charges,38.8% of total billed charges,275.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,125.91,308.28,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112013,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,337,269.6,,252.75,75,,,percent of total billed charges,75% of total billed charges,134.8,40,,,percent of total billed charges,40% of total billed charges,266.9,79.2,,,percent of total billed charges,79.2% of total billed charges,286.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,320.15,95,,,percent of total billed charges,95% of total billed charges,269.6,80,,,percent of total billed charges,80% of total billed charges,286.45,85,,,percent of total billed charges,85% of total billed charges,303.3,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,134.8,40,,,percent of total billed charges,40% of total billed charges,134.8,40,,,percent of total billed charges,40% of total billed charges,303.3,90,,,percent of total billed charges,90% of total billed charges,256.12,76,,,percent of total billed charges,76% of total billed charges,134.8,40,,,percent of total billed charges,40% of total billed charges,286.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,269.6,80,,,percent of total billed charges,80% of total billed charges,130.76,38.8,,,percent of total billed charges,38.8% of total billed charges,286.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,130.76,320.15,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112014,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,412.6,330.08,,309.45,75,,,percent of total billed charges,75% of total billed charges,165.04,40,,,percent of total billed charges,40% of total billed charges,326.78,79.2,,,percent of total billed charges,79.2% of total billed charges,350.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,391.97,95,,,percent of total billed charges,95% of total billed charges,330.08,80,,,percent of total billed charges,80% of total billed charges,350.71,85,,,percent of total billed charges,85% of total billed charges,371.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,165.04,40,,,percent of total billed charges,40% of total billed charges,165.04,40,,,percent of total billed charges,40% of total billed charges,371.34,90,,,percent of total billed charges,90% of total billed charges,313.58,76,,,percent of total billed charges,76% of total billed charges,165.04,40,,,percent of total billed charges,40% of total billed charges,350.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,330.08,80,,,percent of total billed charges,80% of total billed charges,160.09,38.8,,,percent of total billed charges,38.8% of total billed charges,350.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,160.09,391.97,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112015,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,493.6,394.88,,370.2,75,,,percent of total billed charges,75% of total billed charges,197.44,40,,,percent of total billed charges,40% of total billed charges,390.93,79.2,,,percent of total billed charges,79.2% of total billed charges,419.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,468.92,95,,,percent of total billed charges,95% of total billed charges,394.88,80,,,percent of total billed charges,80% of total billed charges,419.56,85,,,percent of total billed charges,85% of total billed charges,444.24,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,197.44,40,,,percent of total billed charges,40% of total billed charges,197.44,40,,,percent of total billed charges,40% of total billed charges,444.24,90,,,percent of total billed charges,90% of total billed charges,375.14,76,,,percent of total billed charges,76% of total billed charges,197.44,40,,,percent of total billed charges,40% of total billed charges,419.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,394.88,80,,,percent of total billed charges,80% of total billed charges,191.52,38.8,,,percent of total billed charges,38.8% of total billed charges,419.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,468.92,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112016,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,629.9,503.92,,472.43,75,,,percent of total billed charges,75% of total billed charges,251.96,40,,,percent of total billed charges,40% of total billed charges,498.88,79.2,,,percent of total billed charges,79.2% of total billed charges,535.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,598.41,95,,,percent of total billed charges,95% of total billed charges,503.92,80,,,percent of total billed charges,80% of total billed charges,535.42,85,,,percent of total billed charges,85% of total billed charges,566.91,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,251.96,40,,,percent of total billed charges,40% of total billed charges,251.96,40,,,percent of total billed charges,40% of total billed charges,566.91,90,,,percent of total billed charges,90% of total billed charges,478.72,76,,,percent of total billed charges,76% of total billed charges,251.96,40,,,percent of total billed charges,40% of total billed charges,535.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,503.92,80,,,percent of total billed charges,80% of total billed charges,244.4,38.8,,,percent of total billed charges,38.8% of total billed charges,535.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,598.41,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112017,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,419.1,335.28,,314.33,75,,,percent of total billed charges,75% of total billed charges,167.64,40,,,percent of total billed charges,40% of total billed charges,331.93,79.2,,,percent of total billed charges,79.2% of total billed charges,356.24,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,398.15,95,,,percent of total billed charges,95% of total billed charges,335.28,80,,,percent of total billed charges,80% of total billed charges,356.24,85,,,percent of total billed charges,85% of total billed charges,377.19,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,167.64,40,,,percent of total billed charges,40% of total billed charges,167.64,40,,,percent of total billed charges,40% of total billed charges,377.19,90,,,percent of total billed charges,90% of total billed charges,318.52,76,,,percent of total billed charges,76% of total billed charges,167.64,40,,,percent of total billed charges,40% of total billed charges,356.24,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,335.28,80,,,percent of total billed charges,80% of total billed charges,162.61,38.8,,,percent of total billed charges,38.8% of total billed charges,356.24,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,162.61,398.15,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112018,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,475.2,380.16,,356.4,75,,,percent of total billed charges,75% of total billed charges,190.08,40,,,percent of total billed charges,40% of total billed charges,376.36,79.2,,,percent of total billed charges,79.2% of total billed charges,403.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,451.44,95,,,percent of total billed charges,95% of total billed charges,380.16,80,,,percent of total billed charges,80% of total billed charges,403.92,85,,,percent of total billed charges,85% of total billed charges,427.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,190.08,40,,,percent of total billed charges,40% of total billed charges,190.08,40,,,percent of total billed charges,40% of total billed charges,427.68,90,,,percent of total billed charges,90% of total billed charges,361.15,76,,,percent of total billed charges,76% of total billed charges,190.08,40,,,percent of total billed charges,40% of total billed charges,403.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,380.16,80,,,percent of total billed charges,80% of total billed charges,184.38,38.8,,,percent of total billed charges,38.8% of total billed charges,403.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,451.44,
Biopsy Endometrial w/ Colposcopy Charge,49158110,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,141.3,113.04,,105.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,111.91,79.2,,,percent of total billed charges,79.2% of total billed charges,120.11,85,,,percent of total billed charges,85% of total billed charges,141.3,100,,,fee schedule,100% of CO APG rates,134.24,95,,,percent of total billed charges,95% of total billed charges,113.04,80,,,percent of total billed charges,80% of total billed charges,120.11,85,,,percent of total billed charges,85% of total billed charges,127.17,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,141.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,127.17,90,,,percent of total billed charges,90% of total billed charges,107.39,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,120.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,113.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,120.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,664.8,100,,,case rate,pays based on per visit rate,105.98,664.8,
11055 Paring Or Cutting Of Benign Hyperkeratotic Lesion; Sin,49111055,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,213.3,170.64,,159.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,168.93,79.2,,,percent of total billed charges,79.2% of total billed charges,181.31,85,,,percent of total billed charges,85% of total billed charges,213.3,100,,,fee schedule,100% of CO APG rates,202.64,95,,,percent of total billed charges,95% of total billed charges,170.64,80,,,percent of total billed charges,80% of total billed charges,181.31,85,,,percent of total billed charges,85% of total billed charges,191.97,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,213.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,191.97,90,,,percent of total billed charges,90% of total billed charges,162.11,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,181.31,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,170.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,181.31,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,808.8,100,,,case rate,pays based on per visit rate,159.98,808.8,
11056 Paring Or Cutting Of Benign Hyperkeratotic Lesion 2 To,49111056,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,243.6,194.88,,182.7,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,192.93,79.2,,,percent of total billed charges,79.2% of total billed charges,207.06,85,,,percent of total billed charges,85% of total billed charges,243.6,100,,,fee schedule,100% of CO APG rates,231.42,95,,,percent of total billed charges,95% of total billed charges,194.88,80,,,percent of total billed charges,80% of total billed charges,207.06,85,,,percent of total billed charges,85% of total billed charges,219.24,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,243.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,219.24,90,,,percent of total billed charges,90% of total billed charges,185.14,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,207.06,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,194.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,207.06,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,869.4,100,,,case rate,pays based on per visit rate,182.7,869.4,
"11200 Removal Of Skin Tags, Up To And Including 15 Lesions",49111200,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,265.9,212.72,,199.43,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,210.59,79.2,,,percent of total billed charges,79.2% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,265.9,100,,,fee schedule,100% of CO APG rates,252.61,95,,,percent of total billed charges,95% of total billed charges,212.72,80,,,percent of total billed charges,80% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,239.31,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,265.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,239.31,90,,,percent of total billed charges,90% of total billed charges,202.08,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,226.02,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,212.72,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,226.02,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,914,100,,,case rate,pays based on per visit rate,199.43,914,
"11201 Removal of Skin Tags, Mult Fibrocutaneous Tags, Ea Add",49111201,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,52.6,42.08,,39.45,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,41.66,79.2,,,percent of total billed charges,79.2% of total billed charges,44.71,85,,,percent of total billed charges,85% of total billed charges,52.6,100,,,fee schedule,100% of CO APG rates,49.97,95,,,percent of total billed charges,95% of total billed charges,42.08,80,,,percent of total billed charges,80% of total billed charges,44.71,85,,,percent of total billed charges,85% of total billed charges,47.34,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,52.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,47.34,90,,,percent of total billed charges,90% of total billed charges,39.98,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,44.71,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,42.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,44.71,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,487.4,100,,,case rate,pays based on per visit rate,39.45,487.4,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 0.5 cm or Le",49111600,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,589.2,471.36,,441.9,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,466.65,79.2,,,percent of total billed charges,79.2% of total billed charges,500.82,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,559.74,95,,,percent of total billed charges,95% of total billed charges,471.36,80,,,percent of total billed charges,80% of total billed charges,500.82,85,,,percent of total billed charges,85% of total billed charges,530.28,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,589.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,530.28,90,,,percent of total billed charges,90% of total billed charges,447.79,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,500.82,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,471.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,500.82,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 0.6 to 1.0 c",49111601,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,677.9,542.32,,508.43,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,536.9,79.2,,,percent of total billed charges,79.2% of total billed charges,576.22,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,644.01,95,,,percent of total billed charges,95% of total billed charges,542.32,80,,,percent of total billed charges,80% of total billed charges,576.22,85,,,percent of total billed charges,85% of total billed charges,610.11,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,677.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,610.11,90,,,percent of total billed charges,90% of total billed charges,515.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,576.22,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,542.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,576.22,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 1.1 to 2.0 c",49111602,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,722.8,578.24,,542.1,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,572.46,79.2,,,percent of total billed charges,79.2% of total billed charges,614.38,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,686.66,95,,,percent of total billed charges,95% of total billed charges,578.24,80,,,percent of total billed charges,80% of total billed charges,614.38,85,,,percent of total billed charges,85% of total billed charges,650.52,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,722.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,650.52,90,,,percent of total billed charges,90% of total billed charges,549.33,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,614.38,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,578.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,614.38,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 c",49111603,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,820,656,,615,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,649.44,79.2,,,percent of total billed charges,79.2% of total billed charges,697,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,779,95,,,percent of total billed charges,95% of total billed charges,656,80,,,percent of total billed charges,80% of total billed charges,697,85,,,percent of total billed charges,85% of total billed charges,738,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,820,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,738,90,,,percent of total billed charges,90% of total billed charges,623.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,697,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,656,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,697,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 3.1 to 4.0 c",49111604,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,913.3,730.64,,684.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,723.33,79.2,,,percent of total billed charges,79.2% of total billed charges,776.31,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,867.64,95,,,percent of total billed charges,95% of total billed charges,730.64,80,,,percent of total billed charges,80% of total billed charges,776.31,85,,,percent of total billed charges,85% of total billed charges,821.97,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,913.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,821.97,90,,,percent of total billed charges,90% of total billed charges,694.11,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,776.31,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,730.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,776.31,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Excised diam 0",49111640,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,605.3,484.24,,453.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,479.4,79.2,,,percent of total billed charges,79.2% of total billed charges,514.51,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,575.04,95,,,percent of total billed charges,95% of total billed charges,484.24,80,,,percent of total billed charges,80% of total billed charges,514.51,85,,,percent of total billed charges,85% of total billed charges,544.77,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,605.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,544.77,90,,,percent of total billed charges,90% of total billed charges,460.03,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,514.51,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,484.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,514.51,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Excised diam 0",49111641,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,700.8,560.64,,525.6,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,555.03,79.2,,,percent of total billed charges,79.2% of total billed charges,595.68,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,665.76,95,,,percent of total billed charges,95% of total billed charges,560.64,80,,,percent of total billed charges,80% of total billed charges,595.68,85,,,percent of total billed charges,85% of total billed charges,630.72,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,700.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,630.72,90,,,percent of total billed charges,90% of total billed charges,532.61,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,595.68,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,560.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,595.68,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Excised diam 1",49111642,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,790.6,632.48,,592.95,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,626.16,79.2,,,percent of total billed charges,79.2% of total billed charges,672.01,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,751.07,95,,,percent of total billed charges,95% of total billed charges,632.48,80,,,percent of total billed charges,80% of total billed charges,672.01,85,,,percent of total billed charges,85% of total billed charges,711.54,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,790.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,711.54,90,,,percent of total billed charges,90% of total billed charges,600.86,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,672.01,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,632.48,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,672.01,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Debride of Nail(s) By Any Method(s); Six or More Charge,49111721,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,126.5,101.2,,94.88,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,100.19,79.2,,,percent of total billed charges,79.2% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,126.5,100,,,fee schedule,100% of CO APG rates,120.18,95,,,percent of total billed charges,95% of total billed charges,101.2,80,,,percent of total billed charges,80% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,113.85,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,126.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,113.85,90,,,percent of total billed charges,90% of total billed charges,96.14,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,107.53,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,101.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,107.53,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,635.2,100,,,case rate,pays based on per visit rate,94.88,635.2,
"Avulsion of Nail Plate, Partial or Complete, Simple; Single Charge",49111730,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,335.7,268.56,,251.78,75,,,percent of total billed charges,75% of total billed charges,134.28,40,,,percent of total billed charges,40% of total billed charges,265.87,79.2,,,percent of total billed charges,79.2% of total billed charges,285.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,318.92,95,,,percent of total billed charges,95% of total billed charges,268.56,80,,,percent of total billed charges,80% of total billed charges,285.35,85,,,percent of total billed charges,85% of total billed charges,302.13,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,134.28,40,,,percent of total billed charges,40% of total billed charges,134.28,40,,,percent of total billed charges,40% of total billed charges,302.13,90,,,percent of total billed charges,90% of total billed charges,255.13,76,,,percent of total billed charges,76% of total billed charges,134.28,40,,,percent of total billed charges,40% of total billed charges,285.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,268.56,80,,,percent of total billed charges,80% of total billed charges,130.25,38.8,,,percent of total billed charges,38.8% of total billed charges,285.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,130.25,318.92,
"Avulsion of Nail Plate, Partial or Complete, Simple; each Addtl Nail Plate Charg",49111732,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,97.2,77.76,,72.9,75,,,percent of total billed charges,75% of total billed charges,38.88,40,,,percent of total billed charges,40% of total billed charges,76.98,79.2,,,percent of total billed charges,79.2% of total billed charges,82.62,85,,,percent of total billed charges,85% of total billed charges,97.2,100,,,fee schedule,100% of CO APG rates,92.34,95,,,percent of total billed charges,95% of total billed charges,77.76,80,,,percent of total billed charges,80% of total billed charges,82.62,85,,,percent of total billed charges,85% of total billed charges,87.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,97.2,100,,,fee schedule,100% of NM APC rate,38.88,40,,,percent of total billed charges,40% of total billed charges,38.88,40,,,percent of total billed charges,40% of total billed charges,87.48,90,,,percent of total billed charges,90% of total billed charges,73.87,76,,,percent of total billed charges,76% of total billed charges,38.88,40,,,percent of total billed charges,40% of total billed charges,82.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,77.76,80,,,percent of total billed charges,80% of total billed charges,37.71,38.8,,,percent of total billed charges,38.8% of total billed charges,82.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,194.4,200,,,fee schedule,200% of CMS fee schedule,37.71,215.49,
"Inj(s); Single Tendon Sheath, or Ligament, Aponeurosis (eg, Planterar ''''Fascia''''",49120550,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,163.9,131.12,,122.93,75,,,percent of total billed charges,75% of total billed charges,65.56,40,,,percent of total billed charges,40% of total billed charges,129.81,79.2,,,percent of total billed charges,79.2% of total billed charges,139.32,85,,,percent of total billed charges,85% of total billed charges,163.9,100,,,fee schedule,100% of CO APG rates,155.71,95,,,percent of total billed charges,95% of total billed charges,131.12,80,,,percent of total billed charges,80% of total billed charges,139.32,85,,,percent of total billed charges,85% of total billed charges,147.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,163.9,100,,,fee schedule,100% of NM APC rate,65.56,40,,,percent of total billed charges,40% of total billed charges,65.56,40,,,percent of total billed charges,40% of total billed charges,147.51,90,,,percent of total billed charges,90% of total billed charges,124.56,76,,,percent of total billed charges,76% of total billed charges,65.56,40,,,percent of total billed charges,40% of total billed charges,139.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,131.12,80,,,percent of total billed charges,80% of total billed charges,63.59,38.8,,,percent of total billed charges,38.8% of total billed charges,139.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,63.59,217.66,
Inj(s); Single Tendon or igin/Insert Charge,49120551,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,166.2,132.96,,124.65,75,,,percent of total billed charges,75% of total billed charges,66.48,40,,,percent of total billed charges,40% of total billed charges,131.63,79.2,,,percent of total billed charges,79.2% of total billed charges,141.27,85,,,percent of total billed charges,85% of total billed charges,166.2,100,,,fee schedule,100% of CO APG rates,157.89,95,,,percent of total billed charges,95% of total billed charges,132.96,80,,,percent of total billed charges,80% of total billed charges,141.27,85,,,percent of total billed charges,85% of total billed charges,149.58,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,166.2,100,,,fee schedule,100% of NM APC rate,66.48,40,,,percent of total billed charges,40% of total billed charges,66.48,40,,,percent of total billed charges,40% of total billed charges,149.58,90,,,percent of total billed charges,90% of total billed charges,126.31,76,,,percent of total billed charges,76% of total billed charges,66.48,40,,,percent of total billed charges,40% of total billed charges,141.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,132.96,80,,,percent of total billed charges,80% of total billed charges,64.49,38.8,,,percent of total billed charges,38.8% of total billed charges,141.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,64.49,217.66,
"Inj(s); Single or Mult Trigger Point(S), One or Two Muscle(s",30020552,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,165.7,132.56,,124.28,75,,,percent of total billed charges,75% of total billed charges,66.28,40,,,percent of total billed charges,40% of total billed charges,131.23,79.2,,,percent of total billed charges,79.2% of total billed charges,140.85,85,,,percent of total billed charges,85% of total billed charges,165.7,100,,,fee schedule,100% of CO APG rates,157.42,95,,,percent of total billed charges,95% of total billed charges,132.56,80,,,percent of total billed charges,80% of total billed charges,140.85,85,,,percent of total billed charges,85% of total billed charges,149.13,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,165.7,100,,,fee schedule,100% of NM APC rate,66.28,40,,,percent of total billed charges,40% of total billed charges,66.28,40,,,percent of total billed charges,40% of total billed charges,149.13,90,,,percent of total billed charges,90% of total billed charges,125.93,76,,,percent of total billed charges,76% of total billed charges,66.28,40,,,percent of total billed charges,40% of total billed charges,140.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,132.56,80,,,percent of total billed charges,80% of total billed charges,64.29,38.8,,,percent of total billed charges,38.8% of total billed charges,140.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,64.29,217.66,
"Inj(s); Single or Mult Trigger Point(S), Three or More Muscle(s) Charge",49120553,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,180.3,144.24,,135.23,75,,,percent of total billed charges,75% of total billed charges,72.12,40,,,percent of total billed charges,40% of total billed charges,142.8,79.2,,,percent of total billed charges,79.2% of total billed charges,153.26,85,,,percent of total billed charges,85% of total billed charges,180.3,100,,,fee schedule,100% of CO APG rates,171.29,95,,,percent of total billed charges,95% of total billed charges,144.24,80,,,percent of total billed charges,80% of total billed charges,153.26,85,,,percent of total billed charges,85% of total billed charges,162.27,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.3,100,,,fee schedule,100% of NM APC rate,72.12,40,,,percent of total billed charges,40% of total billed charges,72.12,40,,,percent of total billed charges,40% of total billed charges,162.27,90,,,percent of total billed charges,90% of total billed charges,137.03,76,,,percent of total billed charges,76% of total billed charges,72.12,40,,,percent of total billed charges,40% of total billed charges,153.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,144.24,80,,,percent of total billed charges,80% of total billed charges,69.96,38.8,,,percent of total billed charges,38.8% of total billed charges,153.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,69.96,217.66,
"Arthrocentesis, Aspirtn and/or Inj; Small Joint or Bursa (eg, Fingers, toes) Cha",49120600,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,151.6,121.28,,113.7,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,120.07,79.2,,,percent of total billed charges,79.2% of total billed charges,128.86,85,,,percent of total billed charges,85% of total billed charges,151.6,100,,,fee schedule,100% of CO APG rates,144.02,95,,,percent of total billed charges,95% of total billed charges,121.28,80,,,percent of total billed charges,80% of total billed charges,128.86,85,,,percent of total billed charges,85% of total billed charges,136.44,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,151.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,136.44,90,,,percent of total billed charges,90% of total billed charges,115.22,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,128.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,121.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,128.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,685.4,100,,,case rate,pays based on per visit rate,113.7,685.4,
23620 Closed Treatment Of Greater Humeral Tuberosity Fractur,60000033,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,790.6,632.48,,592.95,75,,,percent of total billed charges,75% of total billed charges,316.24,40,,,percent of total billed charges,40% of total billed charges,626.16,79.2,,,percent of total billed charges,79.2% of total billed charges,672.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,751.07,95,,,percent of total billed charges,95% of total billed charges,632.48,80,,,percent of total billed charges,80% of total billed charges,672.01,85,,,percent of total billed charges,85% of total billed charges,711.54,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,316.24,40,,,percent of total billed charges,40% of total billed charges,316.24,40,,,percent of total billed charges,40% of total billed charges,711.54,90,,,percent of total billed charges,90% of total billed charges,600.86,76,,,percent of total billed charges,76% of total billed charges,316.24,40,,,percent of total billed charges,40% of total billed charges,672.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,632.48,80,,,percent of total billed charges,80% of total billed charges,306.75,38.8,,,percent of total billed charges,38.8% of total billed charges,672.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,751.07,
25622 Closed Treatment Of Carpal Scaphoid w/o Manipulation,60000003,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,898.7,718.96,,674.03,75,,,percent of total billed charges,75% of total billed charges,359.48,40,,,percent of total billed charges,40% of total billed charges,711.77,79.2,,,percent of total billed charges,79.2% of total billed charges,763.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,853.77,95,,,percent of total billed charges,95% of total billed charges,718.96,80,,,percent of total billed charges,80% of total billed charges,763.9,85,,,percent of total billed charges,85% of total billed charges,808.83,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,359.48,40,,,percent of total billed charges,40% of total billed charges,359.48,40,,,percent of total billed charges,40% of total billed charges,808.83,90,,,percent of total billed charges,90% of total billed charges,683.01,76,,,percent of total billed charges,76% of total billed charges,359.48,40,,,percent of total billed charges,40% of total billed charges,763.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,718.96,80,,,percent of total billed charges,80% of total billed charges,348.7,38.8,,,percent of total billed charges,38.8% of total billed charges,763.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,853.77,
"Closed Trtmt of Metatarsal Fx; w/Manipulation, each Charge",60000067,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,737.2,589.76,,552.9,75,,,percent of total billed charges,75% of total billed charges,294.88,40,,,percent of total billed charges,40% of total billed charges,583.86,79.2,,,percent of total billed charges,79.2% of total billed charges,626.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,700.34,95,,,percent of total billed charges,95% of total billed charges,589.76,80,,,percent of total billed charges,80% of total billed charges,626.62,85,,,percent of total billed charges,85% of total billed charges,663.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,294.88,40,,,percent of total billed charges,40% of total billed charges,294.88,40,,,percent of total billed charges,40% of total billed charges,663.48,90,,,percent of total billed charges,90% of total billed charges,560.27,76,,,percent of total billed charges,76% of total billed charges,294.88,40,,,percent of total billed charges,40% of total billed charges,626.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,589.76,80,,,percent of total billed charges,80% of total billed charges,286.03,38.8,,,percent of total billed charges,38.8% of total billed charges,626.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,700.34,
"Applic, Cast; Shoulder to Hand (Long Arm) Charge",49129065,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,274.1,219.28,,205.58,75,,,percent of total billed charges,75% of total billed charges,109.64,40,,,percent of total billed charges,40% of total billed charges,217.09,79.2,,,percent of total billed charges,79.2% of total billed charges,232.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,260.4,95,,,percent of total billed charges,95% of total billed charges,219.28,80,,,percent of total billed charges,80% of total billed charges,232.99,85,,,percent of total billed charges,85% of total billed charges,246.69,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,109.64,40,,,percent of total billed charges,40% of total billed charges,109.64,40,,,percent of total billed charges,40% of total billed charges,246.69,90,,,percent of total billed charges,90% of total billed charges,208.32,76,,,percent of total billed charges,76% of total billed charges,109.64,40,,,percent of total billed charges,40% of total billed charges,232.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,219.28,80,,,percent of total billed charges,80% of total billed charges,106.35,38.8,,,percent of total billed charges,38.8% of total billed charges,232.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,106.35,260.4,
"Applic, Cast; Elbow to Finger (Short Arm) Charge",49129075,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,246.7,197.36,,185.03,75,,,percent of total billed charges,75% of total billed charges,98.68,40,,,percent of total billed charges,40% of total billed charges,195.39,79.2,,,percent of total billed charges,79.2% of total billed charges,209.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,234.37,95,,,percent of total billed charges,95% of total billed charges,197.36,80,,,percent of total billed charges,80% of total billed charges,209.7,85,,,percent of total billed charges,85% of total billed charges,222.03,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,98.68,40,,,percent of total billed charges,40% of total billed charges,98.68,40,,,percent of total billed charges,40% of total billed charges,222.03,90,,,percent of total billed charges,90% of total billed charges,187.49,76,,,percent of total billed charges,76% of total billed charges,98.68,40,,,percent of total billed charges,40% of total billed charges,209.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,197.36,80,,,percent of total billed charges,80% of total billed charges,95.72,38.8,,,percent of total billed charges,38.8% of total billed charges,209.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,95.72,234.37,
"Applic, Cast; Hand  Lower Forearm (Gauntlet) Charge",49129085,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,271.4,217.12,,203.55,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,214.95,79.2,,,percent of total billed charges,79.2% of total billed charges,230.69,85,,,percent of total billed charges,85% of total billed charges,271.4,100,,,fee schedule,100% of CO APG rates,257.83,95,,,percent of total billed charges,95% of total billed charges,217.12,80,,,percent of total billed charges,80% of total billed charges,230.69,85,,,percent of total billed charges,85% of total billed charges,244.26,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,271.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,244.26,90,,,percent of total billed charges,90% of total billed charges,206.26,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,230.69,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,217.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,230.69,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,925,100,,,case rate,pays based on per visit rate,203.55,925,
Applic of Long Arm Splint (Shoulder to Hand) Charge,49129105,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,231.6,185.28,,173.7,75,,,percent of total billed charges,75% of total billed charges,92.64,40,,,percent of total billed charges,40% of total billed charges,183.43,79.2,,,percent of total billed charges,79.2% of total billed charges,196.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,220.02,95,,,percent of total billed charges,95% of total billed charges,185.28,80,,,percent of total billed charges,80% of total billed charges,196.86,85,,,percent of total billed charges,85% of total billed charges,208.44,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,92.64,40,,,percent of total billed charges,40% of total billed charges,92.64,40,,,percent of total billed charges,40% of total billed charges,208.44,90,,,percent of total billed charges,90% of total billed charges,176.02,76,,,percent of total billed charges,76% of total billed charges,92.64,40,,,percent of total billed charges,40% of total billed charges,196.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,185.28,80,,,percent of total billed charges,80% of total billed charges,89.86,38.8,,,percent of total billed charges,38.8% of total billed charges,196.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,89.86,220.02,
29125 Application Of Short Arm Splint,49129125,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,187.3,149.84,,140.48,75,,,percent of total billed charges,75% of total billed charges,74.92,40,,,percent of total billed charges,40% of total billed charges,148.34,79.2,,,percent of total billed charges,79.2% of total billed charges,159.21,85,,,percent of total billed charges,85% of total billed charges,187.3,100,,,fee schedule,100% of CO APG rates,177.94,95,,,percent of total billed charges,95% of total billed charges,149.84,80,,,percent of total billed charges,80% of total billed charges,159.21,85,,,percent of total billed charges,85% of total billed charges,168.57,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,74.92,40,,,percent of total billed charges,40% of total billed charges,74.92,40,,,percent of total billed charges,40% of total billed charges,168.57,90,,,percent of total billed charges,90% of total billed charges,142.35,76,,,percent of total billed charges,76% of total billed charges,74.92,40,,,percent of total billed charges,40% of total billed charges,159.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,149.84,80,,,percent of total billed charges,80% of total billed charges,72.67,38.8,,,percent of total billed charges,38.8% of total billed charges,159.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,72.67,217.66,
29130 Application Of Finger Splint; Static,49129130,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,124.8,99.84,,93.6,75,,,percent of total billed charges,75% of total billed charges,49.92,40,,,percent of total billed charges,40% of total billed charges,98.84,79.2,,,percent of total billed charges,79.2% of total billed charges,106.08,85,,,percent of total billed charges,85% of total billed charges,124.8,100,,,fee schedule,100% of CO APG rates,118.56,95,,,percent of total billed charges,95% of total billed charges,99.84,80,,,percent of total billed charges,80% of total billed charges,106.08,85,,,percent of total billed charges,85% of total billed charges,112.32,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,124.8,100,,,fee schedule,100% of NM APC rate,49.92,40,,,percent of total billed charges,40% of total billed charges,49.92,40,,,percent of total billed charges,40% of total billed charges,112.32,90,,,percent of total billed charges,90% of total billed charges,94.85,76,,,percent of total billed charges,76% of total billed charges,49.92,40,,,percent of total billed charges,40% of total billed charges,106.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,99.84,80,,,percent of total billed charges,80% of total billed charges,48.42,38.8,,,percent of total billed charges,38.8% of total billed charges,106.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,48.42,217.66,
29345 Application Of Long Leg Cast,49129345,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,383.3,306.64,,287.48,75,,,percent of total billed charges,75% of total billed charges,153.32,40,,,percent of total billed charges,40% of total billed charges,303.57,79.2,,,percent of total billed charges,79.2% of total billed charges,325.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,364.14,95,,,percent of total billed charges,95% of total billed charges,306.64,80,,,percent of total billed charges,80% of total billed charges,325.81,85,,,percent of total billed charges,85% of total billed charges,344.97,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,153.32,40,,,percent of total billed charges,40% of total billed charges,153.32,40,,,percent of total billed charges,40% of total billed charges,344.97,90,,,percent of total billed charges,90% of total billed charges,291.31,76,,,percent of total billed charges,76% of total billed charges,153.32,40,,,percent of total billed charges,40% of total billed charges,325.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,306.64,80,,,percent of total billed charges,80% of total billed charges,148.72,38.8,,,percent of total billed charges,38.8% of total billed charges,325.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,148.72,364.14,
29405 Application Of Short Leg Cast,49129405,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,226.1,180.88,,169.58,75,,,percent of total billed charges,75% of total billed charges,90.44,40,,,percent of total billed charges,40% of total billed charges,179.07,79.2,,,percent of total billed charges,79.2% of total billed charges,192.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,214.8,95,,,percent of total billed charges,95% of total billed charges,180.88,80,,,percent of total billed charges,80% of total billed charges,192.19,85,,,percent of total billed charges,85% of total billed charges,203.49,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,90.44,40,,,percent of total billed charges,40% of total billed charges,90.44,40,,,percent of total billed charges,40% of total billed charges,203.49,90,,,percent of total billed charges,90% of total billed charges,171.84,76,,,percent of total billed charges,76% of total billed charges,90.44,40,,,percent of total billed charges,40% of total billed charges,192.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,180.88,80,,,percent of total billed charges,80% of total billed charges,87.73,38.8,,,percent of total billed charges,38.8% of total billed charges,192.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,87.73,217.66,
"Control Nasal Hemorrhage, Anterior, Simple (Limited Cautery And/Or Packing) Any",49130901,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,465.8,372.64,,349.35,75,,,percent of total billed charges,75% of total billed charges,186.32,40,,,percent of total billed charges,40% of total billed charges,368.91,79.2,,,percent of total billed charges,79.2% of total billed charges,395.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,442.51,95,,,percent of total billed charges,95% of total billed charges,372.64,80,,,percent of total billed charges,80% of total billed charges,395.93,85,,,percent of total billed charges,85% of total billed charges,419.22,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,186.32,40,,,percent of total billed charges,40% of total billed charges,186.32,40,,,percent of total billed charges,40% of total billed charges,419.22,90,,,percent of total billed charges,90% of total billed charges,354.01,76,,,percent of total billed charges,76% of total billed charges,186.32,40,,,percent of total billed charges,40% of total billed charges,395.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,372.64,80,,,percent of total billed charges,80% of total billed charges,180.73,38.8,,,percent of total billed charges,38.8% of total billed charges,395.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,442.51,
"Vasectomy, Unilateral or Bilateral (Separate Procedure), w/Postoperative Semen E",60000098,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,974.9,779.92,,731.18,75,,,percent of total billed charges,75% of total billed charges,389.96,40,,,percent of total billed charges,40% of total billed charges,772.12,79.2,,,percent of total billed charges,79.2% of total billed charges,828.67,85,,,percent of total billed charges,85% of total billed charges,974.9,100,,,fee schedule,100% of CO APG rates,926.16,95,,,percent of total billed charges,95% of total billed charges,779.92,80,,,percent of total billed charges,80% of total billed charges,828.67,85,,,percent of total billed charges,85% of total billed charges,877.41,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,974.9,100,,,fee schedule,100% of NM APC rate,389.96,40,,,percent of total billed charges,40% of total billed charges,389.96,40,,,percent of total billed charges,40% of total billed charges,877.41,90,,,percent of total billed charges,90% of total billed charges,740.92,76,,,percent of total billed charges,76% of total billed charges,389.96,40,,,percent of total billed charges,40% of total billed charges,828.67,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,779.92,80,,,percent of total billed charges,80% of total billed charges,378.26,38.8,,,percent of total billed charges,38.8% of total billed charges,828.67,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,378.26,2713.28,
"11976 Removal, Implantable Contraceptive Capsules",60000013,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,413.4,330.72,,310.05,75,,,percent of total billed charges,75% of total billed charges,165.36,40,,,percent of total billed charges,40% of total billed charges,327.41,79.2,,,percent of total billed charges,79.2% of total billed charges,351.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,392.73,95,,,percent of total billed charges,95% of total billed charges,330.72,80,,,percent of total billed charges,80% of total billed charges,351.39,85,,,percent of total billed charges,85% of total billed charges,372.06,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,165.36,40,,,percent of total billed charges,40% of total billed charges,165.36,40,,,percent of total billed charges,40% of total billed charges,372.06,90,,,percent of total billed charges,90% of total billed charges,314.18,76,,,percent of total billed charges,76% of total billed charges,165.36,40,,,percent of total billed charges,40% of total billed charges,351.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,330.72,80,,,percent of total billed charges,80% of total billed charges,160.4,38.8,,,percent of total billed charges,38.8% of total billed charges,351.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,160.4,392.73,
"Hemophilus Influenza B Vaccine (Hib), PRP-OMP conj. 3-dose IM use POC",49190647,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,64.7,51.76,,48.53,75,,,percent of total billed charges,75% of total billed charges,25.88,40,,,percent of total billed charges,40% of total billed charges,51.24,79.2,,,percent of total billed charges,79.2% of total billed charges,55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,61.47,95,,,percent of total billed charges,95% of total billed charges,51.76,80,,,percent of total billed charges,80% of total billed charges,55,85,,,percent of total billed charges,85% of total billed charges,58.23,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,64.7,100,,,fee schedule,100% of NM fee schedule,25.88,40,,,percent of total billed charges,40% of total billed charges,25.88,40,,,percent of total billed charges,40% of total billed charges,58.23,90,,,percent of total billed charges,90% of total billed charges,49.17,76,,,percent of total billed charges,76% of total billed charges,25.88,40,,,percent of total billed charges,40% of total billed charges,55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,51.76,80,,,percent of total billed charges,80% of total billed charges,25.1,38.8,,,percent of total billed charges,38.8% of total billed charges,55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,25.1,64.7,
"Excise of Nail  matrix, Part. or Complete, for Permanent Removal Charge",49111750,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,474.7,379.76,,356.03,75,,,percent of total billed charges,75% of total billed charges,189.88,40,,,percent of total billed charges,40% of total billed charges,375.96,79.2,,,percent of total billed charges,79.2% of total billed charges,403.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,450.97,95,,,percent of total billed charges,95% of total billed charges,379.76,80,,,percent of total billed charges,80% of total billed charges,403.5,85,,,percent of total billed charges,85% of total billed charges,427.23,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,189.88,40,,,percent of total billed charges,40% of total billed charges,189.88,40,,,percent of total billed charges,40% of total billed charges,427.23,90,,,percent of total billed charges,90% of total billed charges,360.77,76,,,percent of total billed charges,76% of total billed charges,189.88,40,,,percent of total billed charges,40% of total billed charges,403.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,379.76,80,,,percent of total billed charges,80% of total billed charges,184.18,38.8,,,percent of total billed charges,38.8% of total billed charges,403.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,450.97,
"Injection, Dexamethosone Sodium Phosphate, Up to 4mg/mL Charge",49100039,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,9.6,7.68,,7.2,75,,,percent of total billed charges,75% of total billed charges,3.84,40,,,percent of total billed charges,40% of total billed charges,7.6,79.2,,,percent of total billed charges,79.2% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,9.6,100,,,fee schedule,100% of CO APG rates,9.12,95,,,percent of total billed charges,95% of total billed charges,7.68,80,,,percent of total billed charges,80% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,8.64,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,9.6,100,,,fee schedule,100% of NM fee schedule,3.84,40,,,percent of total billed charges,40% of total billed charges,3.84,40,,,percent of total billed charges,40% of total billed charges,8.64,90,,,percent of total billed charges,90% of total billed charges,7.3,76,,,percent of total billed charges,76% of total billed charges,3.84,40,,,percent of total billed charges,40% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,7.68,80,,,percent of total billed charges,80% of total billed charges,3.72,38.8,,,percent of total billed charges,38.8% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.72,35.65,
69200 Removal Foreign Body From External Auditory Canal; Wit,49169200,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,231.5,185.2,,173.63,75,,,percent of total billed charges,75% of total billed charges,92.6,40,,,percent of total billed charges,40% of total billed charges,183.35,79.2,,,percent of total billed charges,79.2% of total billed charges,196.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,219.93,95,,,percent of total billed charges,95% of total billed charges,185.2,80,,,percent of total billed charges,80% of total billed charges,196.78,85,,,percent of total billed charges,85% of total billed charges,208.35,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,92.6,40,,,percent of total billed charges,40% of total billed charges,92.6,40,,,percent of total billed charges,40% of total billed charges,208.35,90,,,percent of total billed charges,90% of total billed charges,175.94,76,,,percent of total billed charges,76% of total billed charges,92.6,40,,,percent of total billed charges,40% of total billed charges,196.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,185.2,80,,,percent of total billed charges,80% of total billed charges,89.82,38.8,,,percent of total billed charges,38.8% of total billed charges,196.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,89.82,219.93,
"Rotavirus vaccine, pentavalent, 3 dose schedule, live, for oral use POC",49190680,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,198.4,158.72,,148.8,75,,,percent of total billed charges,75% of total billed charges,79.36,40,,,percent of total billed charges,40% of total billed charges,157.13,79.2,,,percent of total billed charges,79.2% of total billed charges,168.64,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,188.48,95,,,percent of total billed charges,95% of total billed charges,158.72,80,,,percent of total billed charges,80% of total billed charges,168.64,85,,,percent of total billed charges,85% of total billed charges,178.56,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,198.4,100,,,fee schedule,100% of NM fee schedule,79.36,40,,,percent of total billed charges,40% of total billed charges,79.36,40,,,percent of total billed charges,40% of total billed charges,178.56,90,,,percent of total billed charges,90% of total billed charges,150.78,76,,,percent of total billed charges,76% of total billed charges,79.36,40,,,percent of total billed charges,40% of total billed charges,168.64,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,158.72,80,,,percent of total billed charges,80% of total billed charges,76.98,38.8,,,percent of total billed charges,38.8% of total billed charges,168.64,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,198.4,
"Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous us",49190710,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,364.9,291.92,,273.68,75,,,percent of total billed charges,75% of total billed charges,145.96,40,,,percent of total billed charges,40% of total billed charges,289,79.2,,,percent of total billed charges,79.2% of total billed charges,310.17,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,346.66,95,,,percent of total billed charges,95% of total billed charges,291.92,80,,,percent of total billed charges,80% of total billed charges,310.17,85,,,percent of total billed charges,85% of total billed charges,328.41,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,364.9,100,,,fee schedule,100% of NM fee schedule,145.96,40,,,percent of total billed charges,40% of total billed charges,145.96,40,,,percent of total billed charges,40% of total billed charges,328.41,90,,,percent of total billed charges,90% of total billed charges,277.32,76,,,percent of total billed charges,76% of total billed charges,145.96,40,,,percent of total billed charges,40% of total billed charges,310.17,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,291.92,80,,,percent of total billed charges,80% of total billed charges,141.58,38.8,,,percent of total billed charges,38.8% of total billed charges,310.17,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,364.9,
"Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 (tetravalent), for",49190734,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,287.5,230,,215.63,75,,,percent of total billed charges,75% of total billed charges,115,40,,,percent of total billed charges,40% of total billed charges,227.7,79.2,,,percent of total billed charges,79.2% of total billed charges,244.38,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,273.13,95,,,percent of total billed charges,95% of total billed charges,230,80,,,percent of total billed charges,80% of total billed charges,244.38,85,,,percent of total billed charges,85% of total billed charges,258.75,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,287.5,100,,,fee schedule,100% of NM fee schedule,115,40,,,percent of total billed charges,40% of total billed charges,115,40,,,percent of total billed charges,40% of total billed charges,258.75,90,,,percent of total billed charges,90% of total billed charges,218.5,76,,,percent of total billed charges,76% of total billed charges,115,40,,,percent of total billed charges,40% of total billed charges,244.38,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,230,80,,,percent of total billed charges,80% of total billed charges,111.55,38.8,,,percent of total billed charges,38.8% of total billed charges,244.38,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,287.5,
Pressurized or nonpressurized inhalation treatment for acute airway obstruction,49194640,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,74.2,59.36,,55.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,58.77,79.2,,,percent of total billed charges,79.2% of total billed charges,63.07,85,,,percent of total billed charges,85% of total billed charges,74.2,100,,,fee schedule,100% of CO APG rates,70.49,95,,,percent of total billed charges,95% of total billed charges,59.36,80,,,percent of total billed charges,80% of total billed charges,63.07,85,,,percent of total billed charges,85% of total billed charges,66.78,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,74.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,66.78,90,,,percent of total billed charges,90% of total billed charges,56.39,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,63.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,59.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,63.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,530.6,100,,,case rate,pays based on per visit rate,55.65,530.6,
"17110 Destruction of Benign Lesions, except skin tag/cutan v",49117110,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,331.6,265.28,,248.7,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,262.63,79.2,,,percent of total billed charges,79.2% of total billed charges,281.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,315.02,95,,,percent of total billed charges,95% of total billed charges,265.28,80,,,percent of total billed charges,80% of total billed charges,281.86,85,,,percent of total billed charges,85% of total billed charges,298.44,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,331.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,298.44,90,,,percent of total billed charges,90% of total billed charges,252.02,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,281.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,265.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,281.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1045.4,100,,,case rate,pays based on per visit rate,248.7,1045.4,
"Destruction (laser/electro/cryo/chemosurgery/curette), of warts; 15 or more lesi",49117111,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,386.8,309.44,,290.1,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,306.35,79.2,,,percent of total billed charges,79.2% of total billed charges,328.78,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,367.46,95,,,percent of total billed charges,95% of total billed charges,309.44,80,,,percent of total billed charges,80% of total billed charges,328.78,85,,,percent of total billed charges,85% of total billed charges,348.12,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,386.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,348.12,90,,,percent of total billed charges,90% of total billed charges,293.97,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,328.78,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,309.44,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,328.78,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1155.8,100,,,case rate,pays based on per visit rate,290.1,1155.8,
"Tetanus, diphtheria toxoids  acellular pertussis vaccine (TdaP), 7 years or old",49190715,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,90.3,72.24,,67.73,75,,,percent of total billed charges,75% of total billed charges,36.12,40,,,percent of total billed charges,40% of total billed charges,71.52,79.2,,,percent of total billed charges,79.2% of total billed charges,76.76,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,85.79,95,,,percent of total billed charges,95% of total billed charges,72.24,80,,,percent of total billed charges,80% of total billed charges,76.76,85,,,percent of total billed charges,85% of total billed charges,81.27,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,90.3,100,,,fee schedule,100% of NM fee schedule,36.12,40,,,percent of total billed charges,40% of total billed charges,36.12,40,,,percent of total billed charges,40% of total billed charges,81.27,90,,,percent of total billed charges,90% of total billed charges,68.63,76,,,percent of total billed charges,76% of total billed charges,36.12,40,,,percent of total billed charges,40% of total billed charges,76.76,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,72.24,80,,,percent of total billed charges,80% of total billed charges,35.04,38.8,,,percent of total billed charges,38.8% of total billed charges,76.76,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.04,90.3,
"Influenza virus vaccine, splie virus, preservative free, for children 6-35 month",49190655,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,49.6,39.68,,37.2,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,39.28,79.2,,,percent of total billed charges,79.2% of total billed charges,42.16,85,,,percent of total billed charges,85% of total billed charges,49.6,100,,,fee schedule,100% of CO APG rates,47.12,95,,,percent of total billed charges,95% of total billed charges,39.68,80,,,percent of total billed charges,80% of total billed charges,42.16,85,,,percent of total billed charges,85% of total billed charges,44.64,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,49.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,44.64,90,,,percent of total billed charges,90% of total billed charges,37.7,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,42.16,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,39.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,42.16,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,481.4,100,,,case rate,pays based on per visit rate,37.2,481.4,
Human Papilloma virus (HPV) Vaccine POC,49190649,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,315.5,252.4,,236.63,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,249.88,79.2,,,percent of total billed charges,79.2% of total billed charges,268.18,85,,,percent of total billed charges,85% of total billed charges,315.5,100,,,fee schedule,100% of CO APG rates,299.73,95,,,percent of total billed charges,95% of total billed charges,252.4,80,,,percent of total billed charges,80% of total billed charges,268.18,85,,,percent of total billed charges,85% of total billed charges,283.95,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,315.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,283.95,90,,,percent of total billed charges,90% of total billed charges,239.78,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,268.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,252.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,268.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1013.2,100,,,case rate,pays based on per visit rate,236.63,1013.2,
"Injection, Ketorolac Tromethamine Charge",49100040,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,6.4,5.12,,4.8,75,,,percent of total billed charges,75% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.07,79.2,,,percent of total billed charges,79.2% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,6.4,100,,,fee schedule,100% of CO APG rates,6.08,95,,,percent of total billed charges,95% of total billed charges,5.12,80,,,percent of total billed charges,80% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,6.4,100,,,fee schedule,100% of NM fee schedule,2.56,40,,,percent of total billed charges,40% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,4.86,76,,,percent of total billed charges,76% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,5.12,80,,,percent of total billed charges,80% of total billed charges,2.48,38.8,,,percent of total billed charges,38.8% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.48,35.65,
"Injection, Promethazine HCL, up to 50 mg Charge",49100042,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,6.4,5.12,,4.8,75,,,percent of total billed charges,75% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.07,79.2,,,percent of total billed charges,79.2% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,6.4,100,,,fee schedule,100% of CO APG rates,6.08,95,,,percent of total billed charges,95% of total billed charges,5.12,80,,,percent of total billed charges,80% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,6.4,100,,,fee schedule,100% of NM fee schedule,2.56,40,,,percent of total billed charges,40% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,4.86,76,,,percent of total billed charges,76% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,5.12,80,,,percent of total billed charges,80% of total billed charges,2.48,38.8,,,percent of total billed charges,38.8% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.48,35.65,
"Injection, Vitamin B-12 Cyanocobalamin, up to 1000 mcg Charge",49100047,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,6.4,5.12,,4.8,75,,,percent of total billed charges,75% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.07,79.2,,,percent of total billed charges,79.2% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,6.4,100,,,fee schedule,100% of CO APG rates,6.08,95,,,percent of total billed charges,95% of total billed charges,5.12,80,,,percent of total billed charges,80% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,6.4,100,,,fee schedule,100% of NM fee schedule,2.56,40,,,percent of total billed charges,40% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,4.86,76,,,percent of total billed charges,76% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,5.12,80,,,percent of total billed charges,80% of total billed charges,2.48,38.8,,,percent of total billed charges,38.8% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.48,35.65,
"Injection, Ceftriaxone Sodium, Per 250 MG Charge",49100036,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,6.4,5.12,,4.8,75,,,percent of total billed charges,75% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.07,79.2,,,percent of total billed charges,79.2% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,6.4,100,,,fee schedule,100% of CO APG rates,6.08,95,,,percent of total billed charges,95% of total billed charges,5.12,80,,,percent of total billed charges,80% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,6.4,100,,,fee schedule,100% of NM fee schedule,2.56,40,,,percent of total billed charges,40% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,4.86,76,,,percent of total billed charges,76% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,5.12,80,,,percent of total billed charges,80% of total billed charges,2.48,38.8,,,percent of total billed charges,38.8% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.48,35.65,
"Shave Exc/ Bengign Lesion Scalp, Neck, Hands, Feet- Over 2.0 cm Charge",49111308,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,436.4,349.12,,327.3,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,345.63,79.2,,,percent of total billed charges,79.2% of total billed charges,370.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,414.58,95,,,percent of total billed charges,95% of total billed charges,349.12,80,,,percent of total billed charges,80% of total billed charges,370.94,85,,,percent of total billed charges,85% of total billed charges,392.76,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,436.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,392.76,90,,,percent of total billed charges,90% of total billed charges,331.66,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,370.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,349.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,370.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Free T4,40084439,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,131.3,105.04,,98.48,75,,,percent of total billed charges,75% of total billed charges,52.52,40,,,percent of total billed charges,40% of total billed charges,103.99,79.2,,,percent of total billed charges,79.2% of total billed charges,111.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,124.74,95,,,percent of total billed charges,95% of total billed charges,105.04,80,,,percent of total billed charges,80% of total billed charges,111.61,85,,,percent of total billed charges,85% of total billed charges,118.17,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,52.52,40,,,percent of total billed charges,40% of total billed charges,52.52,40,,,percent of total billed charges,40% of total billed charges,118.17,90,,,percent of total billed charges,90% of total billed charges,99.79,76,,,percent of total billed charges,76% of total billed charges,52.52,40,,,percent of total billed charges,40% of total billed charges,111.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,105.04,80,,,percent of total billed charges,80% of total billed charges,50.94,38.8,,,percent of total billed charges,38.8% of total billed charges,111.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,124.74,
25605 Closed Treatment Of Distal Radial Fracture w/ manipula,60000045,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1560.5,1248.4,,1170.38,75,,,percent of total billed charges,75% of total billed charges,624.2,40,,,percent of total billed charges,40% of total billed charges,1235.92,79.2,,,percent of total billed charges,79.2% of total billed charges,1326.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1482.48,95,,,percent of total billed charges,95% of total billed charges,1248.4,80,,,percent of total billed charges,80% of total billed charges,1326.43,85,,,percent of total billed charges,85% of total billed charges,1404.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,624.2,40,,,percent of total billed charges,40% of total billed charges,624.2,40,,,percent of total billed charges,40% of total billed charges,1404.45,90,,,percent of total billed charges,90% of total billed charges,1185.98,76,,,percent of total billed charges,76% of total billed charges,624.2,40,,,percent of total billed charges,40% of total billed charges,1326.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1248.4,80,,,percent of total billed charges,80% of total billed charges,605.47,38.8,,,percent of total billed charges,38.8% of total billed charges,1326.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1482.48,
"Closed tx of phalangeal shaft fx, proximal or midlle phalanx, finger or thumb: w",60000052,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,584.8,467.84,,438.6,75,,,percent of total billed charges,75% of total billed charges,233.92,40,,,percent of total billed charges,40% of total billed charges,463.16,79.2,,,percent of total billed charges,79.2% of total billed charges,497.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,555.56,95,,,percent of total billed charges,95% of total billed charges,467.84,80,,,percent of total billed charges,80% of total billed charges,497.08,85,,,percent of total billed charges,85% of total billed charges,526.32,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,233.92,40,,,percent of total billed charges,40% of total billed charges,233.92,40,,,percent of total billed charges,40% of total billed charges,526.32,90,,,percent of total billed charges,90% of total billed charges,444.45,76,,,percent of total billed charges,76% of total billed charges,233.92,40,,,percent of total billed charges,40% of total billed charges,497.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,467.84,80,,,percent of total billed charges,80% of total billed charges,226.9,38.8,,,percent of total billed charges,38.8% of total billed charges,497.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,555.56,
PSA Screen,40000003,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,107.73,
PSA Diagnostic,40084153,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,107.73,
Iron Level,40083540,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,70.4,56.32,,52.8,75,,,percent of total billed charges,75% of total billed charges,28.16,40,,,percent of total billed charges,40% of total billed charges,55.76,79.2,,,percent of total billed charges,79.2% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,66.88,95,,,percent of total billed charges,95% of total billed charges,56.32,80,,,percent of total billed charges,80% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,63.36,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,28.16,40,,,percent of total billed charges,40% of total billed charges,28.16,40,,,percent of total billed charges,40% of total billed charges,63.36,90,,,percent of total billed charges,90% of total billed charges,53.5,76,,,percent of total billed charges,76% of total billed charges,28.16,40,,,percent of total billed charges,40% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,56.32,80,,,percent of total billed charges,80% of total billed charges,27.32,38.8,,,percent of total billed charges,38.8% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,66.88,
"Application, cast; finger (eg, contracture)",49129086,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,218,174.4,,163.5,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,172.66,79.2,,,percent of total billed charges,79.2% of total billed charges,185.3,85,,,percent of total billed charges,85% of total billed charges,218,100,,,fee schedule,100% of CO APG rates,207.1,95,,,percent of total billed charges,95% of total billed charges,174.4,80,,,percent of total billed charges,80% of total billed charges,185.3,85,,,percent of total billed charges,85% of total billed charges,196.2,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,218,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,196.2,90,,,percent of total billed charges,90% of total billed charges,165.68,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,185.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,174.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,185.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,818.2,100,,,case rate,pays based on per visit rate,163.5,818.2,
"19120 Excision Of Cyst, Fibroadenoma, Or Other Benign Or Mal",60000024,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1488.8,1191.04,,1116.6,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1179.13,79.2,,,percent of total billed charges,79.2% of total billed charges,1265.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1414.36,95,,,percent of total billed charges,95% of total billed charges,1191.04,80,,,percent of total billed charges,80% of total billed charges,1265.48,85,,,percent of total billed charges,85% of total billed charges,1339.92,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1488.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1339.92,90,,,percent of total billed charges,90% of total billed charges,1131.49,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1265.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1191.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1265.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1488.8,
"Pneumococcal conjugate vaccine, 13 valent, for intramuscular use",49190670,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,309.8,247.84,,232.35,75,,,percent of total billed charges,75% of total billed charges,123.92,40,,,percent of total billed charges,40% of total billed charges,245.36,79.2,,,percent of total billed charges,79.2% of total billed charges,263.33,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,294.31,95,,,percent of total billed charges,95% of total billed charges,247.84,80,,,percent of total billed charges,80% of total billed charges,263.33,85,,,percent of total billed charges,85% of total billed charges,278.82,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,309.8,100,,,fee schedule,100% of NM fee schedule,123.92,40,,,percent of total billed charges,40% of total billed charges,123.92,40,,,percent of total billed charges,40% of total billed charges,278.82,90,,,percent of total billed charges,90% of total billed charges,235.45,76,,,percent of total billed charges,76% of total billed charges,123.92,40,,,percent of total billed charges,40% of total billed charges,263.33,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,247.84,80,,,percent of total billed charges,80% of total billed charges,120.2,38.8,,,percent of total billed charges,38.8% of total billed charges,263.33,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,309.8,
Initial preventive exam,49100003,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,456.3,365.04,,342.23,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,361.39,79.2,,,percent of total billed charges,79.2% of total billed charges,387.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,433.49,95,,,percent of total billed charges,95% of total billed charges,365.04,80,,,percent of total billed charges,80% of total billed charges,387.86,85,,,percent of total billed charges,85% of total billed charges,410.67,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,456.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,410.67,90,,,percent of total billed charges,90% of total billed charges,346.79,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,387.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,365.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,387.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Methylprednisolone 40 MG inj,49100037,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,57.3,45.84,,42.98,75,,,percent of total billed charges,75% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,45.38,79.2,,,percent of total billed charges,79.2% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,54.44,95,,,percent of total billed charges,95% of total billed charges,45.84,80,,,percent of total billed charges,80% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,51.57,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,57.3,100,,,fee schedule,100% of NM fee schedule,22.92,40,,,percent of total billed charges,40% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,51.57,90,,,percent of total billed charges,90% of total billed charges,43.55,76,,,percent of total billed charges,76% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,45.84,80,,,percent of total billed charges,80% of total billed charges,22.23,38.8,,,percent of total billed charges,38.8% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,22.23,57.3,
Cefazolin sodium injection,49100035,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,6.4,5.12,,4.8,75,,,percent of total billed charges,75% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.07,79.2,,,percent of total billed charges,79.2% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,6.4,100,,,fee schedule,100% of CO APG rates,6.08,95,,,percent of total billed charges,95% of total billed charges,5.12,80,,,percent of total billed charges,80% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,6.4,100,,,fee schedule,100% of NM fee schedule,2.56,40,,,percent of total billed charges,40% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,4.86,76,,,percent of total billed charges,76% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,5.12,80,,,percent of total billed charges,80% of total billed charges,2.48,38.8,,,percent of total billed charges,38.8% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.48,35.65,
"96372  Therapeutic, prophylactic, or diagnostic injection, subcutaneous or intra",49196372,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,37.1,29.68,,27.83,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,29.38,79.2,,,percent of total billed charges,79.2% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,37.1,100,,,fee schedule,100% of CO APG rates,35.25,95,,,percent of total billed charges,95% of total billed charges,29.68,80,,,percent of total billed charges,80% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,33.39,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,37.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,33.39,90,,,percent of total billed charges,90% of total billed charges,28.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,31.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,29.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,31.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,456.4,100,,,case rate,pays based on per visit rate,27.83,456.4,
Administration of 1 vaccine,49190471,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,23.2,18.56,,17.4,75,,,percent of total billed charges,75% of total billed charges,9.28,40,,,percent of total billed charges,40% of total billed charges,18.37,79.2,,,percent of total billed charges,79.2% of total billed charges,19.72,85,,,percent of total billed charges,85% of total billed charges,23.2,100,,,fee schedule,100% of CO APG rates,22.04,95,,,percent of total billed charges,95% of total billed charges,18.56,80,,,percent of total billed charges,80% of total billed charges,19.72,85,,,percent of total billed charges,85% of total billed charges,20.88,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,23.2,100,,,fee schedule,100% of NM APC rate,9.28,40,,,percent of total billed charges,40% of total billed charges,9.28,40,,,percent of total billed charges,40% of total billed charges,20.88,90,,,percent of total billed charges,90% of total billed charges,17.63,76,,,percent of total billed charges,76% of total billed charges,9.28,40,,,percent of total billed charges,40% of total billed charges,19.72,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,18.56,80,,,percent of total billed charges,80% of total billed charges,9,38.8,,,percent of total billed charges,38.8% of total billed charges,19.72,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,9,50.67,
90472  Each additional vaccine,49190472,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.8,50.67,
IPRATROPIUM 0.002,49100053,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,6.7,5.36,,5.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,5.31,79.2,,,percent of total billed charges,79.2% of total billed charges,5.7,85,,,percent of total billed charges,85% of total billed charges,6.7,100,,,fee schedule,100% of CO APG rates,6.37,95,,,percent of total billed charges,95% of total billed charges,5.36,80,,,percent of total billed charges,80% of total billed charges,5.7,85,,,percent of total billed charges,85% of total billed charges,6.03,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,6.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,6.03,90,,,percent of total billed charges,90% of total billed charges,5.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,5.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,5.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,5.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,395.6,100,,,case rate,pays based on per visit rate,5.03,395.6,
24530 Closed Treatment Of Supracondylar Or Transcondylar Hum,60000038,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1113.5,890.8,,835.13,75,,,percent of total billed charges,75% of total billed charges,445.4,40,,,percent of total billed charges,40% of total billed charges,881.89,79.2,,,percent of total billed charges,79.2% of total billed charges,946.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1057.83,95,,,percent of total billed charges,95% of total billed charges,890.8,80,,,percent of total billed charges,80% of total billed charges,946.48,85,,,percent of total billed charges,85% of total billed charges,1002.15,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,445.4,40,,,percent of total billed charges,40% of total billed charges,445.4,40,,,percent of total billed charges,40% of total billed charges,1002.15,90,,,percent of total billed charges,90% of total billed charges,846.26,76,,,percent of total billed charges,76% of total billed charges,445.4,40,,,percent of total billed charges,40% of total billed charges,946.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,890.8,80,,,percent of total billed charges,80% of total billed charges,432.04,38.8,,,percent of total billed charges,38.8% of total billed charges,946.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1057.83,
Hemorrhoidectomy  internal  by rubber band ligation(s),60000089,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,840.9,672.72,,630.68,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,665.99,79.2,,,percent of total billed charges,79.2% of total billed charges,714.77,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,798.86,95,,,percent of total billed charges,95% of total billed charges,672.72,80,,,percent of total billed charges,80% of total billed charges,714.77,85,,,percent of total billed charges,85% of total billed charges,756.81,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,840.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,756.81,90,,,percent of total billed charges,90% of total billed charges,639.08,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,714.77,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,672.72,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,714.77,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Application of finger splint; dynamic Charge,49129131,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,150.1,120.08,,112.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,118.88,79.2,,,percent of total billed charges,79.2% of total billed charges,127.59,85,,,percent of total billed charges,85% of total billed charges,150.1,100,,,fee schedule,100% of CO APG rates,142.6,95,,,percent of total billed charges,95% of total billed charges,120.08,80,,,percent of total billed charges,80% of total billed charges,127.59,85,,,percent of total billed charges,85% of total billed charges,135.09,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,150.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,135.09,90,,,percent of total billed charges,90% of total billed charges,114.08,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,127.59,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,120.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,127.59,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,682.4,100,,,case rate,pays based on per visit rate,112.58,682.4,
DTaP-Hib-IPV Vaccine IM,49190698,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,211.9,169.52,,158.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,167.82,79.2,,,percent of total billed charges,79.2% of total billed charges,180.12,85,,,percent of total billed charges,85% of total billed charges,211.9,100,,,fee schedule,100% of CO APG rates,201.31,95,,,percent of total billed charges,95% of total billed charges,169.52,80,,,percent of total billed charges,80% of total billed charges,180.12,85,,,percent of total billed charges,85% of total billed charges,190.71,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,211.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,190.71,90,,,percent of total billed charges,90% of total billed charges,161.04,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,180.12,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,169.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,180.12,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,806,100,,,case rate,pays based on per visit rate,158.93,806,
Albuterol non-comp unit,49100050,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,6.7,5.36,,5.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,5.31,79.2,,,percent of total billed charges,79.2% of total billed charges,5.7,85,,,percent of total billed charges,85% of total billed charges,6.7,100,,,fee schedule,100% of CO APG rates,6.37,95,,,percent of total billed charges,95% of total billed charges,5.36,80,,,percent of total billed charges,80% of total billed charges,5.7,85,,,percent of total billed charges,85% of total billed charges,6.03,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,6.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,6.03,90,,,percent of total billed charges,90% of total billed charges,5.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,5.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,5.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,5.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,395.6,100,,,case rate,pays based on per visit rate,5.03,395.6,
Methylprednisolone injection,49100045,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,7.4,5.92,,5.55,75,,,percent of total billed charges,75% of total billed charges,2.96,40,,,percent of total billed charges,40% of total billed charges,5.86,79.2,,,percent of total billed charges,79.2% of total billed charges,6.29,85,,,percent of total billed charges,85% of total billed charges,7.4,100,,,fee schedule,100% of CO APG rates,7.03,95,,,percent of total billed charges,95% of total billed charges,5.92,80,,,percent of total billed charges,80% of total billed charges,6.29,85,,,percent of total billed charges,85% of total billed charges,6.66,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,7.4,100,,,fee schedule,100% of NM fee schedule,2.96,40,,,percent of total billed charges,40% of total billed charges,2.96,40,,,percent of total billed charges,40% of total billed charges,6.66,90,,,percent of total billed charges,90% of total billed charges,5.62,76,,,percent of total billed charges,76% of total billed charges,2.96,40,,,percent of total billed charges,40% of total billed charges,6.29,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,5.92,80,,,percent of total billed charges,80% of total billed charges,2.87,38.8,,,percent of total billed charges,38.8% of total billed charges,6.29,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.87,35.65,
Office/OP New Visit Level 2 99202,49199202,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,185.7,148.56,,139.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,147.07,79.2,,,percent of total billed charges,79.2% of total billed charges,157.85,85,,,percent of total billed charges,85% of total billed charges,185.7,100,,,fee schedule,100% of CO APG rates,176.42,95,,,percent of total billed charges,95% of total billed charges,148.56,80,,,percent of total billed charges,80% of total billed charges,157.85,85,,,percent of total billed charges,85% of total billed charges,167.13,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,185.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,167.13,90,,,percent of total billed charges,90% of total billed charges,141.13,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,157.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,148.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,157.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,753.6,100,,,case rate,pays based on per visit rate,139.28,753.6,
Office/OP New Visit Level 3 99203,49199203,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,244.6,195.68,,183.45,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,193.72,79.2,,,percent of total billed charges,79.2% of total billed charges,207.91,85,,,percent of total billed charges,85% of total billed charges,244.6,100,,,fee schedule,100% of CO APG rates,232.37,95,,,percent of total billed charges,95% of total billed charges,195.68,80,,,percent of total billed charges,80% of total billed charges,207.91,85,,,percent of total billed charges,85% of total billed charges,220.14,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,244.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,220.14,90,,,percent of total billed charges,90% of total billed charges,185.9,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,207.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,195.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,207.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,871.4,100,,,case rate,pays based on per visit rate,183.45,871.4,
Office/OP New Visit Level 4 99204,49199204,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,297.5,238,,223.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,235.62,79.2,,,percent of total billed charges,79.2% of total billed charges,252.88,85,,,percent of total billed charges,85% of total billed charges,297.5,100,,,fee schedule,100% of CO APG rates,282.63,95,,,percent of total billed charges,95% of total billed charges,238,80,,,percent of total billed charges,80% of total billed charges,252.88,85,,,percent of total billed charges,85% of total billed charges,267.75,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,297.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,267.75,90,,,percent of total billed charges,90% of total billed charges,226.1,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,252.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,238,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,252.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,977.2,100,,,case rate,pays based on per visit rate,223.13,977.2,
Office/OP Established  Visit Level 2 99212,49199212,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,120,96,,90,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,95.04,79.2,,,percent of total billed charges,79.2% of total billed charges,102,85,,,percent of total billed charges,85% of total billed charges,120,100,,,fee schedule,100% of CO APG rates,114,95,,,percent of total billed charges,95% of total billed charges,96,80,,,percent of total billed charges,80% of total billed charges,102,85,,,percent of total billed charges,85% of total billed charges,108,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,120,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,108,90,,,percent of total billed charges,90% of total billed charges,91.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,102,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,102,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,622.2,100,,,case rate,pays based on per visit rate,90,622.2,
Office/OP Established  Visit Level 4 99214,49199214,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,224.6,179.68,,168.45,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,177.88,79.2,,,percent of total billed charges,79.2% of total billed charges,190.91,85,,,percent of total billed charges,85% of total billed charges,224.6,100,,,fee schedule,100% of CO APG rates,213.37,95,,,percent of total billed charges,95% of total billed charges,179.68,80,,,percent of total billed charges,80% of total billed charges,190.91,85,,,percent of total billed charges,85% of total billed charges,202.14,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,224.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,202.14,90,,,percent of total billed charges,90% of total billed charges,170.7,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,190.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,179.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,190.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,831.4,100,,,case rate,pays based on per visit rate,168.45,831.4,
Office/OP Established  Visit Level 5 99215,49199215,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,324.7,259.76,,243.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,257.16,79.2,,,percent of total billed charges,79.2% of total billed charges,276,85,,,percent of total billed charges,85% of total billed charges,324.7,100,,,fee schedule,100% of CO APG rates,308.47,95,,,percent of total billed charges,95% of total billed charges,259.76,80,,,percent of total billed charges,80% of total billed charges,276,85,,,percent of total billed charges,85% of total billed charges,292.23,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,324.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,292.23,90,,,percent of total billed charges,90% of total billed charges,246.77,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,276,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,259.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,276,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1031.6,100,,,case rate,pays based on per visit rate,243.53,1031.6,
Rapid Flu POC,49187804,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,50.9,40.72,QW,38.18,75,,,percent of total billed charges,75% of total billed charges,20.36,40,,,percent of total billed charges,40% of total billed charges,40.31,79.2,,,percent of total billed charges,79.2% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,48.36,95,,,percent of total billed charges,95% of total billed charges,40.72,80,,,percent of total billed charges,80% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,45.81,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,20.36,40,,,percent of total billed charges,40% of total billed charges,20.36,40,,,percent of total billed charges,40% of total billed charges,45.81,90,,,percent of total billed charges,90% of total billed charges,38.68,76,,,percent of total billed charges,76% of total billed charges,20.36,40,,,percent of total billed charges,40% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,40.72,80,,,percent of total billed charges,80% of total billed charges,19.75,38.8,,,percent of total billed charges,38.8% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,48.36,
Application of Short Arm Splint Dynamic,49129126,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,220.2,176.16,,165.15,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,174.4,79.2,,,percent of total billed charges,79.2% of total billed charges,187.17,85,,,percent of total billed charges,85% of total billed charges,220.2,100,,,fee schedule,100% of CO APG rates,209.19,95,,,percent of total billed charges,95% of total billed charges,176.16,80,,,percent of total billed charges,80% of total billed charges,187.17,85,,,percent of total billed charges,85% of total billed charges,198.18,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,220.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,198.18,90,,,percent of total billed charges,90% of total billed charges,167.35,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,187.17,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,176.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,187.17,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,822.6,100,,,case rate,pays based on per visit rate,165.15,822.6,
"T4, Total",40084436,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,80.9,64.72,,60.68,75,,,percent of total billed charges,75% of total billed charges,32.36,40,,,percent of total billed charges,40% of total billed charges,64.07,79.2,,,percent of total billed charges,79.2% of total billed charges,68.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,76.86,95,,,percent of total billed charges,95% of total billed charges,64.72,80,,,percent of total billed charges,80% of total billed charges,68.77,85,,,percent of total billed charges,85% of total billed charges,72.81,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,32.36,40,,,percent of total billed charges,40% of total billed charges,32.36,40,,,percent of total billed charges,40% of total billed charges,72.81,90,,,percent of total billed charges,90% of total billed charges,61.48,76,,,percent of total billed charges,76% of total billed charges,32.36,40,,,percent of total billed charges,40% of total billed charges,68.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,64.72,80,,,percent of total billed charges,80% of total billed charges,31.39,38.8,,,percent of total billed charges,38.8% of total billed charges,68.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,76.86,
"Annual Wellness Visit, Initial (AWV)",49100004,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,496.4,397.12,,372.3,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,393.15,79.2,,,percent of total billed charges,79.2% of total billed charges,421.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,471.58,95,,,percent of total billed charges,95% of total billed charges,397.12,80,,,percent of total billed charges,80% of total billed charges,421.94,85,,,percent of total billed charges,85% of total billed charges,446.76,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,496.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,446.76,90,,,percent of total billed charges,90% of total billed charges,377.26,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,421.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,397.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,421.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Annual Wellness Visit, Subsequent (AWV)",49100005,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,317.5,254,,238.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,251.46,79.2,,,percent of total billed charges,79.2% of total billed charges,269.88,85,,,percent of total billed charges,85% of total billed charges,317.5,100,,,fee schedule,100% of CO APG rates,301.63,95,,,percent of total billed charges,95% of total billed charges,254,80,,,percent of total billed charges,80% of total billed charges,269.88,85,,,percent of total billed charges,85% of total billed charges,285.75,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,317.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,285.75,90,,,percent of total billed charges,90% of total billed charges,241.3,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,269.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,254,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,269.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1017.2,100,,,case rate,pays based on per visit rate,238.13,1017.2,
Administration Of Influenza Virus Vaccine When No Physician Fee Schedule Service,49190656,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,42.4,33.92,,31.8,75,,,percent of total billed charges,75% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,33.58,79.2,,,percent of total billed charges,79.2% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,42.4,100,,,fee schedule,100% of CO APG rates,40.28,95,,,percent of total billed charges,95% of total billed charges,33.92,80,,,percent of total billed charges,80% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,38.16,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,42.4,100,,,fee schedule,100% of NM APC rate,16.96,40,,,percent of total billed charges,40% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,38.16,90,,,percent of total billed charges,90% of total billed charges,32.22,76,,,percent of total billed charges,76% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,33.92,80,,,percent of total billed charges,80% of total billed charges,16.45,38.8,,,percent of total billed charges,38.8% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.45,50.67,
Administration Of Hepatitis B Vaccine When No Physician Fee Schedule Service On,49100060,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,33.1,26.48,,24.83,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,26.22,79.2,,,percent of total billed charges,79.2% of total billed charges,28.14,85,,,percent of total billed charges,85% of total billed charges,33.1,100,,,fee schedule,100% of CO APG rates,31.45,95,,,percent of total billed charges,95% of total billed charges,26.48,80,,,percent of total billed charges,80% of total billed charges,28.14,85,,,percent of total billed charges,85% of total billed charges,29.79,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,33.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,29.79,90,,,percent of total billed charges,90% of total billed charges,25.16,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,28.14,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,26.48,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,28.14,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,448.4,100,,,case rate,pays based on per visit rate,24.83,448.4,
Urine Drug Tox POC,49180305,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,101.8,81.44,QW,76.35,75,,,percent of total billed charges,75% of total billed charges,40.72,40,,,percent of total billed charges,40% of total billed charges,80.63,79.2,,,percent of total billed charges,79.2% of total billed charges,86.53,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,96.71,95,,,percent of total billed charges,95% of total billed charges,81.44,80,,,percent of total billed charges,80% of total billed charges,86.53,85,,,percent of total billed charges,85% of total billed charges,91.62,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,40.72,40,,,percent of total billed charges,40% of total billed charges,40.72,40,,,percent of total billed charges,40% of total billed charges,91.62,90,,,percent of total billed charges,90% of total billed charges,77.37,76,,,percent of total billed charges,76% of total billed charges,40.72,40,,,percent of total billed charges,40% of total billed charges,86.53,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,81.44,80,,,percent of total billed charges,80% of total billed charges,39.5,38.8,,,percent of total billed charges,38.8% of total billed charges,86.53,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,96.71,
"19100 Biopsy of breast; percutaneous, needle core, not using imaging guidance Te",60000023,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,450.8,360.64,,338.1,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,357.03,79.2,,,percent of total billed charges,79.2% of total billed charges,383.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,428.26,95,,,percent of total billed charges,95% of total billed charges,360.64,80,,,percent of total billed charges,80% of total billed charges,383.18,85,,,percent of total billed charges,85% of total billed charges,405.72,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,450.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,405.72,90,,,percent of total billed charges,90% of total billed charges,342.61,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,383.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,360.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,383.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Colposcopy of the entire vagina, with cervix if present; with biopsy(s)  Technic",60000103,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,510.6,408.48,,382.95,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,404.4,79.2,,,percent of total billed charges,79.2% of total billed charges,434.01,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,485.07,95,,,percent of total billed charges,95% of total billed charges,408.48,80,,,percent of total billed charges,80% of total billed charges,434.01,85,,,percent of total billed charges,85% of total billed charges,459.54,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,510.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,459.54,90,,,percent of total billed charges,90% of total billed charges,388.06,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,434.01,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,408.48,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,434.01,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Colposcopy with endocervical curettage Technical Charge,60000106,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,437.8,350.24,,328.35,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,346.74,79.2,,,percent of total billed charges,79.2% of total billed charges,372.13,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,415.91,95,,,percent of total billed charges,95% of total billed charges,350.24,80,,,percent of total billed charges,80% of total billed charges,372.13,85,,,percent of total billed charges,85% of total billed charges,394.02,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,437.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,394.02,90,,,percent of total billed charges,90% of total billed charges,332.73,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,372.13,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,350.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,372.13,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Endocervical curettage Technical Charge,60000109,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,391.09,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,391.09,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Colposcopy of the Cervix w/Biopsy and endocervical curettage Technical Charge,60000105,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,486,388.8,,364.5,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,384.91,79.2,,,percent of total billed charges,79.2% of total billed charges,413.1,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,461.7,95,,,percent of total billed charges,95% of total billed charges,388.8,80,,,percent of total billed charges,80% of total billed charges,413.1,85,,,percent of total billed charges,85% of total billed charges,437.4,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,486,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,437.4,90,,,percent of total billed charges,90% of total billed charges,369.36,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,413.1,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,388.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,413.1,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
HyAlgan Injection,J7321,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,410.5,328.4,,307.88,75,,,percent of total billed charges,75% of total billed charges,164.2,40,,,percent of total billed charges,40% of total billed charges,325.12,79.2,,,percent of total billed charges,79.2% of total billed charges,348.93,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,389.98,95,,,percent of total billed charges,95% of total billed charges,328.4,80,,,percent of total billed charges,80% of total billed charges,348.93,85,,,percent of total billed charges,85% of total billed charges,369.45,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,410.5,100,,,fee schedule,100% of NM fee schedule,164.2,40,,,percent of total billed charges,40% of total billed charges,164.2,40,,,percent of total billed charges,40% of total billed charges,369.45,90,,,percent of total billed charges,90% of total billed charges,311.98,76,,,percent of total billed charges,76% of total billed charges,164.2,40,,,percent of total billed charges,40% of total billed charges,348.93,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,328.4,80,,,percent of total billed charges,80% of total billed charges,159.27,38.8,,,percent of total billed charges,38.8% of total billed charges,348.93,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,410.5,
Orthovisc inj per dose,J7324,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,937.8,750.24,,703.35,75,,,percent of total billed charges,75% of total billed charges,375.12,40,,,percent of total billed charges,40% of total billed charges,742.74,79.2,,,percent of total billed charges,79.2% of total billed charges,797.13,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,890.91,95,,,percent of total billed charges,95% of total billed charges,750.24,80,,,percent of total billed charges,80% of total billed charges,797.13,85,,,percent of total billed charges,85% of total billed charges,844.02,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,937.8,100,,,fee schedule,100% of NM fee schedule,375.12,40,,,percent of total billed charges,40% of total billed charges,375.12,40,,,percent of total billed charges,40% of total billed charges,844.02,90,,,percent of total billed charges,90% of total billed charges,712.73,76,,,percent of total billed charges,76% of total billed charges,375.12,40,,,percent of total billed charges,40% of total billed charges,797.13,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,750.24,80,,,percent of total billed charges,80% of total billed charges,363.87,38.8,,,percent of total billed charges,38.8% of total billed charges,797.13,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,937.8,
Adrenalin epinephrine inject,49100034,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,9.6,7.68,,7.2,75,,,percent of total billed charges,75% of total billed charges,3.84,40,,,percent of total billed charges,40% of total billed charges,7.6,79.2,,,percent of total billed charges,79.2% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,9.6,100,,,fee schedule,100% of CO APG rates,9.12,95,,,percent of total billed charges,95% of total billed charges,7.68,80,,,percent of total billed charges,80% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,8.64,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,9.6,100,,,fee schedule,100% of NM fee schedule,3.84,40,,,percent of total billed charges,40% of total billed charges,3.84,40,,,percent of total billed charges,40% of total billed charges,8.64,90,,,percent of total billed charges,90% of total billed charges,7.3,76,,,percent of total billed charges,76% of total billed charges,3.84,40,,,percent of total billed charges,40% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,7.68,80,,,percent of total billed charges,80% of total billed charges,3.72,38.8,,,percent of total billed charges,38.8% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.72,35.65,
Admin of Pneumoccocal Immunization,49190670,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,40.3,32.24,,30.23,75,,,percent of total billed charges,75% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,31.92,79.2,,,percent of total billed charges,79.2% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,38.29,95,,,percent of total billed charges,95% of total billed charges,32.24,80,,,percent of total billed charges,80% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,40.3,100,,,fee schedule,100% of NM fee schedule,16.12,40,,,percent of total billed charges,40% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,30.63,76,,,percent of total billed charges,76% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,32.24,80,,,percent of total billed charges,80% of total billed charges,15.64,38.8,,,percent of total billed charges,38.8% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,15.64,40.3,
"69210 Removal Impacted Cerumen Requiring Instrumentation, Un",49169210,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,145.4,116.32,,109.05,75,,,percent of total billed charges,75% of total billed charges,58.16,40,,,percent of total billed charges,40% of total billed charges,115.16,79.2,,,percent of total billed charges,79.2% of total billed charges,123.59,85,,,percent of total billed charges,85% of total billed charges,145.4,100,,,fee schedule,100% of CO APG rates,138.13,95,,,percent of total billed charges,95% of total billed charges,116.32,80,,,percent of total billed charges,80% of total billed charges,123.59,85,,,percent of total billed charges,85% of total billed charges,130.86,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,145.4,100,,,fee schedule,100% of NM APC rate,58.16,40,,,percent of total billed charges,40% of total billed charges,58.16,40,,,percent of total billed charges,40% of total billed charges,130.86,90,,,percent of total billed charges,90% of total billed charges,110.5,76,,,percent of total billed charges,76% of total billed charges,58.16,40,,,percent of total billed charges,40% of total billed charges,123.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,116.32,80,,,percent of total billed charges,80% of total billed charges,56.42,38.8,,,percent of total billed charges,38.8% of total billed charges,123.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,56.42,217.66,
Office/OP New Visit Level 5 99205 Tech Chg,49199205,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,370.6,296.48,,277.95,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,293.52,79.2,,,percent of total billed charges,79.2% of total billed charges,315.01,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,352.07,95,,,percent of total billed charges,95% of total billed charges,296.48,80,,,percent of total billed charges,80% of total billed charges,315.01,85,,,percent of total billed charges,85% of total billed charges,333.54,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,370.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,333.54,90,,,percent of total billed charges,90% of total billed charges,281.66,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,315.01,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,296.48,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,315.01,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1123.4,100,,,case rate,pays based on per visit rate,277.95,1123.4,
"Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg",49100052,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,6.7,5.36,,5.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,5.31,79.2,,,percent of total billed charges,79.2% of total billed charges,5.7,85,,,percent of total billed charges,85% of total billed charges,6.7,100,,,fee schedule,100% of CO APG rates,6.37,95,,,percent of total billed charges,95% of total billed charges,5.36,80,,,percent of total billed charges,80% of total billed charges,5.7,85,,,percent of total billed charges,85% of total billed charges,6.03,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,6.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,6.03,90,,,percent of total billed charges,90% of total billed charges,5.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,5.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,5.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,5.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,395.6,100,,,case rate,pays based on per visit rate,5.03,395.6,
11057 Paring Or Cutting Of Benign Hyperkeratotic Lesion; Mor,46011057,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,266.7,213.36,,200.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,211.23,79.2,,,percent of total billed charges,79.2% of total billed charges,226.7,85,,,percent of total billed charges,85% of total billed charges,266.7,100,,,fee schedule,100% of CO APG rates,253.37,95,,,percent of total billed charges,95% of total billed charges,213.36,80,,,percent of total billed charges,80% of total billed charges,226.7,85,,,percent of total billed charges,85% of total billed charges,240.03,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,266.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,240.03,90,,,percent of total billed charges,90% of total billed charges,202.69,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,226.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,213.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,226.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,915.6,100,,,case rate,pays based on per visit rate,200.03,915.6,
"Diphtheria, tetanus toxoids, acellular pertussis vaccine and poliovirus vaccine,",49190696,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,94.4,75.52,,70.8,75,,,percent of total billed charges,75% of total billed charges,37.76,40,,,percent of total billed charges,40% of total billed charges,74.76,79.2,,,percent of total billed charges,79.2% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,89.68,95,,,percent of total billed charges,95% of total billed charges,75.52,80,,,percent of total billed charges,80% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,84.96,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,94.4,100,,,fee schedule,100% of NM fee schedule,37.76,40,,,percent of total billed charges,40% of total billed charges,37.76,40,,,percent of total billed charges,40% of total billed charges,84.96,90,,,percent of total billed charges,90% of total billed charges,71.74,76,,,percent of total billed charges,76% of total billed charges,37.76,40,,,percent of total billed charges,40% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,75.52,80,,,percent of total billed charges,80% of total billed charges,36.63,38.8,,,percent of total billed charges,38.8% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,94.4,
"11982 Removal, Non-Biodegradable Drug Delivery Implant",49111982,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,324.3,259.44,,243.23,75,,,percent of total billed charges,75% of total billed charges,129.72,40,,,percent of total billed charges,40% of total billed charges,256.85,79.2,,,percent of total billed charges,79.2% of total billed charges,275.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,308.09,95,,,percent of total billed charges,95% of total billed charges,259.44,80,,,percent of total billed charges,80% of total billed charges,275.66,85,,,percent of total billed charges,85% of total billed charges,291.87,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,129.72,40,,,percent of total billed charges,40% of total billed charges,129.72,40,,,percent of total billed charges,40% of total billed charges,291.87,90,,,percent of total billed charges,90% of total billed charges,246.47,76,,,percent of total billed charges,76% of total billed charges,129.72,40,,,percent of total billed charges,40% of total billed charges,275.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,259.44,80,,,percent of total billed charges,80% of total billed charges,125.83,38.8,,,percent of total billed charges,38.8% of total billed charges,275.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,125.83,308.09,
Drainage Abscess Palate Uvula,60000085,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,509,407.2,,381.75,75,,,percent of total billed charges,75% of total billed charges,203.6,40,,,percent of total billed charges,40% of total billed charges,403.13,79.2,,,percent of total billed charges,79.2% of total billed charges,432.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,483.55,95,,,percent of total billed charges,95% of total billed charges,407.2,80,,,percent of total billed charges,80% of total billed charges,432.65,85,,,percent of total billed charges,85% of total billed charges,458.1,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,203.6,40,,,percent of total billed charges,40% of total billed charges,203.6,40,,,percent of total billed charges,40% of total billed charges,458.1,90,,,percent of total billed charges,90% of total billed charges,386.84,76,,,percent of total billed charges,76% of total billed charges,203.6,40,,,percent of total billed charges,40% of total billed charges,432.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,407.2,80,,,percent of total billed charges,80% of total billed charges,197.49,38.8,,,percent of total billed charges,38.8% of total billed charges,432.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,483.55,
Injection Plantar Common Digital Nerve,49164455,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,141.8,113.44,,106.35,75,,,percent of total billed charges,75% of total billed charges,56.72,40,,,percent of total billed charges,40% of total billed charges,112.31,79.2,,,percent of total billed charges,79.2% of total billed charges,120.53,85,,,percent of total billed charges,85% of total billed charges,141.8,100,,,fee schedule,100% of CO APG rates,134.71,95,,,percent of total billed charges,95% of total billed charges,113.44,80,,,percent of total billed charges,80% of total billed charges,120.53,85,,,percent of total billed charges,85% of total billed charges,127.62,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,141.8,100,,,fee schedule,100% of NM APC rate,56.72,40,,,percent of total billed charges,40% of total billed charges,56.72,40,,,percent of total billed charges,40% of total billed charges,127.62,90,,,percent of total billed charges,90% of total billed charges,107.77,76,,,percent of total billed charges,76% of total billed charges,56.72,40,,,percent of total billed charges,40% of total billed charges,120.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,113.44,80,,,percent of total billed charges,80% of total billed charges,55.02,38.8,,,percent of total billed charges,38.8% of total billed charges,120.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,55.02,217.66,
Ferritin Level,40082728,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,105,84,,78.75,75,,,percent of total billed charges,75% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,83.16,79.2,,,percent of total billed charges,79.2% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,99.75,95,,,percent of total billed charges,95% of total billed charges,84,80,,,percent of total billed charges,80% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,42,40,,,percent of total billed charges,40% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,79.8,76,,,percent of total billed charges,76% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,84,80,,,percent of total billed charges,80% of total billed charges,40.74,38.8,,,percent of total billed charges,38.8% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,99.75,
CA 27.29 LC,40086300,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,164.9,131.92,,123.68,75,,,percent of total billed charges,75% of total billed charges,65.96,40,,,percent of total billed charges,40% of total billed charges,130.6,79.2,,,percent of total billed charges,79.2% of total billed charges,140.17,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,156.66,95,,,percent of total billed charges,95% of total billed charges,131.92,80,,,percent of total billed charges,80% of total billed charges,140.17,85,,,percent of total billed charges,85% of total billed charges,148.41,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,65.96,40,,,percent of total billed charges,40% of total billed charges,65.96,40,,,percent of total billed charges,40% of total billed charges,148.41,90,,,percent of total billed charges,90% of total billed charges,125.32,76,,,percent of total billed charges,76% of total billed charges,65.96,40,,,percent of total billed charges,40% of total billed charges,140.17,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,131.92,80,,,percent of total billed charges,80% of total billed charges,63.98,38.8,,,percent of total billed charges,38.8% of total billed charges,140.17,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,156.66,
EKG/ECG 12 Lead,31093000,CDM,730,RC,93005,HCPCS,OUTPATIENT,,,187.1,149.68,,140.33,75,,,percent of total billed charges,75% of total billed charges,74.84,40,,,percent of total billed charges,40% of total billed charges,148.18,79.2,,,percent of total billed charges,79.2% of total billed charges,159.04,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,177.75,95,,,percent of total billed charges,95% of total billed charges,149.68,80,,,percent of total billed charges,80% of total billed charges,159.04,85,,,percent of total billed charges,85% of total billed charges,168.39,90,,,percent of total billed charges,90% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,34.77,100,,,fee schedule,100% of CO APG rates,57.48,100,,,fee schedule,100% of NM APC rate,74.84,40,,,percent of total billed charges,40% of total billed charges,74.84,40,,,percent of total billed charges,40% of total billed charges,168.39,90,,,percent of total billed charges,90% of total billed charges,142.2,76,,,percent of total billed charges,76% of total billed charges,74.84,40,,,percent of total billed charges,40% of total billed charges,159.04,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rate,149.68,80,,,percent of total billed charges,80% of total billed charges,72.59,38.8,,,percent of total billed charges,38.8% of total billed charges,159.04,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of APG fee schedule,13.34,200,,,fee schedule,200% of CMS fee schedule,13.34,177.75,
Allergy Injection Single POC,49195115,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,32,25.6,,24,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,25.34,79.2,,,percent of total billed charges,79.2% of total billed charges,27.2,85,,,percent of total billed charges,85% of total billed charges,32,100,,,fee schedule,100% of CO APG rates,30.4,95,,,percent of total billed charges,95% of total billed charges,25.6,80,,,percent of total billed charges,80% of total billed charges,27.2,85,,,percent of total billed charges,85% of total billed charges,28.8,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,32,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,28.8,90,,,percent of total billed charges,90% of total billed charges,24.32,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,27.2,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,25.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,27.2,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,446.2,100,,,case rate,pays based on per visit rate,24,446.2,
Allergy Injection Multi POC,49195117,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,38.6,30.88,,28.95,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,30.57,79.2,,,percent of total billed charges,79.2% of total billed charges,32.81,85,,,percent of total billed charges,85% of total billed charges,38.6,100,,,fee schedule,100% of CO APG rates,36.67,95,,,percent of total billed charges,95% of total billed charges,30.88,80,,,percent of total billed charges,80% of total billed charges,32.81,85,,,percent of total billed charges,85% of total billed charges,34.74,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,38.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,34.74,90,,,percent of total billed charges,90% of total billed charges,29.34,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,32.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,30.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,32.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,459.4,100,,,case rate,pays based on per visit rate,28.95,459.4,
Blood Glucose POC,49182948,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,12.7,10.16,QW,9.53,75,,,percent of total billed charges,75% of total billed charges,5.08,40,,,percent of total billed charges,40% of total billed charges,10.06,79.2,,,percent of total billed charges,79.2% of total billed charges,10.8,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,12.07,95,,,percent of total billed charges,95% of total billed charges,10.16,80,,,percent of total billed charges,80% of total billed charges,10.8,85,,,percent of total billed charges,85% of total billed charges,11.43,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,5.08,40,,,percent of total billed charges,40% of total billed charges,5.08,40,,,percent of total billed charges,40% of total billed charges,11.43,90,,,percent of total billed charges,90% of total billed charges,9.65,76,,,percent of total billed charges,76% of total billed charges,5.08,40,,,percent of total billed charges,40% of total billed charges,10.8,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,10.16,80,,,percent of total billed charges,80% of total billed charges,4.93,38.8,,,percent of total billed charges,38.8% of total billed charges,10.8,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,12.07,
KENALOG 40MG IM/IV,49100046,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,6.4,5.12,,4.8,75,,,percent of total billed charges,75% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.07,79.2,,,percent of total billed charges,79.2% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,6.4,100,,,fee schedule,100% of CO APG rates,6.08,95,,,percent of total billed charges,95% of total billed charges,5.12,80,,,percent of total billed charges,80% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,6.4,100,,,fee schedule,100% of NM fee schedule,2.56,40,,,percent of total billed charges,40% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,4.86,76,,,percent of total billed charges,76% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,5.12,80,,,percent of total billed charges,80% of total billed charges,2.48,38.8,,,percent of total billed charges,38.8% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.48,35.65,
SUPARTZ INJECTION PER,60000157,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,775.4,620.32,,581.55,75,,,percent of total billed charges,75% of total billed charges,310.16,40,,,percent of total billed charges,40% of total billed charges,614.12,79.2,,,percent of total billed charges,79.2% of total billed charges,659.09,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,736.63,95,,,percent of total billed charges,95% of total billed charges,620.32,80,,,percent of total billed charges,80% of total billed charges,659.09,85,,,percent of total billed charges,85% of total billed charges,697.86,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,775.4,100,,,fee schedule,100% of NM fee schedule,310.16,40,,,percent of total billed charges,40% of total billed charges,310.16,40,,,percent of total billed charges,40% of total billed charges,697.86,90,,,percent of total billed charges,90% of total billed charges,589.3,76,,,percent of total billed charges,76% of total billed charges,310.16,40,,,percent of total billed charges,40% of total billed charges,659.09,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,620.32,80,,,percent of total billed charges,80% of total billed charges,300.86,38.8,,,percent of total billed charges,38.8% of total billed charges,659.09,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,775.4,
SYNVISC PER 1MG INTRA,49100049,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,47.7,38.16,,35.78,75,,,percent of total billed charges,75% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,37.78,79.2,,,percent of total billed charges,79.2% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,45.32,95,,,percent of total billed charges,95% of total billed charges,38.16,80,,,percent of total billed charges,80% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,42.93,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,47.7,100,,,fee schedule,100% of NM fee schedule,19.08,40,,,percent of total billed charges,40% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,42.93,90,,,percent of total billed charges,90% of total billed charges,36.25,76,,,percent of total billed charges,76% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,38.16,80,,,percent of total billed charges,80% of total billed charges,18.51,38.8,,,percent of total billed charges,38.8% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.51,47.7,
TB Test POC,49186580,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,21,16.8,,15.75,75,,,percent of total billed charges,75% of total billed charges,8.4,40,,,percent of total billed charges,40% of total billed charges,16.63,79.2,,,percent of total billed charges,79.2% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,19.95,95,,,percent of total billed charges,95% of total billed charges,16.8,80,,,percent of total billed charges,80% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,18.9,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,8.4,40,,,percent of total billed charges,40% of total billed charges,8.4,40,,,percent of total billed charges,40% of total billed charges,18.9,90,,,percent of total billed charges,90% of total billed charges,15.96,76,,,percent of total billed charges,76% of total billed charges,8.4,40,,,percent of total billed charges,40% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,16.8,80,,,percent of total billed charges,80% of total billed charges,8.15,38.8,,,percent of total billed charges,38.8% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,8.15,33.06,
TELEHEALTH  FACILITY FEE,49100061,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,32.7,26.16,,24.53,75,,,percent of total billed charges,75% of total billed charges,13.08,40,,,percent of total billed charges,40% of total billed charges,25.9,79.2,,,percent of total billed charges,79.2% of total billed charges,27.8,85,,,percent of total billed charges,85% of total billed charges,32.7,100,,,fee schedule,100% of CO APG rates,31.07,95,,,percent of total billed charges,95% of total billed charges,26.16,80,,,percent of total billed charges,80% of total billed charges,27.8,85,,,percent of total billed charges,85% of total billed charges,29.43,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,32.7,100,,,fee schedule,100% of NM APC rate,13.08,40,,,percent of total billed charges,40% of total billed charges,13.08,40,,,percent of total billed charges,40% of total billed charges,29.43,90,,,percent of total billed charges,90% of total billed charges,24.85,76,,,percent of total billed charges,76% of total billed charges,13.08,40,,,percent of total billed charges,40% of total billed charges,27.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,26.16,80,,,percent of total billed charges,80% of total billed charges,12.69,38.8,,,percent of total billed charges,38.8% of total billed charges,27.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,65.4,200,,,fee schedule,200% of CMS fee schedule,12.69,215.49,
RSV POC,49187807,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,34,27.2,QW,25.5,75,,,percent of total billed charges,75% of total billed charges,13.6,40,,,percent of total billed charges,40% of total billed charges,26.93,79.2,,,percent of total billed charges,79.2% of total billed charges,28.9,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,32.3,95,,,percent of total billed charges,95% of total billed charges,27.2,80,,,percent of total billed charges,80% of total billed charges,28.9,85,,,percent of total billed charges,85% of total billed charges,30.6,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,13.6,40,,,percent of total billed charges,40% of total billed charges,13.6,40,,,percent of total billed charges,40% of total billed charges,30.6,90,,,percent of total billed charges,90% of total billed charges,25.84,76,,,percent of total billed charges,76% of total billed charges,13.6,40,,,percent of total billed charges,40% of total billed charges,28.9,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,27.2,80,,,percent of total billed charges,80% of total billed charges,13.19,38.8,,,percent of total billed charges,38.8% of total billed charges,28.9,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,33.1,
VFC - 90723 DTaP-Hep B- IPV (Pediarix),49190723,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
VFC - 90715 Tdap,90715VFC,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
VFC - 90700 Dtap,49190700,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
"VFC - 90633 Hep A, Ped/Adol",90633VFC,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
"VFC - 90744 Hep B, Ped/Adol",90744VFC,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
"VFC - 90670 Pneumo Vacc, 13 Val",49190670,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
VFC - 90716 Varicella Vaccine,90716VFC,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
VFC - 90707 MMR,49190707,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
VFC - 90713 IPV Vaccine,60000216,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
VFC - 90734 Meningococcal Vaccine,60000217,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
90847 FAMILY PSYCHOTHERAPY WITH PT CHARGE,49190847,CDM,900,RC,90847,HCPCS,OUTPATIENT,,,234.1,187.28,,175.58,75,,,percent of total billed charges,75% of total billed charges,93.64,40,,,percent of total billed charges,40% of total billed charges,185.41,79.2,,,percent of total billed charges,79.2% of total billed charges,198.99,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,222.4,95,,,percent of total billed charges,95% of total billed charges,187.28,80,,,percent of total billed charges,80% of total billed charges,198.99,85,,,percent of total billed charges,85% of total billed charges,210.69,90,,,percent of total billed charges,90% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,198.82,100,,,fee schedule,100% of CO APG rates,145.69,100,,,fee schedule,100% of NM APC rate,93.64,40,,,percent of total billed charges,40% of total billed charges,93.64,40,,,percent of total billed charges,40% of total billed charges,210.69,90,,,percent of total billed charges,90% of total billed charges,177.92,76,,,percent of total billed charges,76% of total billed charges,93.64,40,,,percent of total billed charges,40% of total billed charges,198.99,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rate,187.28,80,,,percent of total billed charges,80% of total billed charges,90.83,38.8,,,percent of total billed charges,38.8% of total billed charges,198.99,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of APG fee schedule,199.68,200,,,fee schedule,200% of CMS fee schedule,90.83,222.4,
"Injection, Solu-Medrol 40MG",49100044,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,6.7,5.36,,5.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,5.31,79.2,,,percent of total billed charges,79.2% of total billed charges,5.7,85,,,percent of total billed charges,85% of total billed charges,6.7,100,,,fee schedule,100% of CO APG rates,6.37,95,,,percent of total billed charges,95% of total billed charges,5.36,80,,,percent of total billed charges,80% of total billed charges,5.7,85,,,percent of total billed charges,85% of total billed charges,6.03,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,6.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,6.03,90,,,percent of total billed charges,90% of total billed charges,5.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,5.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,5.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,5.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,395.6,100,,,case rate,pays based on per visit rate,5.03,395.6,
Cancer Antigen (CA) 15-3 LC,40086300,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,148.1,118.48,,111.08,75,,,percent of total billed charges,75% of total billed charges,59.24,40,,,percent of total billed charges,40% of total billed charges,117.3,79.2,,,percent of total billed charges,79.2% of total billed charges,125.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,140.7,95,,,percent of total billed charges,95% of total billed charges,118.48,80,,,percent of total billed charges,80% of total billed charges,125.89,85,,,percent of total billed charges,85% of total billed charges,133.29,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,59.24,40,,,percent of total billed charges,40% of total billed charges,59.24,40,,,percent of total billed charges,40% of total billed charges,133.29,90,,,percent of total billed charges,90% of total billed charges,112.56,76,,,percent of total billed charges,76% of total billed charges,59.24,40,,,percent of total billed charges,40% of total billed charges,125.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,118.48,80,,,percent of total billed charges,80% of total billed charges,57.46,38.8,,,percent of total billed charges,38.8% of total billed charges,125.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,140.7,
Lipid Panel 1,40080061,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,140.8,112.64,,105.6,75,,,percent of total billed charges,75% of total billed charges,56.32,40,,,percent of total billed charges,40% of total billed charges,111.51,79.2,,,percent of total billed charges,79.2% of total billed charges,119.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,133.76,95,,,percent of total billed charges,95% of total billed charges,112.64,80,,,percent of total billed charges,80% of total billed charges,119.68,85,,,percent of total billed charges,85% of total billed charges,126.72,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,56.32,40,,,percent of total billed charges,40% of total billed charges,56.32,40,,,percent of total billed charges,40% of total billed charges,126.72,90,,,percent of total billed charges,90% of total billed charges,107.01,76,,,percent of total billed charges,76% of total billed charges,56.32,40,,,percent of total billed charges,40% of total billed charges,119.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,112.64,80,,,percent of total billed charges,80% of total billed charges,54.63,38.8,,,percent of total billed charges,38.8% of total billed charges,119.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,133.76,
HIV 1/2 Ab,40086703,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,84,67.2,,63,75,,,percent of total billed charges,75% of total billed charges,33.6,40,,,percent of total billed charges,40% of total billed charges,66.53,79.2,,,percent of total billed charges,79.2% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,79.8,95,,,percent of total billed charges,95% of total billed charges,67.2,80,,,percent of total billed charges,80% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,75.6,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,33.6,40,,,percent of total billed charges,40% of total billed charges,33.6,40,,,percent of total billed charges,40% of total billed charges,75.6,90,,,percent of total billed charges,90% of total billed charges,63.84,76,,,percent of total billed charges,76% of total billed charges,33.6,40,,,percent of total billed charges,40% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,67.2,80,,,percent of total billed charges,80% of total billed charges,32.59,38.8,,,percent of total billed charges,38.8% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,79.8,
RHOPHYLAC INJECTION,49100043,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,190.8,152.64,,143.1,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,151.11,79.2,,,percent of total billed charges,79.2% of total billed charges,162.18,85,,,percent of total billed charges,85% of total billed charges,190.8,100,,,fee schedule,100% of CO APG rates,181.26,95,,,percent of total billed charges,95% of total billed charges,152.64,80,,,percent of total billed charges,80% of total billed charges,162.18,85,,,percent of total billed charges,85% of total billed charges,171.72,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,190.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,171.72,90,,,percent of total billed charges,90% of total billed charges,145.01,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,162.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,152.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,162.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,763.8,100,,,case rate,pays based on per visit rate,143.1,763.8,
"Vitamin D, 25-Hydroxy",40082306,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,262.6,210.08,,196.95,75,,,percent of total billed charges,75% of total billed charges,105.04,40,,,percent of total billed charges,40% of total billed charges,207.98,79.2,,,percent of total billed charges,79.2% of total billed charges,223.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,249.47,95,,,percent of total billed charges,95% of total billed charges,210.08,80,,,percent of total billed charges,80% of total billed charges,223.21,85,,,percent of total billed charges,85% of total billed charges,236.34,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,105.04,40,,,percent of total billed charges,40% of total billed charges,105.04,40,,,percent of total billed charges,40% of total billed charges,236.34,90,,,percent of total billed charges,90% of total billed charges,199.58,76,,,percent of total billed charges,76% of total billed charges,105.04,40,,,percent of total billed charges,40% of total billed charges,223.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,210.08,80,,,percent of total billed charges,80% of total billed charges,101.89,38.8,,,percent of total billed charges,38.8% of total billed charges,223.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,249.47,
Folate Level,40082746,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,124,99.2,,93,75,,,percent of total billed charges,75% of total billed charges,49.6,40,,,percent of total billed charges,40% of total billed charges,98.21,79.2,,,percent of total billed charges,79.2% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,117.8,95,,,percent of total billed charges,95% of total billed charges,99.2,80,,,percent of total billed charges,80% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,111.6,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,49.6,40,,,percent of total billed charges,40% of total billed charges,49.6,40,,,percent of total billed charges,40% of total billed charges,111.6,90,,,percent of total billed charges,90% of total billed charges,94.24,76,,,percent of total billed charges,76% of total billed charges,49.6,40,,,percent of total billed charges,40% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,99.2,80,,,percent of total billed charges,80% of total billed charges,48.11,38.8,,,percent of total billed charges,38.8% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,117.8,
"90472 IMMUNIZAITON ADMIN, EA ADD VACCINE CHARGE",31090472,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,21.6,17.28,,16.2,75,,,percent of total billed charges,75% of total billed charges,8.64,40,,,percent of total billed charges,40% of total billed charges,17.11,79.2,,,percent of total billed charges,79.2% of total billed charges,18.36,85,,,percent of total billed charges,85% of total billed charges,21.6,100,,,fee schedule,100% of CO APG rates,20.52,95,,,percent of total billed charges,95% of total billed charges,17.28,80,,,percent of total billed charges,80% of total billed charges,18.36,85,,,percent of total billed charges,85% of total billed charges,19.44,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,21.6,100,,,fee schedule,100% of NM APC rate,8.64,40,,,percent of total billed charges,40% of total billed charges,8.64,40,,,percent of total billed charges,40% of total billed charges,19.44,90,,,percent of total billed charges,90% of total billed charges,16.42,76,,,percent of total billed charges,76% of total billed charges,8.64,40,,,percent of total billed charges,40% of total billed charges,18.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,17.28,80,,,percent of total billed charges,80% of total billed charges,8.38,38.8,,,percent of total billed charges,38.8% of total billed charges,18.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,43.2,200,,,fee schedule,200% of CMS fee schedule,8.38,215.49,
Alpha Fetoprotein,40082105,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,124,99.2,,93,75,,,percent of total billed charges,75% of total billed charges,49.6,40,,,percent of total billed charges,40% of total billed charges,98.21,79.2,,,percent of total billed charges,79.2% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,117.8,95,,,percent of total billed charges,95% of total billed charges,99.2,80,,,percent of total billed charges,80% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,111.6,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,49.6,40,,,percent of total billed charges,40% of total billed charges,49.6,40,,,percent of total billed charges,40% of total billed charges,111.6,90,,,percent of total billed charges,90% of total billed charges,94.24,76,,,percent of total billed charges,76% of total billed charges,49.6,40,,,percent of total billed charges,40% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,99.2,80,,,percent of total billed charges,80% of total billed charges,48.11,38.8,,,percent of total billed charges,38.8% of total billed charges,105.4,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,117.8,
CA-125,40086304,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,185.9,148.72,,139.43,75,,,percent of total billed charges,75% of total billed charges,74.36,40,,,percent of total billed charges,40% of total billed charges,147.23,79.2,,,percent of total billed charges,79.2% of total billed charges,158.02,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,176.61,95,,,percent of total billed charges,95% of total billed charges,148.72,80,,,percent of total billed charges,80% of total billed charges,158.02,85,,,percent of total billed charges,85% of total billed charges,167.31,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,74.36,40,,,percent of total billed charges,40% of total billed charges,74.36,40,,,percent of total billed charges,40% of total billed charges,167.31,90,,,percent of total billed charges,90% of total billed charges,141.28,76,,,percent of total billed charges,76% of total billed charges,74.36,40,,,percent of total billed charges,40% of total billed charges,158.02,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,148.72,80,,,percent of total billed charges,80% of total billed charges,72.13,38.8,,,percent of total billed charges,38.8% of total billed charges,158.02,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,176.61,
Urine Drug Screen 7,40080306,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,110.3,88.24,,82.73,75,,,percent of total billed charges,75% of total billed charges,44.12,40,,,percent of total billed charges,40% of total billed charges,87.36,79.2,,,percent of total billed charges,79.2% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,104.79,95,,,percent of total billed charges,95% of total billed charges,88.24,80,,,percent of total billed charges,80% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,99.27,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,44.12,40,,,percent of total billed charges,40% of total billed charges,44.12,40,,,percent of total billed charges,40% of total billed charges,99.27,90,,,percent of total billed charges,90% of total billed charges,83.83,76,,,percent of total billed charges,76% of total billed charges,44.12,40,,,percent of total billed charges,40% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,88.24,80,,,percent of total billed charges,80% of total billed charges,42.8,38.8,,,percent of total billed charges,38.8% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,104.79,
Urine Culture Screen,40087086,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,76.7,61.36,,57.53,75,,,percent of total billed charges,75% of total billed charges,30.68,40,,,percent of total billed charges,40% of total billed charges,60.75,79.2,,,percent of total billed charges,79.2% of total billed charges,65.2,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,72.87,95,,,percent of total billed charges,95% of total billed charges,61.36,80,,,percent of total billed charges,80% of total billed charges,65.2,85,,,percent of total billed charges,85% of total billed charges,69.03,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,30.68,40,,,percent of total billed charges,40% of total billed charges,30.68,40,,,percent of total billed charges,40% of total billed charges,69.03,90,,,percent of total billed charges,90% of total billed charges,58.29,76,,,percent of total billed charges,76% of total billed charges,30.68,40,,,percent of total billed charges,40% of total billed charges,65.2,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,61.36,80,,,percent of total billed charges,80% of total billed charges,29.76,38.8,,,percent of total billed charges,38.8% of total billed charges,65.2,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,72.87,
Psychiatric Diagnostic Evaluation,49190791,CDM,900,RC,90847,HCPCS,OUTPATIENT,,,411.6,329.28,,308.7,75,,,percent of total billed charges,75% of total billed charges,164.64,40,,,percent of total billed charges,40% of total billed charges,325.99,79.2,,,percent of total billed charges,79.2% of total billed charges,349.86,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,391.02,95,,,percent of total billed charges,95% of total billed charges,329.28,80,,,percent of total billed charges,80% of total billed charges,349.86,85,,,percent of total billed charges,85% of total billed charges,370.44,90,,,percent of total billed charges,90% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,198.82,100,,,fee schedule,100% of CO APG rates,145.69,100,,,fee schedule,100% of NM APC rate,164.64,40,,,percent of total billed charges,40% of total billed charges,164.64,40,,,percent of total billed charges,40% of total billed charges,370.44,90,,,percent of total billed charges,90% of total billed charges,312.82,76,,,percent of total billed charges,76% of total billed charges,164.64,40,,,percent of total billed charges,40% of total billed charges,349.86,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rate,329.28,80,,,percent of total billed charges,80% of total billed charges,159.7,38.8,,,percent of total billed charges,38.8% of total billed charges,349.86,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of APG fee schedule,199.68,200,,,fee schedule,200% of CMS fee schedule,145.69,391.02,
Psychotherapy; 30 mins,49190832,CDM,900,RC,90847,HCPCS,OUTPATIENT,,,141.4,113.12,,106.05,75,,,percent of total billed charges,75% of total billed charges,56.56,40,,,percent of total billed charges,40% of total billed charges,111.99,79.2,,,percent of total billed charges,79.2% of total billed charges,120.19,85,,,percent of total billed charges,85% of total billed charges,141.4,100,,,fee schedule,100% of CO APG rates,134.33,95,,,percent of total billed charges,95% of total billed charges,113.12,80,,,percent of total billed charges,80% of total billed charges,120.19,85,,,percent of total billed charges,85% of total billed charges,127.26,90,,,percent of total billed charges,90% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,198.82,100,,,fee schedule,100% of CO APG rates,141.4,100,,,fee schedule,100% of NM APC rate,56.56,40,,,percent of total billed charges,40% of total billed charges,56.56,40,,,percent of total billed charges,40% of total billed charges,127.26,90,,,percent of total billed charges,90% of total billed charges,107.46,76,,,percent of total billed charges,76% of total billed charges,56.56,40,,,percent of total billed charges,40% of total billed charges,120.19,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rate,113.12,80,,,percent of total billed charges,80% of total billed charges,54.86,38.8,,,percent of total billed charges,38.8% of total billed charges,120.19,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of APG fee schedule,199.68,200,,,fee schedule,200% of CMS fee schedule,54.86,199.68,
Psychotherapy; 45 mins,49190834,CDM,900,RC,90847,HCPCS,OUTPATIENT,,,217.1,173.68,,162.83,75,,,percent of total billed charges,75% of total billed charges,86.84,40,,,percent of total billed charges,40% of total billed charges,171.94,79.2,,,percent of total billed charges,79.2% of total billed charges,184.54,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,206.25,95,,,percent of total billed charges,95% of total billed charges,173.68,80,,,percent of total billed charges,80% of total billed charges,184.54,85,,,percent of total billed charges,85% of total billed charges,195.39,90,,,percent of total billed charges,90% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,198.82,100,,,fee schedule,100% of CO APG rates,145.69,100,,,fee schedule,100% of NM APC rate,86.84,40,,,percent of total billed charges,40% of total billed charges,86.84,40,,,percent of total billed charges,40% of total billed charges,195.39,90,,,percent of total billed charges,90% of total billed charges,165,76,,,percent of total billed charges,76% of total billed charges,86.84,40,,,percent of total billed charges,40% of total billed charges,184.54,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rate,173.68,80,,,percent of total billed charges,80% of total billed charges,84.23,38.8,,,percent of total billed charges,38.8% of total billed charges,184.54,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of APG fee schedule,199.68,200,,,fee schedule,200% of CMS fee schedule,84.23,206.25,
Psychotherapy; 60 mins,49190837,CDM,900,RC,90847,HCPCS,OUTPATIENT,,,252.2,201.76,,189.15,75,,,percent of total billed charges,75% of total billed charges,100.88,40,,,percent of total billed charges,40% of total billed charges,199.74,79.2,,,percent of total billed charges,79.2% of total billed charges,214.37,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,239.59,95,,,percent of total billed charges,95% of total billed charges,201.76,80,,,percent of total billed charges,80% of total billed charges,214.37,85,,,percent of total billed charges,85% of total billed charges,226.98,90,,,percent of total billed charges,90% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,198.82,100,,,fee schedule,100% of CO APG rates,145.69,100,,,fee schedule,100% of NM APC rate,100.88,40,,,percent of total billed charges,40% of total billed charges,100.88,40,,,percent of total billed charges,40% of total billed charges,226.98,90,,,percent of total billed charges,90% of total billed charges,191.67,76,,,percent of total billed charges,76% of total billed charges,100.88,40,,,percent of total billed charges,40% of total billed charges,214.37,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rate,201.76,80,,,percent of total billed charges,80% of total billed charges,97.85,38.8,,,percent of total billed charges,38.8% of total billed charges,214.37,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of APG fee schedule,199.68,200,,,fee schedule,200% of CMS fee schedule,97.85,239.59,
VFC - 90696 Kinrix,49190696,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
VFC - 90710 PROQUAD VACCINE,90710VFC,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
VFC - 90680 ROTAVIRUS ORAL,90680VFC,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
"ANTI-EMBOLISM STOCKING, THIGH  MED SHORT",52872,CDM,270,RC,,,OUTPATIENT,,,28.4,22.72,,21.3,75,,,percent of total billed charges,75% of total billed charges,11.36,40,,,percent of total billed charges,40% of total billed charges,22.49,79.2,,,percent of total billed charges,79.2% of total billed charges,24.14,85,,,percent of total billed charges,85% of total billed charges,28.4,100,,,fee schedule,100% of CO APG rates,26.98,95,,,percent of total billed charges,95% of total billed charges,22.72,80,,,percent of total billed charges,80% of total billed charges,24.14,85,,,percent of total billed charges,85% of total billed charges,25.56,90,,,percent of total billed charges,90% of total billed charges,28.4,100,,,fee schedule,100% of CO APG rates,28.4,100,,,fee schedule,100% of CO APG rates,28.4,100,,,fee schedule,100% of NM fee schedule,11.36,40,,,percent of total billed charges,40% of total billed charges,11.36,40,,,percent of total billed charges,40% of total billed charges,25.56,90,,,percent of total billed charges,90% of total billed charges,21.58,76,,,percent of total billed charges,76% of total billed charges,11.36,40,,,percent of total billed charges,40% of total billed charges,24.14,85,,,percent of total billed charges,85% of total billed charges,28.4,100,,,fee schedule,100% of CO APG rate,22.72,80,,,percent of total billed charges,80% of total billed charges,11.02,38.8,,,percent of total billed charges,38.8% of total billed charges,24.14,85,,,percent of total billed charges,85% of total billed charges,28.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,11.02,28.4,
CATH WORD BARTHOLIM GLAND 10/5  LTX,51082,CDM,270,RC,,,OUTPATIENT,,,118.7,94.96,,89.03,75,,,percent of total billed charges,75% of total billed charges,47.48,40,,,percent of total billed charges,40% of total billed charges,94.01,79.2,,,percent of total billed charges,79.2% of total billed charges,100.9,85,,,percent of total billed charges,85% of total billed charges,118.7,100,,,fee schedule,100% of CO APG rates,112.77,95,,,percent of total billed charges,95% of total billed charges,94.96,80,,,percent of total billed charges,80% of total billed charges,100.9,85,,,percent of total billed charges,85% of total billed charges,106.83,90,,,percent of total billed charges,90% of total billed charges,118.7,100,,,fee schedule,100% of CO APG rates,118.7,100,,,fee schedule,100% of CO APG rates,118.7,100,,,fee schedule,100% of NM fee schedule,47.48,40,,,percent of total billed charges,40% of total billed charges,47.48,40,,,percent of total billed charges,40% of total billed charges,106.83,90,,,percent of total billed charges,90% of total billed charges,90.21,76,,,percent of total billed charges,76% of total billed charges,47.48,40,,,percent of total billed charges,40% of total billed charges,100.9,85,,,percent of total billed charges,85% of total billed charges,118.7,100,,,fee schedule,100% of CO APG rate,94.96,80,,,percent of total billed charges,80% of total billed charges,46.06,38.8,,,percent of total billed charges,38.8% of total billed charges,100.9,85,,,percent of total billed charges,85% of total billed charges,118.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,46.06,118.7,
VFC - 90698 Dtap/Hib/IPV Vaccine,49190698,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,382.2,100,,,case rate,pays based on per visit rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,382.2,100,,,case rate,pays based on per visit rate,,,,,other,not separately reimbursable,324.76,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,370.73,100,,,case rate,pays based on per visit rate,,,,,other,not separately reimbursable,324.76,100,,,fee schedule,100% of APG fee schedule,382.22,100,,,case rate,pays based on per visit rate,324.76,382.22,
11740 Evacuation Of Subungual Hematoma,31011740,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,180.3,144.24,,135.23,75,,,percent of total billed charges,75% of total billed charges,72.12,40,,,percent of total billed charges,40% of total billed charges,142.8,79.2,,,percent of total billed charges,79.2% of total billed charges,153.26,85,,,percent of total billed charges,85% of total billed charges,180.3,100,,,fee schedule,100% of CO APG rates,171.29,95,,,percent of total billed charges,95% of total billed charges,144.24,80,,,percent of total billed charges,80% of total billed charges,153.26,85,,,percent of total billed charges,85% of total billed charges,162.27,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.3,100,,,fee schedule,100% of NM APC rate,72.12,40,,,percent of total billed charges,40% of total billed charges,72.12,40,,,percent of total billed charges,40% of total billed charges,162.27,90,,,percent of total billed charges,90% of total billed charges,137.03,76,,,percent of total billed charges,76% of total billed charges,72.12,40,,,percent of total billed charges,40% of total billed charges,153.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,144.24,80,,,percent of total billed charges,80% of total billed charges,69.96,38.8,,,percent of total billed charges,38.8% of total billed charges,153.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,69.96,217.66,
11760 Repair Nail Bed,31011760,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,593.3,474.64,,444.98,75,,,percent of total billed charges,75% of total billed charges,237.32,40,,,percent of total billed charges,40% of total billed charges,469.89,79.2,,,percent of total billed charges,79.2% of total billed charges,504.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,563.64,95,,,percent of total billed charges,95% of total billed charges,474.64,80,,,percent of total billed charges,80% of total billed charges,504.31,85,,,percent of total billed charges,85% of total billed charges,533.97,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,237.32,40,,,percent of total billed charges,40% of total billed charges,237.32,40,,,percent of total billed charges,40% of total billed charges,533.97,90,,,percent of total billed charges,90% of total billed charges,450.91,76,,,percent of total billed charges,76% of total billed charges,237.32,40,,,percent of total billed charges,40% of total billed charges,504.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,474.64,80,,,percent of total billed charges,80% of total billed charges,230.2,38.8,,,percent of total billed charges,38.8% of total billed charges,504.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,563.64,
11765 Wedge Excision Of Skin Of Nail Fold,31011765,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,496.2,396.96,,372.15,75,,,percent of total billed charges,75% of total billed charges,198.48,40,,,percent of total billed charges,40% of total billed charges,392.99,79.2,,,percent of total billed charges,79.2% of total billed charges,421.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,471.39,95,,,percent of total billed charges,95% of total billed charges,396.96,80,,,percent of total billed charges,80% of total billed charges,421.77,85,,,percent of total billed charges,85% of total billed charges,446.58,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,198.48,40,,,percent of total billed charges,40% of total billed charges,198.48,40,,,percent of total billed charges,40% of total billed charges,446.58,90,,,percent of total billed charges,90% of total billed charges,377.11,76,,,percent of total billed charges,76% of total billed charges,198.48,40,,,percent of total billed charges,40% of total billed charges,421.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,396.96,80,,,percent of total billed charges,80% of total billed charges,192.53,38.8,,,percent of total billed charges,38.8% of total billed charges,421.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,471.39,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012034,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1052.1,841.68,,789.08,75,,,percent of total billed charges,75% of total billed charges,420.84,40,,,percent of total billed charges,40% of total billed charges,833.26,79.2,,,percent of total billed charges,79.2% of total billed charges,894.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,999.5,95,,,percent of total billed charges,95% of total billed charges,841.68,80,,,percent of total billed charges,80% of total billed charges,894.29,85,,,percent of total billed charges,85% of total billed charges,946.89,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,420.84,40,,,percent of total billed charges,40% of total billed charges,420.84,40,,,percent of total billed charges,40% of total billed charges,946.89,90,,,percent of total billed charges,90% of total billed charges,799.6,76,,,percent of total billed charges,76% of total billed charges,420.84,40,,,percent of total billed charges,40% of total billed charges,894.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,841.68,80,,,percent of total billed charges,80% of total billed charges,408.21,38.8,,,percent of total billed charges,38.8% of total billed charges,894.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,999.5,
31575 - DIAG LARYNGOSCOPY FIBERO CHARGE,46031575,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,407.1,325.68,,305.33,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,322.42,79.2,,,percent of total billed charges,79.2% of total billed charges,346.04,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,386.75,95,,,percent of total billed charges,95% of total billed charges,325.68,80,,,percent of total billed charges,80% of total billed charges,346.04,85,,,percent of total billed charges,85% of total billed charges,366.39,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,407.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,366.39,90,,,percent of total billed charges,90% of total billed charges,309.4,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,346.04,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,325.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,346.04,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1196.4,100,,,case rate,pays based on per visit rate,305.33,1196.4,
46922 - ANAL CANAL LESION RMVL CHARGE,46046922,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,936.9,749.52,,702.68,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,742.02,79.2,,,percent of total billed charges,79.2% of total billed charges,796.37,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,890.06,95,,,percent of total billed charges,95% of total billed charges,749.52,80,,,percent of total billed charges,80% of total billed charges,796.37,85,,,percent of total billed charges,85% of total billed charges,843.21,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,936.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,843.21,90,,,percent of total billed charges,90% of total billed charges,712.04,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,796.37,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,749.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,796.37,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"G0127 TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER",46011719,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,69.5,55.6,,52.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,55.04,79.2,,,percent of total billed charges,79.2% of total billed charges,59.08,85,,,percent of total billed charges,85% of total billed charges,69.5,100,,,fee schedule,100% of CO APG rates,66.03,95,,,percent of total billed charges,95% of total billed charges,55.6,80,,,percent of total billed charges,80% of total billed charges,59.08,85,,,percent of total billed charges,85% of total billed charges,62.55,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,69.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,62.55,90,,,percent of total billed charges,90% of total billed charges,52.82,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,59.08,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,55.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,59.08,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,521.2,100,,,case rate,pays based on per visit rate,52.13,521.2,
58100 - ENDOMETRIAL SAMPLING CHARGE,46058100,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,296.2,236.96,,222.15,75,,,percent of total billed charges,75% of total billed charges,118.48,40,,,percent of total billed charges,40% of total billed charges,234.59,79.2,,,percent of total billed charges,79.2% of total billed charges,251.77,85,,,percent of total billed charges,85% of total billed charges,296.2,100,,,fee schedule,100% of CO APG rates,281.39,95,,,percent of total billed charges,95% of total billed charges,236.96,80,,,percent of total billed charges,80% of total billed charges,251.77,85,,,percent of total billed charges,85% of total billed charges,266.58,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,296.2,100,,,fee schedule,100% of NM APC rate,118.48,40,,,percent of total billed charges,40% of total billed charges,118.48,40,,,percent of total billed charges,40% of total billed charges,266.58,90,,,percent of total billed charges,90% of total billed charges,225.11,76,,,percent of total billed charges,76% of total billed charges,118.48,40,,,percent of total billed charges,40% of total billed charges,251.77,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,236.96,80,,,percent of total billed charges,80% of total billed charges,114.93,38.8,,,percent of total billed charges,38.8% of total billed charges,251.77,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,114.93,2713.28,
46040 - INCISION OF RECTAL ABSCES CHARGE,46046040,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1235.5,988.4,,926.63,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,978.52,79.2,,,percent of total billed charges,79.2% of total billed charges,1050.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1173.73,95,,,percent of total billed charges,95% of total billed charges,988.4,80,,,percent of total billed charges,80% of total billed charges,1050.18,85,,,percent of total billed charges,85% of total billed charges,1111.95,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1235.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1111.95,90,,,percent of total billed charges,90% of total billed charges,938.98,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1050.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,988.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1050.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
10080 Incision And Drainage Of Pilonidal Cyst; Simple,46010080,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,819.4,655.52,,614.55,75,,,percent of total billed charges,75% of total billed charges,327.76,40,,,percent of total billed charges,40% of total billed charges,648.96,79.2,,,percent of total billed charges,79.2% of total billed charges,696.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,778.43,95,,,percent of total billed charges,95% of total billed charges,655.52,80,,,percent of total billed charges,80% of total billed charges,696.49,85,,,percent of total billed charges,85% of total billed charges,737.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,327.76,40,,,percent of total billed charges,40% of total billed charges,327.76,40,,,percent of total billed charges,40% of total billed charges,737.46,90,,,percent of total billed charges,90% of total billed charges,622.74,76,,,percent of total billed charges,76% of total billed charges,327.76,40,,,percent of total billed charges,40% of total billed charges,696.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,655.52,80,,,percent of total billed charges,80% of total billed charges,317.93,38.8,,,percent of total billed charges,38.8% of total billed charges,696.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,778.43,
10040 Acne Surgery,46010040,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,338.3,270.64,,253.73,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,267.93,79.2,,,percent of total billed charges,79.2% of total billed charges,287.56,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,321.39,95,,,percent of total billed charges,95% of total billed charges,270.64,80,,,percent of total billed charges,80% of total billed charges,287.56,85,,,percent of total billed charges,85% of total billed charges,304.47,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,338.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,304.47,90,,,percent of total billed charges,90% of total billed charges,257.11,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,287.56,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,270.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,287.56,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1058.8,100,,,case rate,pays based on per visit rate,253.73,1058.8,
21931 - EXC BACK LES SC 3 CM/> CHARGE,46021931,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1327.9,1062.32,,995.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1051.7,79.2,,,percent of total billed charges,79.2% of total billed charges,1128.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1261.51,95,,,percent of total billed charges,95% of total billed charges,1062.32,80,,,percent of total billed charges,80% of total billed charges,1128.72,85,,,percent of total billed charges,85% of total billed charges,1195.11,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1327.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1195.11,90,,,percent of total billed charges,90% of total billed charges,1009.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1128.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1062.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1128.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1327.9,
11981 - INSERT DRUG IMPLANT DEVIC CHARGE,46011981,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,290,232,,217.5,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,229.68,79.2,,,percent of total billed charges,79.2% of total billed charges,246.5,85,,,percent of total billed charges,85% of total billed charges,290,100,,,fee schedule,100% of CO APG rates,275.5,95,,,percent of total billed charges,95% of total billed charges,232,80,,,percent of total billed charges,80% of total billed charges,246.5,85,,,percent of total billed charges,85% of total billed charges,261,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,290,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,261,90,,,percent of total billed charges,90% of total billed charges,220.4,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,246.5,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,232,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,246.5,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,962.2,100,,,case rate,pays based on per visit rate,217.5,962.2,
"24200 Removal Of Foreign Body, Upper Arm Or Elbow Area; Subc",31024200,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,642.1,513.68,,481.58,75,,,percent of total billed charges,75% of total billed charges,256.84,40,,,percent of total billed charges,40% of total billed charges,508.54,79.2,,,percent of total billed charges,79.2% of total billed charges,545.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,610,95,,,percent of total billed charges,95% of total billed charges,513.68,80,,,percent of total billed charges,80% of total billed charges,545.79,85,,,percent of total billed charges,85% of total billed charges,577.89,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,256.84,40,,,percent of total billed charges,40% of total billed charges,256.84,40,,,percent of total billed charges,40% of total billed charges,577.89,90,,,percent of total billed charges,90% of total billed charges,488,76,,,percent of total billed charges,76% of total billed charges,256.84,40,,,percent of total billed charges,40% of total billed charges,545.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,513.68,80,,,percent of total billed charges,80% of total billed charges,249.13,38.8,,,percent of total billed charges,38.8% of total billed charges,545.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,610,
25650 CD FX TX ULNAR STYLOID Charge,31025650,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,963.9,771.12,,722.93,75,,,percent of total billed charges,75% of total billed charges,385.56,40,,,percent of total billed charges,40% of total billed charges,763.41,79.2,,,percent of total billed charges,79.2% of total billed charges,819.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,915.71,95,,,percent of total billed charges,95% of total billed charges,771.12,80,,,percent of total billed charges,80% of total billed charges,819.32,85,,,percent of total billed charges,85% of total billed charges,867.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,385.56,40,,,percent of total billed charges,40% of total billed charges,385.56,40,,,percent of total billed charges,40% of total billed charges,867.51,90,,,percent of total billed charges,90% of total billed charges,732.56,76,,,percent of total billed charges,76% of total billed charges,385.56,40,,,percent of total billed charges,40% of total billed charges,819.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,771.12,80,,,percent of total billed charges,80% of total billed charges,373.99,38.8,,,percent of total billed charges,38.8% of total billed charges,819.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,915.71,
26010 DRAINAGE FING ABSCESS SIM,31026010,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1040.1,832.08,,780.08,75,,,percent of total billed charges,75% of total billed charges,416.04,40,,,percent of total billed charges,40% of total billed charges,823.76,79.2,,,percent of total billed charges,79.2% of total billed charges,884.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,988.1,95,,,percent of total billed charges,95% of total billed charges,832.08,80,,,percent of total billed charges,80% of total billed charges,884.09,85,,,percent of total billed charges,85% of total billed charges,936.09,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,416.04,40,,,percent of total billed charges,40% of total billed charges,416.04,40,,,percent of total billed charges,40% of total billed charges,936.09,90,,,percent of total billed charges,90% of total billed charges,790.48,76,,,percent of total billed charges,76% of total billed charges,416.04,40,,,percent of total billed charges,40% of total billed charges,884.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,832.08,80,,,percent of total billed charges,80% of total billed charges,403.56,38.8,,,percent of total billed charges,38.8% of total billed charges,884.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,988.1,
SUTURE,30530,CDM,270,RC,,,OUTPATIENT,,,15.8,12.64,,11.85,75,,,percent of total billed charges,75% of total billed charges,6.32,40,,,percent of total billed charges,40% of total billed charges,12.51,79.2,,,percent of total billed charges,79.2% of total billed charges,13.43,85,,,percent of total billed charges,85% of total billed charges,15.8,100,,,fee schedule,100% of CO APG rates,15.01,95,,,percent of total billed charges,95% of total billed charges,12.64,80,,,percent of total billed charges,80% of total billed charges,13.43,85,,,percent of total billed charges,85% of total billed charges,14.22,90,,,percent of total billed charges,90% of total billed charges,15.8,100,,,fee schedule,100% of CO APG rates,15.8,100,,,fee schedule,100% of CO APG rates,15.8,100,,,fee schedule,100% of NM fee schedule,6.32,40,,,percent of total billed charges,40% of total billed charges,6.32,40,,,percent of total billed charges,40% of total billed charges,14.22,90,,,percent of total billed charges,90% of total billed charges,12.01,76,,,percent of total billed charges,76% of total billed charges,6.32,40,,,percent of total billed charges,40% of total billed charges,13.43,85,,,percent of total billed charges,85% of total billed charges,15.8,100,,,fee schedule,100% of CO APG rate,12.64,80,,,percent of total billed charges,80% of total billed charges,6.13,38.8,,,percent of total billed charges,38.8% of total billed charges,13.43,85,,,percent of total billed charges,85% of total billed charges,15.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.13,15.8,
27096 - INJECT SACROILIAC JOINT CHARGE,46227096,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,512.2,409.76,,384.15,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,405.66,79.2,,,percent of total billed charges,79.2% of total billed charges,435.37,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,486.59,95,,,percent of total billed charges,95% of total billed charges,409.76,80,,,percent of total billed charges,80% of total billed charges,435.37,85,,,percent of total billed charges,85% of total billed charges,460.98,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,512.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,460.98,90,,,percent of total billed charges,90% of total billed charges,389.27,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,435.37,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,409.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,435.37,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
CDL Physical  UA,49100CDL,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,75.4,60.32,,56.55,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,59.72,79.2,,,percent of total billed charges,79.2% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,75.4,100,,,fee schedule,100% of CO APG rates,71.63,95,,,percent of total billed charges,95% of total billed charges,60.32,80,,,percent of total billed charges,80% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,75.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,67.86,90,,,percent of total billed charges,90% of total billed charges,57.3,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,64.09,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,60.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,64.09,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,533,100,,,case rate,pays based on per visit rate,56.55,533,
26700 CLO TX KNUCKL SNGL W/MANI,31026700,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,981.2,784.96,,735.9,75,,,percent of total billed charges,75% of total billed charges,392.48,40,,,percent of total billed charges,40% of total billed charges,777.11,79.2,,,percent of total billed charges,79.2% of total billed charges,834.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,932.14,95,,,percent of total billed charges,95% of total billed charges,784.96,80,,,percent of total billed charges,80% of total billed charges,834.02,85,,,percent of total billed charges,85% of total billed charges,883.08,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,392.48,40,,,percent of total billed charges,40% of total billed charges,392.48,40,,,percent of total billed charges,40% of total billed charges,883.08,90,,,percent of total billed charges,90% of total billed charges,745.71,76,,,percent of total billed charges,76% of total billed charges,392.48,40,,,percent of total billed charges,40% of total billed charges,834.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,784.96,80,,,percent of total billed charges,80% of total billed charges,380.71,38.8,,,percent of total billed charges,38.8% of total billed charges,834.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,932.14,
26770 CLSD REDUCTN DSLCTED FING,31026770,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,829.3,663.44,,621.98,75,,,percent of total billed charges,75% of total billed charges,331.72,40,,,percent of total billed charges,40% of total billed charges,656.81,79.2,,,percent of total billed charges,79.2% of total billed charges,704.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,787.84,95,,,percent of total billed charges,95% of total billed charges,663.44,80,,,percent of total billed charges,80% of total billed charges,704.91,85,,,percent of total billed charges,85% of total billed charges,746.37,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,331.72,40,,,percent of total billed charges,40% of total billed charges,331.72,40,,,percent of total billed charges,40% of total billed charges,746.37,90,,,percent of total billed charges,90% of total billed charges,630.27,76,,,percent of total billed charges,76% of total billed charges,331.72,40,,,percent of total billed charges,40% of total billed charges,704.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,663.44,80,,,percent of total billed charges,80% of total billed charges,321.77,38.8,,,percent of total billed charges,38.8% of total billed charges,704.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,787.84,
28190 REMOV FB FOOT  SUBCUTAN,31028190,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,708.3,566.64,,531.23,75,,,percent of total billed charges,75% of total billed charges,283.32,40,,,percent of total billed charges,40% of total billed charges,560.97,79.2,,,percent of total billed charges,79.2% of total billed charges,602.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,672.89,95,,,percent of total billed charges,95% of total billed charges,566.64,80,,,percent of total billed charges,80% of total billed charges,602.06,85,,,percent of total billed charges,85% of total billed charges,637.47,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,283.32,40,,,percent of total billed charges,40% of total billed charges,283.32,40,,,percent of total billed charges,40% of total billed charges,637.47,90,,,percent of total billed charges,90% of total billed charges,538.31,76,,,percent of total billed charges,76% of total billed charges,283.32,40,,,percent of total billed charges,40% of total billed charges,602.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,566.64,80,,,percent of total billed charges,80% of total billed charges,274.82,38.8,,,percent of total billed charges,38.8% of total billed charges,602.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,672.89,
"29700 Removal Or Bivalving; Gauntlet, Boot Or Body Cast",31029700,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,179.1,143.28,,134.33,75,,,percent of total billed charges,75% of total billed charges,71.64,40,,,percent of total billed charges,40% of total billed charges,141.85,79.2,,,percent of total billed charges,79.2% of total billed charges,152.24,85,,,percent of total billed charges,85% of total billed charges,179.1,100,,,fee schedule,100% of CO APG rates,170.15,95,,,percent of total billed charges,95% of total billed charges,143.28,80,,,percent of total billed charges,80% of total billed charges,152.24,85,,,percent of total billed charges,85% of total billed charges,161.19,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,179.1,100,,,fee schedule,100% of NM APC rate,71.64,40,,,percent of total billed charges,40% of total billed charges,71.64,40,,,percent of total billed charges,40% of total billed charges,161.19,90,,,percent of total billed charges,90% of total billed charges,136.12,76,,,percent of total billed charges,76% of total billed charges,71.64,40,,,percent of total billed charges,40% of total billed charges,152.24,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,143.28,80,,,percent of total billed charges,80% of total billed charges,69.49,38.8,,,percent of total billed charges,38.8% of total billed charges,152.24,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,69.49,217.66,
46083 INCISION THROMB XT HEMORR,31046083,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,670.8,536.64,,503.1,75,,,percent of total billed charges,75% of total billed charges,268.32,40,,,percent of total billed charges,40% of total billed charges,531.27,79.2,,,percent of total billed charges,79.2% of total billed charges,570.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,637.26,95,,,percent of total billed charges,95% of total billed charges,536.64,80,,,percent of total billed charges,80% of total billed charges,570.18,85,,,percent of total billed charges,85% of total billed charges,603.72,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,268.32,40,,,percent of total billed charges,40% of total billed charges,268.32,40,,,percent of total billed charges,40% of total billed charges,603.72,90,,,percent of total billed charges,90% of total billed charges,509.81,76,,,percent of total billed charges,76% of total billed charges,268.32,40,,,percent of total billed charges,40% of total billed charges,570.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,536.64,80,,,percent of total billed charges,80% of total billed charges,260.27,38.8,,,percent of total billed charges,38.8% of total billed charges,570.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,637.26,
56420 DRAINAGE OF GLAND ABSCESS,31056420,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,561.4,449.12,,421.05,75,,,percent of total billed charges,75% of total billed charges,224.56,40,,,percent of total billed charges,40% of total billed charges,444.63,79.2,,,percent of total billed charges,79.2% of total billed charges,477.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,533.33,95,,,percent of total billed charges,95% of total billed charges,449.12,80,,,percent of total billed charges,80% of total billed charges,477.19,85,,,percent of total billed charges,85% of total billed charges,505.26,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,224.56,40,,,percent of total billed charges,40% of total billed charges,224.56,40,,,percent of total billed charges,40% of total billed charges,505.26,90,,,percent of total billed charges,90% of total billed charges,426.66,76,,,percent of total billed charges,76% of total billed charges,224.56,40,,,percent of total billed charges,40% of total billed charges,477.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,449.12,80,,,percent of total billed charges,80% of total billed charges,217.82,38.8,,,percent of total billed charges,38.8% of total billed charges,477.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,533.33,
"VFC - 90647 Hemophilus influenza b vaccine (Hib), PRP-T conj",90647VFC,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
17000 DESTR LESION Premalign 1st one Clinic Charge,60000019,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,194.3,155.44,,145.73,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,153.89,79.2,,,percent of total billed charges,79.2% of total billed charges,165.16,85,,,percent of total billed charges,85% of total billed charges,194.3,100,,,fee schedule,100% of CO APG rates,184.59,95,,,percent of total billed charges,95% of total billed charges,155.44,80,,,percent of total billed charges,80% of total billed charges,165.16,85,,,percent of total billed charges,85% of total billed charges,174.87,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,194.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,174.87,90,,,percent of total billed charges,90% of total billed charges,147.67,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,165.16,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,155.44,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,165.16,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,770.8,100,,,case rate,pays based on per visit rate,145.73,770.8,
17003 DESTR LESION premalign 2-14 EA Clinic Charge,60000020,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,19.8,15.84,,14.85,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,15.68,79.2,,,percent of total billed charges,79.2% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,19.8,100,,,fee schedule,100% of CO APG rates,18.81,95,,,percent of total billed charges,95% of total billed charges,15.84,80,,,percent of total billed charges,80% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,17.82,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,19.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,17.82,90,,,percent of total billed charges,90% of total billed charges,15.05,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,16.83,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,15.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,16.83,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,421.8,100,,,case rate,pays based on per visit rate,14.85,421.8,
27780 Closed Tx Prox Fibula Clinic Charge,60000061,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,922.7,738.16,,692.03,75,,,percent of total billed charges,75% of total billed charges,369.08,40,,,percent of total billed charges,40% of total billed charges,730.78,79.2,,,percent of total billed charges,79.2% of total billed charges,784.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,876.57,95,,,percent of total billed charges,95% of total billed charges,738.16,80,,,percent of total billed charges,80% of total billed charges,784.3,85,,,percent of total billed charges,85% of total billed charges,830.43,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,369.08,40,,,percent of total billed charges,40% of total billed charges,369.08,40,,,percent of total billed charges,40% of total billed charges,830.43,90,,,percent of total billed charges,90% of total billed charges,701.25,76,,,percent of total billed charges,76% of total billed charges,369.08,40,,,percent of total billed charges,40% of total billed charges,784.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,738.16,80,,,percent of total billed charges,80% of total billed charges,358.01,38.8,,,percent of total billed charges,38.8% of total billed charges,784.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,876.57,
27808 Closed TX ankle FX w/o Man Clinic Charge,60000063,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,980.8,784.64,,735.6,75,,,percent of total billed charges,75% of total billed charges,392.32,40,,,percent of total billed charges,40% of total billed charges,776.79,79.2,,,percent of total billed charges,79.2% of total billed charges,833.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,931.76,95,,,percent of total billed charges,95% of total billed charges,784.64,80,,,percent of total billed charges,80% of total billed charges,833.68,85,,,percent of total billed charges,85% of total billed charges,882.72,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,392.32,40,,,percent of total billed charges,40% of total billed charges,392.32,40,,,percent of total billed charges,40% of total billed charges,882.72,90,,,percent of total billed charges,90% of total billed charges,745.41,76,,,percent of total billed charges,76% of total billed charges,392.32,40,,,percent of total billed charges,40% of total billed charges,833.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,784.64,80,,,percent of total billed charges,80% of total billed charges,380.55,38.8,,,percent of total billed charges,38.8% of total billed charges,833.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,931.76,
51705 Change of Cystostomy tube; simple,60000094,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,303,242.4,,227.25,75,,,percent of total billed charges,75% of total billed charges,121.2,40,,,percent of total billed charges,40% of total billed charges,239.98,79.2,,,percent of total billed charges,79.2% of total billed charges,257.55,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,287.85,95,,,percent of total billed charges,95% of total billed charges,242.4,80,,,percent of total billed charges,80% of total billed charges,257.55,85,,,percent of total billed charges,85% of total billed charges,272.7,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,121.2,40,,,percent of total billed charges,40% of total billed charges,121.2,40,,,percent of total billed charges,40% of total billed charges,272.7,90,,,percent of total billed charges,90% of total billed charges,230.28,76,,,percent of total billed charges,76% of total billed charges,121.2,40,,,percent of total billed charges,40% of total billed charges,257.55,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,242.4,80,,,percent of total billed charges,80% of total billed charges,117.56,38.8,,,percent of total billed charges,38.8% of total billed charges,257.55,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,117.56,287.85,
20526 - INJ OF CARPAL TUNNEL CHARGE,46020526,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,253.3,202.64,,189.98,75,,,percent of total billed charges,75% of total billed charges,101.32,40,,,percent of total billed charges,40% of total billed charges,200.61,79.2,,,percent of total billed charges,79.2% of total billed charges,215.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,240.64,95,,,percent of total billed charges,95% of total billed charges,202.64,80,,,percent of total billed charges,80% of total billed charges,215.31,85,,,percent of total billed charges,85% of total billed charges,227.97,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,101.32,40,,,percent of total billed charges,40% of total billed charges,101.32,40,,,percent of total billed charges,40% of total billed charges,227.97,90,,,percent of total billed charges,90% of total billed charges,192.51,76,,,percent of total billed charges,76% of total billed charges,101.32,40,,,percent of total billed charges,40% of total billed charges,215.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,202.64,80,,,percent of total billed charges,80% of total billed charges,98.28,38.8,,,percent of total billed charges,38.8% of total billed charges,215.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,98.28,240.64,
23500 - CLOSED TREATMENT OF CLAVICULAR FRACTURE W/O MANIPULATION,46023500,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,647.6,518.08,,485.7,75,,,percent of total billed charges,75% of total billed charges,259.04,40,,,percent of total billed charges,40% of total billed charges,512.9,79.2,,,percent of total billed charges,79.2% of total billed charges,550.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,615.22,95,,,percent of total billed charges,95% of total billed charges,518.08,80,,,percent of total billed charges,80% of total billed charges,550.46,85,,,percent of total billed charges,85% of total billed charges,582.84,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,259.04,40,,,percent of total billed charges,40% of total billed charges,259.04,40,,,percent of total billed charges,40% of total billed charges,582.84,90,,,percent of total billed charges,90% of total billed charges,492.18,76,,,percent of total billed charges,76% of total billed charges,259.04,40,,,percent of total billed charges,40% of total billed charges,550.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,518.08,80,,,percent of total billed charges,80% of total billed charges,251.27,38.8,,,percent of total billed charges,38.8% of total billed charges,550.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,615.22,
25560 - CLOSED TREATMENT OF RADIAL SHAFT FRACTURE W/O MANIPULATION,46025560,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,848.4,678.72,,636.3,75,,,percent of total billed charges,75% of total billed charges,339.36,40,,,percent of total billed charges,40% of total billed charges,671.93,79.2,,,percent of total billed charges,79.2% of total billed charges,721.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,805.98,95,,,percent of total billed charges,95% of total billed charges,678.72,80,,,percent of total billed charges,80% of total billed charges,721.14,85,,,percent of total billed charges,85% of total billed charges,763.56,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,339.36,40,,,percent of total billed charges,40% of total billed charges,339.36,40,,,percent of total billed charges,40% of total billed charges,763.56,90,,,percent of total billed charges,90% of total billed charges,644.78,76,,,percent of total billed charges,76% of total billed charges,339.36,40,,,percent of total billed charges,40% of total billed charges,721.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,678.72,80,,,percent of total billed charges,80% of total billed charges,329.18,38.8,,,percent of total billed charges,38.8% of total billed charges,721.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,805.98,
90633 VAQTA,49190633,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,238.3,190.64,,178.73,75,,,percent of total billed charges,75% of total billed charges,95.32,40,,,percent of total billed charges,40% of total billed charges,188.73,79.2,,,percent of total billed charges,79.2% of total billed charges,202.56,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,226.39,95,,,percent of total billed charges,95% of total billed charges,190.64,80,,,percent of total billed charges,80% of total billed charges,202.56,85,,,percent of total billed charges,85% of total billed charges,214.47,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,238.3,100,,,fee schedule,100% of NM fee schedule,95.32,40,,,percent of total billed charges,40% of total billed charges,95.32,40,,,percent of total billed charges,40% of total billed charges,214.47,90,,,percent of total billed charges,90% of total billed charges,181.11,76,,,percent of total billed charges,76% of total billed charges,95.32,40,,,percent of total billed charges,40% of total billed charges,202.56,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,190.64,80,,,percent of total billed charges,80% of total billed charges,92.46,38.8,,,percent of total billed charges,38.8% of total billed charges,202.56,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,238.3,
ADHESIVE DERMABOND 0.5ML,51165,CDM,270,RC,,,OUTPATIENT,,,71.4,57.12,,53.55,75,,,percent of total billed charges,75% of total billed charges,28.56,40,,,percent of total billed charges,40% of total billed charges,56.55,79.2,,,percent of total billed charges,79.2% of total billed charges,60.69,85,,,percent of total billed charges,85% of total billed charges,71.4,100,,,fee schedule,100% of CO APG rates,67.83,95,,,percent of total billed charges,95% of total billed charges,57.12,80,,,percent of total billed charges,80% of total billed charges,60.69,85,,,percent of total billed charges,85% of total billed charges,64.26,90,,,percent of total billed charges,90% of total billed charges,71.4,100,,,fee schedule,100% of CO APG rates,71.4,100,,,fee schedule,100% of CO APG rates,71.4,100,,,fee schedule,100% of NM fee schedule,28.56,40,,,percent of total billed charges,40% of total billed charges,28.56,40,,,percent of total billed charges,40% of total billed charges,64.26,90,,,percent of total billed charges,90% of total billed charges,54.26,76,,,percent of total billed charges,76% of total billed charges,28.56,40,,,percent of total billed charges,40% of total billed charges,60.69,85,,,percent of total billed charges,85% of total billed charges,71.4,100,,,fee schedule,100% of CO APG rate,57.12,80,,,percent of total billed charges,80% of total billed charges,27.7,38.8,,,percent of total billed charges,38.8% of total billed charges,60.69,85,,,percent of total billed charges,85% of total billed charges,71.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,27.7,71.4,
"ANTI-EMBOLISM STOCKING, THIGH  LG REG",52876,CDM,270,RC,,,OUTPATIENT,,,21,16.8,,15.75,75,,,percent of total billed charges,75% of total billed charges,8.4,40,,,percent of total billed charges,40% of total billed charges,16.63,79.2,,,percent of total billed charges,79.2% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,21,100,,,fee schedule,100% of CO APG rates,19.95,95,,,percent of total billed charges,95% of total billed charges,16.8,80,,,percent of total billed charges,80% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,18.9,90,,,percent of total billed charges,90% of total billed charges,21,100,,,fee schedule,100% of CO APG rates,21,100,,,fee schedule,100% of CO APG rates,21,100,,,fee schedule,100% of NM fee schedule,8.4,40,,,percent of total billed charges,40% of total billed charges,8.4,40,,,percent of total billed charges,40% of total billed charges,18.9,90,,,percent of total billed charges,90% of total billed charges,15.96,76,,,percent of total billed charges,76% of total billed charges,8.4,40,,,percent of total billed charges,40% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,21,100,,,fee schedule,100% of CO APG rate,16.8,80,,,percent of total billed charges,80% of total billed charges,8.15,38.8,,,percent of total billed charges,38.8% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,21,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.15,21,
26160 - EXCISION OF LESION OF TENDON SHEATH OR JOINT CAPSULE,46026160,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,812,649.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
VFC - 90632,79190632,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
"J1725 Injection, hydroxyprogesterone caproate, 1mg",49100062,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,29.7,23.76,,22.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,23.52,79.2,,,percent of total billed charges,79.2% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,29.7,100,,,fee schedule,100% of CO APG rates,28.22,95,,,percent of total billed charges,95% of total billed charges,23.76,80,,,percent of total billed charges,80% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,26.73,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,29.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,26.73,90,,,percent of total billed charges,90% of total billed charges,22.57,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,25.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,23.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,25.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,441.6,100,,,case rate,pays based on per visit rate,22.28,441.6,
97597 Active Wound Care 2 cm< Clinic Charge,60000115,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,468.1,374.48,,351.08,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,370.74,79.2,,,percent of total billed charges,79.2% of total billed charges,397.89,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,444.7,95,,,percent of total billed charges,95% of total billed charges,374.48,80,,,percent of total billed charges,80% of total billed charges,397.89,85,,,percent of total billed charges,85% of total billed charges,421.29,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,468.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,421.29,90,,,percent of total billed charges,90% of total billed charges,355.76,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,397.89,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,374.48,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,397.89,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Z0750-WC Initial Report,10137693,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,62.9,50.32,,47.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,49.82,79.2,,,percent of total billed charges,79.2% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,62.9,100,,,fee schedule,100% of CO APG rates,59.76,95,,,percent of total billed charges,95% of total billed charges,50.32,80,,,percent of total billed charges,80% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,56.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,62.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,56.61,90,,,percent of total billed charges,90% of total billed charges,47.8,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,53.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,50.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,53.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,508,100,,,case rate,pays based on per visit rate,47.18,508,
Z0751-WC Progress Report,10137709,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,62.9,50.32,,47.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,49.82,79.2,,,percent of total billed charges,79.2% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,62.9,100,,,fee schedule,100% of CO APG rates,59.76,95,,,percent of total billed charges,95% of total billed charges,50.32,80,,,percent of total billed charges,80% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,56.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,62.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,56.61,90,,,percent of total billed charges,90% of total billed charges,47.8,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,53.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,50.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,53.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,508,100,,,case rate,pays based on per visit rate,47.18,508,
Z0752-WC Closing Report,10137710,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,62.9,50.32,,47.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,49.82,79.2,,,percent of total billed charges,79.2% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,62.9,100,,,fee schedule,100% of CO APG rates,59.76,95,,,percent of total billed charges,95% of total billed charges,50.32,80,,,percent of total billed charges,80% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,56.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,62.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,56.61,90,,,percent of total billed charges,90% of total billed charges,47.8,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,53.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,50.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,53.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,508,100,,,case rate,pays based on per visit rate,47.18,508,
Z0753-WC Initial  Closing Report Same Day,10137711,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,62.9,50.32,,47.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,49.82,79.2,,,percent of total billed charges,79.2% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,62.9,100,,,fee schedule,100% of CO APG rates,59.76,95,,,percent of total billed charges,95% of total billed charges,50.32,80,,,percent of total billed charges,80% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,56.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,62.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,56.61,90,,,percent of total billed charges,90% of total billed charges,47.8,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,53.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,50.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,53.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,508,100,,,case rate,pays based on per visit rate,47.18,508,
23570 Closed Treatment Of Scapular Fracture; Without Manipul,60000031,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,684.1,547.28,,513.08,75,,,percent of total billed charges,75% of total billed charges,273.64,40,,,percent of total billed charges,40% of total billed charges,541.81,79.2,,,percent of total billed charges,79.2% of total billed charges,581.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,649.9,95,,,percent of total billed charges,95% of total billed charges,547.28,80,,,percent of total billed charges,80% of total billed charges,581.49,85,,,percent of total billed charges,85% of total billed charges,615.69,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,273.64,40,,,percent of total billed charges,40% of total billed charges,273.64,40,,,percent of total billed charges,40% of total billed charges,615.69,90,,,percent of total billed charges,90% of total billed charges,519.92,76,,,percent of total billed charges,76% of total billed charges,273.64,40,,,percent of total billed charges,40% of total billed charges,581.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,547.28,80,,,percent of total billed charges,80% of total billed charges,265.43,38.8,,,percent of total billed charges,38.8% of total billed charges,581.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,649.9,
"10140 Incision And Drainage Of Hematoma, Seroma Or Fluid Col",60000007,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,494.1,395.28,,370.58,75,,,percent of total billed charges,75% of total billed charges,197.64,40,,,percent of total billed charges,40% of total billed charges,391.33,79.2,,,percent of total billed charges,79.2% of total billed charges,419.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,469.4,95,,,percent of total billed charges,95% of total billed charges,395.28,80,,,percent of total billed charges,80% of total billed charges,419.99,85,,,percent of total billed charges,85% of total billed charges,444.69,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,197.64,40,,,percent of total billed charges,40% of total billed charges,197.64,40,,,percent of total billed charges,40% of total billed charges,444.69,90,,,percent of total billed charges,90% of total billed charges,375.52,76,,,percent of total billed charges,76% of total billed charges,197.64,40,,,percent of total billed charges,40% of total billed charges,419.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,395.28,80,,,percent of total billed charges,80% of total billed charges,191.71,38.8,,,percent of total billed charges,38.8% of total billed charges,419.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,469.4,
20612 ASP/INJ GANGLION CYST,60000026,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,184.2,147.36,,138.15,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,145.89,79.2,,,percent of total billed charges,79.2% of total billed charges,156.57,85,,,percent of total billed charges,85% of total billed charges,184.2,100,,,fee schedule,100% of CO APG rates,174.99,95,,,percent of total billed charges,95% of total billed charges,147.36,80,,,percent of total billed charges,80% of total billed charges,156.57,85,,,percent of total billed charges,85% of total billed charges,165.78,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,184.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,165.78,90,,,percent of total billed charges,90% of total billed charges,139.99,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,156.57,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,147.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,156.57,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,750.6,100,,,case rate,pays based on per visit rate,138.15,750.6,
25500 Closed Treatment Of Radial Shaft Fracture; Without Man,60000042,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,831.7,665.36,,623.78,75,,,percent of total billed charges,75% of total billed charges,332.68,40,,,percent of total billed charges,40% of total billed charges,658.71,79.2,,,percent of total billed charges,79.2% of total billed charges,706.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,790.12,95,,,percent of total billed charges,95% of total billed charges,665.36,80,,,percent of total billed charges,80% of total billed charges,706.95,85,,,percent of total billed charges,85% of total billed charges,748.53,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,332.68,40,,,percent of total billed charges,40% of total billed charges,332.68,40,,,percent of total billed charges,40% of total billed charges,748.53,90,,,percent of total billed charges,90% of total billed charges,632.09,76,,,percent of total billed charges,76% of total billed charges,332.68,40,,,percent of total billed charges,40% of total billed charges,706.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,665.36,80,,,percent of total billed charges,80% of total billed charges,322.7,38.8,,,percent of total billed charges,38.8% of total billed charges,706.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,790.12,
29515 Application Of Short Leg Splint,60000072,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,201.8,161.44,,151.35,75,,,percent of total billed charges,75% of total billed charges,80.72,40,,,percent of total billed charges,40% of total billed charges,159.83,79.2,,,percent of total billed charges,79.2% of total billed charges,171.53,85,,,percent of total billed charges,85% of total billed charges,201.8,100,,,fee schedule,100% of CO APG rates,191.71,95,,,percent of total billed charges,95% of total billed charges,161.44,80,,,percent of total billed charges,80% of total billed charges,171.53,85,,,percent of total billed charges,85% of total billed charges,181.62,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,80.72,40,,,percent of total billed charges,40% of total billed charges,80.72,40,,,percent of total billed charges,40% of total billed charges,181.62,90,,,percent of total billed charges,90% of total billed charges,153.37,76,,,percent of total billed charges,76% of total billed charges,80.72,40,,,percent of total billed charges,40% of total billed charges,171.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,161.44,80,,,percent of total billed charges,80% of total billed charges,78.3,38.8,,,percent of total billed charges,38.8% of total billed charges,171.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,78.3,217.66,
29425 Application Of Short Leg Cast Walking,60000070,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,213.7,170.96,,160.28,75,,,percent of total billed charges,75% of total billed charges,85.48,40,,,percent of total billed charges,40% of total billed charges,169.25,79.2,,,percent of total billed charges,79.2% of total billed charges,181.65,85,,,percent of total billed charges,85% of total billed charges,213.7,100,,,fee schedule,100% of CO APG rates,203.02,95,,,percent of total billed charges,95% of total billed charges,170.96,80,,,percent of total billed charges,80% of total billed charges,181.65,85,,,percent of total billed charges,85% of total billed charges,192.33,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,85.48,40,,,percent of total billed charges,40% of total billed charges,85.48,40,,,percent of total billed charges,40% of total billed charges,192.33,90,,,percent of total billed charges,90% of total billed charges,162.41,76,,,percent of total billed charges,76% of total billed charges,85.48,40,,,percent of total billed charges,40% of total billed charges,181.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,170.96,80,,,percent of total billed charges,80% of total billed charges,82.92,38.8,,,percent of total billed charges,38.8% of total billed charges,181.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,82.92,217.66,
57460 LEEP,60000107,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,932.1,745.68,,699.08,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,738.22,79.2,,,percent of total billed charges,79.2% of total billed charges,792.29,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,885.5,95,,,percent of total billed charges,95% of total billed charges,745.68,80,,,percent of total billed charges,80% of total billed charges,792.29,85,,,percent of total billed charges,85% of total billed charges,838.89,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,932.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,838.89,90,,,percent of total billed charges,90% of total billed charges,708.4,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,792.29,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,745.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,792.29,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
57522 LEEP WITH LOOP ELECTRODE EXCISION,60000110,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,879.2,703.36,,659.4,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,696.33,79.2,,,percent of total billed charges,79.2% of total billed charges,747.32,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,835.24,95,,,percent of total billed charges,95% of total billed charges,703.36,80,,,percent of total billed charges,80% of total billed charges,747.32,85,,,percent of total billed charges,85% of total billed charges,791.28,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,879.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,791.28,90,,,percent of total billed charges,90% of total billed charges,668.19,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,747.32,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,703.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,747.32,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
27750 Fx Tibia Shaft W/O Manipulation,60000004,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1011.8,809.44,,758.85,75,,,percent of total billed charges,75% of total billed charges,404.72,40,,,percent of total billed charges,40% of total billed charges,801.35,79.2,,,percent of total billed charges,79.2% of total billed charges,860.03,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,961.21,95,,,percent of total billed charges,95% of total billed charges,809.44,80,,,percent of total billed charges,80% of total billed charges,860.03,85,,,percent of total billed charges,85% of total billed charges,910.62,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,404.72,40,,,percent of total billed charges,40% of total billed charges,404.72,40,,,percent of total billed charges,40% of total billed charges,910.62,90,,,percent of total billed charges,90% of total billed charges,768.97,76,,,percent of total billed charges,76% of total billed charges,404.72,40,,,percent of total billed charges,40% of total billed charges,860.03,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,809.44,80,,,percent of total billed charges,80% of total billed charges,392.58,38.8,,,percent of total billed charges,38.8% of total billed charges,860.03,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,961.21,
27810 Fx Bimalleolar W/ Manip,60000064,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1364.4,1091.52,,1023.3,75,,,percent of total billed charges,75% of total billed charges,545.76,40,,,percent of total billed charges,40% of total billed charges,1080.6,79.2,,,percent of total billed charges,79.2% of total billed charges,1159.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1296.18,95,,,percent of total billed charges,95% of total billed charges,1091.52,80,,,percent of total billed charges,80% of total billed charges,1159.74,85,,,percent of total billed charges,85% of total billed charges,1227.96,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,545.76,40,,,percent of total billed charges,40% of total billed charges,545.76,40,,,percent of total billed charges,40% of total billed charges,1227.96,90,,,percent of total billed charges,90% of total billed charges,1036.94,76,,,percent of total billed charges,76% of total billed charges,545.76,40,,,percent of total billed charges,40% of total billed charges,1159.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1091.52,80,,,percent of total billed charges,80% of total billed charges,529.39,38.8,,,percent of total billed charges,38.8% of total billed charges,1159.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1296.18,
"28039 Exc Tumor, Soft Tissue Foot,Toe; 1.5Cm",60000065,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1408.4,1126.72,,1056.3,75,,,percent of total billed charges,75% of total billed charges,563.36,40,,,percent of total billed charges,40% of total billed charges,1115.45,79.2,,,percent of total billed charges,79.2% of total billed charges,1197.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1337.98,95,,,percent of total billed charges,95% of total billed charges,1126.72,80,,,percent of total billed charges,80% of total billed charges,1197.14,85,,,percent of total billed charges,85% of total billed charges,1267.56,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,563.36,40,,,percent of total billed charges,40% of total billed charges,563.36,40,,,percent of total billed charges,40% of total billed charges,1267.56,90,,,percent of total billed charges,90% of total billed charges,1070.38,76,,,percent of total billed charges,76% of total billed charges,563.36,40,,,percent of total billed charges,40% of total billed charges,1197.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1126.72,80,,,percent of total billed charges,80% of total billed charges,546.46,38.8,,,percent of total billed charges,38.8% of total billed charges,1197.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1337.98,
10021 Fine needle aspiration; without imaging,60000005,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,299.8,239.84,,224.85,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,237.44,79.2,,,percent of total billed charges,79.2% of total billed charges,254.83,85,,,percent of total billed charges,85% of total billed charges,299.8,100,,,fee schedule,100% of CO APG rates,284.81,95,,,percent of total billed charges,95% of total billed charges,239.84,80,,,percent of total billed charges,80% of total billed charges,254.83,85,,,percent of total billed charges,85% of total billed charges,269.82,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,299.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,269.82,90,,,percent of total billed charges,90% of total billed charges,227.85,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,254.83,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,239.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,254.83,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,981.8,100,,,case rate,pays based on per visit rate,224.85,981.8,
"Repair, intermediate, wounds of neck, hands, feet and/or ext",60000017,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,905.5,724.4,,679.13,75,,,percent of total billed charges,75% of total billed charges,362.2,40,,,percent of total billed charges,40% of total billed charges,717.16,79.2,,,percent of total billed charges,79.2% of total billed charges,769.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,860.23,95,,,percent of total billed charges,95% of total billed charges,724.4,80,,,percent of total billed charges,80% of total billed charges,769.68,85,,,percent of total billed charges,85% of total billed charges,814.95,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,362.2,40,,,percent of total billed charges,40% of total billed charges,362.2,40,,,percent of total billed charges,40% of total billed charges,814.95,90,,,percent of total billed charges,90% of total billed charges,688.18,76,,,percent of total billed charges,76% of total billed charges,362.2,40,,,percent of total billed charges,40% of total billed charges,769.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,724.4,80,,,percent of total billed charges,80% of total billed charges,351.33,38.8,,,percent of total billed charges,38.8% of total billed charges,769.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,860.23,
24650 CLOSED TREATMENT OF RADIAL NECK OR HEAD.,60000041,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,770.9,616.72,,578.18,75,,,percent of total billed charges,75% of total billed charges,308.36,40,,,percent of total billed charges,40% of total billed charges,610.55,79.2,,,percent of total billed charges,79.2% of total billed charges,655.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,732.36,95,,,percent of total billed charges,95% of total billed charges,616.72,80,,,percent of total billed charges,80% of total billed charges,655.27,85,,,percent of total billed charges,85% of total billed charges,693.81,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,308.36,40,,,percent of total billed charges,40% of total billed charges,308.36,40,,,percent of total billed charges,40% of total billed charges,693.81,90,,,percent of total billed charges,90% of total billed charges,585.88,76,,,percent of total billed charges,76% of total billed charges,308.36,40,,,percent of total billed charges,40% of total billed charges,655.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,616.72,80,,,percent of total billed charges,80% of total billed charges,299.11,38.8,,,percent of total billed charges,38.8% of total billed charges,655.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,732.36,
26115 EXCISION TUMOR OR VASCULAR MALFORMATION.,60000048,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1619,1295.2,,1214.25,75,,,percent of total billed charges,75% of total billed charges,647.6,40,,,percent of total billed charges,40% of total billed charges,1282.25,79.2,,,percent of total billed charges,79.2% of total billed charges,1376.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1538.05,95,,,percent of total billed charges,95% of total billed charges,1295.2,80,,,percent of total billed charges,80% of total billed charges,1376.15,85,,,percent of total billed charges,85% of total billed charges,1457.1,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,647.6,40,,,percent of total billed charges,40% of total billed charges,647.6,40,,,percent of total billed charges,40% of total billed charges,1457.1,90,,,percent of total billed charges,90% of total billed charges,1230.44,76,,,percent of total billed charges,76% of total billed charges,647.6,40,,,percent of total billed charges,40% of total billed charges,1376.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1295.2,80,,,percent of total billed charges,80% of total billed charges,628.17,38.8,,,percent of total billed charges,38.8% of total billed charges,1376.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1538.05,
"26341 - Manipulation, plamar fascial",60000975,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,241.7,193.36,,181.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,191.43,79.2,,,percent of total billed charges,79.2% of total billed charges,205.45,85,,,percent of total billed charges,85% of total billed charges,241.7,100,,,fee schedule,100% of CO APG rates,229.62,95,,,percent of total billed charges,95% of total billed charges,193.36,80,,,percent of total billed charges,80% of total billed charges,205.45,85,,,percent of total billed charges,85% of total billed charges,217.53,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,241.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,217.53,90,,,percent of total billed charges,90% of total billed charges,183.69,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,205.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,193.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,205.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,865.6,100,,,case rate,pays based on per visit rate,181.28,865.6,
26600 CLOSED METACARPAL FX ONE BONE.,60000049,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,880.6,704.48,,660.45,75,,,percent of total billed charges,75% of total billed charges,352.24,40,,,percent of total billed charges,40% of total billed charges,697.44,79.2,,,percent of total billed charges,79.2% of total billed charges,748.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,836.57,95,,,percent of total billed charges,95% of total billed charges,704.48,80,,,percent of total billed charges,80% of total billed charges,748.51,85,,,percent of total billed charges,85% of total billed charges,792.54,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,352.24,40,,,percent of total billed charges,40% of total billed charges,352.24,40,,,percent of total billed charges,40% of total billed charges,792.54,90,,,percent of total billed charges,90% of total billed charges,669.26,76,,,percent of total billed charges,76% of total billed charges,352.24,40,,,percent of total billed charges,40% of total billed charges,748.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,704.48,80,,,percent of total billed charges,80% of total billed charges,341.67,38.8,,,percent of total billed charges,38.8% of total billed charges,748.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,836.57,
26605 CLOSED TREATMENT OF METACARPAL FRACTURE.,60000050,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,968,774.4,,726,75,,,percent of total billed charges,75% of total billed charges,387.2,40,,,percent of total billed charges,40% of total billed charges,766.66,79.2,,,percent of total billed charges,79.2% of total billed charges,822.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,919.6,95,,,percent of total billed charges,95% of total billed charges,774.4,80,,,percent of total billed charges,80% of total billed charges,822.8,85,,,percent of total billed charges,85% of total billed charges,871.2,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,387.2,40,,,percent of total billed charges,40% of total billed charges,387.2,40,,,percent of total billed charges,40% of total billed charges,871.2,90,,,percent of total billed charges,90% of total billed charges,735.68,76,,,percent of total billed charges,76% of total billed charges,387.2,40,,,percent of total billed charges,40% of total billed charges,822.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,774.4,80,,,percent of total billed charges,80% of total billed charges,375.58,38.8,,,percent of total billed charges,38.8% of total billed charges,822.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,919.6,
26750 CLOSED TREATMENT OF DISTAL PHALAGEAL FRA.,60000056,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,545.7,436.56,,409.28,75,,,percent of total billed charges,75% of total billed charges,218.28,40,,,percent of total billed charges,40% of total billed charges,432.19,79.2,,,percent of total billed charges,79.2% of total billed charges,463.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,518.42,95,,,percent of total billed charges,95% of total billed charges,436.56,80,,,percent of total billed charges,80% of total billed charges,463.85,85,,,percent of total billed charges,85% of total billed charges,491.13,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,218.28,40,,,percent of total billed charges,40% of total billed charges,218.28,40,,,percent of total billed charges,40% of total billed charges,491.13,90,,,percent of total billed charges,90% of total billed charges,414.73,76,,,percent of total billed charges,76% of total billed charges,218.28,40,,,percent of total billed charges,40% of total billed charges,463.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,436.56,80,,,percent of total billed charges,80% of total billed charges,211.73,38.8,,,percent of total billed charges,38.8% of total billed charges,463.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,518.42,
27786 CLOSED TREATMENT OF DISTAL FIBULAR FRACT.,60000062,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,917.2,733.76,,687.9,75,,,percent of total billed charges,75% of total billed charges,366.88,40,,,percent of total billed charges,40% of total billed charges,726.42,79.2,,,percent of total billed charges,79.2% of total billed charges,779.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,871.34,95,,,percent of total billed charges,95% of total billed charges,733.76,80,,,percent of total billed charges,80% of total billed charges,779.62,85,,,percent of total billed charges,85% of total billed charges,825.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,366.88,40,,,percent of total billed charges,40% of total billed charges,366.88,40,,,percent of total billed charges,40% of total billed charges,825.48,90,,,percent of total billed charges,90% of total billed charges,697.07,76,,,percent of total billed charges,76% of total billed charges,366.88,40,,,percent of total billed charges,40% of total billed charges,779.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,733.76,80,,,percent of total billed charges,80% of total billed charges,355.87,38.8,,,percent of total billed charges,38.8% of total billed charges,779.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,871.34,
28470 CLOSED TREATMENT OF METATARSAL FRACTURE.,60000066,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,633.9,507.12,,475.43,75,,,percent of total billed charges,75% of total billed charges,253.56,40,,,percent of total billed charges,40% of total billed charges,502.05,79.2,,,percent of total billed charges,79.2% of total billed charges,538.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,602.21,95,,,percent of total billed charges,95% of total billed charges,507.12,80,,,percent of total billed charges,80% of total billed charges,538.82,85,,,percent of total billed charges,85% of total billed charges,570.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,253.56,40,,,percent of total billed charges,40% of total billed charges,253.56,40,,,percent of total billed charges,40% of total billed charges,570.51,90,,,percent of total billed charges,90% of total billed charges,481.76,76,,,percent of total billed charges,76% of total billed charges,253.56,40,,,percent of total billed charges,40% of total billed charges,538.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,507.12,80,,,percent of total billed charges,80% of total billed charges,245.95,38.8,,,percent of total billed charges,38.8% of total billed charges,538.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,602.21,
28490 CLTX FX GRT TOE PHLY PHLG W/O MNPJ.,60000068,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,410.1,328.08,,307.58,75,,,percent of total billed charges,75% of total billed charges,164.04,40,,,percent of total billed charges,40% of total billed charges,324.8,79.2,,,percent of total billed charges,79.2% of total billed charges,348.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,389.6,95,,,percent of total billed charges,95% of total billed charges,328.08,80,,,percent of total billed charges,80% of total billed charges,348.59,85,,,percent of total billed charges,85% of total billed charges,369.09,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,164.04,40,,,percent of total billed charges,40% of total billed charges,164.04,40,,,percent of total billed charges,40% of total billed charges,369.09,90,,,percent of total billed charges,90% of total billed charges,311.68,76,,,percent of total billed charges,76% of total billed charges,164.04,40,,,percent of total billed charges,40% of total billed charges,348.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,328.08,80,,,percent of total billed charges,80% of total billed charges,159.12,38.8,,,percent of total billed charges,38.8% of total billed charges,348.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,159.12,389.6,
"28515 Cl Tx Fx phalanx, phalanges w/ manip",60000470,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,482.3,385.84,,361.73,75,,,percent of total billed charges,75% of total billed charges,192.92,40,,,percent of total billed charges,40% of total billed charges,381.98,79.2,,,percent of total billed charges,79.2% of total billed charges,409.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,458.19,95,,,percent of total billed charges,95% of total billed charges,385.84,80,,,percent of total billed charges,80% of total billed charges,409.96,85,,,percent of total billed charges,85% of total billed charges,434.07,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,192.92,40,,,percent of total billed charges,40% of total billed charges,192.92,40,,,percent of total billed charges,40% of total billed charges,434.07,90,,,percent of total billed charges,90% of total billed charges,366.55,76,,,percent of total billed charges,76% of total billed charges,192.92,40,,,percent of total billed charges,40% of total billed charges,409.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,385.84,80,,,percent of total billed charges,80% of total billed charges,187.13,38.8,,,percent of total billed charges,38.8% of total billed charges,409.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,458.19,
"46320 EXC OF THROMBOSED HEMORRHOID, EXTERNAL.",60000090,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,630.9,504.72,,473.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,499.67,79.2,,,percent of total billed charges,79.2% of total billed charges,536.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,599.36,95,,,percent of total billed charges,95% of total billed charges,504.72,80,,,percent of total billed charges,80% of total billed charges,536.27,85,,,percent of total billed charges,85% of total billed charges,567.81,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,630.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,567.81,90,,,percent of total billed charges,90% of total billed charges,479.48,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,536.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,504.72,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,536.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
46600 ANOSCOPE/EXPLORATION.,60000091,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,360.9,288.72,,270.68,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,285.83,79.2,,,percent of total billed charges,79.2% of total billed charges,306.77,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,342.86,95,,,percent of total billed charges,95% of total billed charges,288.72,80,,,percent of total billed charges,80% of total billed charges,306.77,85,,,percent of total billed charges,85% of total billed charges,324.81,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,360.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,324.81,90,,,percent of total billed charges,90% of total billed charges,274.28,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,306.77,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,288.72,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,306.77,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1104,100,,,case rate,pays based on per visit rate,270.68,1104,
"54065 DEST LESION, PENIS, EXTENSIVE.",60000096,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,637,509.6,,477.75,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,504.5,79.2,,,percent of total billed charges,79.2% of total billed charges,541.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,605.15,95,,,percent of total billed charges,95% of total billed charges,509.6,80,,,percent of total billed charges,80% of total billed charges,541.45,85,,,percent of total billed charges,85% of total billed charges,573.3,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,637,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,573.3,90,,,percent of total billed charges,90% of total billed charges,484.12,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,541.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,509.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,541.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
54150 CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK.,60000097,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,426.7,341.36,,320.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,337.95,79.2,,,percent of total billed charges,79.2% of total billed charges,362.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,405.37,95,,,percent of total billed charges,95% of total billed charges,341.36,80,,,percent of total billed charges,80% of total billed charges,362.7,85,,,percent of total billed charges,85% of total billed charges,384.03,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,426.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,384.03,90,,,percent of total billed charges,90% of total billed charges,324.29,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,362.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,341.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,362.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1235.6,100,,,case rate,pays based on per visit rate,320.03,1235.6,
"24560 Closed Treatment Of Humeral Epicondylar Fracture, Medi",60000039,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,992.3,793.84,,744.23,75,,,percent of total billed charges,75% of total billed charges,396.92,40,,,percent of total billed charges,40% of total billed charges,785.9,79.2,,,percent of total billed charges,79.2% of total billed charges,843.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,942.69,95,,,percent of total billed charges,95% of total billed charges,793.84,80,,,percent of total billed charges,80% of total billed charges,843.46,85,,,percent of total billed charges,85% of total billed charges,893.07,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,396.92,40,,,percent of total billed charges,40% of total billed charges,396.92,40,,,percent of total billed charges,40% of total billed charges,893.07,90,,,percent of total billed charges,90% of total billed charges,754.15,76,,,percent of total billed charges,76% of total billed charges,396.92,40,,,percent of total billed charges,40% of total billed charges,843.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,793.84,80,,,percent of total billed charges,80% of total billed charges,385.01,38.8,,,percent of total billed charges,38.8% of total billed charges,843.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,942.69,
23600 Closed Treatment Of Proximal Humeral Fracture; Without,60000032,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,993.2,794.56,,744.9,75,,,percent of total billed charges,75% of total billed charges,397.28,40,,,percent of total billed charges,40% of total billed charges,786.61,79.2,,,percent of total billed charges,79.2% of total billed charges,844.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,943.54,95,,,percent of total billed charges,95% of total billed charges,794.56,80,,,percent of total billed charges,80% of total billed charges,844.22,85,,,percent of total billed charges,85% of total billed charges,893.88,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,397.28,40,,,percent of total billed charges,40% of total billed charges,397.28,40,,,percent of total billed charges,40% of total billed charges,893.88,90,,,percent of total billed charges,90% of total billed charges,754.83,76,,,percent of total billed charges,76% of total billed charges,397.28,40,,,percent of total billed charges,40% of total billed charges,844.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,794.56,80,,,percent of total billed charges,80% of total billed charges,385.36,38.8,,,percent of total billed charges,38.8% of total billed charges,844.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,943.54,
"Hepatitis A Vaccine, Adult",49190632,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,135.7,108.56,,101.78,75,,,percent of total billed charges,75% of total billed charges,54.28,40,,,percent of total billed charges,40% of total billed charges,107.47,79.2,,,percent of total billed charges,79.2% of total billed charges,115.35,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,128.92,95,,,percent of total billed charges,95% of total billed charges,108.56,80,,,percent of total billed charges,80% of total billed charges,115.35,85,,,percent of total billed charges,85% of total billed charges,122.13,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,135.7,100,,,fee schedule,100% of NM fee schedule,54.28,40,,,percent of total billed charges,40% of total billed charges,54.28,40,,,percent of total billed charges,40% of total billed charges,122.13,90,,,percent of total billed charges,90% of total billed charges,103.13,76,,,percent of total billed charges,76% of total billed charges,54.28,40,,,percent of total billed charges,40% of total billed charges,115.35,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,108.56,80,,,percent of total billed charges,80% of total billed charges,52.65,38.8,,,percent of total billed charges,38.8% of total billed charges,115.35,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,135.7,
64788 - EXCISION OF NEUROFIBROMA CHARGE,46064788,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1151.1,920.88,,863.33,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,911.67,79.2,,,percent of total billed charges,79.2% of total billed charges,978.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1093.55,95,,,percent of total billed charges,95% of total billed charges,920.88,80,,,percent of total billed charges,80% of total billed charges,978.44,85,,,percent of total billed charges,85% of total billed charges,1035.99,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1151.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1035.99,90,,,percent of total billed charges,90% of total billed charges,874.84,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,978.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,920.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,978.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
25600 - CLOSED TX OF DISTAL RADIAL FX; W/O MANIPULATION CHAR,46025600,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,991.4,793.12,,743.55,75,,,percent of total billed charges,75% of total billed charges,396.56,40,,,percent of total billed charges,40% of total billed charges,785.19,79.2,,,percent of total billed charges,79.2% of total billed charges,842.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,941.83,95,,,percent of total billed charges,95% of total billed charges,793.12,80,,,percent of total billed charges,80% of total billed charges,842.69,85,,,percent of total billed charges,85% of total billed charges,892.26,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,396.56,40,,,percent of total billed charges,40% of total billed charges,396.56,40,,,percent of total billed charges,40% of total billed charges,892.26,90,,,percent of total billed charges,90% of total billed charges,753.46,76,,,percent of total billed charges,76% of total billed charges,396.56,40,,,percent of total billed charges,40% of total billed charges,842.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,793.12,80,,,percent of total billed charges,80% of total billed charges,384.66,38.8,,,percent of total billed charges,38.8% of total billed charges,842.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,941.83,
KETOROLAC TROMETHAMINE 30MG/ML INJ 1 ML VIAL  IM/IV,J188530,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,6.4,5.12,,4.8,75,,,percent of total billed charges,75% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.07,79.2,,,percent of total billed charges,79.2% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,6.4,100,,,fee schedule,100% of CO APG rates,6.08,95,,,percent of total billed charges,95% of total billed charges,5.12,80,,,percent of total billed charges,80% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,6.4,100,,,fee schedule,100% of NM fee schedule,2.56,40,,,percent of total billed charges,40% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,4.86,76,,,percent of total billed charges,76% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,5.12,80,,,percent of total billed charges,80% of total billed charges,2.48,38.8,,,percent of total billed charges,38.8% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.48,35.65,
G0439 ANNUAL WELLNESS VISIT SUBSQUENT VISIT,49100005,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,317.5,254,,238.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,251.46,79.2,,,percent of total billed charges,79.2% of total billed charges,269.88,85,,,percent of total billed charges,85% of total billed charges,317.5,100,,,fee schedule,100% of CO APG rates,301.63,95,,,percent of total billed charges,95% of total billed charges,254,80,,,percent of total billed charges,80% of total billed charges,269.88,85,,,percent of total billed charges,85% of total billed charges,285.75,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,317.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,285.75,90,,,percent of total billed charges,90% of total billed charges,241.3,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,269.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,254,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,269.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1017.2,100,,,case rate,pays based on per visit rate,238.13,1017.2,
"Poliovirus vaccine, inactivated (IPV), for subcutaneous or i",90713,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,72.5,58,,54.38,75,,,percent of total billed charges,75% of total billed charges,29,40,,,percent of total billed charges,40% of total billed charges,57.42,79.2,,,percent of total billed charges,79.2% of total billed charges,61.63,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,68.88,95,,,percent of total billed charges,95% of total billed charges,58,80,,,percent of total billed charges,80% of total billed charges,61.63,85,,,percent of total billed charges,85% of total billed charges,65.25,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,72.5,100,,,fee schedule,100% of NM fee schedule,29,40,,,percent of total billed charges,40% of total billed charges,29,40,,,percent of total billed charges,40% of total billed charges,65.25,90,,,percent of total billed charges,90% of total billed charges,55.1,76,,,percent of total billed charges,76% of total billed charges,29,40,,,percent of total billed charges,40% of total billed charges,61.63,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,58,80,,,percent of total billed charges,80% of total billed charges,28.13,38.8,,,percent of total billed charges,38.8% of total billed charges,61.63,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,28.13,72.5,
"57500 Biopsy of Cervix, 1 or more, or local excision of lesion w/wo fulguration",60000108,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,459.1,367.28,,344.33,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,363.61,79.2,,,percent of total billed charges,79.2% of total billed charges,390.24,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,436.15,95,,,percent of total billed charges,95% of total billed charges,367.28,80,,,percent of total billed charges,80% of total billed charges,390.24,85,,,percent of total billed charges,85% of total billed charges,413.19,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,459.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,413.19,90,,,percent of total billed charges,90% of total billed charges,348.92,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,390.24,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,367.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,390.24,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"VFC - 90732 Pneumococcal polysaccharide vaccine, 23-valent,",90732VFC,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
"ECG 12-Lead, TRACING ONLY",42893005,CDM,730,RC,93005,HCPCS,OUTPATIENT,,,187.1,149.68,,140.33,75,,,percent of total billed charges,75% of total billed charges,74.84,40,,,percent of total billed charges,40% of total billed charges,148.18,79.2,,,percent of total billed charges,79.2% of total billed charges,159.04,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,177.75,95,,,percent of total billed charges,95% of total billed charges,149.68,80,,,percent of total billed charges,80% of total billed charges,159.04,85,,,percent of total billed charges,85% of total billed charges,168.39,90,,,percent of total billed charges,90% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,34.77,100,,,fee schedule,100% of CO APG rates,57.48,100,,,fee schedule,100% of NM APC rate,74.84,40,,,percent of total billed charges,40% of total billed charges,74.84,40,,,percent of total billed charges,40% of total billed charges,168.39,90,,,percent of total billed charges,90% of total billed charges,142.2,76,,,percent of total billed charges,76% of total billed charges,74.84,40,,,percent of total billed charges,40% of total billed charges,159.04,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rate,149.68,80,,,percent of total billed charges,80% of total billed charges,72.59,38.8,,,percent of total billed charges,38.8% of total billed charges,159.04,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of APG fee schedule,13.34,200,,,fee schedule,200% of CMS fee schedule,13.34,177.75,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012032,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,901.5,721.2,,676.13,75,,,percent of total billed charges,75% of total billed charges,360.6,40,,,percent of total billed charges,40% of total billed charges,713.99,79.2,,,percent of total billed charges,79.2% of total billed charges,766.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,856.43,95,,,percent of total billed charges,95% of total billed charges,721.2,80,,,percent of total billed charges,80% of total billed charges,766.28,85,,,percent of total billed charges,85% of total billed charges,811.35,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,360.6,40,,,percent of total billed charges,40% of total billed charges,360.6,40,,,percent of total billed charges,40% of total billed charges,811.35,90,,,percent of total billed charges,90% of total billed charges,685.14,76,,,percent of total billed charges,76% of total billed charges,360.6,40,,,percent of total billed charges,40% of total billed charges,766.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,721.2,80,,,percent of total billed charges,80% of total billed charges,349.78,38.8,,,percent of total billed charges,38.8% of total billed charges,766.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,856.43,
27618 EXC TUMOR LEG/ANKLE SUBCU,60000058,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1437.1,1149.68,,1077.83,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1138.18,79.2,,,percent of total billed charges,79.2% of total billed charges,1221.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1365.25,95,,,percent of total billed charges,95% of total billed charges,1149.68,80,,,percent of total billed charges,80% of total billed charges,1221.54,85,,,percent of total billed charges,85% of total billed charges,1293.39,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1437.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1293.39,90,,,percent of total billed charges,90% of total billed charges,1092.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1221.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1149.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1221.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1437.1,
TNC Drivers Medical Exam,60000627,CDM,999,RC,VA0018A,HCPCS,OUTPATIENT,,,71.1,56.88,,53.33,75,,,percent of total billed charges,75% of total billed charges,28.44,40,,,percent of total billed charges,40% of total billed charges,56.31,79.2,,,percent of total billed charges,79.2% of total billed charges,60.44,85,,,percent of total billed charges,85% of total billed charges,71.1,100,,,fee schedule,100% of CO APG rates,67.55,95,,,percent of total billed charges,95% of total billed charges,56.88,80,,,percent of total billed charges,80% of total billed charges,60.44,85,,,percent of total billed charges,85% of total billed charges,63.99,90,,,percent of total billed charges,90% of total billed charges,71.1,100,,,fee schedule,100% of CO APG rates,71.1,100,,,fee schedule,100% of CO APG rates,71.1,100,,,fee schedule,100% of NM fee schedule,28.44,40,,,percent of total billed charges,40% of total billed charges,28.44,40,,,percent of total billed charges,40% of total billed charges,63.99,90,,,percent of total billed charges,90% of total billed charges,54.04,76,,,percent of total billed charges,76% of total billed charges,28.44,40,,,percent of total billed charges,40% of total billed charges,60.44,85,,,percent of total billed charges,85% of total billed charges,71.1,100,,,fee schedule,100% of CO APG rate,56.88,80,,,percent of total billed charges,80% of total billed charges,27.59,38.8,,,percent of total billed charges,38.8% of total billed charges,60.44,85,,,percent of total billed charges,85% of total billed charges,71.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,27.59,71.1,
Debride of Nail(s) By Any Method(s); One to Five Charge,49111720,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,93.5,74.8,,70.13,75,,,percent of total billed charges,75% of total billed charges,37.4,40,,,percent of total billed charges,40% of total billed charges,74.05,79.2,,,percent of total billed charges,79.2% of total billed charges,79.48,85,,,percent of total billed charges,85% of total billed charges,93.5,100,,,fee schedule,100% of CO APG rates,88.83,95,,,percent of total billed charges,95% of total billed charges,74.8,80,,,percent of total billed charges,80% of total billed charges,79.48,85,,,percent of total billed charges,85% of total billed charges,84.15,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,93.5,100,,,fee schedule,100% of NM APC rate,37.4,40,,,percent of total billed charges,40% of total billed charges,37.4,40,,,percent of total billed charges,40% of total billed charges,84.15,90,,,percent of total billed charges,90% of total billed charges,71.06,76,,,percent of total billed charges,76% of total billed charges,37.4,40,,,percent of total billed charges,40% of total billed charges,79.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,74.8,80,,,percent of total billed charges,80% of total billed charges,36.28,38.8,,,percent of total billed charges,38.8% of total billed charges,79.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,187,200,,,fee schedule,200% of CMS fee schedule,36.28,215.49,
AQUACEL AG (SILVER) SURGICAL 9 x 35cm,52417,CDM,270,RC,,,OUTPATIENT,,,170.2,136.16,,127.65,75,,,percent of total billed charges,75% of total billed charges,68.08,40,,,percent of total billed charges,40% of total billed charges,134.8,79.2,,,percent of total billed charges,79.2% of total billed charges,144.67,85,,,percent of total billed charges,85% of total billed charges,170.2,100,,,fee schedule,100% of CO APG rates,161.69,95,,,percent of total billed charges,95% of total billed charges,136.16,80,,,percent of total billed charges,80% of total billed charges,144.67,85,,,percent of total billed charges,85% of total billed charges,153.18,90,,,percent of total billed charges,90% of total billed charges,170.2,100,,,fee schedule,100% of CO APG rates,170.2,100,,,fee schedule,100% of CO APG rates,170.2,100,,,fee schedule,100% of NM fee schedule,68.08,40,,,percent of total billed charges,40% of total billed charges,68.08,40,,,percent of total billed charges,40% of total billed charges,153.18,90,,,percent of total billed charges,90% of total billed charges,129.35,76,,,percent of total billed charges,76% of total billed charges,68.08,40,,,percent of total billed charges,40% of total billed charges,144.67,85,,,percent of total billed charges,85% of total billed charges,170.2,100,,,fee schedule,100% of CO APG rate,136.16,80,,,percent of total billed charges,80% of total billed charges,66.04,38.8,,,percent of total billed charges,38.8% of total billed charges,144.67,85,,,percent of total billed charges,85% of total billed charges,170.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,66.04,170.2,
24500 Closed Treatment Of Humeral Shaft Fracture; Without Ma,46024500,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1055.4,844.32,,791.55,75,,,percent of total billed charges,75% of total billed charges,422.16,40,,,percent of total billed charges,40% of total billed charges,835.88,79.2,,,percent of total billed charges,79.2% of total billed charges,897.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1002.63,95,,,percent of total billed charges,95% of total billed charges,844.32,80,,,percent of total billed charges,80% of total billed charges,897.09,85,,,percent of total billed charges,85% of total billed charges,949.86,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,422.16,40,,,percent of total billed charges,40% of total billed charges,422.16,40,,,percent of total billed charges,40% of total billed charges,949.86,90,,,percent of total billed charges,90% of total billed charges,802.1,76,,,percent of total billed charges,76% of total billed charges,422.16,40,,,percent of total billed charges,40% of total billed charges,897.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,844.32,80,,,percent of total billed charges,80% of total billed charges,409.5,38.8,,,percent of total billed charges,38.8% of total billed charges,897.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1002.63,
28510 Closed treatment of FX phalanx or phalanges,60000069,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,347.5,278,,260.63,75,,,percent of total billed charges,75% of total billed charges,139,40,,,percent of total billed charges,40% of total billed charges,275.22,79.2,,,percent of total billed charges,79.2% of total billed charges,295.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,330.13,95,,,percent of total billed charges,95% of total billed charges,278,80,,,percent of total billed charges,80% of total billed charges,295.38,85,,,percent of total billed charges,85% of total billed charges,312.75,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,139,40,,,percent of total billed charges,40% of total billed charges,139,40,,,percent of total billed charges,40% of total billed charges,312.75,90,,,percent of total billed charges,90% of total billed charges,264.1,76,,,percent of total billed charges,76% of total billed charges,139,40,,,percent of total billed charges,40% of total billed charges,295.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,278,80,,,percent of total billed charges,80% of total billed charges,134.83,38.8,,,percent of total billed charges,38.8% of total billed charges,295.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,134.83,330.13,
69000 DRAIN EXTERNAL EAR LESION,31069000,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,557.7,446.16,,418.28,75,,,percent of total billed charges,75% of total billed charges,223.08,40,,,percent of total billed charges,40% of total billed charges,441.7,79.2,,,percent of total billed charges,79.2% of total billed charges,474.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,529.82,95,,,percent of total billed charges,95% of total billed charges,446.16,80,,,percent of total billed charges,80% of total billed charges,474.05,85,,,percent of total billed charges,85% of total billed charges,501.93,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,223.08,40,,,percent of total billed charges,40% of total billed charges,223.08,40,,,percent of total billed charges,40% of total billed charges,501.93,90,,,percent of total billed charges,90% of total billed charges,423.85,76,,,percent of total billed charges,76% of total billed charges,223.08,40,,,percent of total billed charges,40% of total billed charges,474.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,446.16,80,,,percent of total billed charges,80% of total billed charges,216.39,38.8,,,percent of total billed charges,38.8% of total billed charges,474.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,529.82,
90685 INS Fluzone Quadrivalent Influenza Vaccine - 6-35 mos,49190685,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,47.3,37.84,,35.48,75,,,percent of total billed charges,75% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,37.46,79.2,,,percent of total billed charges,79.2% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,44.94,95,,,percent of total billed charges,95% of total billed charges,37.84,80,,,percent of total billed charges,80% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,47.3,100,,,fee schedule,100% of NM fee schedule,18.92,40,,,percent of total billed charges,40% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.95,76,,,percent of total billed charges,76% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,37.84,80,,,percent of total billed charges,80% of total billed charges,18.35,38.8,,,percent of total billed charges,38.8% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.35,47.3,
90658 INS Fluzone Influenza Vaccine -3+ yrs multi dose vial,49190658,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,47.7,38.16,,35.78,75,,,percent of total billed charges,75% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,37.78,79.2,,,percent of total billed charges,79.2% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,45.32,95,,,percent of total billed charges,95% of total billed charges,38.16,80,,,percent of total billed charges,80% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,42.93,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,47.7,100,,,fee schedule,100% of NM fee schedule,19.08,40,,,percent of total billed charges,40% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,42.93,90,,,percent of total billed charges,90% of total billed charges,36.25,76,,,percent of total billed charges,76% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,38.16,80,,,percent of total billed charges,80% of total billed charges,18.51,38.8,,,percent of total billed charges,38.8% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.51,47.7,
Q2037 Medicare Fluvirin Influenza Vaccine,49100064,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,30.9,24.72,,23.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,24.47,79.2,,,percent of total billed charges,79.2% of total billed charges,26.27,85,,,percent of total billed charges,85% of total billed charges,30.9,100,,,fee schedule,100% of CO APG rates,29.36,95,,,percent of total billed charges,95% of total billed charges,24.72,80,,,percent of total billed charges,80% of total billed charges,26.27,85,,,percent of total billed charges,85% of total billed charges,27.81,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,30.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,27.81,90,,,percent of total billed charges,90% of total billed charges,23.48,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,26.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,24.72,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,26.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,444,100,,,case rate,pays based on per visit rate,23.18,444,
25705 EXC TUMOR SOFT TISSUE FOREARM /WRIST SUBQ 3CM,60000002,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1536.7,1229.36,,1152.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1217.07,79.2,,,percent of total billed charges,79.2% of total billed charges,1306.2,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1459.87,95,,,percent of total billed charges,95% of total billed charges,1229.36,80,,,percent of total billed charges,80% of total billed charges,1306.2,85,,,percent of total billed charges,85% of total billed charges,1383.03,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1536.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1383.03,90,,,percent of total billed charges,90% of total billed charges,1167.89,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1306.2,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1229.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1306.2,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1536.7,
92511 Nasopharyngoscopy with endoscope (separate procedure),60000474,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,482.3,385.84,,361.73,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,381.98,79.2,,,percent of total billed charges,79.2% of total billed charges,409.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,458.19,95,,,percent of total billed charges,95% of total billed charges,385.84,80,,,percent of total billed charges,80% of total billed charges,409.96,85,,,percent of total billed charges,85% of total billed charges,434.07,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,482.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,434.07,90,,,percent of total billed charges,90% of total billed charges,366.55,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,409.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,385.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,409.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
27760 Closed Treatment of medial malleous fracture; without manipulation,60000060,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1046,836.8,,784.5,75,,,percent of total billed charges,75% of total billed charges,418.4,40,,,percent of total billed charges,40% of total billed charges,828.43,79.2,,,percent of total billed charges,79.2% of total billed charges,889.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,993.7,95,,,percent of total billed charges,95% of total billed charges,836.8,80,,,percent of total billed charges,80% of total billed charges,889.1,85,,,percent of total billed charges,85% of total billed charges,941.4,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,418.4,40,,,percent of total billed charges,40% of total billed charges,418.4,40,,,percent of total billed charges,40% of total billed charges,941.4,90,,,percent of total billed charges,90% of total billed charges,794.96,76,,,percent of total billed charges,76% of total billed charges,418.4,40,,,percent of total billed charges,40% of total billed charges,889.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,836.8,80,,,percent of total billed charges,80% of total billed charges,405.85,38.8,,,percent of total billed charges,38.8% of total billed charges,889.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,993.7,
"Closed Treatment of Humeral Condylar Fracture, Medial or Lat",60000040,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1027.8,822.24,,770.85,75,,,percent of total billed charges,75% of total billed charges,411.12,40,,,percent of total billed charges,40% of total billed charges,814.02,79.2,,,percent of total billed charges,79.2% of total billed charges,873.63,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,976.41,95,,,percent of total billed charges,95% of total billed charges,822.24,80,,,percent of total billed charges,80% of total billed charges,873.63,85,,,percent of total billed charges,85% of total billed charges,925.02,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,411.12,40,,,percent of total billed charges,40% of total billed charges,411.12,40,,,percent of total billed charges,40% of total billed charges,925.02,90,,,percent of total billed charges,90% of total billed charges,781.13,76,,,percent of total billed charges,76% of total billed charges,411.12,40,,,percent of total billed charges,40% of total billed charges,873.63,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,822.24,80,,,percent of total billed charges,80% of total billed charges,398.79,38.8,,,percent of total billed charges,38.8% of total billed charges,873.63,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,976.41,
"10160 Puncture Aspiration Of Abscess, Hematoma, Bulla, Or Cy",46010160,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,374.5,299.6,,280.88,75,,,percent of total billed charges,75% of total billed charges,149.8,40,,,percent of total billed charges,40% of total billed charges,296.6,79.2,,,percent of total billed charges,79.2% of total billed charges,318.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,355.78,95,,,percent of total billed charges,95% of total billed charges,299.6,80,,,percent of total billed charges,80% of total billed charges,318.33,85,,,percent of total billed charges,85% of total billed charges,337.05,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,149.8,40,,,percent of total billed charges,40% of total billed charges,149.8,40,,,percent of total billed charges,40% of total billed charges,337.05,90,,,percent of total billed charges,90% of total billed charges,284.62,76,,,percent of total billed charges,76% of total billed charges,149.8,40,,,percent of total billed charges,40% of total billed charges,318.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,299.6,80,,,percent of total billed charges,80% of total billed charges,145.31,38.8,,,percent of total billed charges,38.8% of total billed charges,318.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,145.31,355.78,
"11045 Debridement, Subcutaneous Tissue; each Add 20 Sq cm",46011045,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,116.3,93.04,,87.23,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,92.11,79.2,,,percent of total billed charges,79.2% of total billed charges,98.86,85,,,percent of total billed charges,85% of total billed charges,116.3,100,,,fee schedule,100% of CO APG rates,110.49,95,,,percent of total billed charges,95% of total billed charges,93.04,80,,,percent of total billed charges,80% of total billed charges,98.86,85,,,percent of total billed charges,85% of total billed charges,104.67,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,116.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,104.67,90,,,percent of total billed charges,90% of total billed charges,88.39,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,98.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,93.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,98.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,614.8,100,,,case rate,pays based on per visit rate,87.23,614.8,
"Excision, malignant lesion including margins, face, ears, ey",46011644,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1117.2,893.76,,837.9,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,884.82,79.2,,,percent of total billed charges,79.2% of total billed charges,949.62,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1061.34,95,,,percent of total billed charges,95% of total billed charges,893.76,80,,,percent of total billed charges,80% of total billed charges,949.62,85,,,percent of total billed charges,85% of total billed charges,1005.48,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1117.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1005.48,90,,,percent of total billed charges,90% of total billed charges,849.07,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,949.62,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,893.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,949.62,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excision, malignant lesion including margins, face, ears, ey",46011646,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1446.1,1156.88,,1084.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1145.31,79.2,,,percent of total billed charges,79.2% of total billed charges,1229.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1373.8,95,,,percent of total billed charges,95% of total billed charges,1156.88,80,,,percent of total billed charges,80% of total billed charges,1229.19,85,,,percent of total billed charges,85% of total billed charges,1301.49,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1446.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1301.49,90,,,percent of total billed charges,90% of total billed charges,1099.04,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1229.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1156.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1229.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1446.1,
12020 Treatment Of Superficial Wound Dehiscence; Simple Clos,46012020,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,874.7,699.76,,656.03,75,,,percent of total billed charges,75% of total billed charges,349.88,40,,,percent of total billed charges,40% of total billed charges,692.76,79.2,,,percent of total billed charges,79.2% of total billed charges,743.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,830.97,95,,,percent of total billed charges,95% of total billed charges,699.76,80,,,percent of total billed charges,80% of total billed charges,743.5,85,,,percent of total billed charges,85% of total billed charges,787.23,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,349.88,40,,,percent of total billed charges,40% of total billed charges,349.88,40,,,percent of total billed charges,40% of total billed charges,787.23,90,,,percent of total billed charges,90% of total billed charges,664.77,76,,,percent of total billed charges,76% of total billed charges,349.88,40,,,percent of total billed charges,40% of total billed charges,743.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,699.76,80,,,percent of total billed charges,80% of total billed charges,339.38,38.8,,,percent of total billed charges,38.8% of total billed charges,743.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,830.97,
"Repair, intermediate, wounds of neck, hands, feet, and/or ex",46012041,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,837.5,670,,628.13,75,,,percent of total billed charges,75% of total billed charges,335,40,,,percent of total billed charges,40% of total billed charges,663.3,79.2,,,percent of total billed charges,79.2% of total billed charges,711.88,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,795.63,95,,,percent of total billed charges,95% of total billed charges,670,80,,,percent of total billed charges,80% of total billed charges,711.88,85,,,percent of total billed charges,85% of total billed charges,753.75,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,335,40,,,percent of total billed charges,40% of total billed charges,335,40,,,percent of total billed charges,40% of total billed charges,753.75,90,,,percent of total billed charges,90% of total billed charges,636.5,76,,,percent of total billed charges,76% of total billed charges,335,40,,,percent of total billed charges,40% of total billed charges,711.88,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,670,80,,,percent of total billed charges,80% of total billed charges,324.95,38.8,,,percent of total billed charges,38.8% of total billed charges,711.88,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,795.63,
"13100 Repair, Complex, Trunk; 1.1 Cm To 2.5 Cm",46013100,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,996.8,797.44,,747.6,75,,,percent of total billed charges,75% of total billed charges,398.72,40,,,percent of total billed charges,40% of total billed charges,789.47,79.2,,,percent of total billed charges,79.2% of total billed charges,847.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,946.96,95,,,percent of total billed charges,95% of total billed charges,797.44,80,,,percent of total billed charges,80% of total billed charges,847.28,85,,,percent of total billed charges,85% of total billed charges,897.12,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,398.72,40,,,percent of total billed charges,40% of total billed charges,398.72,40,,,percent of total billed charges,40% of total billed charges,897.12,90,,,percent of total billed charges,90% of total billed charges,757.57,76,,,percent of total billed charges,76% of total billed charges,398.72,40,,,percent of total billed charges,40% of total billed charges,847.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,797.44,80,,,percent of total billed charges,80% of total billed charges,386.76,38.8,,,percent of total billed charges,38.8% of total billed charges,847.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,946.96,
"17250 Chemical cauterization of granulation tissue (proud flesh, sinus, or fistu",60000022,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,263.2,210.56,,197.4,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,208.45,79.2,,,percent of total billed charges,79.2% of total billed charges,223.72,85,,,percent of total billed charges,85% of total billed charges,263.2,100,,,fee schedule,100% of CO APG rates,250.04,95,,,percent of total billed charges,95% of total billed charges,210.56,80,,,percent of total billed charges,80% of total billed charges,223.72,85,,,percent of total billed charges,85% of total billed charges,236.88,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,263.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,236.88,90,,,percent of total billed charges,90% of total billed charges,200.03,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,223.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,210.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,223.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,908.6,100,,,case rate,pays based on per visit rate,197.4,908.6,
51701 Insertion of non dwelling bladder catheter (e.g. straight cath for residua,60000092,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,138.6,110.88,,103.95,75,,,percent of total billed charges,75% of total billed charges,55.44,40,,,percent of total billed charges,40% of total billed charges,109.77,79.2,,,percent of total billed charges,79.2% of total billed charges,117.81,85,,,percent of total billed charges,85% of total billed charges,138.6,100,,,fee schedule,100% of CO APG rates,131.67,95,,,percent of total billed charges,95% of total billed charges,110.88,80,,,percent of total billed charges,80% of total billed charges,117.81,85,,,percent of total billed charges,85% of total billed charges,124.74,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,138.6,100,,,fee schedule,100% of NM APC rate,55.44,40,,,percent of total billed charges,40% of total billed charges,55.44,40,,,percent of total billed charges,40% of total billed charges,124.74,90,,,percent of total billed charges,90% of total billed charges,105.34,76,,,percent of total billed charges,76% of total billed charges,55.44,40,,,percent of total billed charges,40% of total billed charges,117.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,110.88,80,,,percent of total billed charges,80% of total billed charges,53.78,38.8,,,percent of total billed charges,38.8% of total billed charges,117.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,53.78,217.66,
Enoxaparin (Lovenox) 30mg/0.3mL,49100065,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,35,28,,26.25,75,,,percent of total billed charges,75% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,27.72,79.2,,,percent of total billed charges,79.2% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35,100,,,fee schedule,100% of CO APG rates,33.25,95,,,percent of total billed charges,95% of total billed charges,28,80,,,percent of total billed charges,80% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,35,100,,,fee schedule,100% of NM fee schedule,14,40,,,percent of total billed charges,40% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,26.6,76,,,percent of total billed charges,76% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,28,80,,,percent of total billed charges,80% of total billed charges,13.58,38.8,,,percent of total billed charges,38.8% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,13.58,35.65,
Enoxaparin (Lovenox) 40mg/0.4mL,49100065,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,35,28,,26.25,75,,,percent of total billed charges,75% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,27.72,79.2,,,percent of total billed charges,79.2% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35,100,,,fee schedule,100% of CO APG rates,33.25,95,,,percent of total billed charges,95% of total billed charges,28,80,,,percent of total billed charges,80% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,35,100,,,fee schedule,100% of NM fee schedule,14,40,,,percent of total billed charges,40% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,26.6,76,,,percent of total billed charges,76% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,28,80,,,percent of total billed charges,80% of total billed charges,13.58,38.8,,,percent of total billed charges,38.8% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,13.58,35.65,
Enoxaparin (Lovenox) 60mg/0.6mL,49100065,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,35,28,,26.25,75,,,percent of total billed charges,75% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,27.72,79.2,,,percent of total billed charges,79.2% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35,100,,,fee schedule,100% of CO APG rates,33.25,95,,,percent of total billed charges,95% of total billed charges,28,80,,,percent of total billed charges,80% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,35,100,,,fee schedule,100% of NM fee schedule,14,40,,,percent of total billed charges,40% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,26.6,76,,,percent of total billed charges,76% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,28,80,,,percent of total billed charges,80% of total billed charges,13.58,38.8,,,percent of total billed charges,38.8% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,13.58,35.65,
Enoxaparin (Lovenox) 100mg/1mL,49100065,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,35,28,,26.25,75,,,percent of total billed charges,75% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,27.72,79.2,,,percent of total billed charges,79.2% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35,100,,,fee schedule,100% of CO APG rates,33.25,95,,,percent of total billed charges,95% of total billed charges,28,80,,,percent of total billed charges,80% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,35,100,,,fee schedule,100% of NM fee schedule,14,40,,,percent of total billed charges,40% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,26.6,76,,,percent of total billed charges,76% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,28,80,,,percent of total billed charges,80% of total billed charges,13.58,38.8,,,percent of total billed charges,38.8% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,13.58,35.65,
21012 Excision tumor soft tissue face or scalp 2cm or greater,60000028,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,962.7,770.16,,722.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,762.46,79.2,,,percent of total billed charges,79.2% of total billed charges,818.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,914.57,95,,,percent of total billed charges,95% of total billed charges,770.16,80,,,percent of total billed charges,80% of total billed charges,818.3,85,,,percent of total billed charges,85% of total billed charges,866.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,962.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,866.43,90,,,percent of total billed charges,90% of total billed charges,731.65,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,818.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,770.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,818.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Removal of Foreign Body from Pharynx,49142809,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,591.7,473.36,,443.78,75,,,percent of total billed charges,75% of total billed charges,236.68,40,,,percent of total billed charges,40% of total billed charges,468.63,79.2,,,percent of total billed charges,79.2% of total billed charges,502.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,562.12,95,,,percent of total billed charges,95% of total billed charges,473.36,80,,,percent of total billed charges,80% of total billed charges,502.95,85,,,percent of total billed charges,85% of total billed charges,532.53,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,236.68,40,,,percent of total billed charges,40% of total billed charges,236.68,40,,,percent of total billed charges,40% of total billed charges,532.53,90,,,percent of total billed charges,90% of total billed charges,449.69,76,,,percent of total billed charges,76% of total billed charges,236.68,40,,,percent of total billed charges,40% of total billed charges,502.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,473.36,80,,,percent of total billed charges,80% of total billed charges,229.58,38.8,,,percent of total billed charges,38.8% of total billed charges,502.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,562.12,
Trimming of Nondystrophic Nails Any Number,49111719,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,39.9,31.92,,29.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,31.6,79.2,,,percent of total billed charges,79.2% of total billed charges,33.92,85,,,percent of total billed charges,85% of total billed charges,39.9,100,,,fee schedule,100% of CO APG rates,37.91,95,,,percent of total billed charges,95% of total billed charges,31.92,80,,,percent of total billed charges,80% of total billed charges,33.92,85,,,percent of total billed charges,85% of total billed charges,35.91,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,39.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,35.91,90,,,percent of total billed charges,90% of total billed charges,30.32,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,33.92,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,31.92,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,33.92,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,462,100,,,case rate,pays based on per visit rate,29.93,462,
56605 BIOPSY OF VULVA OR PERINEUM(SEPARATE PROCEDURE); 1 LESION,60000099,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,280.2,224.16,,210.15,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,221.92,79.2,,,percent of total billed charges,79.2% of total billed charges,238.17,85,,,percent of total billed charges,85% of total billed charges,280.2,100,,,fee schedule,100% of CO APG rates,266.19,95,,,percent of total billed charges,95% of total billed charges,224.16,80,,,percent of total billed charges,80% of total billed charges,238.17,85,,,percent of total billed charges,85% of total billed charges,252.18,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,280.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,252.18,90,,,percent of total billed charges,90% of total billed charges,212.95,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,238.17,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,224.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,238.17,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,942.6,100,,,case rate,pays based on per visit rate,210.15,942.6,
57420 Colposcopy of the entire vagina with cervix present,60000102,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,380,304,,285,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,300.96,79.2,,,percent of total billed charges,79.2% of total billed charges,323,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,361,95,,,percent of total billed charges,95% of total billed charges,304,80,,,percent of total billed charges,80% of total billed charges,323,85,,,percent of total billed charges,85% of total billed charges,342,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,380,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,342,90,,,percent of total billed charges,90% of total billed charges,288.8,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,323,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,304,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,323,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1142.2,100,,,case rate,pays based on per visit rate,285,1142.2,
57452 Colposcopy of the cervix including the upper vagina,60000104,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,365.8,292.64,,274.35,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,289.71,79.2,,,percent of total billed charges,79.2% of total billed charges,310.93,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,347.51,95,,,percent of total billed charges,95% of total billed charges,292.64,80,,,percent of total billed charges,80% of total billed charges,310.93,85,,,percent of total billed charges,85% of total billed charges,329.22,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,365.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,329.22,90,,,percent of total billed charges,90% of total billed charges,278.01,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,310.93,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,292.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,310.93,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1113.8,100,,,case rate,pays based on per visit rate,274.35,1113.8,
90460 Immunization Administration w/Counseling by Provider;,79190460,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,24.2,19.36,,18.15,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,19.17,79.2,,,percent of total billed charges,79.2% of total billed charges,20.57,85,,,percent of total billed charges,85% of total billed charges,24.2,100,,,fee schedule,100% of CO APG rates,22.99,95,,,percent of total billed charges,95% of total billed charges,19.36,80,,,percent of total billed charges,80% of total billed charges,20.57,85,,,percent of total billed charges,85% of total billed charges,21.78,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,24.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,21.78,90,,,percent of total billed charges,90% of total billed charges,18.39,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,20.57,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,19.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,20.57,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,430.6,100,,,case rate,pays based on per visit rate,18.15,430.6,
90461 Immunization Administration w/Counseling by Provider;,79190461,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,13.2,10.56,,9.9,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,10.45,79.2,,,percent of total billed charges,79.2% of total billed charges,11.22,85,,,percent of total billed charges,85% of total billed charges,13.2,100,,,fee schedule,100% of CO APG rates,12.54,95,,,percent of total billed charges,95% of total billed charges,10.56,80,,,percent of total billed charges,80% of total billed charges,11.22,85,,,percent of total billed charges,85% of total billed charges,11.88,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,13.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,11.88,90,,,percent of total billed charges,90% of total billed charges,10.03,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,11.22,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,10.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,11.22,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,408.6,100,,,case rate,pays based on per visit rate,9.9,408.6,
90672 Flumist Intranasal Influenza Vaccine - 2-18 yrs; INS,49190672,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,49.6,39.68,,37.2,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,39.28,79.2,,,percent of total billed charges,79.2% of total billed charges,42.16,85,,,percent of total billed charges,85% of total billed charges,49.6,100,,,fee schedule,100% of CO APG rates,47.12,95,,,percent of total billed charges,95% of total billed charges,39.68,80,,,percent of total billed charges,80% of total billed charges,42.16,85,,,percent of total billed charges,85% of total billed charges,44.64,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,49.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,44.64,90,,,percent of total billed charges,90% of total billed charges,37.7,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,42.16,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,39.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,42.16,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,481.4,100,,,case rate,pays based on per visit rate,37.2,481.4,
90658 Fluvirin 5.0mL Multi-dose vial; Trivalent Influenza Va,49190658,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,49.6,39.68,,37.2,75,,,percent of total billed charges,75% of total billed charges,19.84,40,,,percent of total billed charges,40% of total billed charges,39.28,79.2,,,percent of total billed charges,79.2% of total billed charges,42.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,47.12,95,,,percent of total billed charges,95% of total billed charges,39.68,80,,,percent of total billed charges,80% of total billed charges,42.16,85,,,percent of total billed charges,85% of total billed charges,44.64,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,49.6,100,,,fee schedule,100% of NM fee schedule,19.84,40,,,percent of total billed charges,40% of total billed charges,19.84,40,,,percent of total billed charges,40% of total billed charges,44.64,90,,,percent of total billed charges,90% of total billed charges,37.7,76,,,percent of total billed charges,76% of total billed charges,19.84,40,,,percent of total billed charges,40% of total billed charges,42.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,39.68,80,,,percent of total billed charges,80% of total billed charges,19.24,38.8,,,percent of total billed charges,38.8% of total billed charges,42.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,19.24,49.6,
90685 Fluzone 0.25mL Single dose syringe; Quadrivalent Influ,49190685,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,47.7,38.16,,35.78,75,,,percent of total billed charges,75% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,37.78,79.2,,,percent of total billed charges,79.2% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,45.32,95,,,percent of total billed charges,95% of total billed charges,38.16,80,,,percent of total billed charges,80% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,42.93,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,47.7,100,,,fee schedule,100% of NM fee schedule,19.08,40,,,percent of total billed charges,40% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,42.93,90,,,percent of total billed charges,90% of total billed charges,36.25,76,,,percent of total billed charges,76% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,38.16,80,,,percent of total billed charges,80% of total billed charges,18.51,38.8,,,percent of total billed charges,38.8% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.51,47.7,
90688 Fluzone 5.0mL Multi-dose vial; Quadrivalent Influenza,49190688,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,49.6,39.68,,37.2,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,39.28,79.2,,,percent of total billed charges,79.2% of total billed charges,42.16,85,,,percent of total billed charges,85% of total billed charges,49.6,100,,,fee schedule,100% of CO APG rates,47.12,95,,,percent of total billed charges,95% of total billed charges,39.68,80,,,percent of total billed charges,80% of total billed charges,42.16,85,,,percent of total billed charges,85% of total billed charges,44.64,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,49.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,44.64,90,,,percent of total billed charges,90% of total billed charges,37.7,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,42.16,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,39.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,42.16,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,481.4,100,,,case rate,pays based on per visit rate,37.2,481.4,
90685 Fluzone 0.25mL Single dose syringe; Quadrivalent Influ,49190685,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
90686 Fluzone 0.5mL Single dose syringe; Quadrivalent Influe,49190686,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,47.3,37.84,,35.48,75,,,percent of total billed charges,75% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,37.46,79.2,,,percent of total billed charges,79.2% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,44.94,95,,,percent of total billed charges,95% of total billed charges,37.84,80,,,percent of total billed charges,80% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,47.3,100,,,fee schedule,100% of NM fee schedule,18.92,40,,,percent of total billed charges,40% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.95,76,,,percent of total billed charges,76% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,37.84,80,,,percent of total billed charges,80% of total billed charges,18.35,38.8,,,percent of total billed charges,38.8% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.35,47.3,
95865 - Needle electromyography-larynx,31095865,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,481.7,385.36,,361.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,381.51,79.2,,,percent of total billed charges,79.2% of total billed charges,409.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,457.62,95,,,percent of total billed charges,95% of total billed charges,385.36,80,,,percent of total billed charges,80% of total billed charges,409.45,85,,,percent of total billed charges,85% of total billed charges,433.53,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,481.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,433.53,90,,,percent of total billed charges,90% of total billed charges,366.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,409.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,385.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,409.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
57160 Fit or Insert Pessary,60000101,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,214.8,171.84,,161.1,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,170.12,79.2,,,percent of total billed charges,79.2% of total billed charges,182.58,85,,,percent of total billed charges,85% of total billed charges,214.8,100,,,fee schedule,100% of CO APG rates,204.06,95,,,percent of total billed charges,95% of total billed charges,171.84,80,,,percent of total billed charges,80% of total billed charges,182.58,85,,,percent of total billed charges,85% of total billed charges,193.32,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,214.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,193.32,90,,,percent of total billed charges,90% of total billed charges,163.25,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,182.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,171.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,182.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,811.8,100,,,case rate,pays based on per visit rate,161.1,811.8,
58300 Insertion of intrauterine device (IUD),60000111,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,195.3,156.24,,146.48,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,154.68,79.2,,,percent of total billed charges,79.2% of total billed charges,166.01,85,,,percent of total billed charges,85% of total billed charges,195.3,100,,,fee schedule,100% of CO APG rates,185.54,95,,,percent of total billed charges,95% of total billed charges,156.24,80,,,percent of total billed charges,80% of total billed charges,166.01,85,,,percent of total billed charges,85% of total billed charges,175.77,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,195.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,175.77,90,,,percent of total billed charges,90% of total billed charges,148.43,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,166.01,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,156.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,166.01,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,772.8,100,,,case rate,pays based on per visit rate,146.48,772.8,
Chronic Care Management 99490 Charge,49699490,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,83.5,66.8,,62.63,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,66.13,79.2,,,percent of total billed charges,79.2% of total billed charges,70.98,85,,,percent of total billed charges,85% of total billed charges,83.5,100,,,fee schedule,100% of CO APG rates,79.33,95,,,percent of total billed charges,95% of total billed charges,66.8,80,,,percent of total billed charges,80% of total billed charges,70.98,85,,,percent of total billed charges,85% of total billed charges,75.15,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,83.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,75.15,90,,,percent of total billed charges,90% of total billed charges,63.46,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,70.98,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,66.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,70.98,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,549.2,100,,,case rate,pays based on per visit rate,62.63,549.2,
"54056 Destruction of Lesions, Penis (eg:condyloma, papilloma, molluscum centaglo",60000095,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,411.8,329.44,,308.85,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,326.15,79.2,,,percent of total billed charges,79.2% of total billed charges,350.03,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,391.21,95,,,percent of total billed charges,95% of total billed charges,329.44,80,,,percent of total billed charges,80% of total billed charges,350.03,85,,,percent of total billed charges,85% of total billed charges,370.62,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,411.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,370.62,90,,,percent of total billed charges,90% of total billed charges,312.97,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,350.03,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,329.44,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,350.03,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1205.8,100,,,case rate,pays based on per visit rate,308.85,1205.8,
GI Panel by PCR,40087507,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,840.3,672.24,,630.23,75,,,percent of total billed charges,75% of total billed charges,336.12,40,,,percent of total billed charges,40% of total billed charges,665.52,79.2,,,percent of total billed charges,79.2% of total billed charges,714.26,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,798.29,95,,,percent of total billed charges,95% of total billed charges,672.24,80,,,percent of total billed charges,80% of total billed charges,714.26,85,,,percent of total billed charges,85% of total billed charges,756.27,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,336.12,40,,,percent of total billed charges,40% of total billed charges,336.12,40,,,percent of total billed charges,40% of total billed charges,756.27,90,,,percent of total billed charges,90% of total billed charges,638.63,76,,,percent of total billed charges,76% of total billed charges,336.12,40,,,percent of total billed charges,40% of total billed charges,714.26,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,672.24,80,,,percent of total billed charges,80% of total billed charges,326.04,38.8,,,percent of total billed charges,38.8% of total billed charges,714.26,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,798.29,
Influenza Vaccine Admin,77100008,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,45,36,,33.75,75,,,percent of total billed charges,75% of total billed charges,18,40,,,percent of total billed charges,40% of total billed charges,35.64,79.2,,,percent of total billed charges,79.2% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,45,100,,,fee schedule,100% of CO APG rates,42.75,95,,,percent of total billed charges,95% of total billed charges,36,80,,,percent of total billed charges,80% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,40.5,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,45,100,,,fee schedule,100% of NM APC rate,18,40,,,percent of total billed charges,40% of total billed charges,18,40,,,percent of total billed charges,40% of total billed charges,40.5,90,,,percent of total billed charges,90% of total billed charges,34.2,76,,,percent of total billed charges,76% of total billed charges,18,40,,,percent of total billed charges,40% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,36,80,,,percent of total billed charges,80% of total billed charges,17.46,38.8,,,percent of total billed charges,38.8% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,17.46,50.67,
"21011 Excision tumor soft tissue of face or scalp subcutaneous, less than 2 CM",60000027,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1089.7,871.76,,817.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,863.04,79.2,,,percent of total billed charges,79.2% of total billed charges,926.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1035.22,95,,,percent of total billed charges,95% of total billed charges,871.76,80,,,percent of total billed charges,80% of total billed charges,926.25,85,,,percent of total billed charges,85% of total billed charges,980.73,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1089.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,980.73,90,,,percent of total billed charges,90% of total billed charges,828.17,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,926.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,871.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,926.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
J2795 Ropivacain hcl injection per 1 mg,60000989,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,17.6,14.08,,13.2,75,,,percent of total billed charges,75% of total billed charges,7.04,40,,,percent of total billed charges,40% of total billed charges,13.94,79.2,,,percent of total billed charges,79.2% of total billed charges,14.96,85,,,percent of total billed charges,85% of total billed charges,17.6,100,,,fee schedule,100% of CO APG rates,16.72,95,,,percent of total billed charges,95% of total billed charges,14.08,80,,,percent of total billed charges,80% of total billed charges,14.96,85,,,percent of total billed charges,85% of total billed charges,15.84,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,17.6,100,,,fee schedule,100% of NM fee schedule,7.04,40,,,percent of total billed charges,40% of total billed charges,7.04,40,,,percent of total billed charges,40% of total billed charges,15.84,90,,,percent of total billed charges,90% of total billed charges,13.38,76,,,percent of total billed charges,76% of total billed charges,7.04,40,,,percent of total billed charges,40% of total billed charges,14.96,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,14.08,80,,,percent of total billed charges,80% of total billed charges,6.83,38.8,,,percent of total billed charges,38.8% of total billed charges,14.96,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.83,35.65,
UTERINE EXPLORA CURETTE,49152564,CDM,270,RC,,,OUTPATIENT,,,53.6,42.88,,40.2,75,,,percent of total billed charges,75% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,42.45,79.2,,,percent of total billed charges,79.2% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rates,50.92,95,,,percent of total billed charges,95% of total billed charges,42.88,80,,,percent of total billed charges,80% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,48.24,90,,,percent of total billed charges,90% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rates,53.6,100,,,fee schedule,100% of CO APG rates,53.6,100,,,fee schedule,100% of NM fee schedule,21.44,40,,,percent of total billed charges,40% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,48.24,90,,,percent of total billed charges,90% of total billed charges,40.74,76,,,percent of total billed charges,76% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rate,42.88,80,,,percent of total billed charges,80% of total billed charges,20.8,38.8,,,percent of total billed charges,38.8% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,20.8,53.6,
J0702 Celestone Soluspan 6mg/mL injectable solution,49100070,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,17,13.6,,12.75,75,,,percent of total billed charges,75% of total billed charges,6.8,40,,,percent of total billed charges,40% of total billed charges,13.46,79.2,,,percent of total billed charges,79.2% of total billed charges,14.45,85,,,percent of total billed charges,85% of total billed charges,17,100,,,fee schedule,100% of CO APG rates,16.15,95,,,percent of total billed charges,95% of total billed charges,13.6,80,,,percent of total billed charges,80% of total billed charges,14.45,85,,,percent of total billed charges,85% of total billed charges,15.3,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,17,100,,,fee schedule,100% of NM fee schedule,6.8,40,,,percent of total billed charges,40% of total billed charges,6.8,40,,,percent of total billed charges,40% of total billed charges,15.3,90,,,percent of total billed charges,90% of total billed charges,12.92,76,,,percent of total billed charges,76% of total billed charges,6.8,40,,,percent of total billed charges,40% of total billed charges,14.45,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,13.6,80,,,percent of total billed charges,80% of total billed charges,6.6,38.8,,,percent of total billed charges,38.8% of total billed charges,14.45,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.6,35.65,
90698 DTaP/Hib/IPV Vaccine - PSMC,49190698,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,203.7,162.96,,152.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,161.33,79.2,,,percent of total billed charges,79.2% of total billed charges,173.15,85,,,percent of total billed charges,85% of total billed charges,203.7,100,,,fee schedule,100% of CO APG rates,193.52,95,,,percent of total billed charges,95% of total billed charges,162.96,80,,,percent of total billed charges,80% of total billed charges,173.15,85,,,percent of total billed charges,85% of total billed charges,183.33,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,203.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,183.33,90,,,percent of total billed charges,90% of total billed charges,154.81,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,173.15,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,162.96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,173.15,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,789.6,100,,,case rate,pays based on per visit rate,152.78,789.6,
16020 DRESS/DEBRID P-THICK BURN S,60000018,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,244.8,195.84,,183.6,75,,,percent of total billed charges,75% of total billed charges,97.92,40,,,percent of total billed charges,40% of total billed charges,193.88,79.2,,,percent of total billed charges,79.2% of total billed charges,208.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,232.56,95,,,percent of total billed charges,95% of total billed charges,195.84,80,,,percent of total billed charges,80% of total billed charges,208.08,85,,,percent of total billed charges,85% of total billed charges,220.32,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,97.92,40,,,percent of total billed charges,40% of total billed charges,97.92,40,,,percent of total billed charges,40% of total billed charges,220.32,90,,,percent of total billed charges,90% of total billed charges,186.05,76,,,percent of total billed charges,76% of total billed charges,97.92,40,,,percent of total billed charges,40% of total billed charges,208.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,195.84,80,,,percent of total billed charges,80% of total billed charges,94.98,38.8,,,percent of total billed charges,38.8% of total billed charges,208.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,94.98,232.56,
J7297 Liletta IUD,60000194,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,726,580.8,TB,544.5,75,,,percent of total billed charges,75% of total billed charges,290.4,40,,,percent of total billed charges,40% of total billed charges,574.99,79.2,,,percent of total billed charges,79.2% of total billed charges,617.1,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,689.7,95,,,percent of total billed charges,95% of total billed charges,580.8,80,,,percent of total billed charges,80% of total billed charges,617.1,85,,,percent of total billed charges,85% of total billed charges,653.4,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,726,100,,,fee schedule,100% of NM fee schedule,290.4,40,,,percent of total billed charges,40% of total billed charges,290.4,40,,,percent of total billed charges,40% of total billed charges,653.4,90,,,percent of total billed charges,90% of total billed charges,551.76,76,,,percent of total billed charges,76% of total billed charges,290.4,40,,,percent of total billed charges,40% of total billed charges,617.1,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,580.8,80,,,percent of total billed charges,80% of total billed charges,281.69,38.8,,,percent of total billed charges,38.8% of total billed charges,617.1,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,726,
"10120 Incision and removal of foreign body, subcutaneous tissue; simple",60000006,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,471.4,377.12,,353.55,75,,,percent of total billed charges,75% of total billed charges,188.56,40,,,percent of total billed charges,40% of total billed charges,373.35,79.2,,,percent of total billed charges,79.2% of total billed charges,400.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,447.83,95,,,percent of total billed charges,95% of total billed charges,377.12,80,,,percent of total billed charges,80% of total billed charges,400.69,85,,,percent of total billed charges,85% of total billed charges,424.26,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,188.56,40,,,percent of total billed charges,40% of total billed charges,188.56,40,,,percent of total billed charges,40% of total billed charges,424.26,90,,,percent of total billed charges,90% of total billed charges,358.26,76,,,percent of total billed charges,76% of total billed charges,188.56,40,,,percent of total billed charges,40% of total billed charges,400.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,377.12,80,,,percent of total billed charges,80% of total billed charges,182.9,38.8,,,percent of total billed charges,38.8% of total billed charges,400.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,447.83,
"11042 Debridement, Subcutaneous Tissue; First 20 Sq Cm Or Le",60000010,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,408.8,327.04,,306.6,75,,,percent of total billed charges,75% of total billed charges,163.52,40,,,percent of total billed charges,40% of total billed charges,323.77,79.2,,,percent of total billed charges,79.2% of total billed charges,347.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,388.36,95,,,percent of total billed charges,95% of total billed charges,327.04,80,,,percent of total billed charges,80% of total billed charges,347.48,85,,,percent of total billed charges,85% of total billed charges,367.92,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,163.52,40,,,percent of total billed charges,40% of total billed charges,163.52,40,,,percent of total billed charges,40% of total billed charges,367.92,90,,,percent of total billed charges,90% of total billed charges,310.69,76,,,percent of total billed charges,76% of total billed charges,163.52,40,,,percent of total billed charges,40% of total billed charges,347.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,327.04,80,,,percent of total billed charges,80% of total billed charges,158.61,38.8,,,percent of total billed charges,38.8% of total billed charges,347.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,158.61,388.36,
31055100 Drainage of scrotal wall abscess,31055100,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,666.4,533.12,,499.8,75,,,percent of total billed charges,75% of total billed charges,266.56,40,,,percent of total billed charges,40% of total billed charges,527.79,79.2,,,percent of total billed charges,79.2% of total billed charges,566.44,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,633.08,95,,,percent of total billed charges,95% of total billed charges,533.12,80,,,percent of total billed charges,80% of total billed charges,566.44,85,,,percent of total billed charges,85% of total billed charges,599.76,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,266.56,40,,,percent of total billed charges,40% of total billed charges,266.56,40,,,percent of total billed charges,40% of total billed charges,599.76,90,,,percent of total billed charges,90% of total billed charges,506.46,76,,,percent of total billed charges,76% of total billed charges,266.56,40,,,percent of total billed charges,40% of total billed charges,566.44,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,533.12,80,,,percent of total billed charges,80% of total billed charges,258.56,38.8,,,percent of total billed charges,38.8% of total billed charges,566.44,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,633.08,
31056820 Colposcopy of the vulva;,31056820,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,360.5,288.4,,270.38,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,285.52,79.2,,,percent of total billed charges,79.2% of total billed charges,306.43,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,342.48,95,,,percent of total billed charges,95% of total billed charges,288.4,80,,,percent of total billed charges,80% of total billed charges,306.43,85,,,percent of total billed charges,85% of total billed charges,324.45,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,360.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,324.45,90,,,percent of total billed charges,90% of total billed charges,273.98,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,306.43,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,288.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,306.43,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1103.2,100,,,case rate,pays based on per visit rate,270.38,1103.2,
31058301 Removal of intrauterine device (IUD),31058301,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,320.8,256.64,,240.6,75,,,percent of total billed charges,75% of total billed charges,128.32,40,,,percent of total billed charges,40% of total billed charges,254.07,79.2,,,percent of total billed charges,79.2% of total billed charges,272.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,304.76,95,,,percent of total billed charges,95% of total billed charges,256.64,80,,,percent of total billed charges,80% of total billed charges,272.68,85,,,percent of total billed charges,85% of total billed charges,288.72,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,128.32,40,,,percent of total billed charges,40% of total billed charges,128.32,40,,,percent of total billed charges,40% of total billed charges,288.72,90,,,percent of total billed charges,90% of total billed charges,243.81,76,,,percent of total billed charges,76% of total billed charges,128.32,40,,,percent of total billed charges,40% of total billed charges,272.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,256.64,80,,,percent of total billed charges,80% of total billed charges,124.47,38.8,,,percent of total billed charges,38.8% of total billed charges,272.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,124.47,304.76,
"11770 - Excision of pilonidal cyst or sinus, simple",46011770,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1147,917.6,,860.25,75,,,percent of total billed charges,75% of total billed charges,458.8,40,,,percent of total billed charges,40% of total billed charges,908.42,79.2,,,percent of total billed charges,79.2% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1089.65,95,,,percent of total billed charges,95% of total billed charges,917.6,80,,,percent of total billed charges,80% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,1032.3,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,458.8,40,,,percent of total billed charges,40% of total billed charges,458.8,40,,,percent of total billed charges,40% of total billed charges,1032.3,90,,,percent of total billed charges,90% of total billed charges,871.72,76,,,percent of total billed charges,76% of total billed charges,458.8,40,,,percent of total billed charges,40% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,917.6,80,,,percent of total billed charges,80% of total billed charges,445.04,38.8,,,percent of total billed charges,38.8% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1089.65,
"46050 - Incision and drainage, perineal abscess,superficial",46046050,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,706.6,565.28,,529.95,75,,,percent of total billed charges,75% of total billed charges,282.64,40,,,percent of total billed charges,40% of total billed charges,559.63,79.2,,,percent of total billed charges,79.2% of total billed charges,600.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,671.27,95,,,percent of total billed charges,95% of total billed charges,565.28,80,,,percent of total billed charges,80% of total billed charges,600.61,85,,,percent of total billed charges,85% of total billed charges,635.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,282.64,40,,,percent of total billed charges,40% of total billed charges,282.64,40,,,percent of total billed charges,40% of total billed charges,635.94,90,,,percent of total billed charges,90% of total billed charges,537.02,76,,,percent of total billed charges,76% of total billed charges,282.64,40,,,percent of total billed charges,40% of total billed charges,600.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,565.28,80,,,percent of total billed charges,80% of total billed charges,274.16,38.8,,,percent of total billed charges,38.8% of total billed charges,600.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,671.27,
11983 Removal with reinsertion of Nexplanon drug delivery im,60000379,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,413.5,330.8,,310.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,327.49,79.2,,,percent of total billed charges,79.2% of total billed charges,351.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,392.83,95,,,percent of total billed charges,95% of total billed charges,330.8,80,,,percent of total billed charges,80% of total billed charges,351.48,85,,,percent of total billed charges,85% of total billed charges,372.15,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,413.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,372.15,90,,,percent of total billed charges,90% of total billed charges,314.26,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,351.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,330.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,351.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1209.2,100,,,case rate,pays based on per visit rate,310.13,1209.2,
64450 Block Peripheral Nerve,60000114,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,237.4,189.92,,178.05,75,,,percent of total billed charges,75% of total billed charges,94.96,40,,,percent of total billed charges,40% of total billed charges,188.02,79.2,,,percent of total billed charges,79.2% of total billed charges,201.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,225.53,95,,,percent of total billed charges,95% of total billed charges,189.92,80,,,percent of total billed charges,80% of total billed charges,201.79,85,,,percent of total billed charges,85% of total billed charges,213.66,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,94.96,40,,,percent of total billed charges,40% of total billed charges,94.96,40,,,percent of total billed charges,40% of total billed charges,213.66,90,,,percent of total billed charges,90% of total billed charges,180.42,76,,,percent of total billed charges,76% of total billed charges,94.96,40,,,percent of total billed charges,40% of total billed charges,201.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,189.92,80,,,percent of total billed charges,80% of total billed charges,92.11,38.8,,,percent of total billed charges,38.8% of total billed charges,201.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,92.11,225.53,
FIT Stool  Occult Blood POC PSMC,49182274,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,101.8,81.44,,76.35,75,,,percent of total billed charges,75% of total billed charges,40.72,40,,,percent of total billed charges,40% of total billed charges,80.63,79.2,,,percent of total billed charges,79.2% of total billed charges,86.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,96.71,95,,,percent of total billed charges,95% of total billed charges,81.44,80,,,percent of total billed charges,80% of total billed charges,86.53,85,,,percent of total billed charges,85% of total billed charges,91.62,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,40.72,40,,,percent of total billed charges,40% of total billed charges,40.72,40,,,percent of total billed charges,40% of total billed charges,91.62,90,,,percent of total billed charges,90% of total billed charges,77.37,76,,,percent of total billed charges,76% of total billed charges,40.72,40,,,percent of total billed charges,40% of total billed charges,86.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,81.44,80,,,percent of total billed charges,80% of total billed charges,39.5,38.8,,,percent of total billed charges,38.8% of total billed charges,86.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,96.71,
"17004  Destruction (eg cryosurgery), 15 or more premalignant",49117004,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,490.5,392.4,,367.88,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,388.48,79.2,,,percent of total billed charges,79.2% of total billed charges,416.93,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,465.98,95,,,percent of total billed charges,95% of total billed charges,392.4,80,,,percent of total billed charges,80% of total billed charges,416.93,85,,,percent of total billed charges,85% of total billed charges,441.45,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,490.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,441.45,90,,,percent of total billed charges,90% of total billed charges,372.78,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,416.93,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,392.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,416.93,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"69209 Removal impacted cerumen using irrigation/lavage, unil",49169209,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,44.7,35.76,,33.53,75,,,percent of total billed charges,75% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,35.4,79.2,,,percent of total billed charges,79.2% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rates,42.47,95,,,percent of total billed charges,95% of total billed charges,35.76,80,,,percent of total billed charges,80% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,44.7,100,,,fee schedule,100% of NM APC rate,17.88,40,,,percent of total billed charges,40% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,33.97,76,,,percent of total billed charges,76% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,35.76,80,,,percent of total billed charges,80% of total billed charges,17.34,38.8,,,percent of total billed charges,38.8% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,89.4,200,,,fee schedule,200% of CMS fee schedule,17.34,215.49,
VFC 90746 Hepatitis B Adult Vaccine,49190746,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
90662 Fluzone High-Dose 0.5mL Single dose syringe; Trivalent,49190662,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,95.5,76.4,,71.63,75,,,percent of total billed charges,75% of total billed charges,38.2,40,,,percent of total billed charges,40% of total billed charges,75.64,79.2,,,percent of total billed charges,79.2% of total billed charges,81.18,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,90.73,95,,,percent of total billed charges,95% of total billed charges,76.4,80,,,percent of total billed charges,80% of total billed charges,81.18,85,,,percent of total billed charges,85% of total billed charges,85.95,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,95.5,100,,,fee schedule,100% of NM fee schedule,38.2,40,,,percent of total billed charges,40% of total billed charges,38.2,40,,,percent of total billed charges,40% of total billed charges,85.95,90,,,percent of total billed charges,90% of total billed charges,72.58,76,,,percent of total billed charges,76% of total billed charges,38.2,40,,,percent of total billed charges,40% of total billed charges,81.18,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,76.4,80,,,percent of total billed charges,80% of total billed charges,37.05,38.8,,,percent of total billed charges,38.8% of total billed charges,81.18,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,95.5,
90686 Fluzone/Fluarix 0.5mL Single dose syringe; Quadrivalen,99990686,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
"42104 Excision, lesion of palate, uvula; without closure",46042104,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,635.2,508.16,,476.4,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,503.08,79.2,,,percent of total billed charges,79.2% of total billed charges,539.92,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,603.44,95,,,percent of total billed charges,95% of total billed charges,508.16,80,,,percent of total billed charges,80% of total billed charges,539.92,85,,,percent of total billed charges,85% of total billed charges,571.68,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,635.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,571.68,90,,,percent of total billed charges,90% of total billed charges,482.75,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,539.92,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,508.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,539.92,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
90473 Immunization administration by oral or intranasal rout,49190473,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,30.9,24.72,,23.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,24.47,79.2,,,percent of total billed charges,79.2% of total billed charges,26.27,85,,,percent of total billed charges,85% of total billed charges,30.9,100,,,fee schedule,100% of CO APG rates,29.36,95,,,percent of total billed charges,95% of total billed charges,24.72,80,,,percent of total billed charges,80% of total billed charges,26.27,85,,,percent of total billed charges,85% of total billed charges,27.81,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,30.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,27.81,90,,,percent of total billed charges,90% of total billed charges,23.48,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,26.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,24.72,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,26.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,444,100,,,case rate,pays based on per visit rate,23.18,444,
26675 Closed tx of carpometacarpal dislocation other than th,25375489,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1342.1,1073.68,,1006.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1062.94,79.2,,,percent of total billed charges,79.2% of total billed charges,1140.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1275,95,,,percent of total billed charges,95% of total billed charges,1073.68,80,,,percent of total billed charges,80% of total billed charges,1140.79,85,,,percent of total billed charges,85% of total billed charges,1207.89,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1342.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1207.89,90,,,percent of total billed charges,90% of total billed charges,1020,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1140.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1073.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1140.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1342.1,
90651 Gardasil 9 HPV vaccine INS,49190651,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,502.8,402.24,,377.1,75,,,percent of total billed charges,75% of total billed charges,201.12,40,,,percent of total billed charges,40% of total billed charges,398.22,79.2,,,percent of total billed charges,79.2% of total billed charges,427.38,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,477.66,95,,,percent of total billed charges,95% of total billed charges,402.24,80,,,percent of total billed charges,80% of total billed charges,427.38,85,,,percent of total billed charges,85% of total billed charges,452.52,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,502.8,100,,,fee schedule,100% of NM fee schedule,201.12,40,,,percent of total billed charges,40% of total billed charges,201.12,40,,,percent of total billed charges,40% of total billed charges,452.52,90,,,percent of total billed charges,90% of total billed charges,382.13,76,,,percent of total billed charges,76% of total billed charges,201.12,40,,,percent of total billed charges,40% of total billed charges,427.38,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,402.24,80,,,percent of total billed charges,80% of total billed charges,195.09,38.8,,,percent of total billed charges,38.8% of total billed charges,427.38,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,502.8,
90651 Gardasil 9 HPV vaccine VFC,99990651,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
55000 - Puncture aspiration of hydrocele,60000790,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,348.8,279.04,,261.6,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,276.25,79.2,,,percent of total billed charges,79.2% of total billed charges,296.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,331.36,95,,,percent of total billed charges,95% of total billed charges,279.04,80,,,percent of total billed charges,80% of total billed charges,296.48,85,,,percent of total billed charges,85% of total billed charges,313.92,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,348.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,313.92,90,,,percent of total billed charges,90% of total billed charges,265.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,296.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,279.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,296.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1079.8,100,,,case rate,pays based on per visit rate,261.6,1079.8,
Q0091 - Pap Smear Collection for MEDICARE Patients,465Q0091,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,47.2,37.76,,35.4,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,37.38,79.2,,,percent of total billed charges,79.2% of total billed charges,40.12,85,,,percent of total billed charges,85% of total billed charges,47.2,100,,,fee schedule,100% of CO APG rates,44.84,95,,,percent of total billed charges,95% of total billed charges,37.76,80,,,percent of total billed charges,80% of total billed charges,40.12,85,,,percent of total billed charges,85% of total billed charges,42.48,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,47.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,42.48,90,,,percent of total billed charges,90% of total billed charges,35.87,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,40.12,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,37.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,40.12,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,476.6,100,,,case rate,pays based on per visit rate,35.4,476.6,
Dexamethasone 10mg/mL / J1100 Decadon 1MG - PSMC,J1100,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,9.6,7.68,,7.2,75,,,percent of total billed charges,75% of total billed charges,3.84,40,,,percent of total billed charges,40% of total billed charges,7.6,79.2,,,percent of total billed charges,79.2% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,9.6,100,,,fee schedule,100% of CO APG rates,9.12,95,,,percent of total billed charges,95% of total billed charges,7.68,80,,,percent of total billed charges,80% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,8.64,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,9.6,100,,,fee schedule,100% of NM fee schedule,3.84,40,,,percent of total billed charges,40% of total billed charges,3.84,40,,,percent of total billed charges,40% of total billed charges,8.64,90,,,percent of total billed charges,90% of total billed charges,7.3,76,,,percent of total billed charges,76% of total billed charges,3.84,40,,,percent of total billed charges,40% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,7.68,80,,,percent of total billed charges,80% of total billed charges,3.72,38.8,,,percent of total billed charges,38.8% of total billed charges,8.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.72,35.65,
32552 - Remove lung catheter,60000789,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,440.4,352.32,,330.3,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,348.8,79.2,,,percent of total billed charges,79.2% of total billed charges,374.34,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,418.38,95,,,percent of total billed charges,95% of total billed charges,352.32,80,,,percent of total billed charges,80% of total billed charges,374.34,85,,,percent of total billed charges,85% of total billed charges,396.36,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,440.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,396.36,90,,,percent of total billed charges,90% of total billed charges,334.7,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,374.34,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,352.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,374.34,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
11000 Debridement of extensive eczematous or infected skin; up to 10% of body su,60000009,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,373.5,298.8,,280.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,295.81,79.2,,,percent of total billed charges,79.2% of total billed charges,317.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,354.83,95,,,percent of total billed charges,95% of total billed charges,298.8,80,,,percent of total billed charges,80% of total billed charges,317.48,85,,,percent of total billed charges,85% of total billed charges,336.15,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,373.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,336.15,90,,,percent of total billed charges,90% of total billed charges,283.86,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,317.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,298.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,317.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1129.2,100,,,case rate,pays based on per visit rate,280.13,1129.2,
19000 Puncture aspiration of cyst of breast,46519000,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,307.3,245.84,,230.48,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,243.38,79.2,,,percent of total billed charges,79.2% of total billed charges,261.21,85,,,percent of total billed charges,85% of total billed charges,307.3,100,,,fee schedule,100% of CO APG rates,291.94,95,,,percent of total billed charges,95% of total billed charges,245.84,80,,,percent of total billed charges,80% of total billed charges,261.21,85,,,percent of total billed charges,85% of total billed charges,276.57,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,307.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,276.57,90,,,percent of total billed charges,90% of total billed charges,233.55,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,261.21,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,245.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,261.21,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,996.8,100,,,case rate,pays based on per visit rate,230.48,996.8,
"90750 Zoster (shingles) vaccine (HZV), recombinant, sub-unit",49190750,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,382.3,305.84,,286.73,75,,,percent of total billed charges,75% of total billed charges,152.92,40,,,percent of total billed charges,40% of total billed charges,302.78,79.2,,,percent of total billed charges,79.2% of total billed charges,324.96,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,363.19,95,,,percent of total billed charges,95% of total billed charges,305.84,80,,,percent of total billed charges,80% of total billed charges,324.96,85,,,percent of total billed charges,85% of total billed charges,344.07,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,382.3,100,,,fee schedule,100% of NM fee schedule,152.92,40,,,percent of total billed charges,40% of total billed charges,152.92,40,,,percent of total billed charges,40% of total billed charges,344.07,90,,,percent of total billed charges,90% of total billed charges,290.55,76,,,percent of total billed charges,76% of total billed charges,152.92,40,,,percent of total billed charges,40% of total billed charges,324.96,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,305.84,80,,,percent of total billed charges,80% of total billed charges,148.33,38.8,,,percent of total billed charges,38.8% of total billed charges,324.96,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,382.3,
"JAK2 V617F Mutation Analysis, Quant LC",40081270,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,551.5,441.2,,413.63,75,,,percent of total billed charges,75% of total billed charges,220.6,40,,,percent of total billed charges,40% of total billed charges,436.79,79.2,,,percent of total billed charges,79.2% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,523.93,95,,,percent of total billed charges,95% of total billed charges,441.2,80,,,percent of total billed charges,80% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,496.35,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,220.6,40,,,percent of total billed charges,40% of total billed charges,220.6,40,,,percent of total billed charges,40% of total billed charges,496.35,90,,,percent of total billed charges,90% of total billed charges,419.14,76,,,percent of total billed charges,76% of total billed charges,220.6,40,,,percent of total billed charges,40% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,441.2,80,,,percent of total billed charges,80% of total billed charges,213.98,38.8,,,percent of total billed charges,38.8% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,523.93,
Q0091 - Pap Smear Collection for MEDICARE Patients Clinic,491Q0091,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,36.4,29.12,,27.3,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,28.83,79.2,,,percent of total billed charges,79.2% of total billed charges,30.94,85,,,percent of total billed charges,85% of total billed charges,36.4,100,,,fee schedule,100% of CO APG rates,34.58,95,,,percent of total billed charges,95% of total billed charges,29.12,80,,,percent of total billed charges,80% of total billed charges,30.94,85,,,percent of total billed charges,85% of total billed charges,32.76,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,36.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,32.76,90,,,percent of total billed charges,90% of total billed charges,27.66,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,30.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,29.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,30.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,455,100,,,case rate,pays based on per visit rate,27.3,455,
29505 Application Of Long Leg Splint,60000071,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,248.9,199.12,,186.68,75,,,percent of total billed charges,75% of total billed charges,99.56,40,,,percent of total billed charges,40% of total billed charges,197.13,79.2,,,percent of total billed charges,79.2% of total billed charges,211.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,236.46,95,,,percent of total billed charges,95% of total billed charges,199.12,80,,,percent of total billed charges,80% of total billed charges,211.57,85,,,percent of total billed charges,85% of total billed charges,224.01,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,99.56,40,,,percent of total billed charges,40% of total billed charges,99.56,40,,,percent of total billed charges,40% of total billed charges,224.01,90,,,percent of total billed charges,90% of total billed charges,189.16,76,,,percent of total billed charges,76% of total billed charges,99.56,40,,,percent of total billed charges,40% of total billed charges,211.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,199.12,80,,,percent of total billed charges,80% of total billed charges,96.57,38.8,,,percent of total billed charges,38.8% of total billed charges,211.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,96.57,236.46,
90474 Each additional vaccine by intranasal or oral route.,60000054,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,22.3,17.84,,16.73,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,17.66,79.2,,,percent of total billed charges,79.2% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,22.3,100,,,fee schedule,100% of CO APG rates,21.19,95,,,percent of total billed charges,95% of total billed charges,17.84,80,,,percent of total billed charges,80% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,20.07,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,22.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,20.07,90,,,percent of total billed charges,90% of total billed charges,16.95,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,18.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,17.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,18.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,426.8,100,,,case rate,pays based on per visit rate,16.73,426.8,
"FOLEY CATH TRAY, SILICONE, 16FR",52706,CDM,270,RC,,,OUTPATIENT,,,130.78,104.624,,98.09,75,,,percent of total billed charges,75% of total billed charges,52.31,40,,,percent of total billed charges,40% of total billed charges,103.58,79.2,,,percent of total billed charges,79.2% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,130.78,100,,,fee schedule,100% of CO APG rates,124.24,95,,,percent of total billed charges,95% of total billed charges,104.62,80,,,percent of total billed charges,80% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,117.7,90,,,percent of total billed charges,90% of total billed charges,130.78,100,,,fee schedule,100% of CO APG rates,130.78,100,,,fee schedule,100% of CO APG rates,130.78,100,,,fee schedule,100% of NM fee schedule,52.31,40,,,percent of total billed charges,40% of total billed charges,52.31,40,,,percent of total billed charges,40% of total billed charges,117.7,90,,,percent of total billed charges,90% of total billed charges,99.39,76,,,percent of total billed charges,76% of total billed charges,52.31,40,,,percent of total billed charges,40% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,130.78,100,,,fee schedule,100% of CO APG rate,104.62,80,,,percent of total billed charges,80% of total billed charges,50.74,38.8,,,percent of total billed charges,38.8% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,130.78,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,50.74,130.78,
"INS FLUAD, 0.5mL, Single Dose Syringe Vaccine, 65 ye",60000134,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,94.5,75.6,,70.88,75,,,percent of total billed charges,75% of total billed charges,37.8,40,,,percent of total billed charges,40% of total billed charges,74.84,79.2,,,percent of total billed charges,79.2% of total billed charges,80.33,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,89.78,95,,,percent of total billed charges,95% of total billed charges,75.6,80,,,percent of total billed charges,80% of total billed charges,80.33,85,,,percent of total billed charges,85% of total billed charges,85.05,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,94.5,100,,,fee schedule,100% of NM fee schedule,37.8,40,,,percent of total billed charges,40% of total billed charges,37.8,40,,,percent of total billed charges,40% of total billed charges,85.05,90,,,percent of total billed charges,90% of total billed charges,71.82,76,,,percent of total billed charges,76% of total billed charges,37.8,40,,,percent of total billed charges,40% of total billed charges,80.33,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,75.6,80,,,percent of total billed charges,80% of total billed charges,36.67,38.8,,,percent of total billed charges,38.8% of total billed charges,80.33,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,94.5,
"90685 - INS Fluzone Quadrivalent, 0.25mL, Pediatric Single D",60000135,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,47.3,37.84,,35.48,75,,,percent of total billed charges,75% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,37.46,79.2,,,percent of total billed charges,79.2% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,44.94,95,,,percent of total billed charges,95% of total billed charges,37.84,80,,,percent of total billed charges,80% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,47.3,100,,,fee schedule,100% of NM fee schedule,18.92,40,,,percent of total billed charges,40% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.95,76,,,percent of total billed charges,76% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,37.84,80,,,percent of total billed charges,80% of total billed charges,18.35,38.8,,,percent of total billed charges,38.8% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.35,47.3,
"90686 - INS Fluzone Quadrivalent, 0.5mL, Single Dose Syringe",60000137,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,47.3,37.84,,35.48,75,,,percent of total billed charges,75% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,37.46,79.2,,,percent of total billed charges,79.2% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,44.94,95,,,percent of total billed charges,95% of total billed charges,37.84,80,,,percent of total billed charges,80% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,47.3,100,,,fee schedule,100% of NM fee schedule,18.92,40,,,percent of total billed charges,40% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.95,76,,,percent of total billed charges,76% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,37.84,80,,,percent of total billed charges,80% of total billed charges,18.35,38.8,,,percent of total billed charges,38.8% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.35,47.3,
"COLLAGEN DRESSING W/ SILVER PROMOGRAN PRISMA, 4-1/3 X 4-1/3",49152720,CDM,270,RC,,,OUTPATIENT,,,22.1,17.68,,16.58,75,,,percent of total billed charges,75% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,17.5,79.2,,,percent of total billed charges,79.2% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,22.1,100,,,fee schedule,100% of CO APG rates,21,95,,,percent of total billed charges,95% of total billed charges,17.68,80,,,percent of total billed charges,80% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,19.89,90,,,percent of total billed charges,90% of total billed charges,22.1,100,,,fee schedule,100% of CO APG rates,22.1,100,,,fee schedule,100% of CO APG rates,22.1,100,,,fee schedule,100% of NM fee schedule,8.84,40,,,percent of total billed charges,40% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,19.89,90,,,percent of total billed charges,90% of total billed charges,16.8,76,,,percent of total billed charges,76% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,22.1,100,,,fee schedule,100% of CO APG rate,17.68,80,,,percent of total billed charges,80% of total billed charges,8.57,38.8,,,percent of total billed charges,38.8% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,22.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.57,22.1,
29580 Strapping; Unna Boot,46029580,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,185.3,148.24,,138.98,75,,,percent of total billed charges,75% of total billed charges,74.12,40,,,percent of total billed charges,40% of total billed charges,146.76,79.2,,,percent of total billed charges,79.2% of total billed charges,157.51,85,,,percent of total billed charges,85% of total billed charges,185.3,100,,,fee schedule,100% of CO APG rates,176.04,95,,,percent of total billed charges,95% of total billed charges,148.24,80,,,percent of total billed charges,80% of total billed charges,157.51,85,,,percent of total billed charges,85% of total billed charges,166.77,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,74.12,40,,,percent of total billed charges,40% of total billed charges,74.12,40,,,percent of total billed charges,40% of total billed charges,166.77,90,,,percent of total billed charges,90% of total billed charges,140.83,76,,,percent of total billed charges,76% of total billed charges,74.12,40,,,percent of total billed charges,40% of total billed charges,157.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,148.24,80,,,percent of total billed charges,80% of total billed charges,71.9,38.8,,,percent of total billed charges,38.8% of total billed charges,157.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,71.9,217.66,
98925 - OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,60000122,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,74.2,59.36,,55.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,58.77,79.2,,,percent of total billed charges,79.2% of total billed charges,63.07,85,,,percent of total billed charges,85% of total billed charges,74.2,100,,,fee schedule,100% of CO APG rates,70.49,95,,,percent of total billed charges,95% of total billed charges,59.36,80,,,percent of total billed charges,80% of total billed charges,63.07,85,,,percent of total billed charges,85% of total billed charges,66.78,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,74.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,66.78,90,,,percent of total billed charges,90% of total billed charges,56.39,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,63.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,59.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,63.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,530.6,100,,,case rate,pays based on per visit rate,55.65,530.6,
98926 - OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,60000123,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,112.9,90.32,,84.68,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,89.42,79.2,,,percent of total billed charges,79.2% of total billed charges,95.97,85,,,percent of total billed charges,85% of total billed charges,112.9,100,,,fee schedule,100% of CO APG rates,107.26,95,,,percent of total billed charges,95% of total billed charges,90.32,80,,,percent of total billed charges,80% of total billed charges,95.97,85,,,percent of total billed charges,85% of total billed charges,101.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,112.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,101.61,90,,,percent of total billed charges,90% of total billed charges,85.8,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,95.97,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,90.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,95.97,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,608,100,,,case rate,pays based on per visit rate,84.68,608,
98927 - OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS,60000124,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,149.3,119.44,,111.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,118.25,79.2,,,percent of total billed charges,79.2% of total billed charges,126.91,85,,,percent of total billed charges,85% of total billed charges,149.3,100,,,fee schedule,100% of CO APG rates,141.84,95,,,percent of total billed charges,95% of total billed charges,119.44,80,,,percent of total billed charges,80% of total billed charges,126.91,85,,,percent of total billed charges,85% of total billed charges,134.37,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,149.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,134.37,90,,,percent of total billed charges,90% of total billed charges,113.47,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,126.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,119.44,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,126.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,680.8,100,,,case rate,pays based on per visit rate,111.98,680.8,
98928 - OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS,60000125,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,187,149.6,,140.25,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,148.1,79.2,,,percent of total billed charges,79.2% of total billed charges,158.95,85,,,percent of total billed charges,85% of total billed charges,187,100,,,fee schedule,100% of CO APG rates,177.65,95,,,percent of total billed charges,95% of total billed charges,149.6,80,,,percent of total billed charges,80% of total billed charges,158.95,85,,,percent of total billed charges,85% of total billed charges,168.3,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,187,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,168.3,90,,,percent of total billed charges,90% of total billed charges,142.12,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,158.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,149.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,158.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,756.2,100,,,case rate,pays based on per visit rate,140.25,756.2,
98929 - OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS,60000126,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,225.8,180.64,,169.35,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,178.83,79.2,,,percent of total billed charges,79.2% of total billed charges,191.93,85,,,percent of total billed charges,85% of total billed charges,225.8,100,,,fee schedule,100% of CO APG rates,214.51,95,,,percent of total billed charges,95% of total billed charges,180.64,80,,,percent of total billed charges,80% of total billed charges,191.93,85,,,percent of total billed charges,85% of total billed charges,203.22,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,225.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,203.22,90,,,percent of total billed charges,90% of total billed charges,171.61,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,191.93,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,180.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,191.93,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,833.8,100,,,case rate,pays based on per visit rate,169.35,833.8,
"90674 - INS Flucelvax Quadrivalent, 0.5mL, Single Dose Syrin",60000154,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,47.7,38.16,,35.78,75,,,percent of total billed charges,75% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,37.78,79.2,,,percent of total billed charges,79.2% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,45.32,95,,,percent of total billed charges,95% of total billed charges,38.16,80,,,percent of total billed charges,80% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,42.93,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,47.7,100,,,fee schedule,100% of NM fee schedule,19.08,40,,,percent of total billed charges,40% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,42.93,90,,,percent of total billed charges,90% of total billed charges,36.25,76,,,percent of total billed charges,76% of total billed charges,19.08,40,,,percent of total billed charges,40% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,38.16,80,,,percent of total billed charges,80% of total billed charges,18.51,38.8,,,percent of total billed charges,38.8% of total billed charges,40.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.51,47.7,
"29355 Application of long leg cast (thigh to toes), walker",60000150,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,432.7,346.16,,324.53,75,,,percent of total billed charges,75% of total billed charges,173.08,40,,,percent of total billed charges,40% of total billed charges,342.7,79.2,,,percent of total billed charges,79.2% of total billed charges,367.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,411.07,95,,,percent of total billed charges,95% of total billed charges,346.16,80,,,percent of total billed charges,80% of total billed charges,367.8,85,,,percent of total billed charges,85% of total billed charges,389.43,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,173.08,40,,,percent of total billed charges,40% of total billed charges,173.08,40,,,percent of total billed charges,40% of total billed charges,389.43,90,,,percent of total billed charges,90% of total billed charges,328.85,76,,,percent of total billed charges,76% of total billed charges,173.08,40,,,percent of total billed charges,40% of total billed charges,367.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,346.16,80,,,percent of total billed charges,80% of total billed charges,167.89,38.8,,,percent of total billed charges,38.8% of total billed charges,367.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,167.89,411.07,
BARD MARQUEE BIOPSY 14X10,52711,CDM,270,RC,,,OUTPATIENT,,,325.6,260.48,,244.2,75,,,percent of total billed charges,75% of total billed charges,130.24,40,,,percent of total billed charges,40% of total billed charges,257.88,79.2,,,percent of total billed charges,79.2% of total billed charges,276.76,85,,,percent of total billed charges,85% of total billed charges,325.6,100,,,fee schedule,100% of CO APG rates,309.32,95,,,percent of total billed charges,95% of total billed charges,260.48,80,,,percent of total billed charges,80% of total billed charges,276.76,85,,,percent of total billed charges,85% of total billed charges,293.04,90,,,percent of total billed charges,90% of total billed charges,325.6,100,,,fee schedule,100% of CO APG rates,325.6,100,,,fee schedule,100% of CO APG rates,325.6,100,,,fee schedule,100% of NM fee schedule,130.24,40,,,percent of total billed charges,40% of total billed charges,130.24,40,,,percent of total billed charges,40% of total billed charges,293.04,90,,,percent of total billed charges,90% of total billed charges,247.46,76,,,percent of total billed charges,76% of total billed charges,130.24,40,,,percent of total billed charges,40% of total billed charges,276.76,85,,,percent of total billed charges,85% of total billed charges,325.6,100,,,fee schedule,100% of CO APG rate,260.48,80,,,percent of total billed charges,80% of total billed charges,126.33,38.8,,,percent of total billed charges,38.8% of total billed charges,276.76,85,,,percent of total billed charges,85% of total billed charges,325.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,126.33,325.6,
BARD MARQUEE BIOPSY 18X16,52712,CDM,270,RC,,,OUTPATIENT,,,325.6,260.48,,244.2,75,,,percent of total billed charges,75% of total billed charges,130.24,40,,,percent of total billed charges,40% of total billed charges,257.88,79.2,,,percent of total billed charges,79.2% of total billed charges,276.76,85,,,percent of total billed charges,85% of total billed charges,325.6,100,,,fee schedule,100% of CO APG rates,309.32,95,,,percent of total billed charges,95% of total billed charges,260.48,80,,,percent of total billed charges,80% of total billed charges,276.76,85,,,percent of total billed charges,85% of total billed charges,293.04,90,,,percent of total billed charges,90% of total billed charges,325.6,100,,,fee schedule,100% of CO APG rates,325.6,100,,,fee schedule,100% of CO APG rates,325.6,100,,,fee schedule,100% of NM fee schedule,130.24,40,,,percent of total billed charges,40% of total billed charges,130.24,40,,,percent of total billed charges,40% of total billed charges,293.04,90,,,percent of total billed charges,90% of total billed charges,247.46,76,,,percent of total billed charges,76% of total billed charges,130.24,40,,,percent of total billed charges,40% of total billed charges,276.76,85,,,percent of total billed charges,85% of total billed charges,325.6,100,,,fee schedule,100% of CO APG rate,260.48,80,,,percent of total billed charges,80% of total billed charges,126.33,38.8,,,percent of total billed charges,38.8% of total billed charges,276.76,85,,,percent of total billed charges,85% of total billed charges,325.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,126.33,325.6,
Synchronous audio-only visit for the evaluation,60000604,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,120,96,,90,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,95.04,79.2,,,percent of total billed charges,79.2% of total billed charges,102,85,,,percent of total billed charges,85% of total billed charges,120,100,,,fee schedule,100% of CO APG rates,114,95,,,percent of total billed charges,95% of total billed charges,96,80,,,percent of total billed charges,80% of total billed charges,102,85,,,percent of total billed charges,85% of total billed charges,108,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,120,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,108,90,,,percent of total billed charges,90% of total billed charges,91.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,102,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,102,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,622.2,100,,,case rate,pays based on per visit rate,90,622.2,
Synchronous audio-only visit for the evaluation,60000605,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,158.9,127.12,,119.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,125.85,79.2,,,percent of total billed charges,79.2% of total billed charges,135.07,85,,,percent of total billed charges,85% of total billed charges,158.9,100,,,fee schedule,100% of CO APG rates,150.96,95,,,percent of total billed charges,95% of total billed charges,127.12,80,,,percent of total billed charges,80% of total billed charges,135.07,85,,,percent of total billed charges,85% of total billed charges,143.01,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,158.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,143.01,90,,,percent of total billed charges,90% of total billed charges,120.76,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,135.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,127.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,135.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,700,100,,,case rate,pays based on per visit rate,119.18,700,
Synchronous audio-only visit for the,60000606,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,224.6,179.68,,168.45,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,177.88,79.2,,,percent of total billed charges,79.2% of total billed charges,190.91,85,,,percent of total billed charges,85% of total billed charges,224.6,100,,,fee schedule,100% of CO APG rates,213.37,95,,,percent of total billed charges,95% of total billed charges,179.68,80,,,percent of total billed charges,80% of total billed charges,190.91,85,,,percent of total billed charges,85% of total billed charges,202.14,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,224.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,202.14,90,,,percent of total billed charges,90% of total billed charges,170.7,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,190.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,179.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,190.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,831.4,100,,,case rate,pays based on per visit rate,168.45,831.4,
11901 - Injection of more than 7 skin growths,60000163,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,202.9,162.32,,152.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,160.7,79.2,,,percent of total billed charges,79.2% of total billed charges,172.47,85,,,percent of total billed charges,85% of total billed charges,202.9,100,,,fee schedule,100% of CO APG rates,192.76,95,,,percent of total billed charges,95% of total billed charges,162.32,80,,,percent of total billed charges,80% of total billed charges,172.47,85,,,percent of total billed charges,85% of total billed charges,182.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,202.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,182.61,90,,,percent of total billed charges,90% of total billed charges,154.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,172.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,162.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,172.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,788,100,,,case rate,pays based on per visit rate,152.18,788,
BONE MARROW TRAY,52717,CDM,272,RC,,,OUTPATIENT,,,105,84,,78.75,75,,,percent of total billed charges,75% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,83.16,79.2,,,percent of total billed charges,79.2% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,105,100,,,fee schedule,100% of CO APG rates,99.75,95,,,percent of total billed charges,95% of total billed charges,84,80,,,percent of total billed charges,80% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,105,100,,,fee schedule,100% of CO APG rates,105,100,,,fee schedule,100% of CO APG rates,105,100,,,fee schedule,100% of NM fee schedule,42,40,,,percent of total billed charges,40% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,79.8,76,,,percent of total billed charges,76% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,105,100,,,fee schedule,100% of CO APG rate,84,80,,,percent of total billed charges,80% of total billed charges,40.74,38.8,,,percent of total billed charges,38.8% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,105,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,40.74,105,
Lead POC,60000132,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,46.7,37.36,,35.03,75,,,percent of total billed charges,75% of total billed charges,18.68,40,,,percent of total billed charges,40% of total billed charges,36.99,79.2,,,percent of total billed charges,79.2% of total billed charges,39.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,44.37,95,,,percent of total billed charges,95% of total billed charges,37.36,80,,,percent of total billed charges,80% of total billed charges,39.7,85,,,percent of total billed charges,85% of total billed charges,42.03,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,18.68,40,,,percent of total billed charges,40% of total billed charges,18.68,40,,,percent of total billed charges,40% of total billed charges,42.03,90,,,percent of total billed charges,90% of total billed charges,35.49,76,,,percent of total billed charges,76% of total billed charges,18.68,40,,,percent of total billed charges,40% of total billed charges,39.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,37.36,80,,,percent of total billed charges,80% of total billed charges,18.12,38.8,,,percent of total billed charges,38.8% of total billed charges,39.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,44.37,
G0404 EKG For Medicare IPPE,G0404,CDM,730,RC,93005,HCPCS,OUTPATIENT,,,37.3,29.84,,27.98,75,,,percent of total billed charges,75% of total billed charges,14.92,40,,,percent of total billed charges,40% of total billed charges,29.54,79.2,,,percent of total billed charges,79.2% of total billed charges,31.71,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,35.44,95,,,percent of total billed charges,95% of total billed charges,29.84,80,,,percent of total billed charges,80% of total billed charges,31.71,85,,,percent of total billed charges,85% of total billed charges,33.57,90,,,percent of total billed charges,90% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,34.77,100,,,fee schedule,100% of CO APG rates,37.3,100,,,fee schedule,100% of NM APC rate,14.92,40,,,percent of total billed charges,40% of total billed charges,14.92,40,,,percent of total billed charges,40% of total billed charges,33.57,90,,,percent of total billed charges,90% of total billed charges,28.35,76,,,percent of total billed charges,76% of total billed charges,14.92,40,,,percent of total billed charges,40% of total billed charges,31.71,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rate,29.84,80,,,percent of total billed charges,80% of total billed charges,14.47,38.8,,,percent of total billed charges,38.8% of total billed charges,31.71,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of APG fee schedule,13.34,200,,,fee schedule,200% of CMS fee schedule,13.34,37.3,
36416 Puncture of skin for collection of blood sample,60000133,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,28.3,22.64,,21.23,75,,,percent of total billed charges,75% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,22.41,79.2,,,percent of total billed charges,79.2% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,28.3,100,,,fee schedule,100% of CO APG rates,26.89,95,,,percent of total billed charges,95% of total billed charges,22.64,80,,,percent of total billed charges,80% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,25.47,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,28.3,100,,,fee schedule,100% of NM APC rate,11.32,40,,,percent of total billed charges,40% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,25.47,90,,,percent of total billed charges,90% of total billed charges,21.51,76,,,percent of total billed charges,76% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,22.64,80,,,percent of total billed charges,80% of total billed charges,10.98,38.8,,,percent of total billed charges,38.8% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,56.6,200,,,fee schedule,200% of CMS fee schedule,10.98,215.49,
28635 Closed treatment of metatarsophalangeal joint dislocat,31028635,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,499.9,399.92,,374.93,75,,,percent of total billed charges,75% of total billed charges,199.96,40,,,percent of total billed charges,40% of total billed charges,395.92,79.2,,,percent of total billed charges,79.2% of total billed charges,424.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,474.91,95,,,percent of total billed charges,95% of total billed charges,399.92,80,,,percent of total billed charges,80% of total billed charges,424.92,85,,,percent of total billed charges,85% of total billed charges,449.91,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,199.96,40,,,percent of total billed charges,40% of total billed charges,199.96,40,,,percent of total billed charges,40% of total billed charges,449.91,90,,,percent of total billed charges,90% of total billed charges,379.92,76,,,percent of total billed charges,76% of total billed charges,199.96,40,,,percent of total billed charges,40% of total billed charges,424.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,399.92,80,,,percent of total billed charges,80% of total billed charges,193.96,38.8,,,percent of total billed charges,38.8% of total billed charges,424.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,474.91,
"20611 Arthrocentesis, aspiration and/or injection, W/US",60000685,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,265.3,212.24,,198.98,75,,,percent of total billed charges,75% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,210.12,79.2,,,percent of total billed charges,79.2% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,265.3,100,,,fee schedule,100% of CO APG rates,252.04,95,,,percent of total billed charges,95% of total billed charges,212.24,80,,,percent of total billed charges,80% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,265.3,100,,,fee schedule,100% of NM APC rate,106.12,40,,,percent of total billed charges,40% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,201.63,76,,,percent of total billed charges,76% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,212.24,80,,,percent of total billed charges,80% of total billed charges,102.94,38.8,,,percent of total billed charges,38.8% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,102.94,2713.28,
G0511 CHRON CARE MGMT SRVC 20 MIN,49699490,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,78.3,62.64,,58.73,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,62.01,79.2,,,percent of total billed charges,79.2% of total billed charges,66.56,85,,,percent of total billed charges,85% of total billed charges,78.3,100,,,fee schedule,100% of CO APG rates,74.39,95,,,percent of total billed charges,95% of total billed charges,62.64,80,,,percent of total billed charges,80% of total billed charges,66.56,85,,,percent of total billed charges,85% of total billed charges,70.47,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,78.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,70.47,90,,,percent of total billed charges,90% of total billed charges,59.51,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,66.56,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,62.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,66.56,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,538.8,100,,,case rate,pays based on per visit rate,58.73,538.8,
62270 - SPINAL PUNCTURE LUMBAR DIAGNOSTIC,60000205,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,373.3,298.64,,279.98,75,,,percent of total billed charges,75% of total billed charges,149.32,40,,,percent of total billed charges,40% of total billed charges,295.65,79.2,,,percent of total billed charges,79.2% of total billed charges,317.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,354.64,95,,,percent of total billed charges,95% of total billed charges,298.64,80,,,percent of total billed charges,80% of total billed charges,317.31,85,,,percent of total billed charges,85% of total billed charges,335.97,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,149.32,40,,,percent of total billed charges,40% of total billed charges,149.32,40,,,percent of total billed charges,40% of total billed charges,335.97,90,,,percent of total billed charges,90% of total billed charges,283.71,76,,,percent of total billed charges,76% of total billed charges,149.32,40,,,percent of total billed charges,40% of total billed charges,317.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,298.64,80,,,percent of total billed charges,80% of total billed charges,144.84,38.8,,,percent of total billed charges,38.8% of total billed charges,317.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,144.84,354.64,
56405 I  D OF VULVA/PERINEUM.,31056405,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,442,353.6,,331.5,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,350.06,79.2,,,percent of total billed charges,79.2% of total billed charges,375.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,419.9,95,,,percent of total billed charges,95% of total billed charges,353.6,80,,,percent of total billed charges,80% of total billed charges,375.7,85,,,percent of total billed charges,85% of total billed charges,397.8,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,442,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,397.8,90,,,percent of total billed charges,90% of total billed charges,335.92,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,375.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,353.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,375.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
95885 - NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,60000207,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,190.1,152.08,,142.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,150.56,79.2,,,percent of total billed charges,79.2% of total billed charges,161.59,85,,,percent of total billed charges,85% of total billed charges,190.1,100,,,fee schedule,100% of CO APG rates,180.6,95,,,percent of total billed charges,95% of total billed charges,152.08,80,,,percent of total billed charges,80% of total billed charges,161.59,85,,,percent of total billed charges,85% of total billed charges,171.09,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,190.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,171.09,90,,,percent of total billed charges,90% of total billed charges,144.48,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,161.59,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,152.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,161.59,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,762.4,100,,,case rate,pays based on per visit rate,142.58,762.4,
95886 - NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,60000208,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,293,234.4,,219.75,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,232.06,79.2,,,percent of total billed charges,79.2% of total billed charges,249.05,85,,,percent of total billed charges,85% of total billed charges,293,100,,,fee schedule,100% of CO APG rates,278.35,95,,,percent of total billed charges,95% of total billed charges,234.4,80,,,percent of total billed charges,80% of total billed charges,249.05,85,,,percent of total billed charges,85% of total billed charges,263.7,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,293,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,263.7,90,,,percent of total billed charges,90% of total billed charges,222.68,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,249.05,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,234.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,249.05,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,968.2,100,,,case rate,pays based on per visit rate,219.75,968.2,
95907 - NERVE CONDUCTION STUDIES 1-2 STUDIES,60000209,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,266.1,212.88,,199.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,210.75,79.2,,,percent of total billed charges,79.2% of total billed charges,226.19,85,,,percent of total billed charges,85% of total billed charges,266.1,100,,,fee schedule,100% of CO APG rates,252.8,95,,,percent of total billed charges,95% of total billed charges,212.88,80,,,percent of total billed charges,80% of total billed charges,226.19,85,,,percent of total billed charges,85% of total billed charges,239.49,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,266.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,239.49,90,,,percent of total billed charges,90% of total billed charges,202.24,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,226.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,212.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,226.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,914.4,100,,,case rate,pays based on per visit rate,199.58,914.4,
95908 - NERVE CONDUCTION STUDIES 3-4 STUDIES,60000210,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,331.7,265.36,,248.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,262.71,79.2,,,percent of total billed charges,79.2% of total billed charges,281.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,315.12,95,,,percent of total billed charges,95% of total billed charges,265.36,80,,,percent of total billed charges,80% of total billed charges,281.95,85,,,percent of total billed charges,85% of total billed charges,298.53,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,331.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,298.53,90,,,percent of total billed charges,90% of total billed charges,252.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,281.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,265.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,281.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1045.6,100,,,case rate,pays based on per visit rate,248.78,1045.6,
95909 - NERVE CONDUCTION STUDIES 5-6 STUDIES,60000211,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,398,318.4,,298.5,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,315.22,79.2,,,percent of total billed charges,79.2% of total billed charges,338.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,378.1,95,,,percent of total billed charges,95% of total billed charges,318.4,80,,,percent of total billed charges,80% of total billed charges,338.3,85,,,percent of total billed charges,85% of total billed charges,358.2,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,398,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,358.2,90,,,percent of total billed charges,90% of total billed charges,302.48,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,338.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,318.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,338.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1178.2,100,,,case rate,pays based on per visit rate,298.5,1178.2,
95910 - NERVE CONDUCTION STUDIES 7-8 STUDIES,60000212,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,520.2,416.16,,390.15,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,412,79.2,,,percent of total billed charges,79.2% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,494.19,95,,,percent of total billed charges,95% of total billed charges,416.16,80,,,percent of total billed charges,80% of total billed charges,442.17,85,,,percent of total billed charges,85% of total billed charges,468.18,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,520.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,468.18,90,,,percent of total billed charges,90% of total billed charges,395.35,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,442.17,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,416.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,442.17,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
95911 - NERVE CONDUCTION STUDIES 9-10 STUDIES,60000213,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,625.7,500.56,,469.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,495.55,79.2,,,percent of total billed charges,79.2% of total billed charges,531.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,594.42,95,,,percent of total billed charges,95% of total billed charges,500.56,80,,,percent of total billed charges,80% of total billed charges,531.85,85,,,percent of total billed charges,85% of total billed charges,563.13,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,625.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,563.13,90,,,percent of total billed charges,90% of total billed charges,475.53,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,531.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,500.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,531.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
95912 - NERVE CONDUCTION STUDIES 11-12 STUDIES,60000214,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,618.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,618.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
95913 - NERVE CONDUCTION STUDIES 13 or more STUDIES,60000215,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,841.6,673.28,,631.2,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,666.55,79.2,,,percent of total billed charges,79.2% of total billed charges,715.36,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,799.52,95,,,percent of total billed charges,95% of total billed charges,673.28,80,,,percent of total billed charges,80% of total billed charges,715.36,85,,,percent of total billed charges,85% of total billed charges,757.44,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,841.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,757.44,90,,,percent of total billed charges,90% of total billed charges,639.62,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,715.36,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,673.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,715.36,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
17260 - DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<,60000244,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,289.2,231.36,,216.9,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,229.05,79.2,,,percent of total billed charges,79.2% of total billed charges,245.82,85,,,percent of total billed charges,85% of total billed charges,289.2,100,,,fee schedule,100% of CO APG rates,274.74,95,,,percent of total billed charges,95% of total billed charges,231.36,80,,,percent of total billed charges,80% of total billed charges,245.82,85,,,percent of total billed charges,85% of total billed charges,260.28,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,289.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,260.28,90,,,percent of total billed charges,90% of total billed charges,219.79,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,245.82,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,231.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,245.82,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,960.6,100,,,case rate,pays based on per visit rate,216.9,960.6,
Z0750 - WC INITIAL REPORT,60000245,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,56.3,45.04,,42.23,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,44.59,79.2,,,percent of total billed charges,79.2% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,56.3,100,,,fee schedule,100% of CO APG rates,53.49,95,,,percent of total billed charges,95% of total billed charges,45.04,80,,,percent of total billed charges,80% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,50.67,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,56.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,50.67,90,,,percent of total billed charges,90% of total billed charges,42.79,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,47.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,45.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,47.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,494.8,100,,,case rate,pays based on per visit rate,42.23,494.8,
Z0751 - WC PROGRESS REPORT,60000246,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,56.3,45.04,,42.23,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,44.59,79.2,,,percent of total billed charges,79.2% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,56.3,100,,,fee schedule,100% of CO APG rates,53.49,95,,,percent of total billed charges,95% of total billed charges,45.04,80,,,percent of total billed charges,80% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,50.67,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,56.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,50.67,90,,,percent of total billed charges,90% of total billed charges,42.79,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,47.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,45.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,47.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,494.8,100,,,case rate,pays based on per visit rate,42.23,494.8,
Z0752 - WC CLOSING REPORT,60000247,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,56.3,45.04,,42.23,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,44.59,79.2,,,percent of total billed charges,79.2% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,56.3,100,,,fee schedule,100% of CO APG rates,53.49,95,,,percent of total billed charges,95% of total billed charges,45.04,80,,,percent of total billed charges,80% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,50.67,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,56.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,50.67,90,,,percent of total billed charges,90% of total billed charges,42.79,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,47.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,45.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,47.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,494.8,100,,,case rate,pays based on per visit rate,42.23,494.8,
Z0753 - WC INITIAL AND CLOSING REPORT,60000248,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,56.3,45.04,,42.23,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,44.59,79.2,,,percent of total billed charges,79.2% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,56.3,100,,,fee schedule,100% of CO APG rates,53.49,95,,,percent of total billed charges,95% of total billed charges,45.04,80,,,percent of total billed charges,80% of total billed charges,47.86,85,,,percent of total billed charges,85% of total billed charges,50.67,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,56.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,50.67,90,,,percent of total billed charges,90% of total billed charges,42.79,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,47.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,45.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,47.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,494.8,100,,,case rate,pays based on per visit rate,42.23,494.8,
G0506 COMP ASSES CARE PLAN CCM SVC,60000238,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,129.1,103.28,,96.83,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,102.25,79.2,,,percent of total billed charges,79.2% of total billed charges,109.74,85,,,percent of total billed charges,85% of total billed charges,129.1,100,,,fee schedule,100% of CO APG rates,122.65,95,,,percent of total billed charges,95% of total billed charges,103.28,80,,,percent of total billed charges,80% of total billed charges,109.74,85,,,percent of total billed charges,85% of total billed charges,116.19,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,129.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,116.19,90,,,percent of total billed charges,90% of total billed charges,98.12,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,109.74,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,103.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,109.74,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,640.4,100,,,case rate,pays based on per visit rate,96.83,640.4,
HIV 1/2 Ab Screen,60000258,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,84,67.2,,63,75,,,percent of total billed charges,75% of total billed charges,33.6,40,,,percent of total billed charges,40% of total billed charges,66.53,79.2,,,percent of total billed charges,79.2% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,79.8,95,,,percent of total billed charges,95% of total billed charges,67.2,80,,,percent of total billed charges,80% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,75.6,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,33.6,40,,,percent of total billed charges,40% of total billed charges,33.6,40,,,percent of total billed charges,40% of total billed charges,75.6,90,,,percent of total billed charges,90% of total billed charges,63.84,76,,,percent of total billed charges,76% of total billed charges,33.6,40,,,percent of total billed charges,40% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,67.2,80,,,percent of total billed charges,80% of total billed charges,32.59,38.8,,,percent of total billed charges,38.8% of total billed charges,71.4,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,79.8,
20680 - EXTREMITY REMOVAL OF IMPLANT DEEP,46020680,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1742.8,1394.24,,1307.1,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1380.3,79.2,,,percent of total billed charges,79.2% of total billed charges,1481.38,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1655.66,95,,,percent of total billed charges,95% of total billed charges,1394.24,80,,,percent of total billed charges,80% of total billed charges,1481.38,85,,,percent of total billed charges,85% of total billed charges,1568.52,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1742.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1568.52,90,,,percent of total billed charges,90% of total billed charges,1324.53,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1481.38,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1394.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1481.38,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1742.8,
Sports/Camp Physical,491SPORT,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,26,20.8,,19.5,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,20.59,79.2,,,percent of total billed charges,79.2% of total billed charges,22.1,85,,,percent of total billed charges,85% of total billed charges,26,100,,,fee schedule,100% of CO APG rates,24.7,95,,,percent of total billed charges,95% of total billed charges,20.8,80,,,percent of total billed charges,80% of total billed charges,22.1,85,,,percent of total billed charges,85% of total billed charges,23.4,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,26,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,23.4,90,,,percent of total billed charges,90% of total billed charges,19.76,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,22.1,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,20.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,22.1,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,434.2,100,,,case rate,pays based on per visit rate,19.5,434.2,
90846 Family Psychotherapy w/o Patient 50 mins,60000306,CDM,900,RC,90847,HCPCS,OUTPATIENT,,,350.6,280.48,,262.95,75,,,percent of total billed charges,75% of total billed charges,140.24,40,,,percent of total billed charges,40% of total billed charges,277.68,79.2,,,percent of total billed charges,79.2% of total billed charges,298.01,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,333.07,95,,,percent of total billed charges,95% of total billed charges,280.48,80,,,percent of total billed charges,80% of total billed charges,298.01,85,,,percent of total billed charges,85% of total billed charges,315.54,90,,,percent of total billed charges,90% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,198.82,100,,,fee schedule,100% of CO APG rates,145.69,100,,,fee schedule,100% of NM APC rate,140.24,40,,,percent of total billed charges,40% of total billed charges,140.24,40,,,percent of total billed charges,40% of total billed charges,315.54,90,,,percent of total billed charges,90% of total billed charges,266.46,76,,,percent of total billed charges,76% of total billed charges,140.24,40,,,percent of total billed charges,40% of total billed charges,298.01,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rate,280.48,80,,,percent of total billed charges,80% of total billed charges,136.03,38.8,,,percent of total billed charges,38.8% of total billed charges,298.01,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of APG fee schedule,199.68,200,,,fee schedule,200% of CMS fee schedule,136.03,333.07,
90853 Group Psychotherapy,60000307,CDM,900,RC,90847,HCPCS,OUTPATIENT,,,243.3,194.64,,182.48,75,,,percent of total billed charges,75% of total billed charges,97.32,40,,,percent of total billed charges,40% of total billed charges,192.69,79.2,,,percent of total billed charges,79.2% of total billed charges,206.81,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,231.14,95,,,percent of total billed charges,95% of total billed charges,194.64,80,,,percent of total billed charges,80% of total billed charges,206.81,85,,,percent of total billed charges,85% of total billed charges,218.97,90,,,percent of total billed charges,90% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rates,198.82,100,,,fee schedule,100% of CO APG rates,145.69,100,,,fee schedule,100% of NM APC rate,97.32,40,,,percent of total billed charges,40% of total billed charges,97.32,40,,,percent of total billed charges,40% of total billed charges,218.97,90,,,percent of total billed charges,90% of total billed charges,184.91,76,,,percent of total billed charges,76% of total billed charges,97.32,40,,,percent of total billed charges,40% of total billed charges,206.81,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of CO APG rate,194.64,80,,,percent of total billed charges,80% of total billed charges,94.4,38.8,,,percent of total billed charges,38.8% of total billed charges,206.81,85,,,percent of total billed charges,85% of total billed charges,198.82,100,,,fee schedule,100% of APG fee schedule,199.68,200,,,fee schedule,200% of CMS fee schedule,94.4,231.14,
90853 Group Psychotherapy,60000307,CDM,900,RC,90847,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,198.82,100,,,fee schedule,100% of CO APG rates,198.82,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,198.82,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,198.82,100,,,fee schedule,100% of APG fee schedule,0.02,,,,other,not separately reimbursable,0.02,198.82,
"90686 INS Fluarix Quadrivalent, 0.5mL, Single Dose Syringe V",60000137,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,47.3,37.84,,35.48,75,,,percent of total billed charges,75% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,37.46,79.2,,,percent of total billed charges,79.2% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,44.94,95,,,percent of total billed charges,95% of total billed charges,37.84,80,,,percent of total billed charges,80% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,47.3,100,,,fee schedule,100% of NM fee schedule,18.92,40,,,percent of total billed charges,40% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.95,76,,,percent of total billed charges,76% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,37.84,80,,,percent of total billed charges,80% of total billed charges,18.35,38.8,,,percent of total billed charges,38.8% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.35,47.3,
"27340 - Excision, Prepatellar Bursa",60000713,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,440,352,,330,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,348.48,79.2,,,percent of total billed charges,79.2% of total billed charges,374,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,418,95,,,percent of total billed charges,95% of total billed charges,352,80,,,percent of total billed charges,80% of total billed charges,374,85,,,percent of total billed charges,85% of total billed charges,396,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,440,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,396,90,,,percent of total billed charges,90% of total billed charges,334.4,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,374,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,352,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,374,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
90471 VFC Immunization administration; 1 vaccine,49190471,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,22.3,17.84,,16.73,75,,,percent of total billed charges,75% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,17.66,79.2,,,percent of total billed charges,79.2% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,22.3,100,,,fee schedule,100% of CO APG rates,21.19,95,,,percent of total billed charges,95% of total billed charges,17.84,80,,,percent of total billed charges,80% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,20.07,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,22.3,100,,,fee schedule,100% of NM APC rate,8.92,40,,,percent of total billed charges,40% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,20.07,90,,,percent of total billed charges,90% of total billed charges,16.95,76,,,percent of total billed charges,76% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,17.84,80,,,percent of total billed charges,80% of total billed charges,8.65,38.8,,,percent of total billed charges,38.8% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,8.65,50.67,
90472 VFC Each additional vaccine,49190472,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,12.7,10.16,,9.53,75,,,percent of total billed charges,75% of total billed charges,5.08,40,,,percent of total billed charges,40% of total billed charges,10.06,79.2,,,percent of total billed charges,79.2% of total billed charges,10.8,85,,,percent of total billed charges,85% of total billed charges,12.7,100,,,fee schedule,100% of CO APG rates,12.07,95,,,percent of total billed charges,95% of total billed charges,10.16,80,,,percent of total billed charges,80% of total billed charges,10.8,85,,,percent of total billed charges,85% of total billed charges,11.43,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,12.7,100,,,fee schedule,100% of NM APC rate,5.08,40,,,percent of total billed charges,40% of total billed charges,5.08,40,,,percent of total billed charges,40% of total billed charges,11.43,90,,,percent of total billed charges,90% of total billed charges,9.65,76,,,percent of total billed charges,76% of total billed charges,5.08,40,,,percent of total billed charges,40% of total billed charges,10.8,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,10.16,80,,,percent of total billed charges,80% of total billed charges,4.93,38.8,,,percent of total billed charges,38.8% of total billed charges,10.8,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,25.4,200,,,fee schedule,200% of CMS fee schedule,4.93,50.67,
90471 INS Immunization administration; 1 vaccine,49190471,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,45,36,,33.75,75,,,percent of total billed charges,75% of total billed charges,18,40,,,percent of total billed charges,40% of total billed charges,35.64,79.2,,,percent of total billed charges,79.2% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,45,100,,,fee schedule,100% of CO APG rates,42.75,95,,,percent of total billed charges,95% of total billed charges,36,80,,,percent of total billed charges,80% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,40.5,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,45,100,,,fee schedule,100% of NM APC rate,18,40,,,percent of total billed charges,40% of total billed charges,18,40,,,percent of total billed charges,40% of total billed charges,40.5,90,,,percent of total billed charges,90% of total billed charges,34.2,76,,,percent of total billed charges,76% of total billed charges,18,40,,,percent of total billed charges,40% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,36,80,,,percent of total billed charges,80% of total billed charges,17.46,38.8,,,percent of total billed charges,38.8% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,17.46,50.67,
90472 INS Each additional vaccine,49190472,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.8,50.67,
90474 VFC Each additional vaccine by intranasal or oral rout,60000054,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,22.3,17.84,,16.73,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,17.66,79.2,,,percent of total billed charges,79.2% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,22.3,100,,,fee schedule,100% of CO APG rates,21.19,95,,,percent of total billed charges,95% of total billed charges,17.84,80,,,percent of total billed charges,80% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,20.07,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,22.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,20.07,90,,,percent of total billed charges,90% of total billed charges,16.95,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,18.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,17.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,18.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,426.8,100,,,case rate,pays based on per visit rate,16.73,426.8,
90472 INS Each additional vaccine,60000447,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.8,50.67,
90472 INS Each additional vaccine,60000446,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,86.6,200,,,fee schedule,200% of CMS fee schedule,16.8,215.49,
95860 Needle EMG; 1 extremity with or without related papasp,60000392,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,333.2,266.56,,249.9,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,263.89,79.2,,,percent of total billed charges,79.2% of total billed charges,283.22,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,316.54,95,,,percent of total billed charges,95% of total billed charges,266.56,80,,,percent of total billed charges,80% of total billed charges,283.22,85,,,percent of total billed charges,85% of total billed charges,299.88,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,333.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,299.88,90,,,percent of total billed charges,90% of total billed charges,253.23,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,283.22,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,266.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,283.22,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1048.6,100,,,case rate,pays based on per visit rate,249.9,1048.6,
90471/G0008 Influenza Vaccine Admin,77100008,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,45,36,,33.75,75,,,percent of total billed charges,75% of total billed charges,18,40,,,percent of total billed charges,40% of total billed charges,35.64,79.2,,,percent of total billed charges,79.2% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,45,100,,,fee schedule,100% of CO APG rates,42.75,95,,,percent of total billed charges,95% of total billed charges,36,80,,,percent of total billed charges,80% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,40.5,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,45,100,,,fee schedule,100% of NM APC rate,18,40,,,percent of total billed charges,40% of total billed charges,18,40,,,percent of total billed charges,40% of total billed charges,40.5,90,,,percent of total billed charges,90% of total billed charges,34.2,76,,,percent of total billed charges,76% of total billed charges,18,40,,,percent of total billed charges,40% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,36,80,,,percent of total billed charges,80% of total billed charges,17.46,38.8,,,percent of total billed charges,38.8% of total billed charges,38.25,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,17.46,50.67,
VFC Flumist intranasal vaccine; 2 - 18 years,49190672,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,382.2,100,,,case rate,pays based on per visit rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,382.2,100,,,case rate,pays based on per visit rate,,,,,other,not separately reimbursable,324.76,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,370.73,100,,,case rate,pays based on per visit rate,,,,,other,not separately reimbursable,324.76,100,,,fee schedule,100% of APG fee schedule,382.22,100,,,case rate,pays based on per visit rate,324.76,382.22,
67700 - Drainage of Eyelid Abscess,60000648,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,847.4,677.92,,635.55,75,,,percent of total billed charges,75% of total billed charges,338.96,40,,,percent of total billed charges,40% of total billed charges,671.14,79.2,,,percent of total billed charges,79.2% of total billed charges,720.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,805.03,95,,,percent of total billed charges,95% of total billed charges,677.92,80,,,percent of total billed charges,80% of total billed charges,720.29,85,,,percent of total billed charges,85% of total billed charges,762.66,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,338.96,40,,,percent of total billed charges,40% of total billed charges,338.96,40,,,percent of total billed charges,40% of total billed charges,762.66,90,,,percent of total billed charges,90% of total billed charges,644.02,76,,,percent of total billed charges,76% of total billed charges,338.96,40,,,percent of total billed charges,40% of total billed charges,720.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,677.92,80,,,percent of total billed charges,80% of total billed charges,328.79,38.8,,,percent of total billed charges,38.8% of total billed charges,720.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,805.03,
J7307 Nexplanon contraceptive implant,60000448,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,1394,1115.2,,1045.5,75,,,percent of total billed charges,75% of total billed charges,557.6,40,,,percent of total billed charges,40% of total billed charges,1104.05,79.2,,,percent of total billed charges,79.2% of total billed charges,1184.9,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,1324.3,95,,,percent of total billed charges,95% of total billed charges,1115.2,80,,,percent of total billed charges,80% of total billed charges,1184.9,85,,,percent of total billed charges,85% of total billed charges,1254.6,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,1394,100,,,fee schedule,100% of NM fee schedule,557.6,40,,,percent of total billed charges,40% of total billed charges,557.6,40,,,percent of total billed charges,40% of total billed charges,1254.6,90,,,percent of total billed charges,90% of total billed charges,1059.44,76,,,percent of total billed charges,76% of total billed charges,557.6,40,,,percent of total billed charges,40% of total billed charges,1184.9,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,1115.2,80,,,percent of total billed charges,80% of total billed charges,540.87,38.8,,,percent of total billed charges,38.8% of total billed charges,1184.9,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,1394,
J7298 Mirena IUD,60000449,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,964.2,771.36,TB,723.15,75,,,percent of total billed charges,75% of total billed charges,385.68,40,,,percent of total billed charges,40% of total billed charges,763.65,79.2,,,percent of total billed charges,79.2% of total billed charges,819.57,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,915.99,95,,,percent of total billed charges,95% of total billed charges,771.36,80,,,percent of total billed charges,80% of total billed charges,819.57,85,,,percent of total billed charges,85% of total billed charges,867.78,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,964.2,100,,,fee schedule,100% of NM fee schedule,385.68,40,,,percent of total billed charges,40% of total billed charges,385.68,40,,,percent of total billed charges,40% of total billed charges,867.78,90,,,percent of total billed charges,90% of total billed charges,732.79,76,,,percent of total billed charges,76% of total billed charges,385.68,40,,,percent of total billed charges,40% of total billed charges,819.57,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,771.36,80,,,percent of total billed charges,80% of total billed charges,374.11,38.8,,,percent of total billed charges,38.8% of total billed charges,819.57,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,964.2,
J7300 Paragard IUD,60000450,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,954.7,763.76,,716.03,75,,,percent of total billed charges,75% of total billed charges,381.88,40,,,percent of total billed charges,40% of total billed charges,756.12,79.2,,,percent of total billed charges,79.2% of total billed charges,811.5,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,906.97,95,,,percent of total billed charges,95% of total billed charges,763.76,80,,,percent of total billed charges,80% of total billed charges,811.5,85,,,percent of total billed charges,85% of total billed charges,859.23,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,954.7,100,,,fee schedule,100% of NM fee schedule,381.88,40,,,percent of total billed charges,40% of total billed charges,381.88,40,,,percent of total billed charges,40% of total billed charges,859.23,90,,,percent of total billed charges,90% of total billed charges,725.57,76,,,percent of total billed charges,76% of total billed charges,381.88,40,,,percent of total billed charges,40% of total billed charges,811.5,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,763.76,80,,,percent of total billed charges,80% of total billed charges,370.42,38.8,,,percent of total billed charges,38.8% of total billed charges,811.5,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,954.7,
"96372 Therapeutic, prophylactic, or diagnostic injection, su",49196372,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,37.1,29.68,,27.83,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,29.38,79.2,,,percent of total billed charges,79.2% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,37.1,100,,,fee schedule,100% of CO APG rates,35.25,95,,,percent of total billed charges,95% of total billed charges,29.68,80,,,percent of total billed charges,80% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,33.39,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,37.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,33.39,90,,,percent of total billed charges,90% of total billed charges,28.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,31.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,29.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,31.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,456.4,100,,,case rate,pays based on per visit rate,27.83,456.4,
11102 Tangential biopsy of skin; single lesion,60000452,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,323.5,258.8,,242.63,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,256.21,79.2,,,percent of total billed charges,79.2% of total billed charges,274.98,85,,,percent of total billed charges,85% of total billed charges,323.5,100,,,fee schedule,100% of CO APG rates,307.33,95,,,percent of total billed charges,95% of total billed charges,258.8,80,,,percent of total billed charges,80% of total billed charges,274.98,85,,,percent of total billed charges,85% of total billed charges,291.15,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,323.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,291.15,90,,,percent of total billed charges,90% of total billed charges,245.86,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,274.98,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,258.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,274.98,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1029.2,100,,,case rate,pays based on per visit rate,242.63,1029.2,
11103 Tangential biopsy of skin; each additional lesion,60000453,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,152.1,121.68,,114.08,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,120.46,79.2,,,percent of total billed charges,79.2% of total billed charges,129.29,85,,,percent of total billed charges,85% of total billed charges,152.1,100,,,fee schedule,100% of CO APG rates,144.5,95,,,percent of total billed charges,95% of total billed charges,121.68,80,,,percent of total billed charges,80% of total billed charges,129.29,85,,,percent of total billed charges,85% of total billed charges,136.89,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,152.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,136.89,90,,,percent of total billed charges,90% of total billed charges,115.6,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,129.29,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,121.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,129.29,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,686.4,100,,,case rate,pays based on per visit rate,114.08,686.4,
"11104 Punch biopsy of skin (including simple closure, when p",60000454,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,402,321.6,,301.5,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,318.38,79.2,,,percent of total billed charges,79.2% of total billed charges,341.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,381.9,95,,,percent of total billed charges,95% of total billed charges,321.6,80,,,percent of total billed charges,80% of total billed charges,341.7,85,,,percent of total billed charges,85% of total billed charges,361.8,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,402,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,361.8,90,,,percent of total billed charges,90% of total billed charges,305.52,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,341.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,321.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,341.7,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1186.2,100,,,case rate,pays based on per visit rate,301.5,1186.2,
"11105 Punch biopsy of skin (including simple closure, when p",60000455,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,177,141.6,,132.75,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,140.18,79.2,,,percent of total billed charges,79.2% of total billed charges,150.45,85,,,percent of total billed charges,85% of total billed charges,177,100,,,fee schedule,100% of CO APG rates,168.15,95,,,percent of total billed charges,95% of total billed charges,141.6,80,,,percent of total billed charges,80% of total billed charges,150.45,85,,,percent of total billed charges,85% of total billed charges,159.3,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,177,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,159.3,90,,,percent of total billed charges,90% of total billed charges,134.52,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,150.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,141.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,150.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,736.2,100,,,case rate,pays based on per visit rate,132.75,736.2,
11106 Incisional biopsy of skin; single lesion,60000456,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,461.3,369.04,,345.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,365.35,79.2,,,percent of total billed charges,79.2% of total billed charges,392.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,438.24,95,,,percent of total billed charges,95% of total billed charges,369.04,80,,,percent of total billed charges,80% of total billed charges,392.11,85,,,percent of total billed charges,85% of total billed charges,415.17,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,461.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,415.17,90,,,percent of total billed charges,90% of total billed charges,350.59,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,392.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,369.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,392.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
11107 Incisional biopsy of skin; each additional lesion,60000457,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,213.7,170.96,,160.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,169.25,79.2,,,percent of total billed charges,79.2% of total billed charges,181.65,85,,,percent of total billed charges,85% of total billed charges,213.7,100,,,fee schedule,100% of CO APG rates,203.02,95,,,percent of total billed charges,95% of total billed charges,170.96,80,,,percent of total billed charges,80% of total billed charges,181.65,85,,,percent of total billed charges,85% of total billed charges,192.33,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,213.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,192.33,90,,,percent of total billed charges,90% of total billed charges,162.41,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,181.65,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,170.96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,181.65,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,809.6,100,,,case rate,pays based on per visit rate,160.28,809.6,
"43762 Replacement of gastrostomy tube, percutan, includes re",60000458,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,748.5,598.8,,561.38,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,592.81,79.2,,,percent of total billed charges,79.2% of total billed charges,636.23,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,711.08,95,,,percent of total billed charges,95% of total billed charges,598.8,80,,,percent of total billed charges,80% of total billed charges,636.23,85,,,percent of total billed charges,85% of total billed charges,673.65,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,748.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,673.65,90,,,percent of total billed charges,90% of total billed charges,568.86,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,636.23,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,598.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,636.23,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Chronic Care Mgmt Srvc 20 MIN,60001067,CDM,520,RC,,,OUTPATIENT,,,75.3,60.24,,56.48,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,59.64,79.2,,,percent of total billed charges,79.2% of total billed charges,64.01,85,,,percent of total billed charges,85% of total billed charges,75.3,100,,,fee schedule,100% of CO APG rates,71.54,95,,,percent of total billed charges,95% of total billed charges,60.24,80,,,percent of total billed charges,80% of total billed charges,64.01,85,,,percent of total billed charges,85% of total billed charges,67.77,90,,,percent of total billed charges,90% of total billed charges,75.3,100,,,fee schedule,100% of CO APG rates,75.3,100,,,fee schedule,100% of CO APG rates,75.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,67.77,90,,,percent of total billed charges,90% of total billed charges,57.23,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,64.01,85,,,percent of total billed charges,85% of total billed charges,75.3,100,,,fee schedule,100% of CO APG rate,60.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,64.01,85,,,percent of total billed charges,85% of total billed charges,75.3,100,,,fee schedule,100% of APG fee schedule,382.2,100,,,case rate,pays based on per visit rate,56.48,382.2,
"33286 - Removal, subcutaneous cardiac rhythm monitor",60000692,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,383,306.4,,287.25,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,303.34,79.2,,,percent of total billed charges,79.2% of total billed charges,325.55,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,363.85,95,,,percent of total billed charges,95% of total billed charges,306.4,80,,,percent of total billed charges,80% of total billed charges,325.55,85,,,percent of total billed charges,85% of total billed charges,344.7,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,383,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,344.7,90,,,percent of total billed charges,90% of total billed charges,291.08,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,325.55,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,306.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,325.55,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1148.2,100,,,case rate,pays based on per visit rate,287.25,1148.2,
J7296 Kyleena IUD,60000469,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,964.2,771.36,,723.15,75,,,percent of total billed charges,75% of total billed charges,385.68,40,,,percent of total billed charges,40% of total billed charges,763.65,79.2,,,percent of total billed charges,79.2% of total billed charges,819.57,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,915.99,95,,,percent of total billed charges,95% of total billed charges,771.36,80,,,percent of total billed charges,80% of total billed charges,819.57,85,,,percent of total billed charges,85% of total billed charges,867.78,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,964.2,100,,,fee schedule,100% of NM fee schedule,385.68,40,,,percent of total billed charges,40% of total billed charges,385.68,40,,,percent of total billed charges,40% of total billed charges,867.78,90,,,percent of total billed charges,90% of total billed charges,732.79,76,,,percent of total billed charges,76% of total billed charges,385.68,40,,,percent of total billed charges,40% of total billed charges,819.57,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,771.36,80,,,percent of total billed charges,80% of total billed charges,374.11,38.8,,,percent of total billed charges,38.8% of total billed charges,819.57,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,964.2,
J7301  Skyla IUD,60000468,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,802.9,642.32,,602.18,75,,,percent of total billed charges,75% of total billed charges,321.16,40,,,percent of total billed charges,40% of total billed charges,635.9,79.2,,,percent of total billed charges,79.2% of total billed charges,682.47,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,762.76,95,,,percent of total billed charges,95% of total billed charges,642.32,80,,,percent of total billed charges,80% of total billed charges,682.47,85,,,percent of total billed charges,85% of total billed charges,722.61,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,802.9,100,,,fee schedule,100% of NM fee schedule,321.16,40,,,percent of total billed charges,40% of total billed charges,321.16,40,,,percent of total billed charges,40% of total billed charges,722.61,90,,,percent of total billed charges,90% of total billed charges,610.2,76,,,percent of total billed charges,76% of total billed charges,321.16,40,,,percent of total billed charges,40% of total billed charges,682.47,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,642.32,80,,,percent of total billed charges,80% of total billed charges,311.53,38.8,,,percent of total billed charges,38.8% of total billed charges,682.47,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,802.9,
"GASTROSTOMY FEEDING TUBE, MIC 18Fr",52459,CDM,270,RC,,,OUTPATIENT,,,173.3,138.64,,129.98,75,,,percent of total billed charges,75% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,137.25,79.2,,,percent of total billed charges,79.2% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rates,164.64,95,,,percent of total billed charges,95% of total billed charges,138.64,80,,,percent of total billed charges,80% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,155.97,90,,,percent of total billed charges,90% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rates,173.3,100,,,fee schedule,100% of CO APG rates,173.3,100,,,fee schedule,100% of NM fee schedule,69.32,40,,,percent of total billed charges,40% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,155.97,90,,,percent of total billed charges,90% of total billed charges,131.71,76,,,percent of total billed charges,76% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rate,138.64,80,,,percent of total billed charges,80% of total billed charges,67.24,38.8,,,percent of total billed charges,38.8% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,67.24,173.3,
"GASTROSTOMY FEEDING TUBE, MIC 20Fr",52460,CDM,270,RC,,,OUTPATIENT,,,173.3,138.64,,129.98,75,,,percent of total billed charges,75% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,137.25,79.2,,,percent of total billed charges,79.2% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rates,164.64,95,,,percent of total billed charges,95% of total billed charges,138.64,80,,,percent of total billed charges,80% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,155.97,90,,,percent of total billed charges,90% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rates,173.3,100,,,fee schedule,100% of CO APG rates,173.3,100,,,fee schedule,100% of NM fee schedule,69.32,40,,,percent of total billed charges,40% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,155.97,90,,,percent of total billed charges,90% of total billed charges,131.71,76,,,percent of total billed charges,76% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rate,138.64,80,,,percent of total billed charges,80% of total billed charges,67.24,38.8,,,percent of total billed charges,38.8% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,67.24,173.3,
"GASTROSTOMY FEEDING TUBE, MIC 22Fr",52464,CDM,270,RC,,,OUTPATIENT,,,173.3,138.64,,129.98,75,,,percent of total billed charges,75% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,137.25,79.2,,,percent of total billed charges,79.2% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rates,164.64,95,,,percent of total billed charges,95% of total billed charges,138.64,80,,,percent of total billed charges,80% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,155.97,90,,,percent of total billed charges,90% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rates,173.3,100,,,fee schedule,100% of CO APG rates,173.3,100,,,fee schedule,100% of NM fee schedule,69.32,40,,,percent of total billed charges,40% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,155.97,90,,,percent of total billed charges,90% of total billed charges,131.71,76,,,percent of total billed charges,76% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rate,138.64,80,,,percent of total billed charges,80% of total billed charges,67.24,38.8,,,percent of total billed charges,38.8% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,67.24,173.3,
"GASTROSTOMY FEEDING TUBE, MIC 24Fr",52467,CDM,270,RC,,,OUTPATIENT,,,173.3,138.64,,129.98,75,,,percent of total billed charges,75% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,137.25,79.2,,,percent of total billed charges,79.2% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rates,164.64,95,,,percent of total billed charges,95% of total billed charges,138.64,80,,,percent of total billed charges,80% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,155.97,90,,,percent of total billed charges,90% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rates,173.3,100,,,fee schedule,100% of CO APG rates,173.3,100,,,fee schedule,100% of NM fee schedule,69.32,40,,,percent of total billed charges,40% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,155.97,90,,,percent of total billed charges,90% of total billed charges,131.71,76,,,percent of total billed charges,76% of total billed charges,69.32,40,,,percent of total billed charges,40% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of CO APG rate,138.64,80,,,percent of total billed charges,80% of total billed charges,67.24,38.8,,,percent of total billed charges,38.8% of total billed charges,147.31,85,,,percent of total billed charges,85% of total billed charges,173.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,67.24,173.3,
96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR,60000484,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,322.9,258.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
J1200 Diphenhydramine (Benadryl); up to 50 mg,60000515,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,6.4,5.12,,4.8,75,,,percent of total billed charges,75% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.07,79.2,,,percent of total billed charges,79.2% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,6.4,100,,,fee schedule,100% of CO APG rates,6.08,95,,,percent of total billed charges,95% of total billed charges,5.12,80,,,percent of total billed charges,80% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,6.4,100,,,fee schedule,100% of NM fee schedule,2.56,40,,,percent of total billed charges,40% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,4.86,76,,,percent of total billed charges,76% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,5.12,80,,,percent of total billed charges,80% of total billed charges,2.48,38.8,,,percent of total billed charges,38.8% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.48,35.65,
Euflexxa 20mg/2ml intra-articular injection,J7323,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,719.2,575.36,,539.4,75,,,percent of total billed charges,75% of total billed charges,287.68,40,,,percent of total billed charges,40% of total billed charges,569.61,79.2,,,percent of total billed charges,79.2% of total billed charges,611.32,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,683.24,95,,,percent of total billed charges,95% of total billed charges,575.36,80,,,percent of total billed charges,80% of total billed charges,611.32,85,,,percent of total billed charges,85% of total billed charges,647.28,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,719.2,100,,,fee schedule,100% of NM fee schedule,287.68,40,,,percent of total billed charges,40% of total billed charges,287.68,40,,,percent of total billed charges,40% of total billed charges,647.28,90,,,percent of total billed charges,90% of total billed charges,546.59,76,,,percent of total billed charges,76% of total billed charges,287.68,40,,,percent of total billed charges,40% of total billed charges,611.32,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,575.36,80,,,percent of total billed charges,80% of total billed charges,279.05,38.8,,,percent of total billed charges,38.8% of total billed charges,611.32,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,719.2,
"11900 Injection, Intralesional; Up To And Including 7 Lesion",60000521,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,177.1,141.68,,132.83,75,,,percent of total billed charges,75% of total billed charges,70.84,40,,,percent of total billed charges,40% of total billed charges,140.26,79.2,,,percent of total billed charges,79.2% of total billed charges,150.54,85,,,percent of total billed charges,85% of total billed charges,177.1,100,,,fee schedule,100% of CO APG rates,168.25,95,,,percent of total billed charges,95% of total billed charges,141.68,80,,,percent of total billed charges,80% of total billed charges,150.54,85,,,percent of total billed charges,85% of total billed charges,159.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,177.1,100,,,fee schedule,100% of NM APC rate,70.84,40,,,percent of total billed charges,40% of total billed charges,70.84,40,,,percent of total billed charges,40% of total billed charges,159.39,90,,,percent of total billed charges,90% of total billed charges,134.6,76,,,percent of total billed charges,76% of total billed charges,70.84,40,,,percent of total billed charges,40% of total billed charges,150.54,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,141.68,80,,,percent of total billed charges,80% of total billed charges,68.71,38.8,,,percent of total billed charges,38.8% of total billed charges,150.54,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,68.71,217.66,
BONE MARROW TRAY,42952717,CDM,272,RC,,,OUTPATIENT,,,105,84,,78.75,75,,,percent of total billed charges,75% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,83.16,79.2,,,percent of total billed charges,79.2% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,105,100,,,fee schedule,100% of CO APG rates,99.75,95,,,percent of total billed charges,95% of total billed charges,84,80,,,percent of total billed charges,80% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,105,100,,,fee schedule,100% of CO APG rates,105,100,,,fee schedule,100% of CO APG rates,105,100,,,fee schedule,100% of NM fee schedule,42,40,,,percent of total billed charges,40% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,79.8,76,,,percent of total billed charges,76% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,105,100,,,fee schedule,100% of CO APG rate,84,80,,,percent of total billed charges,80% of total billed charges,40.74,38.8,,,percent of total billed charges,38.8% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,105,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,40.74,105,
"69220 - Debridement, mastoidectomy cavity, simple",60000641,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,222.3,177.84,,166.73,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,176.06,79.2,,,percent of total billed charges,79.2% of total billed charges,188.96,85,,,percent of total billed charges,85% of total billed charges,222.3,100,,,fee schedule,100% of CO APG rates,211.19,95,,,percent of total billed charges,95% of total billed charges,177.84,80,,,percent of total billed charges,80% of total billed charges,188.96,85,,,percent of total billed charges,85% of total billed charges,200.07,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,222.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,200.07,90,,,percent of total billed charges,90% of total billed charges,168.95,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,188.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,177.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,188.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,826.8,100,,,case rate,pays based on per visit rate,166.73,826.8,
"96372 Therapeutic, prophylactic, or diagnostic injection, su",49196372,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,36.1,28.88,,27.08,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,28.59,79.2,,,percent of total billed charges,79.2% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,36.1,100,,,fee schedule,100% of CO APG rates,34.3,95,,,percent of total billed charges,95% of total billed charges,28.88,80,,,percent of total billed charges,80% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,32.49,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,36.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,32.49,90,,,percent of total billed charges,90% of total billed charges,27.44,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,30.69,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,28.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,30.69,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,454.4,100,,,case rate,pays based on per visit rate,27.08,454.4,
G2025 - RHC/FQHC Distant Site services via telehealth,60000620,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,262.7,210.16,,197.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,208.06,79.2,,,percent of total billed charges,79.2% of total billed charges,223.3,85,,,percent of total billed charges,85% of total billed charges,262.7,100,,,fee schedule,100% of CO APG rates,249.57,95,,,percent of total billed charges,95% of total billed charges,210.16,80,,,percent of total billed charges,80% of total billed charges,223.3,85,,,percent of total billed charges,85% of total billed charges,236.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,262.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,236.43,90,,,percent of total billed charges,90% of total billed charges,199.65,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,223.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,210.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,223.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,907.6,100,,,case rate,pays based on per visit rate,197.03,907.6,
"JAK2 V617F Mutation Analysis, Quant LC",40081270,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,551.5,441.2,,413.63,75,,,percent of total billed charges,75% of total billed charges,220.6,40,,,percent of total billed charges,40% of total billed charges,436.79,79.2,,,percent of total billed charges,79.2% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,523.93,95,,,percent of total billed charges,95% of total billed charges,441.2,80,,,percent of total billed charges,80% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,496.35,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,220.6,40,,,percent of total billed charges,40% of total billed charges,220.6,40,,,percent of total billed charges,40% of total billed charges,496.35,90,,,percent of total billed charges,90% of total billed charges,419.14,76,,,percent of total billed charges,76% of total billed charges,220.6,40,,,percent of total billed charges,40% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,441.2,80,,,percent of total billed charges,80% of total billed charges,213.98,38.8,,,percent of total billed charges,38.8% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,523.93,
Hyaluronan Gel One (J7326),60000629,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,3092.2,2473.76,,2319.15,75,,,percent of total billed charges,75% of total billed charges,1236.88,40,,,percent of total billed charges,40% of total billed charges,2449.02,79.2,,,percent of total billed charges,79.2% of total billed charges,2628.37,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,2937.59,95,,,percent of total billed charges,95% of total billed charges,2473.76,80,,,percent of total billed charges,80% of total billed charges,2628.37,85,,,percent of total billed charges,85% of total billed charges,2782.98,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,3092.2,100,,,fee schedule,100% of NM fee schedule,1236.88,40,,,percent of total billed charges,40% of total billed charges,1236.88,40,,,percent of total billed charges,40% of total billed charges,2782.98,90,,,percent of total billed charges,90% of total billed charges,2350.07,76,,,percent of total billed charges,76% of total billed charges,1236.88,40,,,percent of total billed charges,40% of total billed charges,2628.37,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,2473.76,80,,,percent of total billed charges,80% of total billed charges,1199.77,38.8,,,percent of total billed charges,38.8% of total billed charges,2628.37,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,3092.2,
0001A Pfizer-Biontech Covid-19 Vaccine - 1st Dose,60000668,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,45.8,36.64,,34.35,75,,,percent of total billed charges,75% of total billed charges,18.32,40,,,percent of total billed charges,40% of total billed charges,36.27,79.2,,,percent of total billed charges,79.2% of total billed charges,38.93,85,,,percent of total billed charges,85% of total billed charges,45.8,100,,,fee schedule,100% of CO APG rates,43.51,95,,,percent of total billed charges,95% of total billed charges,36.64,80,,,percent of total billed charges,80% of total billed charges,38.93,85,,,percent of total billed charges,85% of total billed charges,41.22,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,45.8,100,,,fee schedule,100% of NM APC rate,18.32,40,,,percent of total billed charges,40% of total billed charges,18.32,40,,,percent of total billed charges,40% of total billed charges,41.22,90,,,percent of total billed charges,90% of total billed charges,34.81,76,,,percent of total billed charges,76% of total billed charges,18.32,40,,,percent of total billed charges,40% of total billed charges,38.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,36.64,80,,,percent of total billed charges,80% of total billed charges,17.77,38.8,,,percent of total billed charges,38.8% of total billed charges,38.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,91.6,200,,,fee schedule,200% of CMS fee schedule,17.77,215.49,
0002A Pfizer-Biontech Covid-19 Vaccine - 2nd Dose,60000669,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,76.8,61.44,,57.6,75,,,percent of total billed charges,75% of total billed charges,30.72,40,,,percent of total billed charges,40% of total billed charges,60.83,79.2,,,percent of total billed charges,79.2% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,76.8,100,,,fee schedule,100% of CO APG rates,72.96,95,,,percent of total billed charges,95% of total billed charges,61.44,80,,,percent of total billed charges,80% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,69.12,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,76.8,100,,,fee schedule,100% of NM APC rate,30.72,40,,,percent of total billed charges,40% of total billed charges,30.72,40,,,percent of total billed charges,40% of total billed charges,69.12,90,,,percent of total billed charges,90% of total billed charges,58.37,76,,,percent of total billed charges,76% of total billed charges,30.72,40,,,percent of total billed charges,40% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,61.44,80,,,percent of total billed charges,80% of total billed charges,29.8,38.8,,,percent of total billed charges,38.8% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,153.6,200,,,fee schedule,200% of CMS fee schedule,29.8,215.49,
Prolonged office or other outpatient evaluation and manageme,60000691,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,92.7,74.16,,69.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,73.42,79.2,,,percent of total billed charges,79.2% of total billed charges,78.8,85,,,percent of total billed charges,85% of total billed charges,92.7,100,,,fee schedule,100% of CO APG rates,88.07,95,,,percent of total billed charges,95% of total billed charges,74.16,80,,,percent of total billed charges,80% of total billed charges,78.8,85,,,percent of total billed charges,85% of total billed charges,83.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,92.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,83.43,90,,,percent of total billed charges,90% of total billed charges,70.45,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,78.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,74.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,78.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,567.6,100,,,case rate,pays based on per visit rate,69.53,567.6,
0031A - Janssen Covid-19 Vaccine Administration,60000712,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,76.8,61.44,,57.6,75,,,percent of total billed charges,75% of total billed charges,30.72,40,,,percent of total billed charges,40% of total billed charges,60.83,79.2,,,percent of total billed charges,79.2% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,72.96,95,,,percent of total billed charges,95% of total billed charges,61.44,80,,,percent of total billed charges,80% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,69.12,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,30.72,40,,,percent of total billed charges,40% of total billed charges,30.72,40,,,percent of total billed charges,40% of total billed charges,69.12,90,,,percent of total billed charges,90% of total billed charges,58.37,76,,,percent of total billed charges,76% of total billed charges,30.72,40,,,percent of total billed charges,40% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,61.44,80,,,percent of total billed charges,80% of total billed charges,29.8,38.8,,,percent of total billed charges,38.8% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,29.8,72.96,
0003A ADMIN COVID-19 VACCINE 3RD DOSE PFIZER,60000749,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,76.8,61.44,,57.6,75,,,percent of total billed charges,75% of total billed charges,30.72,40,,,percent of total billed charges,40% of total billed charges,60.83,79.2,,,percent of total billed charges,79.2% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,72.96,95,,,percent of total billed charges,95% of total billed charges,61.44,80,,,percent of total billed charges,80% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,69.12,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,30.72,40,,,percent of total billed charges,40% of total billed charges,30.72,40,,,percent of total billed charges,40% of total billed charges,69.12,90,,,percent of total billed charges,90% of total billed charges,58.37,76,,,percent of total billed charges,76% of total billed charges,30.72,40,,,percent of total billed charges,40% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,61.44,80,,,percent of total billed charges,80% of total billed charges,29.8,38.8,,,percent of total billed charges,38.8% of total billed charges,65.28,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,29.8,72.96,
Covid-19 Pediatric Vaccine 1st dose,60000765,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,55,44,,41.25,75,,,percent of total billed charges,75% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,43.56,79.2,,,percent of total billed charges,79.2% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,52.25,95,,,percent of total billed charges,95% of total billed charges,44,80,,,percent of total billed charges,80% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,49.5,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,55,100,,,fee schedule,100% of NM APC rate,22,40,,,percent of total billed charges,40% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,49.5,90,,,percent of total billed charges,90% of total billed charges,41.8,76,,,percent of total billed charges,76% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,44,80,,,percent of total billed charges,80% of total billed charges,21.34,38.8,,,percent of total billed charges,38.8% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,21.34,55,
Covid-19 Pediatric Vaccine 2nd dose,60000766,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,92.1,73.68,,69.08,75,,,percent of total billed charges,75% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,72.94,79.2,,,percent of total billed charges,79.2% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,87.5,95,,,percent of total billed charges,95% of total billed charges,73.68,80,,,percent of total billed charges,80% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,36.84,40,,,percent of total billed charges,40% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,70,76,,,percent of total billed charges,76% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,73.68,80,,,percent of total billed charges,80% of total billed charges,35.73,38.8,,,percent of total billed charges,38.8% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,35.73,87.5,
0071A Pfizer-Biontech Covid-19 Pediatric Vaccine - 1st Pedia,60000765,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,55,44,,41.25,75,,,percent of total billed charges,75% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,43.56,79.2,,,percent of total billed charges,79.2% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,52.25,95,,,percent of total billed charges,95% of total billed charges,44,80,,,percent of total billed charges,80% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,49.5,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,55,100,,,fee schedule,100% of NM APC rate,22,40,,,percent of total billed charges,40% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,49.5,90,,,percent of total billed charges,90% of total billed charges,41.8,76,,,percent of total billed charges,76% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,44,80,,,percent of total billed charges,80% of total billed charges,21.34,38.8,,,percent of total billed charges,38.8% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,21.34,55,
0072A Pfizer-Biontech Covid-19 Pediatric Vaccine - 2nd Pedia,60000766,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,92.1,73.68,,69.08,75,,,percent of total billed charges,75% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,72.94,79.2,,,percent of total billed charges,79.2% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,87.5,95,,,percent of total billed charges,95% of total billed charges,73.68,80,,,percent of total billed charges,80% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,36.84,40,,,percent of total billed charges,40% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,70,76,,,percent of total billed charges,76% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,73.68,80,,,percent of total billed charges,80% of total billed charges,35.73,38.8,,,percent of total billed charges,38.8% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,35.73,87.5,
"J0561 - Injection, penicillin g benzathine 1.2M units",60000807,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,486.2,388.96,,364.65,75,,,percent of total billed charges,75% of total billed charges,194.48,40,,,percent of total billed charges,40% of total billed charges,385.07,79.2,,,percent of total billed charges,79.2% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,461.89,95,,,percent of total billed charges,95% of total billed charges,388.96,80,,,percent of total billed charges,80% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,437.58,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,486.2,100,,,fee schedule,100% of NM fee schedule,194.48,40,,,percent of total billed charges,40% of total billed charges,194.48,40,,,percent of total billed charges,40% of total billed charges,437.58,90,,,percent of total billed charges,90% of total billed charges,369.51,76,,,percent of total billed charges,76% of total billed charges,194.48,40,,,percent of total billed charges,40% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,388.96,80,,,percent of total billed charges,80% of total billed charges,188.65,38.8,,,percent of total billed charges,38.8% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,486.2,
"J0561 - Injection, penicillin g benzathine 2.4M units",60000807,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,486.2,388.96,,364.65,75,,,percent of total billed charges,75% of total billed charges,194.48,40,,,percent of total billed charges,40% of total billed charges,385.07,79.2,,,percent of total billed charges,79.2% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,461.89,95,,,percent of total billed charges,95% of total billed charges,388.96,80,,,percent of total billed charges,80% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,437.58,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,486.2,100,,,fee schedule,100% of NM fee schedule,194.48,40,,,percent of total billed charges,40% of total billed charges,194.48,40,,,percent of total billed charges,40% of total billed charges,437.58,90,,,percent of total billed charges,90% of total billed charges,369.51,76,,,percent of total billed charges,76% of total billed charges,194.48,40,,,percent of total billed charges,40% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,388.96,80,,,percent of total billed charges,80% of total billed charges,188.65,38.8,,,percent of total billed charges,38.8% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,486.2,
90677 PCV 20 Vaccine,60000809,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,658.9,527.12,,494.18,75,,,percent of total billed charges,75% of total billed charges,263.56,40,,,percent of total billed charges,40% of total billed charges,521.85,79.2,,,percent of total billed charges,79.2% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,625.96,95,,,percent of total billed charges,95% of total billed charges,527.12,80,,,percent of total billed charges,80% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,593.01,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,658.9,100,,,fee schedule,100% of NM fee schedule,263.56,40,,,percent of total billed charges,40% of total billed charges,263.56,40,,,percent of total billed charges,40% of total billed charges,593.01,90,,,percent of total billed charges,90% of total billed charges,500.76,76,,,percent of total billed charges,76% of total billed charges,263.56,40,,,percent of total billed charges,40% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,527.12,80,,,percent of total billed charges,80% of total billed charges,255.65,38.8,,,percent of total billed charges,38.8% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,658.9,
90697 DTaP-IPV-Hib-HepB (Vaxelis) for intramuscular injectio,60000805,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,658.9,527.12,,494.18,75,,,percent of total billed charges,75% of total billed charges,263.56,40,,,percent of total billed charges,40% of total billed charges,521.85,79.2,,,percent of total billed charges,79.2% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,625.96,95,,,percent of total billed charges,95% of total billed charges,527.12,80,,,percent of total billed charges,80% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,593.01,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,658.9,100,,,fee schedule,100% of NM fee schedule,263.56,40,,,percent of total billed charges,40% of total billed charges,263.56,40,,,percent of total billed charges,40% of total billed charges,593.01,90,,,percent of total billed charges,90% of total billed charges,500.76,76,,,percent of total billed charges,76% of total billed charges,263.56,40,,,percent of total billed charges,40% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,527.12,80,,,percent of total billed charges,80% of total billed charges,255.65,38.8,,,percent of total billed charges,38.8% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,658.9,
VFC 90697 DTaP-IPV-Hib-HepB (Vaxelis) for intramuscular inje,60000806,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
G0269 Counseling visit to discuss need for lung cancer scree,60000979,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,96.6,77.28,,72.45,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,76.51,79.2,,,percent of total billed charges,79.2% of total billed charges,82.11,85,,,percent of total billed charges,85% of total billed charges,96.6,100,,,fee schedule,100% of CO APG rates,91.77,95,,,percent of total billed charges,95% of total billed charges,77.28,80,,,percent of total billed charges,80% of total billed charges,82.11,85,,,percent of total billed charges,85% of total billed charges,86.94,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,96.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,86.94,90,,,percent of total billed charges,90% of total billed charges,73.42,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,82.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,77.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,82.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,575.4,100,,,case rate,pays based on per visit rate,72.45,575.4,
0124A COVID-19 Pfizer Bivalent Vaccine Admin,60000992,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,53.9,43.12,,40.43,75,,,percent of total billed charges,75% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,42.69,79.2,,,percent of total billed charges,79.2% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,51.21,95,,,percent of total billed charges,95% of total billed charges,43.12,80,,,percent of total billed charges,80% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,48.51,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,53.9,100,,,fee schedule,100% of NM APC rate,21.56,40,,,percent of total billed charges,40% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,48.51,90,,,percent of total billed charges,90% of total billed charges,40.96,76,,,percent of total billed charges,76% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,43.12,80,,,percent of total billed charges,80% of total billed charges,20.91,38.8,,,percent of total billed charges,38.8% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,20.91,53.9,
0124A - ADM SARSCV2BVL,60000992,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,53.9,43.12,,40.43,75,,,percent of total billed charges,75% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,42.69,79.2,,,percent of total billed charges,79.2% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,51.21,95,,,percent of total billed charges,95% of total billed charges,43.12,80,,,percent of total billed charges,80% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,48.51,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,53.9,100,,,fee schedule,100% of NM APC rate,21.56,40,,,percent of total billed charges,40% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,48.51,90,,,percent of total billed charges,90% of total billed charges,40.96,76,,,percent of total billed charges,76% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,43.12,80,,,percent of total billed charges,80% of total billed charges,20.91,38.8,,,percent of total billed charges,38.8% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,20.91,53.9,
Counseling Visit - G0296,60001050,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,96.6,77.28,,72.45,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,76.51,79.2,,,percent of total billed charges,79.2% of total billed charges,82.11,85,,,percent of total billed charges,85% of total billed charges,96.6,100,,,fee schedule,100% of CO APG rates,91.77,95,,,percent of total billed charges,95% of total billed charges,77.28,80,,,percent of total billed charges,80% of total billed charges,82.11,85,,,percent of total billed charges,85% of total billed charges,86.94,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,96.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,86.94,90,,,percent of total billed charges,90% of total billed charges,73.42,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,82.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,77.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,82.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,575.4,100,,,case rate,pays based on per visit rate,72.45,575.4,
91321 - INS SARSCOV2 VAC 25 MCG,60001085,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,379.4,303.52,,284.55,75,,,percent of total billed charges,75% of total billed charges,151.76,40,,,percent of total billed charges,40% of total billed charges,300.48,79.2,,,percent of total billed charges,79.2% of total billed charges,322.49,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,360.43,95,,,percent of total billed charges,95% of total billed charges,303.52,80,,,percent of total billed charges,80% of total billed charges,322.49,85,,,percent of total billed charges,85% of total billed charges,341.46,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,379.4,100,,,fee schedule,100% of NM fee schedule,151.76,40,,,percent of total billed charges,40% of total billed charges,151.76,40,,,percent of total billed charges,40% of total billed charges,341.46,90,,,percent of total billed charges,90% of total billed charges,288.34,76,,,percent of total billed charges,76% of total billed charges,151.76,40,,,percent of total billed charges,40% of total billed charges,322.49,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,303.52,80,,,percent of total billed charges,80% of total billed charges,147.21,38.8,,,percent of total billed charges,38.8% of total billed charges,322.49,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,379.4,
91322 - INS SARSCOV2 VAC 50 MCG,60001086,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,379.4,303.52,,284.55,75,,,percent of total billed charges,75% of total billed charges,151.76,40,,,percent of total billed charges,40% of total billed charges,300.48,79.2,,,percent of total billed charges,79.2% of total billed charges,322.49,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,360.43,95,,,percent of total billed charges,95% of total billed charges,303.52,80,,,percent of total billed charges,80% of total billed charges,322.49,85,,,percent of total billed charges,85% of total billed charges,341.46,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,379.4,100,,,fee schedule,100% of NM fee schedule,151.76,40,,,percent of total billed charges,40% of total billed charges,151.76,40,,,percent of total billed charges,40% of total billed charges,341.46,90,,,percent of total billed charges,90% of total billed charges,288.34,76,,,percent of total billed charges,76% of total billed charges,151.76,40,,,percent of total billed charges,40% of total billed charges,322.49,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,303.52,80,,,percent of total billed charges,80% of total billed charges,147.21,38.8,,,percent of total billed charges,38.8% of total billed charges,322.49,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,379.4,
90480 - INS ADMN SARSCOV2 VACC 1 DOSE,60001084,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,104,83.2,,78,75,,,percent of total billed charges,75% of total billed charges,41.6,40,,,percent of total billed charges,40% of total billed charges,82.37,79.2,,,percent of total billed charges,79.2% of total billed charges,88.4,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,98.8,95,,,percent of total billed charges,95% of total billed charges,83.2,80,,,percent of total billed charges,80% of total billed charges,88.4,85,,,percent of total billed charges,85% of total billed charges,93.6,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,41.6,40,,,percent of total billed charges,40% of total billed charges,41.6,40,,,percent of total billed charges,40% of total billed charges,93.6,90,,,percent of total billed charges,90% of total billed charges,79.04,76,,,percent of total billed charges,76% of total billed charges,41.6,40,,,percent of total billed charges,40% of total billed charges,88.4,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,83.2,80,,,percent of total billed charges,80% of total billed charges,40.35,38.8,,,percent of total billed charges,38.8% of total billed charges,88.4,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,40.35,98.8,
90480 - VFC ADMN SARSCOV2 VACC 1 DOSE,60001087,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,22.3,17.84,,16.73,75,,,percent of total billed charges,75% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,17.66,79.2,,,percent of total billed charges,79.2% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,22.3,100,,,fee schedule,100% of CO APG rates,21.19,95,,,percent of total billed charges,95% of total billed charges,17.84,80,,,percent of total billed charges,80% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,20.07,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,22.3,100,,,fee schedule,100% of NM APC rate,8.92,40,,,percent of total billed charges,40% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,20.07,90,,,percent of total billed charges,90% of total billed charges,16.95,76,,,percent of total billed charges,76% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,17.84,80,,,percent of total billed charges,80% of total billed charges,8.65,38.8,,,percent of total billed charges,38.8% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,8.65,50.67,
Office/Outpatient Visit Level 1 Es,49199211,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,20.4,16.32,,15.3,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,16.16,79.2,,,percent of total billed charges,79.2% of total billed charges,17.34,85,,,percent of total billed charges,85% of total billed charges,20.4,100,,,fee schedule,100% of CO APG rates,19.38,95,,,percent of total billed charges,95% of total billed charges,16.32,80,,,percent of total billed charges,80% of total billed charges,17.34,85,,,percent of total billed charges,85% of total billed charges,18.36,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,20.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,18.36,90,,,percent of total billed charges,90% of total billed charges,15.5,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,17.34,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,16.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,17.34,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,423,100,,,case rate,pays based on per visit rate,15.3,423,
Office/Outpatient Visit Level 3 Established - 99213,49199213,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,152.8,122.24,,114.6,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,121.02,79.2,,,percent of total billed charges,79.2% of total billed charges,129.88,85,,,percent of total billed charges,85% of total billed charges,152.8,100,,,fee schedule,100% of CO APG rates,145.16,95,,,percent of total billed charges,95% of total billed charges,122.24,80,,,percent of total billed charges,80% of total billed charges,129.88,85,,,percent of total billed charges,85% of total billed charges,137.52,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,152.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,137.52,90,,,percent of total billed charges,90% of total billed charges,116.13,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,129.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,122.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,129.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,687.8,100,,,case rate,pays based on per visit rate,114.6,687.8,
10060 Incision And Drainage Of Abscess Simple,49110060,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,322.9,258.32,,242.18,75,,,percent of total billed charges,75% of total billed charges,129.16,40,,,percent of total billed charges,40% of total billed charges,255.74,79.2,,,percent of total billed charges,79.2% of total billed charges,274.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,306.76,95,,,percent of total billed charges,95% of total billed charges,258.32,80,,,percent of total billed charges,80% of total billed charges,274.47,85,,,percent of total billed charges,85% of total billed charges,290.61,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,129.16,40,,,percent of total billed charges,40% of total billed charges,129.16,40,,,percent of total billed charges,40% of total billed charges,290.61,90,,,percent of total billed charges,90% of total billed charges,245.4,76,,,percent of total billed charges,76% of total billed charges,129.16,40,,,percent of total billed charges,40% of total billed charges,274.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,258.32,80,,,percent of total billed charges,80% of total billed charges,125.29,38.8,,,percent of total billed charges,38.8% of total billed charges,274.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,125.29,306.76,
10061 Incision And Drainage Of Abscess Complicated Or Multip,49110061,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,550.9,440.72,,413.18,75,,,percent of total billed charges,75% of total billed charges,220.36,40,,,percent of total billed charges,40% of total billed charges,436.31,79.2,,,percent of total billed charges,79.2% of total billed charges,468.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,523.36,95,,,percent of total billed charges,95% of total billed charges,440.72,80,,,percent of total billed charges,80% of total billed charges,468.27,85,,,percent of total billed charges,85% of total billed charges,495.81,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,220.36,40,,,percent of total billed charges,40% of total billed charges,220.36,40,,,percent of total billed charges,40% of total billed charges,495.81,90,,,percent of total billed charges,90% of total billed charges,418.68,76,,,percent of total billed charges,76% of total billed charges,220.36,40,,,percent of total billed charges,40% of total billed charges,468.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,440.72,80,,,percent of total billed charges,80% of total billed charges,213.75,38.8,,,percent of total billed charges,38.8% of total billed charges,468.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,523.36,
"Remove Lesion, Trunk/Arm/Leg <.5 cm Charge",49111400,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,255.8,204.64,,191.85,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,202.59,79.2,,,percent of total billed charges,79.2% of total billed charges,217.43,85,,,percent of total billed charges,85% of total billed charges,255.8,100,,,fee schedule,100% of CO APG rates,243.01,95,,,percent of total billed charges,95% of total billed charges,204.64,80,,,percent of total billed charges,80% of total billed charges,217.43,85,,,percent of total billed charges,85% of total billed charges,230.22,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,255.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,230.22,90,,,percent of total billed charges,90% of total billed charges,194.41,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,217.43,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,204.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,217.43,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,893.8,100,,,case rate,pays based on per visit rate,191.85,893.8,
"Remove Lesion, Trunk/Arm/Leg .6 to 1.0 cm Charge",49111401,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,318.9,255.12,,239.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,252.57,79.2,,,percent of total billed charges,79.2% of total billed charges,271.07,85,,,percent of total billed charges,85% of total billed charges,318.9,100,,,fee schedule,100% of CO APG rates,302.96,95,,,percent of total billed charges,95% of total billed charges,255.12,80,,,percent of total billed charges,80% of total billed charges,271.07,85,,,percent of total billed charges,85% of total billed charges,287.01,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,318.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,287.01,90,,,percent of total billed charges,90% of total billed charges,242.36,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,271.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,255.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,271.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1020,100,,,case rate,pays based on per visit rate,239.18,1020,
"Remove Lesion, Trunk/Arm/Leg 1.1 to 2.0 cm Charge",49111402,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,348.4,278.72,,261.3,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,275.93,79.2,,,percent of total billed charges,79.2% of total billed charges,296.14,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,330.98,95,,,percent of total billed charges,95% of total billed charges,278.72,80,,,percent of total billed charges,80% of total billed charges,296.14,85,,,percent of total billed charges,85% of total billed charges,313.56,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,348.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,313.56,90,,,percent of total billed charges,90% of total billed charges,264.78,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,296.14,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,278.72,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,296.14,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1079,100,,,case rate,pays based on per visit rate,261.3,1079,
"Remove Lesion, Trunk/Arm/Leg 2.1 to 3.0 cm Charge",49111403,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,452.8,362.24,,339.6,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,358.62,79.2,,,percent of total billed charges,79.2% of total billed charges,384.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,430.16,95,,,percent of total billed charges,95% of total billed charges,362.24,80,,,percent of total billed charges,80% of total billed charges,384.88,85,,,percent of total billed charges,85% of total billed charges,407.52,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,452.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,407.52,90,,,percent of total billed charges,90% of total billed charges,344.13,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,384.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,362.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,384.88,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Trunk/Arm/Leg 3.1 to 4.0 cm Charge",49111404,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,496.9,397.52,,372.68,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,393.54,79.2,,,percent of total billed charges,79.2% of total billed charges,422.37,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,472.06,95,,,percent of total billed charges,95% of total billed charges,397.52,80,,,percent of total billed charges,80% of total billed charges,422.37,85,,,percent of total billed charges,85% of total billed charges,447.21,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,496.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,447.21,90,,,percent of total billed charges,90% of total billed charges,377.64,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,422.37,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,397.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,422.37,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Trunk/Arm/Leg >4.0 cm Charge",49111406,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,742.1,593.68,,556.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,587.74,79.2,,,percent of total billed charges,79.2% of total billed charges,630.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,705,95,,,percent of total billed charges,95% of total billed charges,593.68,80,,,percent of total billed charges,80% of total billed charges,630.79,85,,,percent of total billed charges,85% of total billed charges,667.89,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,742.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,667.89,90,,,percent of total billed charges,90% of total billed charges,564,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,630.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,593.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,630.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Scalp/Neck/Hand/Foot < .5 cm Charge",49111420,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,249.4,199.52,,187.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,197.52,79.2,,,percent of total billed charges,79.2% of total billed charges,211.99,85,,,percent of total billed charges,85% of total billed charges,249.4,100,,,fee schedule,100% of CO APG rates,236.93,95,,,percent of total billed charges,95% of total billed charges,199.52,80,,,percent of total billed charges,80% of total billed charges,211.99,85,,,percent of total billed charges,85% of total billed charges,224.46,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,249.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,224.46,90,,,percent of total billed charges,90% of total billed charges,189.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,211.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,199.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,211.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,881,100,,,case rate,pays based on per visit rate,187.05,881,
"Remove Lesion, Scalp/Neck/Hand/Foot .6 to 1.0 cm Charge",49111421,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,328.3,262.64,,246.23,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,260.01,79.2,,,percent of total billed charges,79.2% of total billed charges,279.06,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,311.89,95,,,percent of total billed charges,95% of total billed charges,262.64,80,,,percent of total billed charges,80% of total billed charges,279.06,85,,,percent of total billed charges,85% of total billed charges,295.47,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,328.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,295.47,90,,,percent of total billed charges,90% of total billed charges,249.51,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,279.06,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,262.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,279.06,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1038.8,100,,,case rate,pays based on per visit rate,246.23,1038.8,
"Remove Lesion, Scalp/Neck/Hand/Foot 1.1 to 2.0 cm Charge",49111422,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,412.1,329.68,,309.08,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,326.38,79.2,,,percent of total billed charges,79.2% of total billed charges,350.29,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,391.5,95,,,percent of total billed charges,95% of total billed charges,329.68,80,,,percent of total billed charges,80% of total billed charges,350.29,85,,,percent of total billed charges,85% of total billed charges,370.89,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,412.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,370.89,90,,,percent of total billed charges,90% of total billed charges,313.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,350.29,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,329.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,350.29,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1206.4,100,,,case rate,pays based on per visit rate,309.08,1206.4,
"Remove Lesion, Scalp/Neck/Hand/Foot 2.1 to 3.0 cm Charge",49111423,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,476.4,381.12,,357.3,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,377.31,79.2,,,percent of total billed charges,79.2% of total billed charges,404.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,452.58,95,,,percent of total billed charges,95% of total billed charges,381.12,80,,,percent of total billed charges,80% of total billed charges,404.94,85,,,percent of total billed charges,85% of total billed charges,428.76,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,476.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,428.76,90,,,percent of total billed charges,90% of total billed charges,362.06,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,404.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,381.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,404.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Scalp/Neck/Hand/Foot 3.1 to 4.0 cm Charge",49111424,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,545.7,436.56,,409.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,432.19,79.2,,,percent of total billed charges,79.2% of total billed charges,463.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,518.42,95,,,percent of total billed charges,95% of total billed charges,436.56,80,,,percent of total billed charges,80% of total billed charges,463.85,85,,,percent of total billed charges,85% of total billed charges,491.13,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,545.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,491.13,90,,,percent of total billed charges,90% of total billed charges,414.73,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,463.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,436.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,463.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Scalp/Neck/Hand/Foot >4.0 cm Charge",49111426,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,803,642.4,,602.25,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,635.98,79.2,,,percent of total billed charges,79.2% of total billed charges,682.55,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,762.85,95,,,percent of total billed charges,95% of total billed charges,642.4,80,,,percent of total billed charges,80% of total billed charges,682.55,85,,,percent of total billed charges,85% of total billed charges,722.7,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,803,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,722.7,90,,,percent of total billed charges,90% of total billed charges,610.28,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,682.55,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,642.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,682.55,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Face/Lid/Ear/Nose/Lip <.5 cm Charge",49111440,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,325.9,260.72,,244.43,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,258.11,79.2,,,percent of total billed charges,79.2% of total billed charges,277.02,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,309.61,95,,,percent of total billed charges,95% of total billed charges,260.72,80,,,percent of total billed charges,80% of total billed charges,277.02,85,,,percent of total billed charges,85% of total billed charges,293.31,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,325.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,293.31,90,,,percent of total billed charges,90% of total billed charges,247.68,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,277.02,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,260.72,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,277.02,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1034,100,,,case rate,pays based on per visit rate,244.43,1034,
"Remove Lesion, Face/Lid/Ear/Nose/Lip .6 to 1.0 cm Charge",49111441,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,402.2,321.76,,301.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,318.54,79.2,,,percent of total billed charges,79.2% of total billed charges,341.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,382.09,95,,,percent of total billed charges,95% of total billed charges,321.76,80,,,percent of total billed charges,80% of total billed charges,341.87,85,,,percent of total billed charges,85% of total billed charges,361.98,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,402.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,361.98,90,,,percent of total billed charges,90% of total billed charges,305.67,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,341.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,321.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,341.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1186.6,100,,,case rate,pays based on per visit rate,301.65,1186.6,
"Remove Lesion, Face/Lid/Ear/Nose/Lip 1.1 to 2.0 cm Charge",49111442,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,444,355.2,,333,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,351.65,79.2,,,percent of total billed charges,79.2% of total billed charges,377.4,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,421.8,95,,,percent of total billed charges,95% of total billed charges,355.2,80,,,percent of total billed charges,80% of total billed charges,377.4,85,,,percent of total billed charges,85% of total billed charges,399.6,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,444,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,399.6,90,,,percent of total billed charges,90% of total billed charges,337.44,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,377.4,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,355.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,377.4,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Face/Lid/Ear/Nose/Lip 2.1 to 3.0 cm Charge",49111443,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,539.4,431.52,,404.55,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,427.2,79.2,,,percent of total billed charges,79.2% of total billed charges,458.49,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,512.43,95,,,percent of total billed charges,95% of total billed charges,431.52,80,,,percent of total billed charges,80% of total billed charges,458.49,85,,,percent of total billed charges,85% of total billed charges,485.46,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,539.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,485.46,90,,,percent of total billed charges,90% of total billed charges,409.94,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,458.49,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,431.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,458.49,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Arthrocentesis Intermed Joint, Wrist, Elbow, Ankle Charge",49120605,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,107.7,86.16,,80.78,75,,,percent of total billed charges,75% of total billed charges,43.08,40,,,percent of total billed charges,40% of total billed charges,85.3,79.2,,,percent of total billed charges,79.2% of total billed charges,91.55,85,,,percent of total billed charges,85% of total billed charges,107.7,100,,,fee schedule,100% of CO APG rates,102.32,95,,,percent of total billed charges,95% of total billed charges,86.16,80,,,percent of total billed charges,80% of total billed charges,91.55,85,,,percent of total billed charges,85% of total billed charges,96.93,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,107.7,100,,,fee schedule,100% of NM APC rate,43.08,40,,,percent of total billed charges,40% of total billed charges,43.08,40,,,percent of total billed charges,40% of total billed charges,96.93,90,,,percent of total billed charges,90% of total billed charges,81.85,76,,,percent of total billed charges,76% of total billed charges,43.08,40,,,percent of total billed charges,40% of total billed charges,91.55,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,86.16,80,,,percent of total billed charges,80% of total billed charges,41.79,38.8,,,percent of total billed charges,38.8% of total billed charges,91.55,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,215.4,200,,,fee schedule,200% of CMS fee schedule,41.79,215.49,
"Arthrocentesis Major Joint, Shoulder, Hip, Knee Charge",49120610,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,132.7,106.16,,99.53,75,,,percent of total billed charges,75% of total billed charges,53.08,40,,,percent of total billed charges,40% of total billed charges,105.1,79.2,,,percent of total billed charges,79.2% of total billed charges,112.8,85,,,percent of total billed charges,85% of total billed charges,132.7,100,,,fee schedule,100% of CO APG rates,126.07,95,,,percent of total billed charges,95% of total billed charges,106.16,80,,,percent of total billed charges,80% of total billed charges,112.8,85,,,percent of total billed charges,85% of total billed charges,119.43,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,132.7,100,,,fee schedule,100% of NM APC rate,53.08,40,,,percent of total billed charges,40% of total billed charges,53.08,40,,,percent of total billed charges,40% of total billed charges,119.43,90,,,percent of total billed charges,90% of total billed charges,100.85,76,,,percent of total billed charges,76% of total billed charges,53.08,40,,,percent of total billed charges,40% of total billed charges,112.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,106.16,80,,,percent of total billed charges,80% of total billed charges,51.49,38.8,,,percent of total billed charges,38.8% of total billed charges,112.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,51.49,217.66,
"Shave (Epi)Dermal Lesion, Single, Trunk, Arms or Legs; Diam 0.6 to 1.0 cm Charge",49111301,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,151.2,120.96,,113.4,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,119.75,79.2,,,percent of total billed charges,79.2% of total billed charges,128.52,85,,,percent of total billed charges,85% of total billed charges,151.2,100,,,fee schedule,100% of CO APG rates,143.64,95,,,percent of total billed charges,95% of total billed charges,120.96,80,,,percent of total billed charges,80% of total billed charges,128.52,85,,,percent of total billed charges,85% of total billed charges,136.08,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,151.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,136.08,90,,,percent of total billed charges,90% of total billed charges,114.91,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,128.52,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,120.96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,128.52,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,684.6,100,,,case rate,pays based on per visit rate,113.4,684.6,
"Shave (Epi)Dermal Lesion, Single, Scalp, Neck, Hands, Feet, Genital; Diam 0.5 cm",49111305,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,108.6,86.88,,81.45,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,86.01,79.2,,,percent of total billed charges,79.2% of total billed charges,92.31,85,,,percent of total billed charges,85% of total billed charges,108.6,100,,,fee schedule,100% of CO APG rates,103.17,95,,,percent of total billed charges,95% of total billed charges,86.88,80,,,percent of total billed charges,80% of total billed charges,92.31,85,,,percent of total billed charges,85% of total billed charges,97.74,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,108.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,97.74,90,,,percent of total billed charges,90% of total billed charges,82.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,92.31,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,86.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,92.31,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,599.4,100,,,case rate,pays based on per visit rate,81.45,599.4,
"Shave (Epi)Dermal Lesion, Single, Scalp, Neck, Hands, Feet, Genital; Diam 0.6 to",49111306,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,142.2,113.76,,106.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,112.62,79.2,,,percent of total billed charges,79.2% of total billed charges,120.87,85,,,percent of total billed charges,85% of total billed charges,142.2,100,,,fee schedule,100% of CO APG rates,135.09,95,,,percent of total billed charges,95% of total billed charges,113.76,80,,,percent of total billed charges,80% of total billed charges,120.87,85,,,percent of total billed charges,85% of total billed charges,127.98,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,142.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,127.98,90,,,percent of total billed charges,90% of total billed charges,108.07,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,120.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,113.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,120.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,666.6,100,,,case rate,pays based on per visit rate,106.65,666.6,
"Remove Other Benign Lesion w/Margins , Face/Ears/Eyelids/Nose/Lips; Diam 3.1 to",49111444,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,679.6,543.68,,509.7,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,538.24,79.2,,,percent of total billed charges,79.2% of total billed charges,577.66,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,645.62,95,,,percent of total billed charges,95% of total billed charges,543.68,80,,,percent of total billed charges,80% of total billed charges,577.66,85,,,percent of total billed charges,85% of total billed charges,611.64,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,679.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,611.64,90,,,percent of total billed charges,90% of total billed charges,516.5,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,577.66,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,543.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,577.66,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Other Benign Lesion w/Margins , Face/Ears/Eyelids/Nose/Lips; Diam 4.0+ cm",49111446,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,950,760,,712.5,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,752.4,79.2,,,percent of total billed charges,79.2% of total billed charges,807.5,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,902.5,95,,,percent of total billed charges,95% of total billed charges,760,80,,,percent of total billed charges,80% of total billed charges,807.5,85,,,percent of total billed charges,85% of total billed charges,855,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,950,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,855,90,,,percent of total billed charges,90% of total billed charges,722,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,807.5,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,760,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,807.5,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Trunk, Arms, or Legs; Diam 4.0+ cm Charge",49111606,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,930.2,744.16,,697.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,736.72,79.2,,,percent of total billed charges,79.2% of total billed charges,790.67,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,883.69,95,,,percent of total billed charges,95% of total billed charges,744.16,80,,,percent of total billed charges,80% of total billed charges,790.67,85,,,percent of total billed charges,85% of total billed charges,837.18,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,930.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,837.18,90,,,percent of total billed charges,90% of total billed charges,706.95,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,790.67,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,744.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,790.67,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 0.5 cm >",49111620,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,368.1,294.48,,276.08,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,291.54,79.2,,,percent of total billed charges,79.2% of total billed charges,312.89,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,349.7,95,,,percent of total billed charges,95% of total billed charges,294.48,80,,,percent of total billed charges,80% of total billed charges,312.89,85,,,percent of total billed charges,85% of total billed charges,331.29,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,368.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,331.29,90,,,percent of total billed charges,90% of total billed charges,279.76,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,312.89,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,294.48,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,312.89,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1118.4,100,,,case rate,pays based on per visit rate,276.08,1118.4,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 0.6 to 1.",49111621,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,446.9,357.52,,335.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,353.94,79.2,,,percent of total billed charges,79.2% of total billed charges,379.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,424.56,95,,,percent of total billed charges,95% of total billed charges,357.52,80,,,percent of total billed charges,80% of total billed charges,379.87,85,,,percent of total billed charges,85% of total billed charges,402.21,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,446.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,402.21,90,,,percent of total billed charges,90% of total billed charges,339.64,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,379.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,357.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,379.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 1.1 to 2.",49111622,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,504.5,403.6,,378.38,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,399.56,79.2,,,percent of total billed charges,79.2% of total billed charges,428.83,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,479.28,95,,,percent of total billed charges,95% of total billed charges,403.6,80,,,percent of total billed charges,80% of total billed charges,428.83,85,,,percent of total billed charges,85% of total billed charges,454.05,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,504.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,454.05,90,,,percent of total billed charges,90% of total billed charges,383.42,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,428.83,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,403.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,428.83,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 2.1 to 3.",49111623,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,621.4,497.12,,466.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,492.15,79.2,,,percent of total billed charges,79.2% of total billed charges,528.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,590.33,95,,,percent of total billed charges,95% of total billed charges,497.12,80,,,percent of total billed charges,80% of total billed charges,528.19,85,,,percent of total billed charges,85% of total billed charges,559.26,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,621.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,559.26,90,,,percent of total billed charges,90% of total billed charges,472.26,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,528.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,497.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,528.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 3.1 to 4.",49111624,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,703.6,562.88,,527.7,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,557.25,79.2,,,percent of total billed charges,79.2% of total billed charges,598.06,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,668.42,95,,,percent of total billed charges,95% of total billed charges,562.88,80,,,percent of total billed charges,80% of total billed charges,598.06,85,,,percent of total billed charges,85% of total billed charges,633.24,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,703.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,633.24,90,,,percent of total billed charges,90% of total billed charges,534.74,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,598.06,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,562.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,598.06,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 4.0+ cm C",49111626,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,857.1,685.68,,642.83,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,678.82,79.2,,,percent of total billed charges,79.2% of total billed charges,728.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,814.25,95,,,percent of total billed charges,95% of total billed charges,685.68,80,,,percent of total billed charges,80% of total billed charges,728.54,85,,,percent of total billed charges,85% of total billed charges,771.39,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,857.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,771.39,90,,,percent of total billed charges,90% of total billed charges,651.4,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,728.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,685.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,728.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Diam 2.1 to 3.0",49111643,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,675.5,540.4,,506.63,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,535,79.2,,,percent of total billed charges,79.2% of total billed charges,574.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,641.73,95,,,percent of total billed charges,95% of total billed charges,540.4,80,,,percent of total billed charges,80% of total billed charges,574.18,85,,,percent of total billed charges,85% of total billed charges,607.95,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,675.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,607.95,90,,,percent of total billed charges,90% of total billed charges,513.38,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,574.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,540.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,574.18,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Repair Simple  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.5 cm >",49112001,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,129.8,103.84,,97.35,75,,,percent of total billed charges,75% of total billed charges,51.92,40,,,percent of total billed charges,40% of total billed charges,102.8,79.2,,,percent of total billed charges,79.2% of total billed charges,110.33,85,,,percent of total billed charges,85% of total billed charges,129.8,100,,,fee schedule,100% of CO APG rates,123.31,95,,,percent of total billed charges,95% of total billed charges,103.84,80,,,percent of total billed charges,80% of total billed charges,110.33,85,,,percent of total billed charges,85% of total billed charges,116.82,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,129.8,100,,,fee schedule,100% of NM APC rate,51.92,40,,,percent of total billed charges,40% of total billed charges,51.92,40,,,percent of total billed charges,40% of total billed charges,116.82,90,,,percent of total billed charges,90% of total billed charges,98.65,76,,,percent of total billed charges,76% of total billed charges,51.92,40,,,percent of total billed charges,40% of total billed charges,110.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,103.84,80,,,percent of total billed charges,80% of total billed charges,50.36,38.8,,,percent of total billed charges,38.8% of total billed charges,110.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,50.36,217.66,
"Simple Repair  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.6 cm t",49112002,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,170,136,,127.5,75,,,percent of total billed charges,75% of total billed charges,68,40,,,percent of total billed charges,40% of total billed charges,134.64,79.2,,,percent of total billed charges,79.2% of total billed charges,144.5,85,,,percent of total billed charges,85% of total billed charges,170,100,,,fee schedule,100% of CO APG rates,161.5,95,,,percent of total billed charges,95% of total billed charges,136,80,,,percent of total billed charges,80% of total billed charges,144.5,85,,,percent of total billed charges,85% of total billed charges,153,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,170,100,,,fee schedule,100% of NM APC rate,68,40,,,percent of total billed charges,40% of total billed charges,68,40,,,percent of total billed charges,40% of total billed charges,153,90,,,percent of total billed charges,90% of total billed charges,129.2,76,,,percent of total billed charges,76% of total billed charges,68,40,,,percent of total billed charges,40% of total billed charges,144.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,136,80,,,percent of total billed charges,80% of total billed charges,65.96,38.8,,,percent of total billed charges,38.8% of total billed charges,144.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,65.96,217.66,
"Simple Repair Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 7.6 cm to",49112004,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,211.4,169.12,,158.55,75,,,percent of total billed charges,75% of total billed charges,84.56,40,,,percent of total billed charges,40% of total billed charges,167.43,79.2,,,percent of total billed charges,79.2% of total billed charges,179.69,85,,,percent of total billed charges,85% of total billed charges,211.4,100,,,fee schedule,100% of CO APG rates,200.83,95,,,percent of total billed charges,95% of total billed charges,169.12,80,,,percent of total billed charges,80% of total billed charges,179.69,85,,,percent of total billed charges,85% of total billed charges,190.26,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,84.56,40,,,percent of total billed charges,40% of total billed charges,84.56,40,,,percent of total billed charges,40% of total billed charges,190.26,90,,,percent of total billed charges,90% of total billed charges,160.66,76,,,percent of total billed charges,76% of total billed charges,84.56,40,,,percent of total billed charges,40% of total billed charges,179.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,169.12,80,,,percent of total billed charges,80% of total billed charges,82.02,38.8,,,percent of total billed charges,38.8% of total billed charges,179.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,82.02,217.66,
"Simple repair of superficial wounds of scalp, neck, axillae,",49112005,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,271,216.8,,203.25,75,,,percent of total billed charges,75% of total billed charges,108.4,40,,,percent of total billed charges,40% of total billed charges,214.63,79.2,,,percent of total billed charges,79.2% of total billed charges,230.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,257.45,95,,,percent of total billed charges,95% of total billed charges,216.8,80,,,percent of total billed charges,80% of total billed charges,230.35,85,,,percent of total billed charges,85% of total billed charges,243.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,108.4,40,,,percent of total billed charges,40% of total billed charges,108.4,40,,,percent of total billed charges,40% of total billed charges,243.9,90,,,percent of total billed charges,90% of total billed charges,205.96,76,,,percent of total billed charges,76% of total billed charges,108.4,40,,,percent of total billed charges,40% of total billed charges,230.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,216.8,80,,,percent of total billed charges,80% of total billed charges,105.15,38.8,,,percent of total billed charges,38.8% of total billed charges,230.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,105.15,257.45,
"Repair Simple  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 20.1 cm",49112006,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,335.2,268.16,,251.4,75,,,percent of total billed charges,75% of total billed charges,134.08,40,,,percent of total billed charges,40% of total billed charges,265.48,79.2,,,percent of total billed charges,79.2% of total billed charges,284.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,318.44,95,,,percent of total billed charges,95% of total billed charges,268.16,80,,,percent of total billed charges,80% of total billed charges,284.92,85,,,percent of total billed charges,85% of total billed charges,301.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,134.08,40,,,percent of total billed charges,40% of total billed charges,134.08,40,,,percent of total billed charges,40% of total billed charges,301.68,90,,,percent of total billed charges,90% of total billed charges,254.75,76,,,percent of total billed charges,76% of total billed charges,134.08,40,,,percent of total billed charges,40% of total billed charges,284.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,268.16,80,,,percent of total billed charges,80% of total billed charges,130.06,38.8,,,percent of total billed charges,38.8% of total billed charges,284.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,130.06,318.44,
"Repair Simple  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 30.0+ cm",49112007,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,416.9,333.52,,312.68,75,,,percent of total billed charges,75% of total billed charges,166.76,40,,,percent of total billed charges,40% of total billed charges,330.18,79.2,,,percent of total billed charges,79.2% of total billed charges,354.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,396.06,95,,,percent of total billed charges,95% of total billed charges,333.52,80,,,percent of total billed charges,80% of total billed charges,354.37,85,,,percent of total billed charges,85% of total billed charges,375.21,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,166.76,40,,,percent of total billed charges,40% of total billed charges,166.76,40,,,percent of total billed charges,40% of total billed charges,375.21,90,,,percent of total billed charges,90% of total billed charges,316.84,76,,,percent of total billed charges,76% of total billed charges,166.76,40,,,percent of total billed charges,40% of total billed charges,354.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,333.52,80,,,percent of total billed charges,80% of total billed charges,161.76,38.8,,,percent of total billed charges,38.8% of total billed charges,354.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,161.76,396.06,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112011,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,161.4,129.12,,121.05,75,,,percent of total billed charges,75% of total billed charges,64.56,40,,,percent of total billed charges,40% of total billed charges,127.83,79.2,,,percent of total billed charges,79.2% of total billed charges,137.19,85,,,percent of total billed charges,85% of total billed charges,161.4,100,,,fee schedule,100% of CO APG rates,153.33,95,,,percent of total billed charges,95% of total billed charges,129.12,80,,,percent of total billed charges,80% of total billed charges,137.19,85,,,percent of total billed charges,85% of total billed charges,145.26,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,161.4,100,,,fee schedule,100% of NM APC rate,64.56,40,,,percent of total billed charges,40% of total billed charges,64.56,40,,,percent of total billed charges,40% of total billed charges,145.26,90,,,percent of total billed charges,90% of total billed charges,122.66,76,,,percent of total billed charges,76% of total billed charges,64.56,40,,,percent of total billed charges,40% of total billed charges,137.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,129.12,80,,,percent of total billed charges,80% of total billed charges,62.62,38.8,,,percent of total billed charges,38.8% of total billed charges,137.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,62.62,217.66,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112013,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,166.2,132.96,,124.65,75,,,percent of total billed charges,75% of total billed charges,66.48,40,,,percent of total billed charges,40% of total billed charges,131.63,79.2,,,percent of total billed charges,79.2% of total billed charges,141.27,85,,,percent of total billed charges,85% of total billed charges,166.2,100,,,fee schedule,100% of CO APG rates,157.89,95,,,percent of total billed charges,95% of total billed charges,132.96,80,,,percent of total billed charges,80% of total billed charges,141.27,85,,,percent of total billed charges,85% of total billed charges,149.58,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,166.2,100,,,fee schedule,100% of NM APC rate,66.48,40,,,percent of total billed charges,40% of total billed charges,66.48,40,,,percent of total billed charges,40% of total billed charges,149.58,90,,,percent of total billed charges,90% of total billed charges,126.31,76,,,percent of total billed charges,76% of total billed charges,66.48,40,,,percent of total billed charges,40% of total billed charges,141.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,132.96,80,,,percent of total billed charges,80% of total billed charges,64.49,38.8,,,percent of total billed charges,38.8% of total billed charges,141.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,64.49,217.66,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112014,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,213.4,170.72,,160.05,75,,,percent of total billed charges,75% of total billed charges,85.36,40,,,percent of total billed charges,40% of total billed charges,169.01,79.2,,,percent of total billed charges,79.2% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,213.4,100,,,fee schedule,100% of CO APG rates,202.73,95,,,percent of total billed charges,95% of total billed charges,170.72,80,,,percent of total billed charges,80% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,192.06,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,85.36,40,,,percent of total billed charges,40% of total billed charges,85.36,40,,,percent of total billed charges,40% of total billed charges,192.06,90,,,percent of total billed charges,90% of total billed charges,162.18,76,,,percent of total billed charges,76% of total billed charges,85.36,40,,,percent of total billed charges,40% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,170.72,80,,,percent of total billed charges,80% of total billed charges,82.8,38.8,,,percent of total billed charges,38.8% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,82.8,217.66,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112015,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,269.7,215.76,,202.28,75,,,percent of total billed charges,75% of total billed charges,107.88,40,,,percent of total billed charges,40% of total billed charges,213.6,79.2,,,percent of total billed charges,79.2% of total billed charges,229.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,256.22,95,,,percent of total billed charges,95% of total billed charges,215.76,80,,,percent of total billed charges,80% of total billed charges,229.25,85,,,percent of total billed charges,85% of total billed charges,242.73,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,107.88,40,,,percent of total billed charges,40% of total billed charges,107.88,40,,,percent of total billed charges,40% of total billed charges,242.73,90,,,percent of total billed charges,90% of total billed charges,204.97,76,,,percent of total billed charges,76% of total billed charges,107.88,40,,,percent of total billed charges,40% of total billed charges,229.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,215.76,80,,,percent of total billed charges,80% of total billed charges,104.64,38.8,,,percent of total billed charges,38.8% of total billed charges,229.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,104.64,256.22,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112016,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,365.6,292.48,,274.2,75,,,percent of total billed charges,75% of total billed charges,146.24,40,,,percent of total billed charges,40% of total billed charges,289.56,79.2,,,percent of total billed charges,79.2% of total billed charges,310.76,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,347.32,95,,,percent of total billed charges,95% of total billed charges,292.48,80,,,percent of total billed charges,80% of total billed charges,310.76,85,,,percent of total billed charges,85% of total billed charges,329.04,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,146.24,40,,,percent of total billed charges,40% of total billed charges,146.24,40,,,percent of total billed charges,40% of total billed charges,329.04,90,,,percent of total billed charges,90% of total billed charges,277.86,76,,,percent of total billed charges,76% of total billed charges,146.24,40,,,percent of total billed charges,40% of total billed charges,310.76,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,292.48,80,,,percent of total billed charges,80% of total billed charges,141.85,38.8,,,percent of total billed charges,38.8% of total billed charges,310.76,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,141.85,347.32,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112017,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,441.5,353.2,,331.13,75,,,percent of total billed charges,75% of total billed charges,176.6,40,,,percent of total billed charges,40% of total billed charges,349.67,79.2,,,percent of total billed charges,79.2% of total billed charges,375.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,419.43,95,,,percent of total billed charges,95% of total billed charges,353.2,80,,,percent of total billed charges,80% of total billed charges,375.28,85,,,percent of total billed charges,85% of total billed charges,397.35,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,176.6,40,,,percent of total billed charges,40% of total billed charges,176.6,40,,,percent of total billed charges,40% of total billed charges,397.35,90,,,percent of total billed charges,90% of total billed charges,335.54,76,,,percent of total billed charges,76% of total billed charges,176.6,40,,,percent of total billed charges,40% of total billed charges,375.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,353.2,80,,,percent of total billed charges,80% of total billed charges,171.3,38.8,,,percent of total billed charges,38.8% of total billed charges,375.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,171.3,419.43,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112018,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,499.7,399.76,,374.78,75,,,percent of total billed charges,75% of total billed charges,199.88,40,,,percent of total billed charges,40% of total billed charges,395.76,79.2,,,percent of total billed charges,79.2% of total billed charges,424.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,474.72,95,,,percent of total billed charges,95% of total billed charges,399.76,80,,,percent of total billed charges,80% of total billed charges,424.75,85,,,percent of total billed charges,85% of total billed charges,449.73,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,199.88,40,,,percent of total billed charges,40% of total billed charges,199.88,40,,,percent of total billed charges,40% of total billed charges,449.73,90,,,percent of total billed charges,90% of total billed charges,379.77,76,,,percent of total billed charges,76% of total billed charges,199.88,40,,,percent of total billed charges,40% of total billed charges,424.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,399.76,80,,,percent of total billed charges,80% of total billed charges,193.88,38.8,,,percent of total billed charges,38.8% of total billed charges,424.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,474.72,
"11200 Removal Of Skin Tags, Up To And Including 15 Lesions",49111200,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,232.7,186.16,,174.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,184.3,79.2,,,percent of total billed charges,79.2% of total billed charges,197.8,85,,,percent of total billed charges,85% of total billed charges,232.7,100,,,fee schedule,100% of CO APG rates,221.07,95,,,percent of total billed charges,95% of total billed charges,186.16,80,,,percent of total billed charges,80% of total billed charges,197.8,85,,,percent of total billed charges,85% of total billed charges,209.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,232.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,209.43,90,,,percent of total billed charges,90% of total billed charges,176.85,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,197.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,186.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,197.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,847.6,100,,,case rate,pays based on per visit rate,174.53,847.6,
"11201 Removal of Skin Tags, Mult Fibrocutaneous Tags, Ea Add",49111201,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,47.1,37.68,,35.33,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,37.3,79.2,,,percent of total billed charges,79.2% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,47.1,100,,,fee schedule,100% of CO APG rates,44.75,95,,,percent of total billed charges,95% of total billed charges,37.68,80,,,percent of total billed charges,80% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,42.39,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,47.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,42.39,90,,,percent of total billed charges,90% of total billed charges,35.8,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,40.04,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,37.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,40.04,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,476.4,100,,,case rate,pays based on per visit rate,35.33,476.4,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 0.5 cm or Le",49111600,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,365.3,292.24,,273.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,289.32,79.2,,,percent of total billed charges,79.2% of total billed charges,310.51,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,347.04,95,,,percent of total billed charges,95% of total billed charges,292.24,80,,,percent of total billed charges,80% of total billed charges,310.51,85,,,percent of total billed charges,85% of total billed charges,328.77,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,365.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,328.77,90,,,percent of total billed charges,90% of total billed charges,277.63,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,310.51,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,292.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,310.51,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1112.8,100,,,case rate,pays based on per visit rate,273.98,1112.8,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 0.6 to 1.0 c",49111601,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,443.3,354.64,,332.48,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,351.09,79.2,,,percent of total billed charges,79.2% of total billed charges,376.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,421.14,95,,,percent of total billed charges,95% of total billed charges,354.64,80,,,percent of total billed charges,80% of total billed charges,376.81,85,,,percent of total billed charges,85% of total billed charges,398.97,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,443.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,398.97,90,,,percent of total billed charges,90% of total billed charges,336.91,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,376.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,354.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,376.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 1.1 to 2.0 c",49111602,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,482.2,385.76,,361.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,381.9,79.2,,,percent of total billed charges,79.2% of total billed charges,409.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,458.09,95,,,percent of total billed charges,95% of total billed charges,385.76,80,,,percent of total billed charges,80% of total billed charges,409.87,85,,,percent of total billed charges,85% of total billed charges,433.98,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,482.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,433.98,90,,,percent of total billed charges,90% of total billed charges,366.47,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,409.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,385.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,409.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 c",49111603,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,574.9,459.92,,431.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,455.32,79.2,,,percent of total billed charges,79.2% of total billed charges,488.67,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,546.16,95,,,percent of total billed charges,95% of total billed charges,459.92,80,,,percent of total billed charges,80% of total billed charges,488.67,85,,,percent of total billed charges,85% of total billed charges,517.41,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,574.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,517.41,90,,,percent of total billed charges,90% of total billed charges,436.92,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,488.67,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,459.92,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,488.67,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 3.1 to 4.0 c",49111604,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,631.7,505.36,,473.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,500.31,79.2,,,percent of total billed charges,79.2% of total billed charges,536.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,600.12,95,,,percent of total billed charges,95% of total billed charges,505.36,80,,,percent of total billed charges,80% of total billed charges,536.95,85,,,percent of total billed charges,85% of total billed charges,568.53,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,631.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,568.53,90,,,percent of total billed charges,90% of total billed charges,480.09,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,536.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,505.36,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,536.95,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Excised diam 0",49111640,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,379.5,303.6,,284.63,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,300.56,79.2,,,percent of total billed charges,79.2% of total billed charges,322.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,360.53,95,,,percent of total billed charges,95% of total billed charges,303.6,80,,,percent of total billed charges,80% of total billed charges,322.58,85,,,percent of total billed charges,85% of total billed charges,341.55,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,379.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,341.55,90,,,percent of total billed charges,90% of total billed charges,288.42,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,322.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,303.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,322.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1141.2,100,,,case rate,pays based on per visit rate,284.63,1141.2,
"Excise, Malign Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Excised diam 0",49111641,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,464.6,371.68,,348.45,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,367.96,79.2,,,percent of total billed charges,79.2% of total billed charges,394.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,441.37,95,,,percent of total billed charges,95% of total billed charges,371.68,80,,,percent of total billed charges,80% of total billed charges,394.91,85,,,percent of total billed charges,85% of total billed charges,418.14,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,464.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,418.14,90,,,percent of total billed charges,90% of total billed charges,353.1,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,394.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,371.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,394.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Excised diam 1",49111642,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,541.3,433.04,,405.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,428.71,79.2,,,percent of total billed charges,79.2% of total billed charges,460.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,514.24,95,,,percent of total billed charges,95% of total billed charges,433.04,80,,,percent of total billed charges,80% of total billed charges,460.11,85,,,percent of total billed charges,85% of total billed charges,487.17,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,541.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,487.17,90,,,percent of total billed charges,90% of total billed charges,411.39,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,460.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,433.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,460.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Debride of Nail(s) By Any Method(s); Six or More Charge,49111721,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,69.3,55.44,,51.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,54.89,79.2,,,percent of total billed charges,79.2% of total billed charges,58.91,85,,,percent of total billed charges,85% of total billed charges,69.3,100,,,fee schedule,100% of CO APG rates,65.84,95,,,percent of total billed charges,95% of total billed charges,55.44,80,,,percent of total billed charges,80% of total billed charges,58.91,85,,,percent of total billed charges,85% of total billed charges,62.37,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,69.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,62.37,90,,,percent of total billed charges,90% of total billed charges,52.67,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,58.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,55.44,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,58.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,520.8,100,,,case rate,pays based on per visit rate,51.98,520.8,
"Avulsion of Nail Plate, Partial or Complete, Simple; Single Charge",49111730,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,158.2,126.56,,118.65,75,,,percent of total billed charges,75% of total billed charges,63.28,40,,,percent of total billed charges,40% of total billed charges,125.29,79.2,,,percent of total billed charges,79.2% of total billed charges,134.47,85,,,percent of total billed charges,85% of total billed charges,158.2,100,,,fee schedule,100% of CO APG rates,150.29,95,,,percent of total billed charges,95% of total billed charges,126.56,80,,,percent of total billed charges,80% of total billed charges,134.47,85,,,percent of total billed charges,85% of total billed charges,142.38,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,158.2,100,,,fee schedule,100% of NM APC rate,63.28,40,,,percent of total billed charges,40% of total billed charges,63.28,40,,,percent of total billed charges,40% of total billed charges,142.38,90,,,percent of total billed charges,90% of total billed charges,120.23,76,,,percent of total billed charges,76% of total billed charges,63.28,40,,,percent of total billed charges,40% of total billed charges,134.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,126.56,80,,,percent of total billed charges,80% of total billed charges,61.38,38.8,,,percent of total billed charges,38.8% of total billed charges,134.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,61.38,217.66,
"Avulsion of Nail Plate, Partial or Complete, Simple; each Addtl Nail Plate Charg",49111732,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,48.8,39.04,,36.6,75,,,percent of total billed charges,75% of total billed charges,19.52,40,,,percent of total billed charges,40% of total billed charges,38.65,79.2,,,percent of total billed charges,79.2% of total billed charges,41.48,85,,,percent of total billed charges,85% of total billed charges,48.8,100,,,fee schedule,100% of CO APG rates,46.36,95,,,percent of total billed charges,95% of total billed charges,39.04,80,,,percent of total billed charges,80% of total billed charges,41.48,85,,,percent of total billed charges,85% of total billed charges,43.92,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,48.8,100,,,fee schedule,100% of NM APC rate,19.52,40,,,percent of total billed charges,40% of total billed charges,19.52,40,,,percent of total billed charges,40% of total billed charges,43.92,90,,,percent of total billed charges,90% of total billed charges,37.09,76,,,percent of total billed charges,76% of total billed charges,19.52,40,,,percent of total billed charges,40% of total billed charges,41.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,39.04,80,,,percent of total billed charges,80% of total billed charges,18.93,38.8,,,percent of total billed charges,38.8% of total billed charges,41.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,97.6,200,,,fee schedule,200% of CMS fee schedule,18.93,215.49,
"Inj(s); Single Tendon Sheath, or Ligament, Aponeurosis (eg, Planterar ''''Fascia''''",49120550,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,114.1,91.28,,85.58,75,,,percent of total billed charges,75% of total billed charges,45.64,40,,,percent of total billed charges,40% of total billed charges,90.37,79.2,,,percent of total billed charges,79.2% of total billed charges,96.99,85,,,percent of total billed charges,85% of total billed charges,114.1,100,,,fee schedule,100% of CO APG rates,108.4,95,,,percent of total billed charges,95% of total billed charges,91.28,80,,,percent of total billed charges,80% of total billed charges,96.99,85,,,percent of total billed charges,85% of total billed charges,102.69,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,114.1,100,,,fee schedule,100% of NM APC rate,45.64,40,,,percent of total billed charges,40% of total billed charges,45.64,40,,,percent of total billed charges,40% of total billed charges,102.69,90,,,percent of total billed charges,90% of total billed charges,86.72,76,,,percent of total billed charges,76% of total billed charges,45.64,40,,,percent of total billed charges,40% of total billed charges,96.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,91.28,80,,,percent of total billed charges,80% of total billed charges,44.27,38.8,,,percent of total billed charges,38.8% of total billed charges,96.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,44.27,217.66,
Inj(s); Single Tendon or igin/Insert Charge,49120551,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,112.5,90,,84.38,75,,,percent of total billed charges,75% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,89.1,79.2,,,percent of total billed charges,79.2% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,112.5,100,,,fee schedule,100% of CO APG rates,106.88,95,,,percent of total billed charges,95% of total billed charges,90,80,,,percent of total billed charges,80% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,112.5,100,,,fee schedule,100% of NM APC rate,45,40,,,percent of total billed charges,40% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,85.5,76,,,percent of total billed charges,76% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,90,80,,,percent of total billed charges,80% of total billed charges,43.65,38.8,,,percent of total billed charges,38.8% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,43.65,217.66,
"Inj(s); Single or Mult Trigger Point(S), One or Two Muscle(s",30020552,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,107,85.6,,80.25,75,,,percent of total billed charges,75% of total billed charges,42.8,40,,,percent of total billed charges,40% of total billed charges,84.74,79.2,,,percent of total billed charges,79.2% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,107,100,,,fee schedule,100% of CO APG rates,101.65,95,,,percent of total billed charges,95% of total billed charges,85.6,80,,,percent of total billed charges,80% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,96.3,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,107,100,,,fee schedule,100% of NM APC rate,42.8,40,,,percent of total billed charges,40% of total billed charges,42.8,40,,,percent of total billed charges,40% of total billed charges,96.3,90,,,percent of total billed charges,90% of total billed charges,81.32,76,,,percent of total billed charges,76% of total billed charges,42.8,40,,,percent of total billed charges,40% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,85.6,80,,,percent of total billed charges,80% of total billed charges,41.52,38.8,,,percent of total billed charges,38.8% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,214,200,,,fee schedule,200% of CMS fee schedule,41.52,215.49,
"Inj(s); Single or Mult Trigger Point(S), Three or More Muscle(s) Charge",49120553,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,121.7,97.36,,91.28,75,,,percent of total billed charges,75% of total billed charges,48.68,40,,,percent of total billed charges,40% of total billed charges,96.39,79.2,,,percent of total billed charges,79.2% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,121.7,100,,,fee schedule,100% of CO APG rates,115.62,95,,,percent of total billed charges,95% of total billed charges,97.36,80,,,percent of total billed charges,80% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,109.53,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,121.7,100,,,fee schedule,100% of NM APC rate,48.68,40,,,percent of total billed charges,40% of total billed charges,48.68,40,,,percent of total billed charges,40% of total billed charges,109.53,90,,,percent of total billed charges,90% of total billed charges,92.49,76,,,percent of total billed charges,76% of total billed charges,48.68,40,,,percent of total billed charges,40% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,97.36,80,,,percent of total billed charges,80% of total billed charges,47.22,38.8,,,percent of total billed charges,38.8% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,47.22,217.66,
"Arthrocentesis, Aspirtn and/or Inj; Small Joint or Bursa (eg, Fingers, toes) Cha",49120600,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,104.7,83.76,,78.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,82.92,79.2,,,percent of total billed charges,79.2% of total billed charges,89,85,,,percent of total billed charges,85% of total billed charges,104.7,100,,,fee schedule,100% of CO APG rates,99.47,95,,,percent of total billed charges,95% of total billed charges,83.76,80,,,percent of total billed charges,80% of total billed charges,89,85,,,percent of total billed charges,85% of total billed charges,94.23,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,104.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,94.23,90,,,percent of total billed charges,90% of total billed charges,79.57,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,89,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,83.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,89,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,591.6,100,,,case rate,pays based on per visit rate,78.53,591.6,
"21555 Excision, Tumor, Soft Tissue Of Neck, Subcutaneous; Le",60000029,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,927.5,742,,695.63,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,734.58,79.2,,,percent of total billed charges,79.2% of total billed charges,788.38,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,881.13,95,,,percent of total billed charges,95% of total billed charges,742,80,,,percent of total billed charges,80% of total billed charges,788.38,85,,,percent of total billed charges,85% of total billed charges,834.75,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,927.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,834.75,90,,,percent of total billed charges,90% of total billed charges,704.9,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,788.38,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,742,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,788.38,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
23620 Closed Treatment Of Greater Humeral Tuberosity Fractur,60000033,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,820.9,656.72,,615.68,75,,,percent of total billed charges,75% of total billed charges,328.36,40,,,percent of total billed charges,40% of total billed charges,650.15,79.2,,,percent of total billed charges,79.2% of total billed charges,697.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,779.86,95,,,percent of total billed charges,95% of total billed charges,656.72,80,,,percent of total billed charges,80% of total billed charges,697.77,85,,,percent of total billed charges,85% of total billed charges,738.81,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,328.36,40,,,percent of total billed charges,40% of total billed charges,328.36,40,,,percent of total billed charges,40% of total billed charges,738.81,90,,,percent of total billed charges,90% of total billed charges,623.88,76,,,percent of total billed charges,76% of total billed charges,328.36,40,,,percent of total billed charges,40% of total billed charges,697.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,656.72,80,,,percent of total billed charges,80% of total billed charges,318.51,38.8,,,percent of total billed charges,38.8% of total billed charges,697.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,779.86,
25622 Closed Treatment Of Carpal Scaphoid w/o Manipulation,60000003,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,898.9,719.12,,674.18,75,,,percent of total billed charges,75% of total billed charges,359.56,40,,,percent of total billed charges,40% of total billed charges,711.93,79.2,,,percent of total billed charges,79.2% of total billed charges,764.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,853.96,95,,,percent of total billed charges,95% of total billed charges,719.12,80,,,percent of total billed charges,80% of total billed charges,764.07,85,,,percent of total billed charges,85% of total billed charges,809.01,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,359.56,40,,,percent of total billed charges,40% of total billed charges,359.56,40,,,percent of total billed charges,40% of total billed charges,809.01,90,,,percent of total billed charges,90% of total billed charges,683.16,76,,,percent of total billed charges,76% of total billed charges,359.56,40,,,percent of total billed charges,40% of total billed charges,764.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,719.12,80,,,percent of total billed charges,80% of total billed charges,348.77,38.8,,,percent of total billed charges,38.8% of total billed charges,764.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,853.96,
"Open Trtmt of Tibial Shaft Fx, (With or w/o Fibular Fx) w/Pl",46027758,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2687.9,2150.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Closed Trtmt of Metatarsal Fx; w/Manipulation, each Charge",60000067,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,708.1,566.48,,531.08,75,,,percent of total billed charges,75% of total billed charges,283.24,40,,,percent of total billed charges,40% of total billed charges,560.82,79.2,,,percent of total billed charges,79.2% of total billed charges,601.89,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,672.7,95,,,percent of total billed charges,95% of total billed charges,566.48,80,,,percent of total billed charges,80% of total billed charges,601.89,85,,,percent of total billed charges,85% of total billed charges,637.29,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,283.24,40,,,percent of total billed charges,40% of total billed charges,283.24,40,,,percent of total billed charges,40% of total billed charges,637.29,90,,,percent of total billed charges,90% of total billed charges,538.16,76,,,percent of total billed charges,76% of total billed charges,283.24,40,,,percent of total billed charges,40% of total billed charges,601.89,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,566.48,80,,,percent of total billed charges,80% of total billed charges,274.74,38.8,,,percent of total billed charges,38.8% of total billed charges,601.89,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,672.7,
29125 Application Of Short Arm Splint,49129125,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,121.7,97.36,,91.28,75,,,percent of total billed charges,75% of total billed charges,48.68,40,,,percent of total billed charges,40% of total billed charges,96.39,79.2,,,percent of total billed charges,79.2% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,121.7,100,,,fee schedule,100% of CO APG rates,115.62,95,,,percent of total billed charges,95% of total billed charges,97.36,80,,,percent of total billed charges,80% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,109.53,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,121.7,100,,,fee schedule,100% of NM APC rate,48.68,40,,,percent of total billed charges,40% of total billed charges,48.68,40,,,percent of total billed charges,40% of total billed charges,109.53,90,,,percent of total billed charges,90% of total billed charges,92.49,76,,,percent of total billed charges,76% of total billed charges,48.68,40,,,percent of total billed charges,40% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,97.36,80,,,percent of total billed charges,80% of total billed charges,47.22,38.8,,,percent of total billed charges,38.8% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,47.22,217.66,
29130 Application Of Finger Splint; Static,49129130,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,85,68,,63.75,75,,,percent of total billed charges,75% of total billed charges,34,40,,,percent of total billed charges,40% of total billed charges,67.32,79.2,,,percent of total billed charges,79.2% of total billed charges,72.25,85,,,percent of total billed charges,85% of total billed charges,85,100,,,fee schedule,100% of CO APG rates,80.75,95,,,percent of total billed charges,95% of total billed charges,68,80,,,percent of total billed charges,80% of total billed charges,72.25,85,,,percent of total billed charges,85% of total billed charges,76.5,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,85,100,,,fee schedule,100% of NM APC rate,34,40,,,percent of total billed charges,40% of total billed charges,34,40,,,percent of total billed charges,40% of total billed charges,76.5,90,,,percent of total billed charges,90% of total billed charges,64.6,76,,,percent of total billed charges,76% of total billed charges,34,40,,,percent of total billed charges,40% of total billed charges,72.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,68,80,,,percent of total billed charges,80% of total billed charges,32.98,38.8,,,percent of total billed charges,38.8% of total billed charges,72.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,170,200,,,fee schedule,200% of CMS fee schedule,32.98,215.49,
29345 Application Of Long Leg Cast,49129345,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,296.6,237.28,,222.45,75,,,percent of total billed charges,75% of total billed charges,118.64,40,,,percent of total billed charges,40% of total billed charges,234.91,79.2,,,percent of total billed charges,79.2% of total billed charges,252.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,281.77,95,,,percent of total billed charges,95% of total billed charges,237.28,80,,,percent of total billed charges,80% of total billed charges,252.11,85,,,percent of total billed charges,85% of total billed charges,266.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,118.64,40,,,percent of total billed charges,40% of total billed charges,118.64,40,,,percent of total billed charges,40% of total billed charges,266.94,90,,,percent of total billed charges,90% of total billed charges,225.42,76,,,percent of total billed charges,76% of total billed charges,118.64,40,,,percent of total billed charges,40% of total billed charges,252.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,237.28,80,,,percent of total billed charges,80% of total billed charges,115.08,38.8,,,percent of total billed charges,38.8% of total billed charges,252.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,115.08,281.77,
29405 Application Of Short Leg Cast,49129405,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,176.6,141.28,,132.45,75,,,percent of total billed charges,75% of total billed charges,70.64,40,,,percent of total billed charges,40% of total billed charges,139.87,79.2,,,percent of total billed charges,79.2% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,176.6,100,,,fee schedule,100% of CO APG rates,167.77,95,,,percent of total billed charges,95% of total billed charges,141.28,80,,,percent of total billed charges,80% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,158.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,176.6,100,,,fee schedule,100% of NM APC rate,70.64,40,,,percent of total billed charges,40% of total billed charges,70.64,40,,,percent of total billed charges,40% of total billed charges,158.94,90,,,percent of total billed charges,90% of total billed charges,134.22,76,,,percent of total billed charges,76% of total billed charges,70.64,40,,,percent of total billed charges,40% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,141.28,80,,,percent of total billed charges,80% of total billed charges,68.52,38.8,,,percent of total billed charges,38.8% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,68.52,217.66,
"Control Nasal Hemorrhage, Anterior, Simple (Limited Cautery And/Or Packing) Any",49130901,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,384.5,307.6,,288.38,75,,,percent of total billed charges,75% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,304.52,79.2,,,percent of total billed charges,79.2% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,365.28,95,,,percent of total billed charges,95% of total billed charges,307.6,80,,,percent of total billed charges,80% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,346.05,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,153.8,40,,,percent of total billed charges,40% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,346.05,90,,,percent of total billed charges,90% of total billed charges,292.22,76,,,percent of total billed charges,76% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,307.6,80,,,percent of total billed charges,80% of total billed charges,149.19,38.8,,,percent of total billed charges,38.8% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,149.19,365.28,
"11976 Removal, Implantable Contraceptive Capsules",60000013,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,267.9,214.32,,200.93,75,,,percent of total billed charges,75% of total billed charges,107.16,40,,,percent of total billed charges,40% of total billed charges,212.18,79.2,,,percent of total billed charges,79.2% of total billed charges,227.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,254.51,95,,,percent of total billed charges,95% of total billed charges,214.32,80,,,percent of total billed charges,80% of total billed charges,227.72,85,,,percent of total billed charges,85% of total billed charges,241.11,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,107.16,40,,,percent of total billed charges,40% of total billed charges,107.16,40,,,percent of total billed charges,40% of total billed charges,241.11,90,,,percent of total billed charges,90% of total billed charges,203.6,76,,,percent of total billed charges,76% of total billed charges,107.16,40,,,percent of total billed charges,40% of total billed charges,227.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,214.32,80,,,percent of total billed charges,80% of total billed charges,103.95,38.8,,,percent of total billed charges,38.8% of total billed charges,227.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,103.95,254.51,
"Excise of Nail  matrix, Part. or Complete, for Permanent Removal Charge",49111750,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,304,243.2,,228,75,,,percent of total billed charges,75% of total billed charges,121.6,40,,,percent of total billed charges,40% of total billed charges,240.77,79.2,,,percent of total billed charges,79.2% of total billed charges,258.4,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,288.8,95,,,percent of total billed charges,95% of total billed charges,243.2,80,,,percent of total billed charges,80% of total billed charges,258.4,85,,,percent of total billed charges,85% of total billed charges,273.6,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,121.6,40,,,percent of total billed charges,40% of total billed charges,121.6,40,,,percent of total billed charges,40% of total billed charges,273.6,90,,,percent of total billed charges,90% of total billed charges,231.04,76,,,percent of total billed charges,76% of total billed charges,121.6,40,,,percent of total billed charges,40% of total billed charges,258.4,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,243.2,80,,,percent of total billed charges,80% of total billed charges,117.95,38.8,,,percent of total billed charges,38.8% of total billed charges,258.4,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,117.95,288.8,
69200 Removal Foreign Body From External Auditory Canal; Wit,49169200,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,284.5,227.6,,213.38,75,,,percent of total billed charges,75% of total billed charges,113.8,40,,,percent of total billed charges,40% of total billed charges,225.32,79.2,,,percent of total billed charges,79.2% of total billed charges,241.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,270.28,95,,,percent of total billed charges,95% of total billed charges,227.6,80,,,percent of total billed charges,80% of total billed charges,241.83,85,,,percent of total billed charges,85% of total billed charges,256.05,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,113.8,40,,,percent of total billed charges,40% of total billed charges,113.8,40,,,percent of total billed charges,40% of total billed charges,256.05,90,,,percent of total billed charges,90% of total billed charges,216.22,76,,,percent of total billed charges,76% of total billed charges,113.8,40,,,percent of total billed charges,40% of total billed charges,241.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,227.6,80,,,percent of total billed charges,80% of total billed charges,110.39,38.8,,,percent of total billed charges,38.8% of total billed charges,241.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,110.39,270.28,
25605 Closed Treatment Of Distal Radial Fracture w/ manipula,60000045,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1572.6,1258.08,,1179.45,75,,,percent of total billed charges,75% of total billed charges,629.04,40,,,percent of total billed charges,40% of total billed charges,1245.5,79.2,,,percent of total billed charges,79.2% of total billed charges,1336.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1493.97,95,,,percent of total billed charges,95% of total billed charges,1258.08,80,,,percent of total billed charges,80% of total billed charges,1336.71,85,,,percent of total billed charges,85% of total billed charges,1415.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,629.04,40,,,percent of total billed charges,40% of total billed charges,629.04,40,,,percent of total billed charges,40% of total billed charges,1415.34,90,,,percent of total billed charges,90% of total billed charges,1195.18,76,,,percent of total billed charges,76% of total billed charges,629.04,40,,,percent of total billed charges,40% of total billed charges,1336.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1258.08,80,,,percent of total billed charges,80% of total billed charges,610.17,38.8,,,percent of total billed charges,38.8% of total billed charges,1336.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1493.97,
"Closed tx of phalangeal shaft fx, proximal or midlle phalanx, finger or thumb: w",60000052,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,602.9,482.32,,452.18,75,,,percent of total billed charges,75% of total billed charges,241.16,40,,,percent of total billed charges,40% of total billed charges,477.5,79.2,,,percent of total billed charges,79.2% of total billed charges,512.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,572.76,95,,,percent of total billed charges,95% of total billed charges,482.32,80,,,percent of total billed charges,80% of total billed charges,512.47,85,,,percent of total billed charges,85% of total billed charges,542.61,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,241.16,40,,,percent of total billed charges,40% of total billed charges,241.16,40,,,percent of total billed charges,40% of total billed charges,542.61,90,,,percent of total billed charges,90% of total billed charges,458.2,76,,,percent of total billed charges,76% of total billed charges,241.16,40,,,percent of total billed charges,40% of total billed charges,512.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,482.32,80,,,percent of total billed charges,80% of total billed charges,233.93,38.8,,,percent of total billed charges,38.8% of total billed charges,512.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,572.76,
Anesthesia Time - 667195,462667195,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,135.5,108.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
38505 US Lymph Node Biopsy,41238505,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,250.1,200.08,,187.58,75,,,percent of total billed charges,75% of total billed charges,100.04,40,,,percent of total billed charges,40% of total billed charges,198.08,79.2,,,percent of total billed charges,79.2% of total billed charges,212.59,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,237.6,95,,,percent of total billed charges,95% of total billed charges,200.08,80,,,percent of total billed charges,80% of total billed charges,212.59,85,,,percent of total billed charges,85% of total billed charges,225.09,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,100.04,40,,,percent of total billed charges,40% of total billed charges,100.04,40,,,percent of total billed charges,40% of total billed charges,225.09,90,,,percent of total billed charges,90% of total billed charges,190.08,76,,,percent of total billed charges,76% of total billed charges,100.04,40,,,percent of total billed charges,40% of total billed charges,212.59,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,200.08,80,,,percent of total billed charges,80% of total billed charges,97.04,38.8,,,percent of total billed charges,38.8% of total billed charges,212.59,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,97.04,246.44,
Removal of tunneled cntrl venous access device  w/subcutaneous port/pump  cntrl/,60000081,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,809.6,647.68,,607.2,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,641.2,79.2,,,percent of total billed charges,79.2% of total billed charges,688.16,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,769.12,95,,,percent of total billed charges,95% of total billed charges,647.68,80,,,percent of total billed charges,80% of total billed charges,688.16,85,,,percent of total billed charges,85% of total billed charges,728.64,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,809.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,728.64,90,,,percent of total billed charges,90% of total billed charges,615.3,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,688.16,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,647.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,688.16,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Event Monitor - up to 30 days,42293270,CDM,730,RC,93005,HCPCS,OUTPATIENT,,,69.8,55.84,,52.35,75,,,percent of total billed charges,75% of total billed charges,27.92,40,,,percent of total billed charges,40% of total billed charges,55.28,79.2,,,percent of total billed charges,79.2% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,66.31,95,,,percent of total billed charges,95% of total billed charges,55.84,80,,,percent of total billed charges,80% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,62.82,90,,,percent of total billed charges,90% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,34.77,100,,,fee schedule,100% of CO APG rates,57.48,100,,,fee schedule,100% of NM APC rate,27.92,40,,,percent of total billed charges,40% of total billed charges,27.92,40,,,percent of total billed charges,40% of total billed charges,62.82,90,,,percent of total billed charges,90% of total billed charges,53.05,76,,,percent of total billed charges,76% of total billed charges,27.92,40,,,percent of total billed charges,40% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rate,55.84,80,,,percent of total billed charges,80% of total billed charges,27.08,38.8,,,percent of total billed charges,38.8% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of APG fee schedule,13.34,200,,,fee schedule,200% of CMS fee schedule,13.34,66.31,
"19120 Excision Of Cyst, Fibroadenoma, Or Other Benign Or Mal",60000024,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1246,996.8,,934.5,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,986.83,79.2,,,percent of total billed charges,79.2% of total billed charges,1059.1,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1183.7,95,,,percent of total billed charges,95% of total billed charges,996.8,80,,,percent of total billed charges,80% of total billed charges,1059.1,85,,,percent of total billed charges,85% of total billed charges,1121.4,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1246,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1121.4,90,,,percent of total billed charges,90% of total billed charges,946.96,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1059.1,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,996.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1059.1,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Insertion of tunneled centrally inserted central venous access device with subcu,60000079,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1050.2,840.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24530 Closed Treatment Of Supracondylar Or Transcondylar Hum,60000038,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1100.3,880.24,,825.23,75,,,percent of total billed charges,75% of total billed charges,440.12,40,,,percent of total billed charges,40% of total billed charges,871.44,79.2,,,percent of total billed charges,79.2% of total billed charges,935.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1045.29,95,,,percent of total billed charges,95% of total billed charges,880.24,80,,,percent of total billed charges,80% of total billed charges,935.26,85,,,percent of total billed charges,85% of total billed charges,990.27,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,440.12,40,,,percent of total billed charges,40% of total billed charges,440.12,40,,,percent of total billed charges,40% of total billed charges,990.27,90,,,percent of total billed charges,90% of total billed charges,836.23,76,,,percent of total billed charges,76% of total billed charges,440.12,40,,,percent of total billed charges,40% of total billed charges,935.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,880.24,80,,,percent of total billed charges,80% of total billed charges,426.92,38.8,,,percent of total billed charges,38.8% of total billed charges,935.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1045.29,
Biopsy or excision of lymph node(s)  open  superficial,60000082,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,754,603.2,,565.5,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,597.17,79.2,,,percent of total billed charges,79.2% of total billed charges,640.9,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,716.3,95,,,percent of total billed charges,95% of total billed charges,603.2,80,,,percent of total billed charges,80% of total billed charges,640.9,85,,,percent of total billed charges,85% of total billed charges,678.6,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,754,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,678.6,90,,,percent of total billed charges,90% of total billed charges,573.04,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,640.9,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,603.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,640.9,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Hemorrhoidectomy  internal  by rubber band ligation(s),60000089,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,583.7,466.96,,437.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,462.29,79.2,,,percent of total billed charges,79.2% of total billed charges,496.15,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,554.52,95,,,percent of total billed charges,95% of total billed charges,466.96,80,,,percent of total billed charges,80% of total billed charges,496.15,85,,,percent of total billed charges,85% of total billed charges,525.33,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,583.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,525.33,90,,,percent of total billed charges,90% of total billed charges,443.61,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,496.15,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,466.96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,496.15,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Office/OP New Visit Level 2 99202,49199202,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,178.6,142.88,,133.95,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,141.45,79.2,,,percent of total billed charges,79.2% of total billed charges,151.81,85,,,percent of total billed charges,85% of total billed charges,178.6,100,,,fee schedule,100% of CO APG rates,169.67,95,,,percent of total billed charges,95% of total billed charges,142.88,80,,,percent of total billed charges,80% of total billed charges,151.81,85,,,percent of total billed charges,85% of total billed charges,160.74,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,178.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,160.74,90,,,percent of total billed charges,90% of total billed charges,135.74,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,151.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,142.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,151.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,739.4,100,,,case rate,pays based on per visit rate,133.95,739.4,
Office/OP New Visit Level 3 99203,49199203,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,235.2,188.16,,176.4,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,186.28,79.2,,,percent of total billed charges,79.2% of total billed charges,199.92,85,,,percent of total billed charges,85% of total billed charges,235.2,100,,,fee schedule,100% of CO APG rates,223.44,95,,,percent of total billed charges,95% of total billed charges,188.16,80,,,percent of total billed charges,80% of total billed charges,199.92,85,,,percent of total billed charges,85% of total billed charges,211.68,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,235.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,211.68,90,,,percent of total billed charges,90% of total billed charges,178.75,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,199.92,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,188.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,199.92,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,852.6,100,,,case rate,pays based on per visit rate,176.4,852.6,
Office/OP New Visit Level 4 99204,49199204,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,286.1,228.88,,214.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,226.59,79.2,,,percent of total billed charges,79.2% of total billed charges,243.19,85,,,percent of total billed charges,85% of total billed charges,286.1,100,,,fee schedule,100% of CO APG rates,271.8,95,,,percent of total billed charges,95% of total billed charges,228.88,80,,,percent of total billed charges,80% of total billed charges,243.19,85,,,percent of total billed charges,85% of total billed charges,257.49,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,286.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,257.49,90,,,percent of total billed charges,90% of total billed charges,217.44,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,243.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,228.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,243.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,954.4,100,,,case rate,pays based on per visit rate,214.58,954.4,
Office/OP Established  Visit Level 2 99212,49199212,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,115.4,92.32,,86.55,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,91.4,79.2,,,percent of total billed charges,79.2% of total billed charges,98.09,85,,,percent of total billed charges,85% of total billed charges,115.4,100,,,fee schedule,100% of CO APG rates,109.63,95,,,percent of total billed charges,95% of total billed charges,92.32,80,,,percent of total billed charges,80% of total billed charges,98.09,85,,,percent of total billed charges,85% of total billed charges,103.86,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,115.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,103.86,90,,,percent of total billed charges,90% of total billed charges,87.7,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,98.09,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,92.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,98.09,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,613,100,,,case rate,pays based on per visit rate,86.55,613,
Office/OP Established  Visit Level 4 99214,49199214,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,216,172.8,,162,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,171.07,79.2,,,percent of total billed charges,79.2% of total billed charges,183.6,85,,,percent of total billed charges,85% of total billed charges,216,100,,,fee schedule,100% of CO APG rates,205.2,95,,,percent of total billed charges,95% of total billed charges,172.8,80,,,percent of total billed charges,80% of total billed charges,183.6,85,,,percent of total billed charges,85% of total billed charges,194.4,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,216,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,194.4,90,,,percent of total billed charges,90% of total billed charges,164.16,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,183.6,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,172.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,183.6,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,814.2,100,,,case rate,pays based on per visit rate,162,814.2,
Office/OP Established  Visit Level 5 99215,49199215,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,312.2,249.76,,234.15,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,247.26,79.2,,,percent of total billed charges,79.2% of total billed charges,265.37,85,,,percent of total billed charges,85% of total billed charges,312.2,100,,,fee schedule,100% of CO APG rates,296.59,95,,,percent of total billed charges,95% of total billed charges,249.76,80,,,percent of total billed charges,80% of total billed charges,265.37,85,,,percent of total billed charges,85% of total billed charges,280.98,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,312.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,280.98,90,,,percent of total billed charges,90% of total billed charges,237.27,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,265.37,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,249.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,265.37,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1006.6,100,,,case rate,pays based on per visit rate,234.15,1006.6,
"OPEN TREATMENT OF MEDIAL MALLEOLUS FRACTURE, INCLUDES INTERN",46027766,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1833.9,1467.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Arthroscopy, Knee, Diagnostic, With Or Without Synovial Biop",46029870,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1259,1007.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Arthroscopy, Knee, Surgical; With Meniscus Repair (Medial Or",46029882,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1927.6,1542.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Report,41175989,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,222.6,178.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"19100 Biopsy of breast; percutaneous, needle core, not using imaging guidance Te",60000023,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,197.6,158.08,,148.2,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,156.5,79.2,,,percent of total billed charges,79.2% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,197.6,100,,,fee schedule,100% of CO APG rates,187.72,95,,,percent of total billed charges,95% of total billed charges,158.08,80,,,percent of total billed charges,80% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,177.84,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,197.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,177.84,90,,,percent of total billed charges,90% of total billed charges,150.18,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,167.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,158.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,167.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,777.4,100,,,case rate,pays based on per visit rate,148.2,777.4,
38221 - BONE MARROW BIOPS NDL CHARGE,46038221,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,203.7,162.96,,152.78,75,,,percent of total billed charges,75% of total billed charges,81.48,40,,,percent of total billed charges,40% of total billed charges,161.33,79.2,,,percent of total billed charges,79.2% of total billed charges,173.15,85,,,percent of total billed charges,85% of total billed charges,203.7,100,,,fee schedule,100% of CO APG rates,193.52,95,,,percent of total billed charges,95% of total billed charges,162.96,80,,,percent of total billed charges,80% of total billed charges,173.15,85,,,percent of total billed charges,85% of total billed charges,183.33,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,203.7,100,,,fee schedule,100% of NM APC rate,81.48,40,,,percent of total billed charges,40% of total billed charges,81.48,40,,,percent of total billed charges,40% of total billed charges,183.33,90,,,percent of total billed charges,90% of total billed charges,154.81,76,,,percent of total billed charges,76% of total billed charges,81.48,40,,,percent of total billed charges,40% of total billed charges,173.15,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,162.96,80,,,percent of total billed charges,80% of total billed charges,79.04,38.8,,,percent of total billed charges,38.8% of total billed charges,173.15,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,407.4,200,,,fee schedule,200% of CMS fee schedule,79.04,2713.28,
Closed treatment of phalangeal shaft fracture  with manipulation  w/wo skin or s,60000053,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,954.1,763.28,,715.58,75,,,percent of total billed charges,75% of total billed charges,381.64,40,,,percent of total billed charges,40% of total billed charges,755.65,79.2,,,percent of total billed charges,79.2% of total billed charges,810.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,906.4,95,,,percent of total billed charges,95% of total billed charges,763.28,80,,,percent of total billed charges,80% of total billed charges,810.99,85,,,percent of total billed charges,85% of total billed charges,858.69,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,381.64,40,,,percent of total billed charges,40% of total billed charges,381.64,40,,,percent of total billed charges,40% of total billed charges,858.69,90,,,percent of total billed charges,90% of total billed charges,725.12,76,,,percent of total billed charges,76% of total billed charges,381.64,40,,,percent of total billed charges,40% of total billed charges,810.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,763.28,80,,,percent of total billed charges,80% of total billed charges,370.19,38.8,,,percent of total billed charges,38.8% of total billed charges,810.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,906.4,
"69210 Removal Impacted Cerumen Requiring Instrumentation, Un",49169210,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,93.9,75.12,,70.43,75,,,percent of total billed charges,75% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,74.37,79.2,,,percent of total billed charges,79.2% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rates,89.21,95,,,percent of total billed charges,95% of total billed charges,75.12,80,,,percent of total billed charges,80% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,84.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,93.9,100,,,fee schedule,100% of NM APC rate,37.56,40,,,percent of total billed charges,40% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,84.51,90,,,percent of total billed charges,90% of total billed charges,71.36,76,,,percent of total billed charges,76% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,75.12,80,,,percent of total billed charges,80% of total billed charges,36.43,38.8,,,percent of total billed charges,38.8% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,187.8,200,,,fee schedule,200% of CMS fee schedule,36.43,215.49,
Office/OP New Visit Level 5 99205 Tech Chg,49199205,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,356.3,285.04,,267.23,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,282.19,79.2,,,percent of total billed charges,79.2% of total billed charges,302.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,338.49,95,,,percent of total billed charges,95% of total billed charges,285.04,80,,,percent of total billed charges,80% of total billed charges,302.86,85,,,percent of total billed charges,85% of total billed charges,320.67,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,356.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,320.67,90,,,percent of total billed charges,90% of total billed charges,270.79,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,302.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,285.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,302.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1094.8,100,,,case rate,pays based on per visit rate,267.23,1094.8,
RT Pre  Post BD Spiro Charge,42294060,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,118.1,94.48,,88.58,75,,,percent of total billed charges,75% of total billed charges,47.24,40,,,percent of total billed charges,40% of total billed charges,93.54,79.2,,,percent of total billed charges,79.2% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,112.2,95,,,percent of total billed charges,95% of total billed charges,94.48,80,,,percent of total billed charges,80% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,106.29,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,118.1,100,,,fee schedule,100% of NM APC rate,47.24,40,,,percent of total billed charges,40% of total billed charges,47.24,40,,,percent of total billed charges,40% of total billed charges,106.29,90,,,percent of total billed charges,90% of total billed charges,89.76,76,,,percent of total billed charges,76% of total billed charges,47.24,40,,,percent of total billed charges,40% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,94.48,80,,,percent of total billed charges,80% of total billed charges,45.82,38.8,,,percent of total billed charges,38.8% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,118.1,
"11982 Removal, Non-Biodegradable Drug Delivery Implant",49111982,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,211.9,169.52,,158.93,75,,,percent of total billed charges,75% of total billed charges,84.76,40,,,percent of total billed charges,40% of total billed charges,167.82,79.2,,,percent of total billed charges,79.2% of total billed charges,180.12,85,,,percent of total billed charges,85% of total billed charges,211.9,100,,,fee schedule,100% of CO APG rates,201.31,95,,,percent of total billed charges,95% of total billed charges,169.52,80,,,percent of total billed charges,80% of total billed charges,180.12,85,,,percent of total billed charges,85% of total billed charges,190.71,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,84.76,40,,,percent of total billed charges,40% of total billed charges,84.76,40,,,percent of total billed charges,40% of total billed charges,190.71,90,,,percent of total billed charges,90% of total billed charges,161.04,76,,,percent of total billed charges,76% of total billed charges,84.76,40,,,percent of total billed charges,40% of total billed charges,180.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,169.52,80,,,percent of total billed charges,80% of total billed charges,82.22,38.8,,,percent of total billed charges,38.8% of total billed charges,180.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,82.22,217.66,
Drainage Abscess Palate Uvula,60000085,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,329.7,263.76,,247.28,75,,,percent of total billed charges,75% of total billed charges,131.88,40,,,percent of total billed charges,40% of total billed charges,261.12,79.2,,,percent of total billed charges,79.2% of total billed charges,280.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,313.22,95,,,percent of total billed charges,95% of total billed charges,263.76,80,,,percent of total billed charges,80% of total billed charges,280.25,85,,,percent of total billed charges,85% of total billed charges,296.73,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,131.88,40,,,percent of total billed charges,40% of total billed charges,131.88,40,,,percent of total billed charges,40% of total billed charges,296.73,90,,,percent of total billed charges,90% of total billed charges,250.57,76,,,percent of total billed charges,76% of total billed charges,131.88,40,,,percent of total billed charges,40% of total billed charges,280.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,263.76,80,,,percent of total billed charges,80% of total billed charges,127.92,38.8,,,percent of total billed charges,38.8% of total billed charges,280.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,127.92,313.22,
Injection Plantar Common Digital Nerve,49164455,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,132,105.6,,99,75,,,percent of total billed charges,75% of total billed charges,52.8,40,,,percent of total billed charges,40% of total billed charges,104.54,79.2,,,percent of total billed charges,79.2% of total billed charges,112.2,85,,,percent of total billed charges,85% of total billed charges,132,100,,,fee schedule,100% of CO APG rates,125.4,95,,,percent of total billed charges,95% of total billed charges,105.6,80,,,percent of total billed charges,80% of total billed charges,112.2,85,,,percent of total billed charges,85% of total billed charges,118.8,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,132,100,,,fee schedule,100% of NM APC rate,52.8,40,,,percent of total billed charges,40% of total billed charges,52.8,40,,,percent of total billed charges,40% of total billed charges,118.8,90,,,percent of total billed charges,90% of total billed charges,100.32,76,,,percent of total billed charges,76% of total billed charges,52.8,40,,,percent of total billed charges,40% of total billed charges,112.2,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,105.6,80,,,percent of total billed charges,80% of total billed charges,51.22,38.8,,,percent of total billed charges,38.8% of total billed charges,112.2,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,51.22,217.66,
"24071 Excision, Tumor, Soft Tissue Of Upper Arm Or Elbow Are",60000035,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1217,973.6,,912.75,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,963.86,79.2,,,percent of total billed charges,79.2% of total billed charges,1034.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1156.15,95,,,percent of total billed charges,95% of total billed charges,973.6,80,,,percent of total billed charges,80% of total billed charges,1034.45,85,,,percent of total billed charges,85% of total billed charges,1095.3,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1217,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1095.3,90,,,percent of total billed charges,90% of total billed charges,924.92,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1034.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,973.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1034.45,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
RT Spirometry with Graphic Record Charge,42294010,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,82.6,66.08,,61.95,75,,,percent of total billed charges,75% of total billed charges,33.04,40,,,percent of total billed charges,40% of total billed charges,65.42,79.2,,,percent of total billed charges,79.2% of total billed charges,70.21,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,78.47,95,,,percent of total billed charges,95% of total billed charges,66.08,80,,,percent of total billed charges,80% of total billed charges,70.21,85,,,percent of total billed charges,85% of total billed charges,74.34,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,82.6,100,,,fee schedule,100% of NM APC rate,33.04,40,,,percent of total billed charges,40% of total billed charges,33.04,40,,,percent of total billed charges,40% of total billed charges,74.34,90,,,percent of total billed charges,90% of total billed charges,62.78,76,,,percent of total billed charges,76% of total billed charges,33.04,40,,,percent of total billed charges,40% of total billed charges,70.21,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,66.08,80,,,percent of total billed charges,80% of total billed charges,32.05,38.8,,,percent of total billed charges,38.8% of total billed charges,70.21,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,32.05,82.6,
Removal of central venous catheter for infusion,30036589,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,397.4,317.92,,298.05,75,,,percent of total billed charges,75% of total billed charges,158.96,40,,,percent of total billed charges,40% of total billed charges,314.74,79.2,,,percent of total billed charges,79.2% of total billed charges,337.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,377.53,95,,,percent of total billed charges,95% of total billed charges,317.92,80,,,percent of total billed charges,80% of total billed charges,337.79,85,,,percent of total billed charges,85% of total billed charges,357.66,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,158.96,40,,,percent of total billed charges,40% of total billed charges,158.96,40,,,percent of total billed charges,40% of total billed charges,357.66,90,,,percent of total billed charges,90% of total billed charges,302.02,76,,,percent of total billed charges,76% of total billed charges,158.96,40,,,percent of total billed charges,40% of total billed charges,337.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,317.92,80,,,percent of total billed charges,80% of total billed charges,154.19,38.8,,,percent of total billed charges,38.8% of total billed charges,337.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,154.19,377.53,
Anesthesia Time Units,46200000,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,135.5,108.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Report,41120225,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1894.9,1515.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
US Breast Wire Placement Lt,41219285,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,242.5,194,TC,181.88,75,,,percent of total billed charges,75% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,192.06,79.2,,,percent of total billed charges,79.2% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,230.38,95,,,percent of total billed charges,95% of total billed charges,194,80,,,percent of total billed charges,80% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,218.25,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,97,40,,,percent of total billed charges,40% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,218.25,90,,,percent of total billed charges,90% of total billed charges,184.3,76,,,percent of total billed charges,76% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,194,80,,,percent of total billed charges,80% of total billed charges,94.09,38.8,,,percent of total billed charges,38.8% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,230.38,
US Breast Wire Placement Rt,41219285,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,242.5,194,TC,181.88,75,,,percent of total billed charges,75% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,192.06,79.2,,,percent of total billed charges,79.2% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,230.38,95,,,percent of total billed charges,95% of total billed charges,194,80,,,percent of total billed charges,80% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,218.25,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,97,40,,,percent of total billed charges,40% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,218.25,90,,,percent of total billed charges,90% of total billed charges,184.3,76,,,percent of total billed charges,76% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,194,80,,,percent of total billed charges,80% of total billed charges,94.09,38.8,,,percent of total billed charges,38.8% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,230.38,
"23931 Incision And Drainage, Upper Arm Or Elbow Area; Bursa",46023931,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,489.1,391.28,,366.83,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,387.37,79.2,,,percent of total billed charges,79.2% of total billed charges,415.74,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,464.65,95,,,percent of total billed charges,95% of total billed charges,391.28,80,,,percent of total billed charges,80% of total billed charges,415.74,85,,,percent of total billed charges,85% of total billed charges,440.19,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,489.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,440.19,90,,,percent of total billed charges,90% of total billed charges,371.72,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,415.74,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,391.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,415.74,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
28092 EXC LES TEND CAPSULE TOE CHARGE,60000800,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,828.2,662.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28110 PART EXC 5TH METATRS HEAD CHARGE,46028110,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,895,716,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25810 - Arthodesis wrist,60000811,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2619.8,2095.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26356 - REPAIR FINGER/HAND TENDON,60000794,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2419.2,1935.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"29886 - Arthroscopy, Knee, Surgical; Drilling For Intact Ost",60000675,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1927.6,1542.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26860 - Arthodesis, interphalangeal joint, w/ or w/o interna",60000796,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1855.5,1484.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99234 IP - OBS W DISCH DETAILED CHARGE,30099234,CDM,987,RC,99315,HCPCS,OUTPATIENT,,,445.6,356.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99235 IP - OBS W DISCH MOD COMPLX CHARGE,30099235,CDM,987,RC,99315,HCPCS,OUTPATIENT,,,594.4,475.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99236 OBSERVATION W DISCH HI COMPLEX CHARGE,30099236,CDM,987,RC,99315,HCPCS,OUTPATIENT,,,722,577.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
94640 METER DOSE INAHL SUBS TX,42294640,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,24.3,19.44,,18.23,75,,,percent of total billed charges,75% of total billed charges,9.72,40,,,percent of total billed charges,40% of total billed charges,19.25,79.2,,,percent of total billed charges,79.2% of total billed charges,20.66,85,,,percent of total billed charges,85% of total billed charges,24.3,100,,,fee schedule,100% of CO APG rates,23.09,95,,,percent of total billed charges,95% of total billed charges,19.44,80,,,percent of total billed charges,80% of total billed charges,20.66,85,,,percent of total billed charges,85% of total billed charges,21.87,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,24.3,100,,,fee schedule,100% of NM APC rate,9.72,40,,,percent of total billed charges,40% of total billed charges,9.72,40,,,percent of total billed charges,40% of total billed charges,21.87,90,,,percent of total billed charges,90% of total billed charges,18.47,76,,,percent of total billed charges,76% of total billed charges,9.72,40,,,percent of total billed charges,40% of total billed charges,20.66,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,19.44,80,,,percent of total billed charges,80% of total billed charges,9.43,38.8,,,percent of total billed charges,38.8% of total billed charges,20.66,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,9.43,68.59,
29823 ARTHROSCOPY SHOULD DEBRI EXTEN CHARGE,46029823,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1787.8,1430.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00140 ANESTH PROC EYE Charge,46200140,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00142 ANESTH LENS SURG EYE Charge,46200142,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00164 ANESTH NOSE/SINUSES BX Charge,46200164,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00300 ANESTH PROC INTEGUMT NCK# Charge,46200300,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00320 ANESTH ESOPH THYROID LARYNX Charge,46200320,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00400 ANESTH ANT INTEGUME Charge,46200400,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00402 ANESTH RECONST BREAST Charge,46200402,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00404 ANESTH RAD/MOD RADICAL Charge,46200404,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00470 ANESTH PARTIAL RIB RESECT Charge,46200470,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00520 ANESTH CLSD CHEST PROC# Charge,46200520,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00532 ANESTH FOR ACCESS CVC Charge,46200532,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00700 ANESTH PROC UPR ANT ABD Charge,46200700,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00702 ANESTH PROC PERCUT LIVER BX Charge,46200702,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00750 ANESTH HERNIA RPR UPR ABD Charge,46200750,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00752 ANESTH HERNIA RPR LUMBAR Charge,46200752,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00790 ANESTH INTRAPERITONEAL UPR Charge,46200790,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00794 ANESTH PANCREATCTOMY Charge,46200794,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00800 ANESTH PROC LWR ANT ABD Charge,46200800,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00830 ANESTH HERNIA LOWER ABD Charge,46200830,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00832 ANESTH VENT/INC HERNIA Charge,46200832,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00840 ANESTH INTRAPERITONEAL LWR Charge,46200840,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00844 ANESTH ABDOMINOPERINEAL Charge,46200844,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00846 ANESTH RAD HYSTERECTOMY Charge,46200846,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00860 ANESTH EXTRAPERITONEAL Charge,46200860,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00902 ANESTH ANORECTAL PROCR Charge,46200902,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00904 ANESTH RAD PERINEAL PROC Charge,46200904,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00930 ANESTH ORCHIOPXY UNI/BIL# Charge,46200930,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00940 ANESTH VAG PROCEDURES Charge,46200940,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00944 ANESTH VAG HYSTERECTOMY Charge,46200944,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01210 ANESTH OPEN PROC HIP JNT Charge,46201210,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01230 ANESTH OPN PROC UPR 2/3 FMR Charge,46201230,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01232 ANESTH UPPER FEMUR AMPUTAT Charge,46201232,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01360 ANESTH OPN PROC LWR 1/3 FMR Charge,46201360,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01480 ANESTH OPEN PROC BONE LWR Charge,46201480,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01482 RADICAL RESECTION (INCLUDING BELOW KNEE AMPUTATION),46201482,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01610 ANESTH ALL PROCEDURES AXIL Charge,46201610,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01710 ANESTH NERVES MUSCLS TENDON Charge,46201710,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"01830 OPEN OR ARTHOSCOPIC ON FOREARM, WRIST OR HAND",46201830,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01951 ANESTH 2ND-3RD%BURN EXC Charge,46201951,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99238 HOSPITAL DISCHARGE 30MIN< Charge,30099238,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,315.6,252.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43752 NASO GASTRIC TUBE PLACEMENT BY PHYSICIAN CHARGE,30043752,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,115.9,92.72,,86.93,75,,,percent of total billed charges,75% of total billed charges,46.36,40,,,percent of total billed charges,40% of total billed charges,91.79,79.2,,,percent of total billed charges,79.2% of total billed charges,98.52,85,,,percent of total billed charges,85% of total billed charges,115.9,100,,,fee schedule,100% of CO APG rates,110.11,95,,,percent of total billed charges,95% of total billed charges,92.72,80,,,percent of total billed charges,80% of total billed charges,98.52,85,,,percent of total billed charges,85% of total billed charges,104.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,115.9,100,,,fee schedule,100% of NM APC rate,46.36,40,,,percent of total billed charges,40% of total billed charges,46.36,40,,,percent of total billed charges,40% of total billed charges,104.31,90,,,percent of total billed charges,90% of total billed charges,88.08,76,,,percent of total billed charges,76% of total billed charges,46.36,40,,,percent of total billed charges,40% of total billed charges,98.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,92.72,80,,,percent of total billed charges,80% of total billed charges,44.97,38.8,,,percent of total billed charges,38.8% of total billed charges,98.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,44.97,217.66,
"23540 CLOSED TX OF ACROMIOCLAVICULAR DISLOCATION, W/O MANIPU",3123540,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,744.3,595.44,,558.23,75,,,percent of total billed charges,75% of total billed charges,297.72,40,,,percent of total billed charges,40% of total billed charges,589.49,79.2,,,percent of total billed charges,79.2% of total billed charges,632.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,707.09,95,,,percent of total billed charges,95% of total billed charges,595.44,80,,,percent of total billed charges,80% of total billed charges,632.66,85,,,percent of total billed charges,85% of total billed charges,669.87,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,297.72,40,,,percent of total billed charges,40% of total billed charges,297.72,40,,,percent of total billed charges,40% of total billed charges,669.87,90,,,percent of total billed charges,90% of total billed charges,565.67,76,,,percent of total billed charges,76% of total billed charges,297.72,40,,,percent of total billed charges,40% of total billed charges,632.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,595.44,80,,,percent of total billed charges,80% of total billed charges,288.79,38.8,,,percent of total billed charges,38.8% of total billed charges,632.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,707.09,
01250 ANESTH PROC NERVE MUSCLE,46201250,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"15100 split thickness autograft, trunk, arms, legs, first 100 sq cm or less, or",60000000,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2130,1704,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01810 ANESTH PROC NERVE MUSCLE Charge,46201810,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27658 - Repair flexor tendon leg w/o graft,60000599,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1124.5,899.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
11012 DEB SKIN BONE AT FX SITE,31011012,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1215.5,972.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
11740 Evacuation Of Subungual Hematoma,31011740,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,98.9,79.12,,74.18,75,,,percent of total billed charges,75% of total billed charges,39.56,40,,,percent of total billed charges,40% of total billed charges,78.33,79.2,,,percent of total billed charges,79.2% of total billed charges,84.07,85,,,percent of total billed charges,85% of total billed charges,98.9,100,,,fee schedule,100% of CO APG rates,93.96,95,,,percent of total billed charges,95% of total billed charges,79.12,80,,,percent of total billed charges,80% of total billed charges,84.07,85,,,percent of total billed charges,85% of total billed charges,89.01,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,98.9,100,,,fee schedule,100% of NM APC rate,39.56,40,,,percent of total billed charges,40% of total billed charges,39.56,40,,,percent of total billed charges,40% of total billed charges,89.01,90,,,percent of total billed charges,90% of total billed charges,75.16,76,,,percent of total billed charges,76% of total billed charges,39.56,40,,,percent of total billed charges,40% of total billed charges,84.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,79.12,80,,,percent of total billed charges,80% of total billed charges,38.37,38.8,,,percent of total billed charges,38.8% of total billed charges,84.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,197.8,200,,,fee schedule,200% of CMS fee schedule,38.37,215.49,
11760 Repair Nail Bed,31011760,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,326.1,260.88,,244.58,75,,,percent of total billed charges,75% of total billed charges,130.44,40,,,percent of total billed charges,40% of total billed charges,258.27,79.2,,,percent of total billed charges,79.2% of total billed charges,277.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,309.8,95,,,percent of total billed charges,95% of total billed charges,260.88,80,,,percent of total billed charges,80% of total billed charges,277.19,85,,,percent of total billed charges,85% of total billed charges,293.49,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,130.44,40,,,percent of total billed charges,40% of total billed charges,130.44,40,,,percent of total billed charges,40% of total billed charges,293.49,90,,,percent of total billed charges,90% of total billed charges,247.84,76,,,percent of total billed charges,76% of total billed charges,130.44,40,,,percent of total billed charges,40% of total billed charges,277.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,260.88,80,,,percent of total billed charges,80% of total billed charges,126.53,38.8,,,percent of total billed charges,38.8% of total billed charges,277.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,126.53,309.8,
11765 Wedge Excision Of Skin Of Nail Fold,31011765,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,280.6,224.48,,210.45,75,,,percent of total billed charges,75% of total billed charges,112.24,40,,,percent of total billed charges,40% of total billed charges,222.24,79.2,,,percent of total billed charges,79.2% of total billed charges,238.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,266.57,95,,,percent of total billed charges,95% of total billed charges,224.48,80,,,percent of total billed charges,80% of total billed charges,238.51,85,,,percent of total billed charges,85% of total billed charges,252.54,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,112.24,40,,,percent of total billed charges,40% of total billed charges,112.24,40,,,percent of total billed charges,40% of total billed charges,252.54,90,,,percent of total billed charges,90% of total billed charges,213.26,76,,,percent of total billed charges,76% of total billed charges,112.24,40,,,percent of total billed charges,40% of total billed charges,238.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,224.48,80,,,percent of total billed charges,80% of total billed charges,108.87,38.8,,,percent of total billed charges,38.8% of total billed charges,238.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,108.87,266.57,
"Repair, Intermediate, Wounds Of Scalp, Axillae, Trunk And/Or",46012031,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,453,362.4,,339.75,75,,,percent of total billed charges,75% of total billed charges,181.2,40,,,percent of total billed charges,40% of total billed charges,358.78,79.2,,,percent of total billed charges,79.2% of total billed charges,385.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,430.35,95,,,percent of total billed charges,95% of total billed charges,362.4,80,,,percent of total billed charges,80% of total billed charges,385.05,85,,,percent of total billed charges,85% of total billed charges,407.7,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,181.2,40,,,percent of total billed charges,40% of total billed charges,181.2,40,,,percent of total billed charges,40% of total billed charges,407.7,90,,,percent of total billed charges,90% of total billed charges,344.28,76,,,percent of total billed charges,76% of total billed charges,181.2,40,,,percent of total billed charges,40% of total billed charges,385.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,362.4,80,,,percent of total billed charges,80% of total billed charges,175.76,38.8,,,percent of total billed charges,38.8% of total billed charges,385.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,175.76,430.35,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012034,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,611,488.8,,458.25,75,,,percent of total billed charges,75% of total billed charges,244.4,40,,,percent of total billed charges,40% of total billed charges,483.91,79.2,,,percent of total billed charges,79.2% of total billed charges,519.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,580.45,95,,,percent of total billed charges,95% of total billed charges,488.8,80,,,percent of total billed charges,80% of total billed charges,519.35,85,,,percent of total billed charges,85% of total billed charges,549.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,244.4,40,,,percent of total billed charges,40% of total billed charges,244.4,40,,,percent of total billed charges,40% of total billed charges,549.9,90,,,percent of total billed charges,90% of total billed charges,464.36,76,,,percent of total billed charges,76% of total billed charges,244.4,40,,,percent of total billed charges,40% of total billed charges,519.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,488.8,80,,,percent of total billed charges,80% of total billed charges,237.07,38.8,,,percent of total billed charges,38.8% of total billed charges,519.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,580.45,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012035,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,716.8,573.44,,537.6,75,,,percent of total billed charges,75% of total billed charges,286.72,40,,,percent of total billed charges,40% of total billed charges,567.71,79.2,,,percent of total billed charges,79.2% of total billed charges,609.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,680.96,95,,,percent of total billed charges,95% of total billed charges,573.44,80,,,percent of total billed charges,80% of total billed charges,609.28,85,,,percent of total billed charges,85% of total billed charges,645.12,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,286.72,40,,,percent of total billed charges,40% of total billed charges,286.72,40,,,percent of total billed charges,40% of total billed charges,645.12,90,,,percent of total billed charges,90% of total billed charges,544.77,76,,,percent of total billed charges,76% of total billed charges,286.72,40,,,percent of total billed charges,40% of total billed charges,609.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,573.44,80,,,percent of total billed charges,80% of total billed charges,278.12,38.8,,,percent of total billed charges,38.8% of total billed charges,609.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,680.96,
12051 LAYER CLO FACE 2.5/LESS,31012051,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,504.6,403.68,,378.45,75,,,percent of total billed charges,75% of total billed charges,201.84,40,,,percent of total billed charges,40% of total billed charges,399.64,79.2,,,percent of total billed charges,79.2% of total billed charges,428.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,479.37,95,,,percent of total billed charges,95% of total billed charges,403.68,80,,,percent of total billed charges,80% of total billed charges,428.91,85,,,percent of total billed charges,85% of total billed charges,454.14,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,201.84,40,,,percent of total billed charges,40% of total billed charges,201.84,40,,,percent of total billed charges,40% of total billed charges,454.14,90,,,percent of total billed charges,90% of total billed charges,383.5,76,,,percent of total billed charges,76% of total billed charges,201.84,40,,,percent of total billed charges,40% of total billed charges,428.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,403.68,80,,,percent of total billed charges,80% of total billed charges,195.78,38.8,,,percent of total billed charges,38.8% of total billed charges,428.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,479.37,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012052,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,594.9,475.92,,446.18,75,,,percent of total billed charges,75% of total billed charges,237.96,40,,,percent of total billed charges,40% of total billed charges,471.16,79.2,,,percent of total billed charges,79.2% of total billed charges,505.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,565.16,95,,,percent of total billed charges,95% of total billed charges,475.92,80,,,percent of total billed charges,80% of total billed charges,505.67,85,,,percent of total billed charges,85% of total billed charges,535.41,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,237.96,40,,,percent of total billed charges,40% of total billed charges,237.96,40,,,percent of total billed charges,40% of total billed charges,535.41,90,,,percent of total billed charges,90% of total billed charges,452.12,76,,,percent of total billed charges,76% of total billed charges,237.96,40,,,percent of total billed charges,40% of total billed charges,505.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,475.92,80,,,percent of total billed charges,80% of total billed charges,230.82,38.8,,,percent of total billed charges,38.8% of total billed charges,505.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,565.16,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012053,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,640.8,512.64,,480.6,75,,,percent of total billed charges,75% of total billed charges,256.32,40,,,percent of total billed charges,40% of total billed charges,507.51,79.2,,,percent of total billed charges,79.2% of total billed charges,544.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,608.76,95,,,percent of total billed charges,95% of total billed charges,512.64,80,,,percent of total billed charges,80% of total billed charges,544.68,85,,,percent of total billed charges,85% of total billed charges,576.72,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,256.32,40,,,percent of total billed charges,40% of total billed charges,256.32,40,,,percent of total billed charges,40% of total billed charges,576.72,90,,,percent of total billed charges,90% of total billed charges,487.01,76,,,percent of total billed charges,76% of total billed charges,256.32,40,,,percent of total billed charges,40% of total billed charges,544.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,512.64,80,,,percent of total billed charges,80% of total billed charges,248.63,38.8,,,percent of total billed charges,38.8% of total billed charges,544.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,608.76,
13121 - REPR CPX ARMS/LEGS2.6-7.5 CHARGE,46013121,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,763.7,610.96,,572.78,75,,,percent of total billed charges,75% of total billed charges,305.48,40,,,percent of total billed charges,40% of total billed charges,604.85,79.2,,,percent of total billed charges,79.2% of total billed charges,649.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,725.52,95,,,percent of total billed charges,95% of total billed charges,610.96,80,,,percent of total billed charges,80% of total billed charges,649.15,85,,,percent of total billed charges,85% of total billed charges,687.33,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,305.48,40,,,percent of total billed charges,40% of total billed charges,305.48,40,,,percent of total billed charges,40% of total billed charges,687.33,90,,,percent of total billed charges,90% of total billed charges,580.41,76,,,percent of total billed charges,76% of total billed charges,305.48,40,,,percent of total billed charges,40% of total billed charges,649.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,610.96,80,,,percent of total billed charges,80% of total billed charges,296.32,38.8,,,percent of total billed charges,38.8% of total billed charges,649.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,725.52,
13122 - REP EA ADDTL 5 CM OR LES CHARGE,46013122,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,239.5,191.6,,179.63,75,,,percent of total billed charges,75% of total billed charges,95.8,40,,,percent of total billed charges,40% of total billed charges,189.68,79.2,,,percent of total billed charges,79.2% of total billed charges,203.58,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,227.53,95,,,percent of total billed charges,95% of total billed charges,191.6,80,,,percent of total billed charges,80% of total billed charges,203.58,85,,,percent of total billed charges,85% of total billed charges,215.55,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,95.8,40,,,percent of total billed charges,40% of total billed charges,95.8,40,,,percent of total billed charges,40% of total billed charges,215.55,90,,,percent of total billed charges,90% of total billed charges,182.02,76,,,percent of total billed charges,76% of total billed charges,95.8,40,,,percent of total billed charges,40% of total billed charges,203.58,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,191.6,80,,,percent of total billed charges,80% of total billed charges,92.93,38.8,,,percent of total billed charges,38.8% of total billed charges,203.58,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,92.93,227.53,
13131 - REP CPX FOREHD/CHIN 1.1-2 CHARGE,46013131,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,717.1,573.68,,537.83,75,,,percent of total billed charges,75% of total billed charges,286.84,40,,,percent of total billed charges,40% of total billed charges,567.94,79.2,,,percent of total billed charges,79.2% of total billed charges,609.54,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,681.25,95,,,percent of total billed charges,95% of total billed charges,573.68,80,,,percent of total billed charges,80% of total billed charges,609.54,85,,,percent of total billed charges,85% of total billed charges,645.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,286.84,40,,,percent of total billed charges,40% of total billed charges,286.84,40,,,percent of total billed charges,40% of total billed charges,645.39,90,,,percent of total billed charges,90% of total billed charges,545,76,,,percent of total billed charges,76% of total billed charges,286.84,40,,,percent of total billed charges,40% of total billed charges,609.54,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,573.68,80,,,percent of total billed charges,80% of total billed charges,278.23,38.8,,,percent of total billed charges,38.8% of total billed charges,609.54,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,681.25,
13132 - REP CPX FOREHD/CHIN 2.6-7 CHARGE,46013132,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,892.8,714.24,,669.6,75,,,percent of total billed charges,75% of total billed charges,357.12,40,,,percent of total billed charges,40% of total billed charges,707.1,79.2,,,percent of total billed charges,79.2% of total billed charges,758.88,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,848.16,95,,,percent of total billed charges,95% of total billed charges,714.24,80,,,percent of total billed charges,80% of total billed charges,758.88,85,,,percent of total billed charges,85% of total billed charges,803.52,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,357.12,40,,,percent of total billed charges,40% of total billed charges,357.12,40,,,percent of total billed charges,40% of total billed charges,803.52,90,,,percent of total billed charges,90% of total billed charges,678.53,76,,,percent of total billed charges,76% of total billed charges,357.12,40,,,percent of total billed charges,40% of total billed charges,758.88,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,714.24,80,,,percent of total billed charges,80% of total billed charges,346.41,38.8,,,percent of total billed charges,38.8% of total billed charges,758.88,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,848.16,
13133 - ADDTL 5CM RPR CMPLX TO 13 CHARGE,46013133,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,365.4,292.32,,274.05,75,,,percent of total billed charges,75% of total billed charges,146.16,40,,,percent of total billed charges,40% of total billed charges,289.4,79.2,,,percent of total billed charges,79.2% of total billed charges,310.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,347.13,95,,,percent of total billed charges,95% of total billed charges,292.32,80,,,percent of total billed charges,80% of total billed charges,310.59,85,,,percent of total billed charges,85% of total billed charges,328.86,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,146.16,40,,,percent of total billed charges,40% of total billed charges,146.16,40,,,percent of total billed charges,40% of total billed charges,328.86,90,,,percent of total billed charges,90% of total billed charges,277.7,76,,,percent of total billed charges,76% of total billed charges,146.16,40,,,percent of total billed charges,40% of total billed charges,310.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,292.32,80,,,percent of total billed charges,80% of total billed charges,141.78,38.8,,,percent of total billed charges,38.8% of total billed charges,310.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,141.78,347.13,
"15050 Pinch Graft, To Cover Small Ulcer, Tip Of Digit, Or Ot",31015050,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1379.6,1103.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"16000 Initial Treatment, First Degree Burn, When No More Tha",31016000,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,132.8,106.24,,99.6,75,,,percent of total billed charges,75% of total billed charges,53.12,40,,,percent of total billed charges,40% of total billed charges,105.18,79.2,,,percent of total billed charges,79.2% of total billed charges,112.88,85,,,percent of total billed charges,85% of total billed charges,132.8,100,,,fee schedule,100% of CO APG rates,126.16,95,,,percent of total billed charges,95% of total billed charges,106.24,80,,,percent of total billed charges,80% of total billed charges,112.88,85,,,percent of total billed charges,85% of total billed charges,119.52,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,132.8,100,,,fee schedule,100% of NM APC rate,53.12,40,,,percent of total billed charges,40% of total billed charges,53.12,40,,,percent of total billed charges,40% of total billed charges,119.52,90,,,percent of total billed charges,90% of total billed charges,100.93,76,,,percent of total billed charges,76% of total billed charges,53.12,40,,,percent of total billed charges,40% of total billed charges,112.88,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,106.24,80,,,percent of total billed charges,80% of total billed charges,51.53,38.8,,,percent of total billed charges,38.8% of total billed charges,112.88,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,51.53,217.66,
16025 DRESS/DEBRID P-THICK BURN M,31016025,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,327.3,261.84,,245.48,75,,,percent of total billed charges,75% of total billed charges,130.92,40,,,percent of total billed charges,40% of total billed charges,259.22,79.2,,,percent of total billed charges,79.2% of total billed charges,278.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,310.94,95,,,percent of total billed charges,95% of total billed charges,261.84,80,,,percent of total billed charges,80% of total billed charges,278.21,85,,,percent of total billed charges,85% of total billed charges,294.57,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,130.92,40,,,percent of total billed charges,40% of total billed charges,130.92,40,,,percent of total billed charges,40% of total billed charges,294.57,90,,,percent of total billed charges,90% of total billed charges,248.75,76,,,percent of total billed charges,76% of total billed charges,130.92,40,,,percent of total billed charges,40% of total billed charges,278.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,261.84,80,,,percent of total billed charges,80% of total billed charges,126.99,38.8,,,percent of total billed charges,38.8% of total billed charges,278.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,126.99,310.94,
16030 DRSS/DBRID P-THICK BURN L,31016030,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,389.3,311.44,,291.98,75,,,percent of total billed charges,75% of total billed charges,155.72,40,,,percent of total billed charges,40% of total billed charges,308.33,79.2,,,percent of total billed charges,79.2% of total billed charges,330.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,369.84,95,,,percent of total billed charges,95% of total billed charges,311.44,80,,,percent of total billed charges,80% of total billed charges,330.91,85,,,percent of total billed charges,85% of total billed charges,350.37,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,155.72,40,,,percent of total billed charges,40% of total billed charges,155.72,40,,,percent of total billed charges,40% of total billed charges,350.37,90,,,percent of total billed charges,90% of total billed charges,295.87,76,,,percent of total billed charges,76% of total billed charges,155.72,40,,,percent of total billed charges,40% of total billed charges,330.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,311.44,80,,,percent of total billed charges,80% of total billed charges,151.05,38.8,,,percent of total billed charges,38.8% of total billed charges,330.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,151.05,369.84,
"19020 Mastotomy With Exploration Or Drainage Of Abscess, Dee",46519020,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,939.6,751.68,,704.7,75,,,percent of total billed charges,75% of total billed charges,375.84,40,,,percent of total billed charges,40% of total billed charges,744.16,79.2,,,percent of total billed charges,79.2% of total billed charges,798.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,892.62,95,,,percent of total billed charges,95% of total billed charges,751.68,80,,,percent of total billed charges,80% of total billed charges,798.66,85,,,percent of total billed charges,85% of total billed charges,845.64,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,375.84,40,,,percent of total billed charges,40% of total billed charges,375.84,40,,,percent of total billed charges,40% of total billed charges,845.64,90,,,percent of total billed charges,90% of total billed charges,714.1,76,,,percent of total billed charges,76% of total billed charges,375.84,40,,,percent of total billed charges,40% of total billed charges,798.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,751.68,80,,,percent of total billed charges,80% of total billed charges,364.56,38.8,,,percent of total billed charges,38.8% of total billed charges,798.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,892.62,
20525 REM FB MSC/TENDON CPX,31020525,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,742.8,594.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
21480 Closed Treatment Of Temporomandibular Dislocation; Ini,31021480,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,91.6,73.28,,68.7,75,,,percent of total billed charges,75% of total billed charges,36.64,40,,,percent of total billed charges,40% of total billed charges,72.55,79.2,,,percent of total billed charges,79.2% of total billed charges,77.86,85,,,percent of total billed charges,85% of total billed charges,91.6,100,,,fee schedule,100% of CO APG rates,87.02,95,,,percent of total billed charges,95% of total billed charges,73.28,80,,,percent of total billed charges,80% of total billed charges,77.86,85,,,percent of total billed charges,85% of total billed charges,82.44,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,91.6,100,,,fee schedule,100% of NM APC rate,36.64,40,,,percent of total billed charges,40% of total billed charges,36.64,40,,,percent of total billed charges,40% of total billed charges,82.44,90,,,percent of total billed charges,90% of total billed charges,69.62,76,,,percent of total billed charges,76% of total billed charges,36.64,40,,,percent of total billed charges,40% of total billed charges,77.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,73.28,80,,,percent of total billed charges,80% of total billed charges,35.54,38.8,,,percent of total billed charges,38.8% of total billed charges,77.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,183.2,200,,,fee schedule,200% of CMS fee schedule,35.54,215.49,
99252 - OR VISIT EXPANDED-EST CHARGE,46099252,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,99.6,79.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99221 INITIAL HOSPITAL CARE/DAY 30 MINUTES,46099221,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,441.8,353.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99222 - ADMIT COMPREHENSIVE MOD CHARGE,46099222,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,568.1,454.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99223 - ADMIT COMPREHENSIVE HIGH CHARGE,46099223,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,694.3,555.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99239 - DISCHARGE MORE THAN 30 MI CHARGE,46099239,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,441.8,353.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99231 SBSQ HOSPITAL CARE/DAY 15 MINUTES,46099231,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,315.6,252.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99232 SBSQ HOSPITAL CARE/DAY 25 MINUTES,46099232,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,441.8,353.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99233 - SUBSEQUENT HIGH CHARGE,46099233,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,568.1,454.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
10081 Drainage of pilonidal cyst; complicated,31010081,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,507.4,405.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"13160 Secondary Closure Of Surgical Wound Or Dehiscence, Ext",46013160,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2366.9,1893.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
19301 - PARTIAL MASTECTOMY CHARGE,46019301,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1945.4,1556.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
19303 - SIMPLE MASTECTOMY CHARGE,46019303,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2822.9,2258.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
19307 - MODIFIED RADICAL MASTECT CHARGE,46019307,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3471.7,2777.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
20100 - EXPLOR PENET WND; NECK CHARGE,46020100,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1754,1403.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
20101 - EXPLOR PENETRAT WND; CHST CHARGE,46020101,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,614.7,491.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
20102 - EXPLORE WOUND ABDOMEN CHARGE,46020102,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,752.9,602.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"20103 - EXPLORATION, WOUND EXTREM CHARGE",46020103,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1019.5,815.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
20220 - BONE BIOPSY TROCAR/NEEDLE CHARGE,46020220,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,254,203.2,,190.5,75,,,percent of total billed charges,75% of total billed charges,101.6,40,,,percent of total billed charges,40% of total billed charges,201.17,79.2,,,percent of total billed charges,79.2% of total billed charges,215.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,241.3,95,,,percent of total billed charges,95% of total billed charges,203.2,80,,,percent of total billed charges,80% of total billed charges,215.9,85,,,percent of total billed charges,85% of total billed charges,228.6,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,254,100,,,fee schedule,100% of NM APC rate,101.6,40,,,percent of total billed charges,40% of total billed charges,101.6,40,,,percent of total billed charges,40% of total billed charges,228.6,90,,,percent of total billed charges,90% of total billed charges,193.04,76,,,percent of total billed charges,76% of total billed charges,101.6,40,,,percent of total billed charges,40% of total billed charges,215.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,203.2,80,,,percent of total billed charges,80% of total billed charges,98.55,38.8,,,percent of total billed charges,38.8% of total billed charges,215.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,98.55,254,
20225 - BONE BIOPSY TROCAR/NDL DP CHARGE,46020225,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,377.2,301.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"21552 Excision, Tumor, Soft Tissue Of Neck, Subcut; 3 Cm Or",46021552,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1334.6,1067.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31505 - LARYNGOSCOPY INDIRECT DX CHARGE,46031505,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,149.1,119.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31575 - DIAG LARYNGOSCOPY FIBERO CHARGE,46031575,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,206.2,164.96,,154.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,163.31,79.2,,,percent of total billed charges,79.2% of total billed charges,175.27,85,,,percent of total billed charges,85% of total billed charges,206.2,100,,,fee schedule,100% of CO APG rates,195.89,95,,,percent of total billed charges,95% of total billed charges,164.96,80,,,percent of total billed charges,80% of total billed charges,175.27,85,,,percent of total billed charges,85% of total billed charges,185.58,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,206.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,185.58,90,,,percent of total billed charges,90% of total billed charges,156.71,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,175.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,164.96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,175.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,794.6,100,,,case rate,pays based on per visit rate,154.65,794.6,
31600 - INCISION OF WINDPIPE CHARGE,46031600,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,880.7,704.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
32400 - NEEDLE BIOPSY CHEST LININ CHARGE,46032400,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,241,192.8,,180.75,75,,,percent of total billed charges,75% of total billed charges,96.4,40,,,percent of total billed charges,40% of total billed charges,190.87,79.2,,,percent of total billed charges,79.2% of total billed charges,204.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,228.95,95,,,percent of total billed charges,95% of total billed charges,192.8,80,,,percent of total billed charges,80% of total billed charges,204.85,85,,,percent of total billed charges,85% of total billed charges,216.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,241,100,,,fee schedule,100% of NM APC rate,96.4,40,,,percent of total billed charges,40% of total billed charges,96.4,40,,,percent of total billed charges,40% of total billed charges,216.9,90,,,percent of total billed charges,90% of total billed charges,183.16,76,,,percent of total billed charges,76% of total billed charges,96.4,40,,,percent of total billed charges,40% of total billed charges,204.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,192.8,80,,,percent of total billed charges,80% of total billed charges,93.51,38.8,,,percent of total billed charges,38.8% of total billed charges,204.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,93.51,241,
32551 - INSERT CHEST TUBE CHARGE,46032551,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,446.2,356.96,,334.65,75,,,percent of total billed charges,75% of total billed charges,178.48,40,,,percent of total billed charges,40% of total billed charges,353.39,79.2,,,percent of total billed charges,79.2% of total billed charges,379.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,423.89,95,,,percent of total billed charges,95% of total billed charges,356.96,80,,,percent of total billed charges,80% of total billed charges,379.27,85,,,percent of total billed charges,85% of total billed charges,401.58,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,178.48,40,,,percent of total billed charges,40% of total billed charges,178.48,40,,,percent of total billed charges,40% of total billed charges,401.58,90,,,percent of total billed charges,90% of total billed charges,339.11,76,,,percent of total billed charges,76% of total billed charges,178.48,40,,,percent of total billed charges,40% of total billed charges,379.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,356.96,80,,,percent of total billed charges,80% of total billed charges,173.13,38.8,,,percent of total billed charges,38.8% of total billed charges,379.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,173.13,423.89,
35840 - EXPLR POSTOP HEMORRHAGE A CHARGE,46035840,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3529.2,2823.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
36555 - CV CATHETER <5YRS CHARGE,46036555,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,242.5,194,,181.88,75,,,percent of total billed charges,75% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,192.06,79.2,,,percent of total billed charges,79.2% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,230.38,95,,,percent of total billed charges,95% of total billed charges,194,80,,,percent of total billed charges,80% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,218.25,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,97,40,,,percent of total billed charges,40% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,218.25,90,,,percent of total billed charges,90% of total billed charges,184.3,76,,,percent of total billed charges,76% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,194,80,,,percent of total billed charges,80% of total billed charges,94.09,38.8,,,percent of total billed charges,38.8% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,94.09,230.38,
38120 - LAP SURG SPLENECTOMY CHARGE,46038120,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3105.4,2484.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
38510 - BX/EXC LYMPH NODE CERVICL CHARGE,46038510,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1235.1,988.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"44120 - ENTERECTOMY, SM INT; SGL CHARGE",46044120,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3559.5,2847.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44121 - ENTERECTOMY SM INT EA ADL CHARGE,46044121,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,690.5,552.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44139 - TAKE DOWN OF SPLENIC FLEX CHARGE,46044139,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,345.1,276.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44140 - COLECTOMY PARTL W/ANASTOM CHARGE,46044140,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3911.9,3129.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44160 - PARTIAL COLECTOMY CHARGE,46044160,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3622.3,2897.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44180 - ADHESIOLYSIS SML BOWEL OB CHARGE,46044180,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2692.6,2154.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44207 - LAP COLY W/COLOPROCTOSTOM CHARGE,46044207,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,5244.2,4195.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44208 - LAP COLY W/COLOSTOMY CHARGE,46044208,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,5707.4,4565.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"44210 - LAP COLY, TOTAL CHARGE",46044210,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,5144.2,4115.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44213 - LAP SGCL MOBIL W/COLY CHARGE,46044213,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,535.2,428.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44320 - COLY/SKIN LVL CECOSTOMY S CHARGE,46044320,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3508.4,2806.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44322 - COLY/CECOSTOMY W/MULT BX CHARGE,46044322,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2961.2,2368.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44626 - CLOSE ENTEROSTOMY W/RESEC CHARGE,46044626,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,4606,3684.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44950 - APPENDECTOMY CHARGE,46044950,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1881.8,1505.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44955 - INCIDENCT APPENDECTOMY OP CHARGE,46044955,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,240.3,192.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44960 - APPENDECTOMY CHARGE,46044960,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2565.6,2052.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44970 - LAP APPENDECTOMY CHARGE,46044970,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1777,1421.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"46250 - HEMORRHOIDECTOMY, EXTERNA CHARGE",46046250,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,960.8,768.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"46255 - HEMORRHOIDECTOMY, INT/EXT CHARGE",46046255,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1061.6,849.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"46260 - HEMORRHOIDECTOMY, INT/EXT CHARGE",46046260,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1442.1,1153.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46270 - FISTULA CHARGE,46046270,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1214.1,971.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46945 - REMOVE BY LIGAT INT HEM G CHARGE,46046945,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1032.8,826.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46946 - RMV BY LIGAT INT HEM 2+ CHARGE,46046946,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1147,917.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43235 - EGD DIAGNOSTIC CHARGE,46043235,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,357.9,286.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"48102 - BX PANCREAS, PERQ CHARGE",46048102,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,680.9,544.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"20206 - BIOPSY, MUSCLE, PERQ NDL CHARGE",46020206,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,168.2,134.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
47001 - BX LIVER W/ANTH PROCEDURE CHARGE,46047001,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,298.7,238.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
47562 - LAP CHOLECYSTECTOMY CHARGE,46047562,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1946.6,1557.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
47600 - CHOLECYSTECTOMY CHARGE,46047600,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3139.9,2511.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
47605 - CHOLECYSTECTOMY W/CHO CHARGE,46047605,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3299.8,2639.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"47000 - BX LIVER, NEEDLE PERQ CHARGE",46047000,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,254,203.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49000 - EXPL LAPAROTOMY EXPL CELI CHARGE,46049000,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2257.5,1806,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49002 - REOPENING OF RECENT LAPAR CHARGE,46049002,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3041.5,2433.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49180 - BIOPSY ABDOMINAL MASS CHARGE,46049180,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,238.1,190.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49322 - LAPAROSCOPY ASPIRATION CHARGE,46049322,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1103.3,882.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49505 - PRP I/HERN INIT REDUC >5 CHARGE,46049505,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1550.4,1240.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49650 - LAP ING HERNIA REPAIR INI CHARGE,46049650,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1288.2,1030.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49651 - LAP ING HERNIA REPAIR REC CHARGE,46049651,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1678.5,1342.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46922 - ANAL CANAL LESION RMVL CHARGE,46046922,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,412.9,330.32,,309.68,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,327.02,79.2,,,percent of total billed charges,79.2% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,392.26,95,,,percent of total billed charges,95% of total billed charges,330.32,80,,,percent of total billed charges,80% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,371.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,412.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,371.61,90,,,percent of total billed charges,90% of total billed charges,313.8,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,350.97,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,330.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,350.97,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1208,100,,,case rate,pays based on per visit rate,309.68,1208,
49520 - RPR RECURRENT INGL HERNIA CHARGE,46049520,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1868.8,1495.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27301 - ID THIGH HEMATOMA CHARGE,46027301,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1535.1,1228.08,,1151.33,75,,,percent of total billed charges,75% of total billed charges,614.04,40,,,percent of total billed charges,40% of total billed charges,1215.8,79.2,,,percent of total billed charges,79.2% of total billed charges,1304.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1458.35,95,,,percent of total billed charges,95% of total billed charges,1228.08,80,,,percent of total billed charges,80% of total billed charges,1304.84,85,,,percent of total billed charges,85% of total billed charges,1381.59,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,614.04,40,,,percent of total billed charges,40% of total billed charges,614.04,40,,,percent of total billed charges,40% of total billed charges,1381.59,90,,,percent of total billed charges,90% of total billed charges,1166.68,76,,,percent of total billed charges,76% of total billed charges,614.04,40,,,percent of total billed charges,40% of total billed charges,1304.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1228.08,80,,,percent of total billed charges,80% of total billed charges,595.62,38.8,,,percent of total billed charges,38.8% of total billed charges,1304.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1458.35,
"10180 Incision And Drainage, Complex, Postoperative Wound In",46010180,CDM,981,RC,10060,HCPCS,OUTPATIENT,,,534.4,427.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49507 - RPR ING HERNIA CHARGE,46049507,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1739,1391.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44005 - ENTEROLYSIS CHARGE,46044005,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3183.2,2546.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
45990 - ANORECTAL EXAM W/ANESTHES CHARGE,46045990,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,311.9,249.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
22902 - EXC TUMOR ABD SUBQ; <3CM CHARGE,46022902,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1004.5,803.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46275 - RMVL ANAL FIST INTER CHARGE,46046275,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1274.9,1019.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"13102 Repair, Complex, Trunk; Each Additional 5 Cm Or Less",46013102,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,208.9,167.12,,156.68,75,,,percent of total billed charges,75% of total billed charges,83.56,40,,,percent of total billed charges,40% of total billed charges,165.45,79.2,,,percent of total billed charges,79.2% of total billed charges,177.57,85,,,percent of total billed charges,85% of total billed charges,208.9,100,,,fee schedule,100% of CO APG rates,198.46,95,,,percent of total billed charges,95% of total billed charges,167.12,80,,,percent of total billed charges,80% of total billed charges,177.57,85,,,percent of total billed charges,85% of total billed charges,188.01,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,83.56,40,,,percent of total billed charges,40% of total billed charges,83.56,40,,,percent of total billed charges,40% of total billed charges,188.01,90,,,percent of total billed charges,90% of total billed charges,158.76,76,,,percent of total billed charges,76% of total billed charges,83.56,40,,,percent of total billed charges,40% of total billed charges,177.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,167.12,80,,,percent of total billed charges,80% of total billed charges,81.05,38.8,,,percent of total billed charges,38.8% of total billed charges,177.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,81.05,217.66,
"11005 - DBRD SKIN, SUBQ W W/O FAS CHARGE",46011005,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2215.9,1772.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"11006 - DBRD SKIN, SUBQ EXT W W/O CHARGE",46011006,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2017,1613.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"11043 Debridement, Muscle And/Or Fascia; First 20 Sq Cm Or L",46011043,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,451.1,360.88,,338.33,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,357.27,79.2,,,percent of total billed charges,79.2% of total billed charges,383.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,428.55,95,,,percent of total billed charges,95% of total billed charges,360.88,80,,,percent of total billed charges,80% of total billed charges,383.44,85,,,percent of total billed charges,85% of total billed charges,405.99,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,451.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,405.99,90,,,percent of total billed charges,90% of total billed charges,342.84,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,383.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,360.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,383.44,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"15120 Split-Thickness Autograft, Face, Scalp, Eyelids, Mouth",46015120,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2053.3,1642.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
15240 SKIN FULL GRFT FACE/GENIT/HF,46015240,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2385.2,1908.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
15260 SKIN FULL GRAFT EEN  and LIPS,46015260,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2532.8,2026.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
15271 - APL GRAFT; TRUNK UP 100 CHARGE,46015271,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,246.3,197.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
15272 - APL GRAFT; EA ADDL 25CM CHARGE,46015272,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,48.8,39.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
15273 - APL GRAFT; TRUNK >100CM CHARGE,46015273,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,562.5,450,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28002 - INCSN/DRNG BLOW FASCIA CHARGE,46028002,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,412.7,330.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28825 - AMPUTATION TOE; INTERPHAL CHARGE,46028825,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,507.9,406.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46606 - RBR BND LIGATION W/BX CHARGE,46046606,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,223.1,178.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
22903 - EXC TMR ABD SUBQ; >3CM CHARGE,46022903,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1313.5,1050.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"25111 Excision Of Ganglion, Wrist",46025111,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1008.3,806.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49521 - REREPAIR ING HERNIA BLOCK CHARGE,46049521,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2114.5,1691.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46040 - INCISION OF RECTAL ABSCES CHARGE,46046040,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1285.8,1028.64,,964.35,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1018.35,79.2,,,percent of total billed charges,79.2% of total billed charges,1092.93,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1221.51,95,,,percent of total billed charges,95% of total billed charges,1028.64,80,,,percent of total billed charges,80% of total billed charges,1092.93,85,,,percent of total billed charges,85% of total billed charges,1157.22,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1285.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1157.22,90,,,percent of total billed charges,90% of total billed charges,977.21,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1092.93,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1028.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1092.93,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1285.8,
"Insertion of central venous catheter for infusion, patient",46036569,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,275.1,220.08,,206.33,75,,,percent of total billed charges,75% of total billed charges,110.04,40,,,percent of total billed charges,40% of total billed charges,217.88,79.2,,,percent of total billed charges,79.2% of total billed charges,233.84,85,,,percent of total billed charges,85% of total billed charges,275.1,100,,,fee schedule,100% of CO APG rates,261.35,95,,,percent of total billed charges,95% of total billed charges,220.08,80,,,percent of total billed charges,80% of total billed charges,233.84,85,,,percent of total billed charges,85% of total billed charges,247.59,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,275.1,100,,,fee schedule,100% of NM APC rate,110.04,40,,,percent of total billed charges,40% of total billed charges,110.04,40,,,percent of total billed charges,40% of total billed charges,247.59,90,,,percent of total billed charges,90% of total billed charges,209.08,76,,,percent of total billed charges,76% of total billed charges,110.04,40,,,percent of total billed charges,40% of total billed charges,233.84,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,220.08,80,,,percent of total billed charges,80% of total billed charges,106.74,38.8,,,percent of total billed charges,38.8% of total billed charges,233.84,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,106.74,2713.28,
46280 - REMOVE ANAL FIST COMPLEX CHARGE,46046280,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1446.3,1157.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"25545 Open Treatment Of Ulnar Shaft Fracture, Includes Inter",46025545,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1905.5,1524.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
10080 Incision And Drainage Of Pilonidal Cyst; Simple,46010080,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,316.3,253.04,,237.23,75,,,percent of total billed charges,75% of total billed charges,126.52,40,,,percent of total billed charges,40% of total billed charges,250.51,79.2,,,percent of total billed charges,79.2% of total billed charges,268.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,300.49,95,,,percent of total billed charges,95% of total billed charges,253.04,80,,,percent of total billed charges,80% of total billed charges,268.86,85,,,percent of total billed charges,85% of total billed charges,284.67,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,126.52,40,,,percent of total billed charges,40% of total billed charges,126.52,40,,,percent of total billed charges,40% of total billed charges,284.67,90,,,percent of total billed charges,90% of total billed charges,240.39,76,,,percent of total billed charges,76% of total billed charges,126.52,40,,,percent of total billed charges,40% of total billed charges,268.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,253.04,80,,,percent of total billed charges,80% of total billed charges,122.72,38.8,,,percent of total billed charges,38.8% of total billed charges,268.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,122.72,300.49,
10040 Acne Surgery,46010040,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,153.2,122.56,,114.9,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,121.33,79.2,,,percent of total billed charges,79.2% of total billed charges,130.22,85,,,percent of total billed charges,85% of total billed charges,153.2,100,,,fee schedule,100% of CO APG rates,145.54,95,,,percent of total billed charges,95% of total billed charges,122.56,80,,,percent of total billed charges,80% of total billed charges,130.22,85,,,percent of total billed charges,85% of total billed charges,137.88,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,153.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,137.88,90,,,percent of total billed charges,90% of total billed charges,116.43,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,130.22,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,122.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,130.22,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,688.6,100,,,case rate,pays based on per visit rate,114.9,688.6,
21931 - EXC BACK LES SC 3 CM/> CHARGE,46021931,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1402.4,1121.92,,1051.8,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1110.7,79.2,,,percent of total billed charges,79.2% of total billed charges,1192.04,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1332.28,95,,,percent of total billed charges,95% of total billed charges,1121.92,80,,,percent of total billed charges,80% of total billed charges,1192.04,85,,,percent of total billed charges,85% of total billed charges,1262.16,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1402.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1262.16,90,,,percent of total billed charges,90% of total billed charges,1065.82,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1192.04,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1121.92,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1192.04,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1402.4,
"23330 Removal Of Foreign Body, Shoulder; Subcutaneous",31023330,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,510.4,408.32,,382.8,75,,,percent of total billed charges,75% of total billed charges,204.16,40,,,percent of total billed charges,40% of total billed charges,404.24,79.2,,,percent of total billed charges,79.2% of total billed charges,433.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,484.88,95,,,percent of total billed charges,95% of total billed charges,408.32,80,,,percent of total billed charges,80% of total billed charges,433.84,85,,,percent of total billed charges,85% of total billed charges,459.36,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,204.16,40,,,percent of total billed charges,40% of total billed charges,204.16,40,,,percent of total billed charges,40% of total billed charges,459.36,90,,,percent of total billed charges,90% of total billed charges,387.9,76,,,percent of total billed charges,76% of total billed charges,204.16,40,,,percent of total billed charges,40% of total billed charges,433.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,408.32,80,,,percent of total billed charges,80% of total billed charges,198.04,38.8,,,percent of total billed charges,38.8% of total billed charges,433.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,484.88,
23350 Injection Procedure For Shoulder Arthrography Or Enhan,31023350,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,144.7,115.76,,108.53,75,,,percent of total billed charges,75% of total billed charges,57.88,40,,,percent of total billed charges,40% of total billed charges,114.6,79.2,,,percent of total billed charges,79.2% of total billed charges,123,85,,,percent of total billed charges,85% of total billed charges,144.7,100,,,fee schedule,100% of CO APG rates,137.47,95,,,percent of total billed charges,95% of total billed charges,115.76,80,,,percent of total billed charges,80% of total billed charges,123,85,,,percent of total billed charges,85% of total billed charges,130.23,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,144.7,100,,,fee schedule,100% of NM APC rate,57.88,40,,,percent of total billed charges,40% of total billed charges,57.88,40,,,percent of total billed charges,40% of total billed charges,130.23,90,,,percent of total billed charges,90% of total billed charges,109.97,76,,,percent of total billed charges,76% of total billed charges,57.88,40,,,percent of total billed charges,40% of total billed charges,123,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,115.76,80,,,percent of total billed charges,80% of total billed charges,56.14,38.8,,,percent of total billed charges,38.8% of total billed charges,123,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,289.4,200,,,fee schedule,200% of CMS fee schedule,56.14,2713.28,
23505 Closed Treatment Of Clavicular Fracture; With Manipula,31023505,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1045,836,,783.75,75,,,percent of total billed charges,75% of total billed charges,418,40,,,percent of total billed charges,40% of total billed charges,827.64,79.2,,,percent of total billed charges,79.2% of total billed charges,888.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,992.75,95,,,percent of total billed charges,95% of total billed charges,836,80,,,percent of total billed charges,80% of total billed charges,888.25,85,,,percent of total billed charges,85% of total billed charges,940.5,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,418,40,,,percent of total billed charges,40% of total billed charges,418,40,,,percent of total billed charges,40% of total billed charges,940.5,90,,,percent of total billed charges,90% of total billed charges,794.2,76,,,percent of total billed charges,76% of total billed charges,418,40,,,percent of total billed charges,40% of total billed charges,888.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,836,80,,,percent of total billed charges,80% of total billed charges,405.46,38.8,,,percent of total billed charges,38.8% of total billed charges,888.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,992.75,
23575 Closed Treatment Of Scapular Fracture; With Manipulati,31023575,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1183.7,946.96,,887.78,75,,,percent of total billed charges,75% of total billed charges,473.48,40,,,percent of total billed charges,40% of total billed charges,937.49,79.2,,,percent of total billed charges,79.2% of total billed charges,1006.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1124.52,95,,,percent of total billed charges,95% of total billed charges,946.96,80,,,percent of total billed charges,80% of total billed charges,1006.15,85,,,percent of total billed charges,85% of total billed charges,1065.33,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,473.48,40,,,percent of total billed charges,40% of total billed charges,473.48,40,,,percent of total billed charges,40% of total billed charges,1065.33,90,,,percent of total billed charges,90% of total billed charges,899.61,76,,,percent of total billed charges,76% of total billed charges,473.48,40,,,percent of total billed charges,40% of total billed charges,1006.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,946.96,80,,,percent of total billed charges,80% of total billed charges,459.28,38.8,,,percent of total billed charges,38.8% of total billed charges,1006.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1124.52,
23605 Closed Treatment Of Proximal Humeral Fracture; With Ma,31023605,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1319.5,1055.6,,989.63,75,,,percent of total billed charges,75% of total billed charges,527.8,40,,,percent of total billed charges,40% of total billed charges,1045.04,79.2,,,percent of total billed charges,79.2% of total billed charges,1121.58,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1253.53,95,,,percent of total billed charges,95% of total billed charges,1055.6,80,,,percent of total billed charges,80% of total billed charges,1121.58,85,,,percent of total billed charges,85% of total billed charges,1187.55,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,527.8,40,,,percent of total billed charges,40% of total billed charges,527.8,40,,,percent of total billed charges,40% of total billed charges,1187.55,90,,,percent of total billed charges,90% of total billed charges,1002.82,76,,,percent of total billed charges,76% of total billed charges,527.8,40,,,percent of total billed charges,40% of total billed charges,1121.58,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1055.6,80,,,percent of total billed charges,80% of total billed charges,511.97,38.8,,,percent of total billed charges,38.8% of total billed charges,1121.58,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1253.53,
"23650 Closed Treatment Of Shoulder Dislocation, With Manipul",31023650,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,940.6,752.48,,705.45,75,,,percent of total billed charges,75% of total billed charges,376.24,40,,,percent of total billed charges,40% of total billed charges,744.96,79.2,,,percent of total billed charges,79.2% of total billed charges,799.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,893.57,95,,,percent of total billed charges,95% of total billed charges,752.48,80,,,percent of total billed charges,80% of total billed charges,799.51,85,,,percent of total billed charges,85% of total billed charges,846.54,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,376.24,40,,,percent of total billed charges,40% of total billed charges,376.24,40,,,percent of total billed charges,40% of total billed charges,846.54,90,,,percent of total billed charges,90% of total billed charges,714.86,76,,,percent of total billed charges,76% of total billed charges,376.24,40,,,percent of total billed charges,40% of total billed charges,799.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,752.48,80,,,percent of total billed charges,80% of total billed charges,364.95,38.8,,,percent of total billed charges,38.8% of total billed charges,799.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,893.57,
"23655 Closed Treatment Of Shoulder Dislocation, With Manipul",31023655,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1254.6,1003.68,,940.95,75,,,percent of total billed charges,75% of total billed charges,501.84,40,,,percent of total billed charges,40% of total billed charges,993.64,79.2,,,percent of total billed charges,79.2% of total billed charges,1066.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1191.87,95,,,percent of total billed charges,95% of total billed charges,1003.68,80,,,percent of total billed charges,80% of total billed charges,1066.41,85,,,percent of total billed charges,85% of total billed charges,1129.14,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,501.84,40,,,percent of total billed charges,40% of total billed charges,501.84,40,,,percent of total billed charges,40% of total billed charges,1129.14,90,,,percent of total billed charges,90% of total billed charges,953.5,76,,,percent of total billed charges,76% of total billed charges,501.84,40,,,percent of total billed charges,40% of total billed charges,1066.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1003.68,80,,,percent of total billed charges,80% of total billed charges,486.78,38.8,,,percent of total billed charges,38.8% of total billed charges,1066.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1191.87,
"24200 Removal Of Foreign Body, Upper Arm Or Elbow Area; Subc",31024200,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,433.4,346.72,,325.05,75,,,percent of total billed charges,75% of total billed charges,173.36,40,,,percent of total billed charges,40% of total billed charges,343.25,79.2,,,percent of total billed charges,79.2% of total billed charges,368.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,411.73,95,,,percent of total billed charges,95% of total billed charges,346.72,80,,,percent of total billed charges,80% of total billed charges,368.39,85,,,percent of total billed charges,85% of total billed charges,390.06,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,173.36,40,,,percent of total billed charges,40% of total billed charges,173.36,40,,,percent of total billed charges,40% of total billed charges,390.06,90,,,percent of total billed charges,90% of total billed charges,329.38,76,,,percent of total billed charges,76% of total billed charges,173.36,40,,,percent of total billed charges,40% of total billed charges,368.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,346.72,80,,,percent of total billed charges,80% of total billed charges,168.16,38.8,,,percent of total billed charges,38.8% of total billed charges,368.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,168.16,411.73,
24505 Closed Treatment Of Humeral Shaft Fracture; With Manip,31024505,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1395.2,1116.16,,1046.4,75,,,percent of total billed charges,75% of total billed charges,558.08,40,,,percent of total billed charges,40% of total billed charges,1105,79.2,,,percent of total billed charges,79.2% of total billed charges,1185.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1325.44,95,,,percent of total billed charges,95% of total billed charges,1116.16,80,,,percent of total billed charges,80% of total billed charges,1185.92,85,,,percent of total billed charges,85% of total billed charges,1255.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,558.08,40,,,percent of total billed charges,40% of total billed charges,558.08,40,,,percent of total billed charges,40% of total billed charges,1255.68,90,,,percent of total billed charges,90% of total billed charges,1060.35,76,,,percent of total billed charges,76% of total billed charges,558.08,40,,,percent of total billed charges,40% of total billed charges,1185.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1116.16,80,,,percent of total billed charges,80% of total billed charges,541.34,38.8,,,percent of total billed charges,38.8% of total billed charges,1185.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1325.44,
24535 Closed Treatment Of Supracondylar Or Transcondylar Hum,31024535,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1758.8,1407.04,,1319.1,75,,,percent of total billed charges,75% of total billed charges,703.52,40,,,percent of total billed charges,40% of total billed charges,1392.97,79.2,,,percent of total billed charges,79.2% of total billed charges,1494.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1670.86,95,,,percent of total billed charges,95% of total billed charges,1407.04,80,,,percent of total billed charges,80% of total billed charges,1494.98,85,,,percent of total billed charges,85% of total billed charges,1582.92,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,703.52,40,,,percent of total billed charges,40% of total billed charges,703.52,40,,,percent of total billed charges,40% of total billed charges,1582.92,90,,,percent of total billed charges,90% of total billed charges,1336.69,76,,,percent of total billed charges,76% of total billed charges,703.52,40,,,percent of total billed charges,40% of total billed charges,1494.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1407.04,80,,,percent of total billed charges,80% of total billed charges,682.41,38.8,,,percent of total billed charges,38.8% of total billed charges,1494.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1670.86,
24600 Treatment Of Closed Elbow Dislocation; Without Anesthe,31024600,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1062.9,850.32,,797.18,75,,,percent of total billed charges,75% of total billed charges,425.16,40,,,percent of total billed charges,40% of total billed charges,841.82,79.2,,,percent of total billed charges,79.2% of total billed charges,903.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1009.76,95,,,percent of total billed charges,95% of total billed charges,850.32,80,,,percent of total billed charges,80% of total billed charges,903.47,85,,,percent of total billed charges,85% of total billed charges,956.61,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,425.16,40,,,percent of total billed charges,40% of total billed charges,425.16,40,,,percent of total billed charges,40% of total billed charges,956.61,90,,,percent of total billed charges,90% of total billed charges,807.8,76,,,percent of total billed charges,76% of total billed charges,425.16,40,,,percent of total billed charges,40% of total billed charges,903.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,850.32,80,,,percent of total billed charges,80% of total billed charges,412.41,38.8,,,percent of total billed charges,38.8% of total billed charges,903.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1009.76,
24605 Treatment Of Closed Elbow Dislocation; Requiring Anest,31024605,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1463.5,1170.8,,1097.63,75,,,percent of total billed charges,75% of total billed charges,585.4,40,,,percent of total billed charges,40% of total billed charges,1159.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1243.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1390.33,95,,,percent of total billed charges,95% of total billed charges,1170.8,80,,,percent of total billed charges,80% of total billed charges,1243.98,85,,,percent of total billed charges,85% of total billed charges,1317.15,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,585.4,40,,,percent of total billed charges,40% of total billed charges,585.4,40,,,percent of total billed charges,40% of total billed charges,1317.15,90,,,percent of total billed charges,90% of total billed charges,1112.26,76,,,percent of total billed charges,76% of total billed charges,585.4,40,,,percent of total billed charges,40% of total billed charges,1243.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1170.8,80,,,percent of total billed charges,80% of total billed charges,567.84,38.8,,,percent of total billed charges,38.8% of total billed charges,1243.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1390.33,
24620 Closed Treatment Of Monteggia Type Of Fracture Disloca,31024620,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1802.1,1441.68,,1351.58,75,,,percent of total billed charges,75% of total billed charges,720.84,40,,,percent of total billed charges,40% of total billed charges,1427.26,79.2,,,percent of total billed charges,79.2% of total billed charges,1531.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1712,95,,,percent of total billed charges,95% of total billed charges,1441.68,80,,,percent of total billed charges,80% of total billed charges,1531.79,85,,,percent of total billed charges,85% of total billed charges,1621.89,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,720.84,40,,,percent of total billed charges,40% of total billed charges,720.84,40,,,percent of total billed charges,40% of total billed charges,1621.89,90,,,percent of total billed charges,90% of total billed charges,1369.6,76,,,percent of total billed charges,76% of total billed charges,720.84,40,,,percent of total billed charges,40% of total billed charges,1531.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1441.68,80,,,percent of total billed charges,80% of total billed charges,699.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1531.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1712,
"24640 Closed Treatment Of Radial Head Subluxation In Child,",31024640,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,237,189.6,,177.75,75,,,percent of total billed charges,75% of total billed charges,94.8,40,,,percent of total billed charges,40% of total billed charges,187.7,79.2,,,percent of total billed charges,79.2% of total billed charges,201.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,225.15,95,,,percent of total billed charges,95% of total billed charges,189.6,80,,,percent of total billed charges,80% of total billed charges,201.45,85,,,percent of total billed charges,85% of total billed charges,213.3,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,94.8,40,,,percent of total billed charges,40% of total billed charges,94.8,40,,,percent of total billed charges,40% of total billed charges,213.3,90,,,percent of total billed charges,90% of total billed charges,180.12,76,,,percent of total billed charges,76% of total billed charges,94.8,40,,,percent of total billed charges,40% of total billed charges,201.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,189.6,80,,,percent of total billed charges,80% of total billed charges,91.96,38.8,,,percent of total billed charges,38.8% of total billed charges,201.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,91.96,225.15,
"24670 Closed Treatment Of Ulnar Fracture, Proximal End",31024670,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,845.2,676.16,,633.9,75,,,percent of total billed charges,75% of total billed charges,338.08,40,,,percent of total billed charges,40% of total billed charges,669.4,79.2,,,percent of total billed charges,79.2% of total billed charges,718.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,802.94,95,,,percent of total billed charges,95% of total billed charges,676.16,80,,,percent of total billed charges,80% of total billed charges,718.42,85,,,percent of total billed charges,85% of total billed charges,760.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,338.08,40,,,percent of total billed charges,40% of total billed charges,338.08,40,,,percent of total billed charges,40% of total billed charges,760.68,90,,,percent of total billed charges,90% of total billed charges,642.35,76,,,percent of total billed charges,76% of total billed charges,338.08,40,,,percent of total billed charges,40% of total billed charges,718.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,676.16,80,,,percent of total billed charges,80% of total billed charges,327.94,38.8,,,percent of total billed charges,38.8% of total billed charges,718.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,802.94,
"25260 Repair, Tendon Or Muscle, Flexor, Forearm And/Or Wrist",31025260,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1937,1549.6,,1452.75,75,,,percent of total billed charges,75% of total billed charges,774.8,40,,,percent of total billed charges,40% of total billed charges,1534.1,79.2,,,percent of total billed charges,79.2% of total billed charges,1646.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1840.15,95,,,percent of total billed charges,95% of total billed charges,1549.6,80,,,percent of total billed charges,80% of total billed charges,1646.45,85,,,percent of total billed charges,85% of total billed charges,1743.3,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,774.8,40,,,percent of total billed charges,40% of total billed charges,774.8,40,,,percent of total billed charges,40% of total billed charges,1743.3,90,,,percent of total billed charges,90% of total billed charges,1472.12,76,,,percent of total billed charges,76% of total billed charges,774.8,40,,,percent of total billed charges,40% of total billed charges,1646.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1549.6,80,,,percent of total billed charges,80% of total billed charges,751.56,38.8,,,percent of total billed charges,38.8% of total billed charges,1646.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1840.15,
"25270 Repair, Tendon Or Muscle, Extensor, Forearm And/Or Wri",31025270,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1513.1,1210.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25530 Closed Treatment Of Ulnar Shaft Fracture; Without Mani,31025530,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,775.6,620.48,,581.7,75,,,percent of total billed charges,75% of total billed charges,310.24,40,,,percent of total billed charges,40% of total billed charges,614.28,79.2,,,percent of total billed charges,79.2% of total billed charges,659.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,736.82,95,,,percent of total billed charges,95% of total billed charges,620.48,80,,,percent of total billed charges,80% of total billed charges,659.26,85,,,percent of total billed charges,85% of total billed charges,698.04,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,310.24,40,,,percent of total billed charges,40% of total billed charges,310.24,40,,,percent of total billed charges,40% of total billed charges,698.04,90,,,percent of total billed charges,90% of total billed charges,589.46,76,,,percent of total billed charges,76% of total billed charges,310.24,40,,,percent of total billed charges,40% of total billed charges,659.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,620.48,80,,,percent of total billed charges,80% of total billed charges,300.93,38.8,,,percent of total billed charges,38.8% of total billed charges,659.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,736.82,
25535 Closed Treatment Of Ulnar Shaft Fracture; With Manipul,31025535,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1414,1131.2,,1060.5,75,,,percent of total billed charges,75% of total billed charges,565.6,40,,,percent of total billed charges,40% of total billed charges,1119.89,79.2,,,percent of total billed charges,79.2% of total billed charges,1201.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1343.3,95,,,percent of total billed charges,95% of total billed charges,1131.2,80,,,percent of total billed charges,80% of total billed charges,1201.9,85,,,percent of total billed charges,85% of total billed charges,1272.6,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,565.6,40,,,percent of total billed charges,40% of total billed charges,565.6,40,,,percent of total billed charges,40% of total billed charges,1272.6,90,,,percent of total billed charges,90% of total billed charges,1074.64,76,,,percent of total billed charges,76% of total billed charges,565.6,40,,,percent of total billed charges,40% of total billed charges,1201.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1131.2,80,,,percent of total billed charges,80% of total billed charges,548.63,38.8,,,percent of total billed charges,38.8% of total billed charges,1201.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1343.3,
25624 CLSD TX WRIST FX W/MANIP,31025624,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1390.3,1112.24,,1042.73,75,,,percent of total billed charges,75% of total billed charges,556.12,40,,,percent of total billed charges,40% of total billed charges,1101.12,79.2,,,percent of total billed charges,79.2% of total billed charges,1181.76,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1320.79,95,,,percent of total billed charges,95% of total billed charges,1112.24,80,,,percent of total billed charges,80% of total billed charges,1181.76,85,,,percent of total billed charges,85% of total billed charges,1251.27,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,556.12,40,,,percent of total billed charges,40% of total billed charges,556.12,40,,,percent of total billed charges,40% of total billed charges,1251.27,90,,,percent of total billed charges,90% of total billed charges,1056.63,76,,,percent of total billed charges,76% of total billed charges,556.12,40,,,percent of total billed charges,40% of total billed charges,1181.76,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1112.24,80,,,percent of total billed charges,80% of total billed charges,539.44,38.8,,,percent of total billed charges,38.8% of total billed charges,1181.76,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1320.79,
25635 CLO TX CARPAL W/ MANIP,31025635,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1320.3,1056.24,,990.23,75,,,percent of total billed charges,75% of total billed charges,528.12,40,,,percent of total billed charges,40% of total billed charges,1045.68,79.2,,,percent of total billed charges,79.2% of total billed charges,1122.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1254.29,95,,,percent of total billed charges,95% of total billed charges,1056.24,80,,,percent of total billed charges,80% of total billed charges,1122.26,85,,,percent of total billed charges,85% of total billed charges,1188.27,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,528.12,40,,,percent of total billed charges,40% of total billed charges,528.12,40,,,percent of total billed charges,40% of total billed charges,1188.27,90,,,percent of total billed charges,90% of total billed charges,1003.43,76,,,percent of total billed charges,76% of total billed charges,528.12,40,,,percent of total billed charges,40% of total billed charges,1122.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1056.24,80,,,percent of total billed charges,80% of total billed charges,512.28,38.8,,,percent of total billed charges,38.8% of total billed charges,1122.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1254.29,
25650 CD FX TX ULNAR STYLOID Charge,31025650,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,962.2,769.76,,721.65,75,,,percent of total billed charges,75% of total billed charges,384.88,40,,,percent of total billed charges,40% of total billed charges,762.06,79.2,,,percent of total billed charges,79.2% of total billed charges,817.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,914.09,95,,,percent of total billed charges,95% of total billed charges,769.76,80,,,percent of total billed charges,80% of total billed charges,817.87,85,,,percent of total billed charges,85% of total billed charges,865.98,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,384.88,40,,,percent of total billed charges,40% of total billed charges,384.88,40,,,percent of total billed charges,40% of total billed charges,865.98,90,,,percent of total billed charges,90% of total billed charges,731.27,76,,,percent of total billed charges,76% of total billed charges,384.88,40,,,percent of total billed charges,40% of total billed charges,817.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,769.76,80,,,percent of total billed charges,80% of total billed charges,373.33,38.8,,,percent of total billed charges,38.8% of total billed charges,817.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,914.09,
25680 CLOTX WRISTFX DIS W/MAN,31025680,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1635.8,1308.64,,1226.85,75,,,percent of total billed charges,75% of total billed charges,654.32,40,,,percent of total billed charges,40% of total billed charges,1295.55,79.2,,,percent of total billed charges,79.2% of total billed charges,1390.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1554.01,95,,,percent of total billed charges,95% of total billed charges,1308.64,80,,,percent of total billed charges,80% of total billed charges,1390.43,85,,,percent of total billed charges,85% of total billed charges,1472.22,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,654.32,40,,,percent of total billed charges,40% of total billed charges,654.32,40,,,percent of total billed charges,40% of total billed charges,1472.22,90,,,percent of total billed charges,90% of total billed charges,1243.21,76,,,percent of total billed charges,76% of total billed charges,654.32,40,,,percent of total billed charges,40% of total billed charges,1390.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1308.64,80,,,percent of total billed charges,80% of total billed charges,634.69,38.8,,,percent of total billed charges,38.8% of total billed charges,1390.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1554.01,
25690 CLD TX W/ MANI LUNATE,31025690,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1517.1,1213.68,,1137.83,75,,,percent of total billed charges,75% of total billed charges,606.84,40,,,percent of total billed charges,40% of total billed charges,1201.54,79.2,,,percent of total billed charges,79.2% of total billed charges,1289.54,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1441.25,95,,,percent of total billed charges,95% of total billed charges,1213.68,80,,,percent of total billed charges,80% of total billed charges,1289.54,85,,,percent of total billed charges,85% of total billed charges,1365.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,606.84,40,,,percent of total billed charges,40% of total billed charges,606.84,40,,,percent of total billed charges,40% of total billed charges,1365.39,90,,,percent of total billed charges,90% of total billed charges,1153,76,,,percent of total billed charges,76% of total billed charges,606.84,40,,,percent of total billed charges,40% of total billed charges,1289.54,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1213.68,80,,,percent of total billed charges,80% of total billed charges,588.63,38.8,,,percent of total billed charges,38.8% of total billed charges,1289.54,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1441.25,
26010 DRAINAGE FING ABSCESS SIM,31026010,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,427.3,341.84,,320.48,75,,,percent of total billed charges,75% of total billed charges,170.92,40,,,percent of total billed charges,40% of total billed charges,338.42,79.2,,,percent of total billed charges,79.2% of total billed charges,363.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,405.94,95,,,percent of total billed charges,95% of total billed charges,341.84,80,,,percent of total billed charges,80% of total billed charges,363.21,85,,,percent of total billed charges,85% of total billed charges,384.57,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,170.92,40,,,percent of total billed charges,40% of total billed charges,170.92,40,,,percent of total billed charges,40% of total billed charges,384.57,90,,,percent of total billed charges,90% of total billed charges,324.75,76,,,percent of total billed charges,76% of total billed charges,170.92,40,,,percent of total billed charges,40% of total billed charges,363.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,341.84,80,,,percent of total billed charges,80% of total billed charges,165.79,38.8,,,percent of total billed charges,38.8% of total billed charges,363.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,165.79,405.94,
"26011 DRNG FINGER ABSCESS, COMP",46026011,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,561.4,449.12,,421.05,75,,,percent of total billed charges,75% of total billed charges,224.56,40,,,percent of total billed charges,40% of total billed charges,444.63,79.2,,,percent of total billed charges,79.2% of total billed charges,477.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,533.33,95,,,percent of total billed charges,95% of total billed charges,449.12,80,,,percent of total billed charges,80% of total billed charges,477.19,85,,,percent of total billed charges,85% of total billed charges,505.26,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,224.56,40,,,percent of total billed charges,40% of total billed charges,224.56,40,,,percent of total billed charges,40% of total billed charges,505.26,90,,,percent of total billed charges,90% of total billed charges,426.66,76,,,percent of total billed charges,76% of total billed charges,224.56,40,,,percent of total billed charges,40% of total billed charges,477.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,449.12,80,,,percent of total billed charges,80% of total billed charges,217.82,38.8,,,percent of total billed charges,38.8% of total billed charges,477.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,533.33,
"26410 - Repair, extensor tendon, hand, primary or secondary,",46026410,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1816.3,1453.04,,1362.23,75,,,percent of total billed charges,75% of total billed charges,726.52,40,,,percent of total billed charges,40% of total billed charges,1438.51,79.2,,,percent of total billed charges,79.2% of total billed charges,1543.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1725.49,95,,,percent of total billed charges,95% of total billed charges,1453.04,80,,,percent of total billed charges,80% of total billed charges,1543.86,85,,,percent of total billed charges,85% of total billed charges,1634.67,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,726.52,40,,,percent of total billed charges,40% of total billed charges,726.52,40,,,percent of total billed charges,40% of total billed charges,1634.67,90,,,percent of total billed charges,90% of total billed charges,1380.39,76,,,percent of total billed charges,76% of total billed charges,726.52,40,,,percent of total billed charges,40% of total billed charges,1543.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1453.04,80,,,percent of total billed charges,80% of total billed charges,704.72,38.8,,,percent of total billed charges,38.8% of total billed charges,1543.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1725.49,
"26418 RPAIR XT TENDON, FINGER",31026418,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1892.3,1513.84,,1419.23,75,,,percent of total billed charges,75% of total billed charges,756.92,40,,,percent of total billed charges,40% of total billed charges,1498.7,79.2,,,percent of total billed charges,79.2% of total billed charges,1608.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1797.69,95,,,percent of total billed charges,95% of total billed charges,1513.84,80,,,percent of total billed charges,80% of total billed charges,1608.46,85,,,percent of total billed charges,85% of total billed charges,1703.07,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,756.92,40,,,percent of total billed charges,40% of total billed charges,756.92,40,,,percent of total billed charges,40% of total billed charges,1703.07,90,,,percent of total billed charges,90% of total billed charges,1438.15,76,,,percent of total billed charges,76% of total billed charges,756.92,40,,,percent of total billed charges,40% of total billed charges,1608.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1513.84,80,,,percent of total billed charges,80% of total billed charges,734.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1608.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1797.69,
13151 CMPLX RPR E/N/E/L 1.1-2.5 CM,46013151,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,822.2,657.76,,616.65,75,,,percent of total billed charges,75% of total billed charges,328.88,40,,,percent of total billed charges,40% of total billed charges,651.18,79.2,,,percent of total billed charges,79.2% of total billed charges,698.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,781.09,95,,,percent of total billed charges,95% of total billed charges,657.76,80,,,percent of total billed charges,80% of total billed charges,698.87,85,,,percent of total billed charges,85% of total billed charges,739.98,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,328.88,40,,,percent of total billed charges,40% of total billed charges,328.88,40,,,percent of total billed charges,40% of total billed charges,739.98,90,,,percent of total billed charges,90% of total billed charges,624.87,76,,,percent of total billed charges,76% of total billed charges,328.88,40,,,percent of total billed charges,40% of total billed charges,698.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,657.76,80,,,percent of total billed charges,80% of total billed charges,319.01,38.8,,,percent of total billed charges,38.8% of total billed charges,698.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,781.09,
13152 CMPLX RPR E/N/E/L 2.6-7.5 CM,46013152,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,987.5,790,,740.63,75,,,percent of total billed charges,75% of total billed charges,395,40,,,percent of total billed charges,40% of total billed charges,782.1,79.2,,,percent of total billed charges,79.2% of total billed charges,839.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,938.13,95,,,percent of total billed charges,95% of total billed charges,790,80,,,percent of total billed charges,80% of total billed charges,839.38,85,,,percent of total billed charges,85% of total billed charges,888.75,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,395,40,,,percent of total billed charges,40% of total billed charges,395,40,,,percent of total billed charges,40% of total billed charges,888.75,90,,,percent of total billed charges,90% of total billed charges,750.5,76,,,percent of total billed charges,76% of total billed charges,395,40,,,percent of total billed charges,40% of total billed charges,839.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,790,80,,,percent of total billed charges,80% of total billed charges,383.15,38.8,,,percent of total billed charges,38.8% of total billed charges,839.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,938.13,
"19101 Biopsy Of Breast; Open, Incisional",46019101,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,662.2,529.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
19302 - P-MASTECTOMY W/LN REMOVAL CHARGE,46019302,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2671.1,2136.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
19306 - MAST RAD URBAN TYPE CHARGE,46019306,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3600.5,2880.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"21550 Biopsy, Soft Tissue Of Neck Or Thorax",46021550,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,465.5,372.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"21558 Radical Resection Of Tumor, Soft Tissue Of Neck; 5 Cm",46021558,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3939.1,3151.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
21930 - EXC BACK LES SC < 3 CM CHARGE,46021930,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1096,876.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43246 - PLACE GASTROSTOMY TUBE CHARGE,46043246,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,579.4,463.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"21554 Excision, Tumor, Soft Tissue Of Neck, Subfascial",46021554,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2171.7,1737.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"21556 Excision, Tumor, Soft Tissue Of Neck, Subfascial",46021556,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1582.5,1266,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
38100 - REMOVAL OF SPLEEN TOTAL CHARGE,46038100,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3352.1,2681.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
38101 - REMOVAL OF SPLEEN PARTIAL CHARGE,46038101,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3392.6,2714.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
38115 - REPAIR OF RUPTURED SPLEEN CHARGE,46038115,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3756.8,3005.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44203 - LAP RESECT S/INTESTINE AD CHARGE,46044203,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,688.6,550.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44206 - LAP PART COLECTOMY W/STOM CHARGE,46044206,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,5042,4033.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44211 - LAP COLECTOMY W/PROCTECTO CHARGE,46044211,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,6154.7,4923.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44212 - LAPARO TOTAL PROCTOCOLECT CHARGE,46044212,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,5902.4,4721.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44603 - SUTURE SMALL INTESTINE CHARGE,46044603,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,4692.6,3754.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44604 - SUTURE LARGE INTESTINE CHARGE,46044604,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3065.6,2452.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44605 - REPAIR OF BOWEL LESION CHARGE,46044605,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3746.6,2997.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44615 - INTESTINAL STRICTUROPLAST CHARGE,46044615,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3123.4,2498.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44620 - REPAIR BOWEL OPENING CHARGE,46044620,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2525.5,2020.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44625 - REPAIR BOWEL OPENING W/ RESEC CHARGE,46044625,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2944.9,2355.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49020 - DRAIN ABDOMINAL ABSCESS CHARGE,46049020,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,4653.4,3722.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49040 - DRAIN OPEN ABDOM ABSCESS CHARGE,46049040,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2945.4,2356.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49060 - DRAIN OPEN RETROP ABSCESS CHARGE,46049060,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3230.1,2584.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46608 - ANOSCOPY REMOVE FOR BODY CHARGE,46046608,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,248.5,198.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
19305 - MAST RADICAL CHARGE,46019305,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3372.4,2697.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"21557 Radical Resection Of Tumor, Soft Tissue Of Neck; Less",46021557,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2817.7,2254.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44602 - SUTURE SMALL INTESTINE CHARGE,46044602,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,4072,3257.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27096 - INJECT SACROILIAC JOINT CHARGE,46227096,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,245.7,196.56,,184.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,194.59,79.2,,,percent of total billed charges,79.2% of total billed charges,208.85,85,,,percent of total billed charges,85% of total billed charges,245.7,100,,,fee schedule,100% of CO APG rates,233.42,95,,,percent of total billed charges,95% of total billed charges,196.56,80,,,percent of total billed charges,80% of total billed charges,208.85,85,,,percent of total billed charges,85% of total billed charges,221.13,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,245.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,221.13,90,,,percent of total billed charges,90% of total billed charges,186.73,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,208.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,196.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,208.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,873.6,100,,,case rate,pays based on per visit rate,184.28,873.6,
"64483 - TRANSFORAMINAL ESI, LUMBAR/SACRAL, SINGLE LEVEL",46264483,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,445.1,356.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64484 - TRANSFORAMINAL ESI, LUMBAR/SACRAL EACH ADD LEVEL",46264484,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,391.8,313.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64490- INJ DIAG OR THERAPEUTIC, CERV / THOR PARAVERTEBRAL FA",46264490,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,311.2,248.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64491- 2nd Level  INJ DIAG OR THERAPEUTIC. CERV / THOR PARAV,46264491,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,174,139.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64492- 3rd + Levels  INJ DIAG OR THERAPEUTIC. CERV / THOR PA,46264492,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,175.2,140.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64493 - FACET LUMBAR/SACRAL ESI, SINGLE LEVEL",46264493,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,865,692,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64494 - FACET LUMBAR/SACRAL ESI, SECOND LEVEL",46264494,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,365.2,292.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64495 - FACET LUMBAR/SACRAL ESI, THIRD AND EACH ADD",46264495,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,150.2,120.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"20240 - Biopsy of bone, open procedure",60000608,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,411.4,329.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01820 ANESTH CLSD PROC FX Charge,46201820,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26500 - Reconstruction of tendon pulley,60000799,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2076.1,1660.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26700 CLO TX KNUCKL SNGL W/MANI,31026700,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,980.3,784.24,,735.23,75,,,percent of total billed charges,75% of total billed charges,392.12,40,,,percent of total billed charges,40% of total billed charges,776.4,79.2,,,percent of total billed charges,79.2% of total billed charges,833.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,931.29,95,,,percent of total billed charges,95% of total billed charges,784.24,80,,,percent of total billed charges,80% of total billed charges,833.26,85,,,percent of total billed charges,85% of total billed charges,882.27,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,392.12,40,,,percent of total billed charges,40% of total billed charges,392.12,40,,,percent of total billed charges,40% of total billed charges,882.27,90,,,percent of total billed charges,90% of total billed charges,745.03,76,,,percent of total billed charges,76% of total billed charges,392.12,40,,,percent of total billed charges,40% of total billed charges,833.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,784.24,80,,,percent of total billed charges,80% of total billed charges,380.36,38.8,,,percent of total billed charges,38.8% of total billed charges,833.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,931.29,
26705 TREAT KNUCKLE DISLOCATION,31026705,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1235.8,988.64,,926.85,75,,,percent of total billed charges,75% of total billed charges,494.32,40,,,percent of total billed charges,40% of total billed charges,978.75,79.2,,,percent of total billed charges,79.2% of total billed charges,1050.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1174.01,95,,,percent of total billed charges,95% of total billed charges,988.64,80,,,percent of total billed charges,80% of total billed charges,1050.43,85,,,percent of total billed charges,85% of total billed charges,1112.22,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,494.32,40,,,percent of total billed charges,40% of total billed charges,494.32,40,,,percent of total billed charges,40% of total billed charges,1112.22,90,,,percent of total billed charges,90% of total billed charges,939.21,76,,,percent of total billed charges,76% of total billed charges,494.32,40,,,percent of total billed charges,40% of total billed charges,1050.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,988.64,80,,,percent of total billed charges,80% of total billed charges,479.49,38.8,,,percent of total billed charges,38.8% of total billed charges,1050.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1174.01,
26740 FX/Disloc Hand/Fingers,31026740,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,702.8,562.24,,527.1,75,,,percent of total billed charges,75% of total billed charges,281.12,40,,,percent of total billed charges,40% of total billed charges,556.62,79.2,,,percent of total billed charges,79.2% of total billed charges,597.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,667.66,95,,,percent of total billed charges,95% of total billed charges,562.24,80,,,percent of total billed charges,80% of total billed charges,597.38,85,,,percent of total billed charges,85% of total billed charges,632.52,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,281.12,40,,,percent of total billed charges,40% of total billed charges,281.12,40,,,percent of total billed charges,40% of total billed charges,632.52,90,,,percent of total billed charges,90% of total billed charges,534.13,76,,,percent of total billed charges,76% of total billed charges,281.12,40,,,percent of total billed charges,40% of total billed charges,597.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,562.24,80,,,percent of total billed charges,80% of total billed charges,272.69,38.8,,,percent of total billed charges,38.8% of total billed charges,597.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,667.66,
26742 TREAT FINGER FRACTURE EAC,31026742,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1043.9,835.12,,782.93,75,,,percent of total billed charges,75% of total billed charges,417.56,40,,,percent of total billed charges,40% of total billed charges,826.77,79.2,,,percent of total billed charges,79.2% of total billed charges,887.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,991.71,95,,,percent of total billed charges,95% of total billed charges,835.12,80,,,percent of total billed charges,80% of total billed charges,887.32,85,,,percent of total billed charges,85% of total billed charges,939.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,417.56,40,,,percent of total billed charges,40% of total billed charges,417.56,40,,,percent of total billed charges,40% of total billed charges,939.51,90,,,percent of total billed charges,90% of total billed charges,793.36,76,,,percent of total billed charges,76% of total billed charges,417.56,40,,,percent of total billed charges,40% of total billed charges,887.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,835.12,80,,,percent of total billed charges,80% of total billed charges,405.03,38.8,,,percent of total billed charges,38.8% of total billed charges,887.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,991.71,
26755 CLOTX DIST PH FX FING MAN,31026755,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,863.9,691.12,,647.93,75,,,percent of total billed charges,75% of total billed charges,345.56,40,,,percent of total billed charges,40% of total billed charges,684.21,79.2,,,percent of total billed charges,79.2% of total billed charges,734.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,820.71,95,,,percent of total billed charges,95% of total billed charges,691.12,80,,,percent of total billed charges,80% of total billed charges,734.32,85,,,percent of total billed charges,85% of total billed charges,777.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,345.56,40,,,percent of total billed charges,40% of total billed charges,345.56,40,,,percent of total billed charges,40% of total billed charges,777.51,90,,,percent of total billed charges,90% of total billed charges,656.56,76,,,percent of total billed charges,76% of total billed charges,345.56,40,,,percent of total billed charges,40% of total billed charges,734.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,691.12,80,,,percent of total billed charges,80% of total billed charges,335.19,38.8,,,percent of total billed charges,38.8% of total billed charges,734.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,820.71,
26770 CLSD REDUCTN DSLCTED FING,31026770,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,826.7,661.36,,620.03,75,,,percent of total billed charges,75% of total billed charges,330.68,40,,,percent of total billed charges,40% of total billed charges,654.75,79.2,,,percent of total billed charges,79.2% of total billed charges,702.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,785.37,95,,,percent of total billed charges,95% of total billed charges,661.36,80,,,percent of total billed charges,80% of total billed charges,702.7,85,,,percent of total billed charges,85% of total billed charges,744.03,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,330.68,40,,,percent of total billed charges,40% of total billed charges,330.68,40,,,percent of total billed charges,40% of total billed charges,744.03,90,,,percent of total billed charges,90% of total billed charges,628.29,76,,,percent of total billed charges,76% of total billed charges,330.68,40,,,percent of total billed charges,40% of total billed charges,702.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,661.36,80,,,percent of total billed charges,80% of total billed charges,320.76,38.8,,,percent of total billed charges,38.8% of total billed charges,702.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,785.37,
27502 CLSD TX FX FEM W/MANIP,31027502,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2252.6,1802.08,,1689.45,75,,,percent of total billed charges,75% of total billed charges,901.04,40,,,percent of total billed charges,40% of total billed charges,1784.06,79.2,,,percent of total billed charges,79.2% of total billed charges,1914.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2139.97,95,,,percent of total billed charges,95% of total billed charges,1802.08,80,,,percent of total billed charges,80% of total billed charges,1914.71,85,,,percent of total billed charges,85% of total billed charges,2027.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,901.04,40,,,percent of total billed charges,40% of total billed charges,901.04,40,,,percent of total billed charges,40% of total billed charges,2027.34,90,,,percent of total billed charges,90% of total billed charges,1711.98,76,,,percent of total billed charges,76% of total billed charges,901.04,40,,,percent of total billed charges,40% of total billed charges,1914.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1802.08,80,,,percent of total billed charges,80% of total billed charges,874.01,38.8,,,percent of total billed charges,38.8% of total billed charges,1914.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2139.97,
"27530 Closed Treatment Of Tibial Fracture, Proximal (Plateau",46027530,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,913,730.4,,684.75,75,,,percent of total billed charges,75% of total billed charges,365.2,40,,,percent of total billed charges,40% of total billed charges,723.1,79.2,,,percent of total billed charges,79.2% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,867.35,95,,,percent of total billed charges,95% of total billed charges,730.4,80,,,percent of total billed charges,80% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,821.7,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,365.2,40,,,percent of total billed charges,40% of total billed charges,365.2,40,,,percent of total billed charges,40% of total billed charges,821.7,90,,,percent of total billed charges,90% of total billed charges,693.88,76,,,percent of total billed charges,76% of total billed charges,365.2,40,,,percent of total billed charges,40% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,730.4,80,,,percent of total billed charges,80% of total billed charges,354.24,38.8,,,percent of total billed charges,38.8% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,867.35,
27550 Closed Treatment Of Knee Dislocation; Without Anesthes,31027550,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1442.9,1154.32,,1082.18,75,,,percent of total billed charges,75% of total billed charges,577.16,40,,,percent of total billed charges,40% of total billed charges,1142.78,79.2,,,percent of total billed charges,79.2% of total billed charges,1226.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1370.76,95,,,percent of total billed charges,95% of total billed charges,1154.32,80,,,percent of total billed charges,80% of total billed charges,1226.47,85,,,percent of total billed charges,85% of total billed charges,1298.61,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,577.16,40,,,percent of total billed charges,40% of total billed charges,577.16,40,,,percent of total billed charges,40% of total billed charges,1298.61,90,,,percent of total billed charges,90% of total billed charges,1096.6,76,,,percent of total billed charges,76% of total billed charges,577.16,40,,,percent of total billed charges,40% of total billed charges,1226.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1154.32,80,,,percent of total billed charges,80% of total billed charges,559.85,38.8,,,percent of total billed charges,38.8% of total billed charges,1226.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1370.76,
27560 Closed Treatment Of Patellar Dislocation; Without Anes,31027560,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1059,847.2,,794.25,75,,,percent of total billed charges,75% of total billed charges,423.6,40,,,percent of total billed charges,40% of total billed charges,838.73,79.2,,,percent of total billed charges,79.2% of total billed charges,900.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1006.05,95,,,percent of total billed charges,95% of total billed charges,847.2,80,,,percent of total billed charges,80% of total billed charges,900.15,85,,,percent of total billed charges,85% of total billed charges,953.1,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,423.6,40,,,percent of total billed charges,40% of total billed charges,423.6,40,,,percent of total billed charges,40% of total billed charges,953.1,90,,,percent of total billed charges,90% of total billed charges,804.84,76,,,percent of total billed charges,76% of total billed charges,423.6,40,,,percent of total billed charges,40% of total billed charges,900.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,847.2,80,,,percent of total billed charges,80% of total billed charges,410.89,38.8,,,percent of total billed charges,38.8% of total billed charges,900.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1006.05,
27562 Closed Treatment Of Patellar Dislocation; Requiring An,31027562,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1507.2,1205.76,,1130.4,75,,,percent of total billed charges,75% of total billed charges,602.88,40,,,percent of total billed charges,40% of total billed charges,1193.7,79.2,,,percent of total billed charges,79.2% of total billed charges,1281.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1431.84,95,,,percent of total billed charges,95% of total billed charges,1205.76,80,,,percent of total billed charges,80% of total billed charges,1281.12,85,,,percent of total billed charges,85% of total billed charges,1356.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,602.88,40,,,percent of total billed charges,40% of total billed charges,602.88,40,,,percent of total billed charges,40% of total billed charges,1356.48,90,,,percent of total billed charges,90% of total billed charges,1145.47,76,,,percent of total billed charges,76% of total billed charges,602.88,40,,,percent of total billed charges,40% of total billed charges,1281.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1205.76,80,,,percent of total billed charges,80% of total billed charges,584.79,38.8,,,percent of total billed charges,38.8% of total billed charges,1281.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1431.84,
27752 - Closed treatment of tibial shaft fracture (with or w,46027752,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1497.9,1198.32,,1123.43,75,,,percent of total billed charges,75% of total billed charges,599.16,40,,,percent of total billed charges,40% of total billed charges,1186.34,79.2,,,percent of total billed charges,79.2% of total billed charges,1273.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1423.01,95,,,percent of total billed charges,95% of total billed charges,1198.32,80,,,percent of total billed charges,80% of total billed charges,1273.22,85,,,percent of total billed charges,85% of total billed charges,1348.11,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,599.16,40,,,percent of total billed charges,40% of total billed charges,599.16,40,,,percent of total billed charges,40% of total billed charges,1348.11,90,,,percent of total billed charges,90% of total billed charges,1138.4,76,,,percent of total billed charges,76% of total billed charges,599.16,40,,,percent of total billed charges,40% of total billed charges,1273.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1198.32,80,,,percent of total billed charges,80% of total billed charges,581.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1273.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1423.01,
27788 CLO TX DIST FIBFX W MAN,31027788,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1190.5,952.4,,892.88,75,,,percent of total billed charges,75% of total billed charges,476.2,40,,,percent of total billed charges,40% of total billed charges,942.88,79.2,,,percent of total billed charges,79.2% of total billed charges,1011.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1130.98,95,,,percent of total billed charges,95% of total billed charges,952.4,80,,,percent of total billed charges,80% of total billed charges,1011.93,85,,,percent of total billed charges,85% of total billed charges,1071.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,476.2,40,,,percent of total billed charges,40% of total billed charges,476.2,40,,,percent of total billed charges,40% of total billed charges,1071.45,90,,,percent of total billed charges,90% of total billed charges,904.78,76,,,percent of total billed charges,76% of total billed charges,476.2,40,,,percent of total billed charges,40% of total billed charges,1011.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,952.4,80,,,percent of total billed charges,80% of total billed charges,461.91,38.8,,,percent of total billed charges,38.8% of total billed charges,1011.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1130.98,
27818 CLD TX TRIMAL W/MANI,31027818,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1353.9,1083.12,,1015.43,75,,,percent of total billed charges,75% of total billed charges,541.56,40,,,percent of total billed charges,40% of total billed charges,1072.29,79.2,,,percent of total billed charges,79.2% of total billed charges,1150.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1286.21,95,,,percent of total billed charges,95% of total billed charges,1083.12,80,,,percent of total billed charges,80% of total billed charges,1150.82,85,,,percent of total billed charges,85% of total billed charges,1218.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,541.56,40,,,percent of total billed charges,40% of total billed charges,541.56,40,,,percent of total billed charges,40% of total billed charges,1218.51,90,,,percent of total billed charges,90% of total billed charges,1028.96,76,,,percent of total billed charges,76% of total billed charges,541.56,40,,,percent of total billed charges,40% of total billed charges,1150.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1083.12,80,,,percent of total billed charges,80% of total billed charges,525.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1150.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1286.21,
27824 CDTX DISTAL TIBIA FX,31027824,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,956.8,765.44,,717.6,75,,,percent of total billed charges,75% of total billed charges,382.72,40,,,percent of total billed charges,40% of total billed charges,757.79,79.2,,,percent of total billed charges,79.2% of total billed charges,813.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,908.96,95,,,percent of total billed charges,95% of total billed charges,765.44,80,,,percent of total billed charges,80% of total billed charges,813.28,85,,,percent of total billed charges,85% of total billed charges,861.12,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,382.72,40,,,percent of total billed charges,40% of total billed charges,382.72,40,,,percent of total billed charges,40% of total billed charges,861.12,90,,,percent of total billed charges,90% of total billed charges,727.17,76,,,percent of total billed charges,76% of total billed charges,382.72,40,,,percent of total billed charges,40% of total billed charges,813.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,765.44,80,,,percent of total billed charges,80% of total billed charges,371.24,38.8,,,percent of total billed charges,38.8% of total billed charges,813.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,908.96,
27842 CLD TX DISL ANK W ANES,31027842,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1500.6,1200.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28190 REMOV FB FOOT  SUBCUTAN,31028190,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,397.6,318.08,,298.2,75,,,percent of total billed charges,75% of total billed charges,159.04,40,,,percent of total billed charges,40% of total billed charges,314.9,79.2,,,percent of total billed charges,79.2% of total billed charges,337.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,377.72,95,,,percent of total billed charges,95% of total billed charges,318.08,80,,,percent of total billed charges,80% of total billed charges,337.96,85,,,percent of total billed charges,85% of total billed charges,357.84,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,159.04,40,,,percent of total billed charges,40% of total billed charges,159.04,40,,,percent of total billed charges,40% of total billed charges,357.84,90,,,percent of total billed charges,90% of total billed charges,302.18,76,,,percent of total billed charges,76% of total billed charges,159.04,40,,,percent of total billed charges,40% of total billed charges,337.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,318.08,80,,,percent of total billed charges,80% of total billed charges,154.27,38.8,,,percent of total billed charges,38.8% of total billed charges,337.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,154.27,377.72,
28495 FX BIG TOE W/MANIP,31028495,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,469,375.2,,351.75,75,,,percent of total billed charges,75% of total billed charges,187.6,40,,,percent of total billed charges,40% of total billed charges,371.45,79.2,,,percent of total billed charges,79.2% of total billed charges,398.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,445.55,95,,,percent of total billed charges,95% of total billed charges,375.2,80,,,percent of total billed charges,80% of total billed charges,398.65,85,,,percent of total billed charges,85% of total billed charges,422.1,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,187.6,40,,,percent of total billed charges,40% of total billed charges,187.6,40,,,percent of total billed charges,40% of total billed charges,422.1,90,,,percent of total billed charges,90% of total billed charges,356.44,76,,,percent of total billed charges,76% of total billed charges,187.6,40,,,percent of total billed charges,40% of total billed charges,398.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,375.2,80,,,percent of total billed charges,80% of total billed charges,181.97,38.8,,,percent of total billed charges,38.8% of total billed charges,398.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,445.55,
28630 CLO TX METATARS JT DISL,31028630,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,333.9,267.12,,250.43,75,,,percent of total billed charges,75% of total billed charges,133.56,40,,,percent of total billed charges,40% of total billed charges,264.45,79.2,,,percent of total billed charges,79.2% of total billed charges,283.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,317.21,95,,,percent of total billed charges,95% of total billed charges,267.12,80,,,percent of total billed charges,80% of total billed charges,283.82,85,,,percent of total billed charges,85% of total billed charges,300.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,133.56,40,,,percent of total billed charges,40% of total billed charges,133.56,40,,,percent of total billed charges,40% of total billed charges,300.51,90,,,percent of total billed charges,90% of total billed charges,253.76,76,,,percent of total billed charges,76% of total billed charges,133.56,40,,,percent of total billed charges,40% of total billed charges,283.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,267.12,80,,,percent of total billed charges,80% of total billed charges,129.55,38.8,,,percent of total billed charges,38.8% of total billed charges,283.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,129.55,317.21,
"29700 Removal Or Bivalving; Gauntlet, Boot Or Body Cast",31029700,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,97.5,78,,73.13,75,,,percent of total billed charges,75% of total billed charges,39,40,,,percent of total billed charges,40% of total billed charges,77.22,79.2,,,percent of total billed charges,79.2% of total billed charges,82.88,85,,,percent of total billed charges,85% of total billed charges,97.5,100,,,fee schedule,100% of CO APG rates,92.63,95,,,percent of total billed charges,95% of total billed charges,78,80,,,percent of total billed charges,80% of total billed charges,82.88,85,,,percent of total billed charges,85% of total billed charges,87.75,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,97.5,100,,,fee schedule,100% of NM APC rate,39,40,,,percent of total billed charges,40% of total billed charges,39,40,,,percent of total billed charges,40% of total billed charges,87.75,90,,,percent of total billed charges,90% of total billed charges,74.1,76,,,percent of total billed charges,76% of total billed charges,39,40,,,percent of total billed charges,40% of total billed charges,82.88,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,78,80,,,percent of total billed charges,80% of total billed charges,37.83,38.8,,,percent of total billed charges,38.8% of total billed charges,82.88,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,195,200,,,fee schedule,200% of CMS fee schedule,37.83,215.49,
29740 Wedging Of Cast,31029740,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,201.8,161.44,,151.35,75,,,percent of total billed charges,75% of total billed charges,80.72,40,,,percent of total billed charges,40% of total billed charges,159.83,79.2,,,percent of total billed charges,79.2% of total billed charges,171.53,85,,,percent of total billed charges,85% of total billed charges,201.8,100,,,fee schedule,100% of CO APG rates,191.71,95,,,percent of total billed charges,95% of total billed charges,161.44,80,,,percent of total billed charges,80% of total billed charges,171.53,85,,,percent of total billed charges,85% of total billed charges,181.62,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,80.72,40,,,percent of total billed charges,40% of total billed charges,80.72,40,,,percent of total billed charges,40% of total billed charges,181.62,90,,,percent of total billed charges,90% of total billed charges,153.37,76,,,percent of total billed charges,76% of total billed charges,80.72,40,,,percent of total billed charges,40% of total billed charges,171.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,161.44,80,,,percent of total billed charges,80% of total billed charges,78.3,38.8,,,percent of total billed charges,38.8% of total billed charges,171.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,78.3,217.66,
30300 REMOV FB INTRANASAL,31030300,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,365.7,292.56,,274.28,75,,,percent of total billed charges,75% of total billed charges,146.28,40,,,percent of total billed charges,40% of total billed charges,289.63,79.2,,,percent of total billed charges,79.2% of total billed charges,310.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,347.42,95,,,percent of total billed charges,95% of total billed charges,292.56,80,,,percent of total billed charges,80% of total billed charges,310.85,85,,,percent of total billed charges,85% of total billed charges,329.13,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,146.28,40,,,percent of total billed charges,40% of total billed charges,146.28,40,,,percent of total billed charges,40% of total billed charges,329.13,90,,,percent of total billed charges,90% of total billed charges,277.93,76,,,percent of total billed charges,76% of total billed charges,146.28,40,,,percent of total billed charges,40% of total billed charges,310.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,292.56,80,,,percent of total billed charges,80% of total billed charges,141.89,38.8,,,percent of total billed charges,38.8% of total billed charges,310.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,141.89,347.42,
31500 INTUBATION ENDOTRACHEAL,31031500,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,408.8,327.04,,306.6,75,,,percent of total billed charges,75% of total billed charges,163.52,40,,,percent of total billed charges,40% of total billed charges,323.77,79.2,,,percent of total billed charges,79.2% of total billed charges,347.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,388.36,95,,,percent of total billed charges,95% of total billed charges,327.04,80,,,percent of total billed charges,80% of total billed charges,347.48,85,,,percent of total billed charges,85% of total billed charges,367.92,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,163.52,40,,,percent of total billed charges,40% of total billed charges,163.52,40,,,percent of total billed charges,40% of total billed charges,367.92,90,,,percent of total billed charges,90% of total billed charges,310.69,76,,,percent of total billed charges,76% of total billed charges,163.52,40,,,percent of total billed charges,40% of total billed charges,347.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,327.04,80,,,percent of total billed charges,80% of total billed charges,158.61,38.8,,,percent of total billed charges,38.8% of total billed charges,347.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,158.61,388.36,
"31530 LARYNGOS DRCT, W/FB REMV",31031530,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,582.8,466.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
36406 VENIPUNCT BY PHYS <3,31036406,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,25.6,20.48,,19.2,75,,,percent of total billed charges,75% of total billed charges,10.24,40,,,percent of total billed charges,40% of total billed charges,20.28,79.2,,,percent of total billed charges,79.2% of total billed charges,21.76,85,,,percent of total billed charges,85% of total billed charges,25.6,100,,,fee schedule,100% of CO APG rates,24.32,95,,,percent of total billed charges,95% of total billed charges,20.48,80,,,percent of total billed charges,80% of total billed charges,21.76,85,,,percent of total billed charges,85% of total billed charges,23.04,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,25.6,100,,,fee schedule,100% of NM APC rate,10.24,40,,,percent of total billed charges,40% of total billed charges,10.24,40,,,percent of total billed charges,40% of total billed charges,23.04,90,,,percent of total billed charges,90% of total billed charges,19.46,76,,,percent of total billed charges,76% of total billed charges,10.24,40,,,percent of total billed charges,40% of total billed charges,21.76,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,20.48,80,,,percent of total billed charges,80% of total billed charges,9.93,38.8,,,percent of total billed charges,38.8% of total billed charges,21.76,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,51.2,200,,,fee schedule,200% of CMS fee schedule,9.93,215.49,
36420 CUTDOWN < 1 YR,31036420,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,134,107.2,,100.5,75,,,percent of total billed charges,75% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,106.13,79.2,,,percent of total billed charges,79.2% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,134,100,,,fee schedule,100% of CO APG rates,127.3,95,,,percent of total billed charges,95% of total billed charges,107.2,80,,,percent of total billed charges,80% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,134,100,,,fee schedule,100% of NM APC rate,53.6,40,,,percent of total billed charges,40% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,101.84,76,,,percent of total billed charges,76% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,107.2,80,,,percent of total billed charges,80% of total billed charges,51.99,38.8,,,percent of total billed charges,38.8% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,51.99,217.66,
36680 PLCNEEDLE BONE INFUSION,31036680,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,172.1,137.68,,129.08,75,,,percent of total billed charges,75% of total billed charges,68.84,40,,,percent of total billed charges,40% of total billed charges,136.3,79.2,,,percent of total billed charges,79.2% of total billed charges,146.29,85,,,percent of total billed charges,85% of total billed charges,172.1,100,,,fee schedule,100% of CO APG rates,163.5,95,,,percent of total billed charges,95% of total billed charges,137.68,80,,,percent of total billed charges,80% of total billed charges,146.29,85,,,percent of total billed charges,85% of total billed charges,154.89,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,172.1,100,,,fee schedule,100% of NM APC rate,68.84,40,,,percent of total billed charges,40% of total billed charges,68.84,40,,,percent of total billed charges,40% of total billed charges,154.89,90,,,percent of total billed charges,90% of total billed charges,130.8,76,,,percent of total billed charges,76% of total billed charges,68.84,40,,,percent of total billed charges,40% of total billed charges,146.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,137.68,80,,,percent of total billed charges,80% of total billed charges,66.77,38.8,,,percent of total billed charges,38.8% of total billed charges,146.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,66.77,217.66,
40830 REPAIR MOUTH LACERATION,31040830,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,442.2,353.76,,331.65,75,,,percent of total billed charges,75% of total billed charges,176.88,40,,,percent of total billed charges,40% of total billed charges,350.22,79.2,,,percent of total billed charges,79.2% of total billed charges,375.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,420.09,95,,,percent of total billed charges,95% of total billed charges,353.76,80,,,percent of total billed charges,80% of total billed charges,375.87,85,,,percent of total billed charges,85% of total billed charges,397.98,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,176.88,40,,,percent of total billed charges,40% of total billed charges,176.88,40,,,percent of total billed charges,40% of total billed charges,397.98,90,,,percent of total billed charges,90% of total billed charges,336.07,76,,,percent of total billed charges,76% of total billed charges,176.88,40,,,percent of total billed charges,40% of total billed charges,375.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,353.76,80,,,percent of total billed charges,80% of total billed charges,171.57,38.8,,,percent of total billed charges,38.8% of total billed charges,375.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,171.57,420.09,
41250 REPAIR TONGUE LACERATN,31041250,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,461.1,368.88,,345.83,75,,,percent of total billed charges,75% of total billed charges,184.44,40,,,percent of total billed charges,40% of total billed charges,365.19,79.2,,,percent of total billed charges,79.2% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,438.05,95,,,percent of total billed charges,95% of total billed charges,368.88,80,,,percent of total billed charges,80% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,414.99,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,184.44,40,,,percent of total billed charges,40% of total billed charges,184.44,40,,,percent of total billed charges,40% of total billed charges,414.99,90,,,percent of total billed charges,90% of total billed charges,350.44,76,,,percent of total billed charges,76% of total billed charges,184.44,40,,,percent of total billed charges,40% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,368.88,80,,,percent of total billed charges,80% of total billed charges,178.91,38.8,,,percent of total billed charges,38.8% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,178.91,438.05,
41800 DRAINAGE OF GUM LESION,31041800,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,481.1,384.88,,360.83,75,,,percent of total billed charges,75% of total billed charges,192.44,40,,,percent of total billed charges,40% of total billed charges,381.03,79.2,,,percent of total billed charges,79.2% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,457.05,95,,,percent of total billed charges,95% of total billed charges,384.88,80,,,percent of total billed charges,80% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,432.99,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,192.44,40,,,percent of total billed charges,40% of total billed charges,192.44,40,,,percent of total billed charges,40% of total billed charges,432.99,90,,,percent of total billed charges,90% of total billed charges,365.64,76,,,percent of total billed charges,76% of total billed charges,192.44,40,,,percent of total billed charges,40% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,384.88,80,,,percent of total billed charges,80% of total billed charges,186.67,38.8,,,percent of total billed charges,38.8% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,457.05,
"42960 CONTROL HEMORRHAGE, ORAL",31042960,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,482.6,386.08,,361.95,75,,,percent of total billed charges,75% of total billed charges,193.04,40,,,percent of total billed charges,40% of total billed charges,382.22,79.2,,,percent of total billed charges,79.2% of total billed charges,410.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,458.47,95,,,percent of total billed charges,95% of total billed charges,386.08,80,,,percent of total billed charges,80% of total billed charges,410.21,85,,,percent of total billed charges,85% of total billed charges,434.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,193.04,40,,,percent of total billed charges,40% of total billed charges,193.04,40,,,percent of total billed charges,40% of total billed charges,434.34,90,,,percent of total billed charges,90% of total billed charges,366.78,76,,,percent of total billed charges,76% of total billed charges,193.04,40,,,percent of total billed charges,40% of total billed charges,410.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,386.08,80,,,percent of total billed charges,80% of total billed charges,187.25,38.8,,,percent of total billed charges,38.8% of total billed charges,410.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,458.47,
43249 ESOPH ENDOSCOPY DILATION,31043249,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,445.8,356.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43753 Gastric Intubation  Aspi,31043753,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,61.9,49.52,,46.43,75,,,percent of total billed charges,75% of total billed charges,24.76,40,,,percent of total billed charges,40% of total billed charges,49.02,79.2,,,percent of total billed charges,79.2% of total billed charges,52.62,85,,,percent of total billed charges,85% of total billed charges,61.9,100,,,fee schedule,100% of CO APG rates,58.81,95,,,percent of total billed charges,95% of total billed charges,49.52,80,,,percent of total billed charges,80% of total billed charges,52.62,85,,,percent of total billed charges,85% of total billed charges,55.71,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,61.9,100,,,fee schedule,100% of NM APC rate,24.76,40,,,percent of total billed charges,40% of total billed charges,24.76,40,,,percent of total billed charges,40% of total billed charges,55.71,90,,,percent of total billed charges,90% of total billed charges,47.04,76,,,percent of total billed charges,76% of total billed charges,24.76,40,,,percent of total billed charges,40% of total billed charges,52.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,49.52,80,,,percent of total billed charges,80% of total billed charges,24.02,38.8,,,percent of total billed charges,38.8% of total billed charges,52.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,123.8,200,,,fee schedule,200% of CMS fee schedule,24.02,215.49,
46083 INCISION THROMB XT HEMORR,31046083,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,330.9,264.72,,248.18,75,,,percent of total billed charges,75% of total billed charges,132.36,40,,,percent of total billed charges,40% of total billed charges,262.07,79.2,,,percent of total billed charges,79.2% of total billed charges,281.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,314.36,95,,,percent of total billed charges,95% of total billed charges,264.72,80,,,percent of total billed charges,80% of total billed charges,281.27,85,,,percent of total billed charges,85% of total billed charges,297.81,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,132.36,40,,,percent of total billed charges,40% of total billed charges,132.36,40,,,percent of total billed charges,40% of total billed charges,297.81,90,,,percent of total billed charges,90% of total billed charges,251.48,76,,,percent of total billed charges,76% of total billed charges,132.36,40,,,percent of total billed charges,40% of total billed charges,281.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,264.72,80,,,percent of total billed charges,80% of total billed charges,128.39,38.8,,,percent of total billed charges,38.8% of total billed charges,281.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,128.39,314.36,
46612 - ANOSCOPY REMOVE LESIONS CHARGE,46046612,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,280.2,224.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"51703 Cath Insertion, Complicat",31051703,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,221.8,177.44,,166.35,75,,,percent of total billed charges,75% of total billed charges,88.72,40,,,percent of total billed charges,40% of total billed charges,175.67,79.2,,,percent of total billed charges,79.2% of total billed charges,188.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,210.71,95,,,percent of total billed charges,95% of total billed charges,177.44,80,,,percent of total billed charges,80% of total billed charges,188.53,85,,,percent of total billed charges,85% of total billed charges,199.62,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,88.72,40,,,percent of total billed charges,40% of total billed charges,88.72,40,,,percent of total billed charges,40% of total billed charges,199.62,90,,,percent of total billed charges,90% of total billed charges,168.57,76,,,percent of total billed charges,76% of total billed charges,88.72,40,,,percent of total billed charges,40% of total billed charges,188.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,177.44,80,,,percent of total billed charges,80% of total billed charges,86.06,38.8,,,percent of total billed charges,38.8% of total billed charges,188.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,86.06,217.66,
54220 - Irrigation of corpora cavernosa for priapism,31054220,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,392.7,314.16,,294.53,75,,,percent of total billed charges,75% of total billed charges,157.08,40,,,percent of total billed charges,40% of total billed charges,311.02,79.2,,,percent of total billed charges,79.2% of total billed charges,333.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,373.07,95,,,percent of total billed charges,95% of total billed charges,314.16,80,,,percent of total billed charges,80% of total billed charges,333.8,85,,,percent of total billed charges,85% of total billed charges,353.43,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,157.08,40,,,percent of total billed charges,40% of total billed charges,157.08,40,,,percent of total billed charges,40% of total billed charges,353.43,90,,,percent of total billed charges,90% of total billed charges,298.45,76,,,percent of total billed charges,76% of total billed charges,157.08,40,,,percent of total billed charges,40% of total billed charges,333.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,314.16,80,,,percent of total billed charges,80% of total billed charges,152.37,38.8,,,percent of total billed charges,38.8% of total billed charges,333.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,152.37,373.07,
56420 DRAINAGE OF GLAND ABSCESS,31056420,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,327.7,262.16,,245.78,75,,,percent of total billed charges,75% of total billed charges,131.08,40,,,percent of total billed charges,40% of total billed charges,259.54,79.2,,,percent of total billed charges,79.2% of total billed charges,278.55,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,311.32,95,,,percent of total billed charges,95% of total billed charges,262.16,80,,,percent of total billed charges,80% of total billed charges,278.55,85,,,percent of total billed charges,85% of total billed charges,294.93,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,131.08,40,,,percent of total billed charges,40% of total billed charges,131.08,40,,,percent of total billed charges,40% of total billed charges,294.93,90,,,percent of total billed charges,90% of total billed charges,249.05,76,,,percent of total billed charges,76% of total billed charges,131.08,40,,,percent of total billed charges,40% of total billed charges,278.55,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,262.16,80,,,percent of total billed charges,80% of total billed charges,127.15,38.8,,,percent of total billed charges,38.8% of total billed charges,278.55,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,127.15,311.32,
59409 DELIVERY,31059409,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2304,1843.2,,1728,75,,,percent of total billed charges,75% of total billed charges,921.6,40,,,percent of total billed charges,40% of total billed charges,1824.77,79.2,,,percent of total billed charges,79.2% of total billed charges,1958.4,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2188.8,95,,,percent of total billed charges,95% of total billed charges,1843.2,80,,,percent of total billed charges,80% of total billed charges,1958.4,85,,,percent of total billed charges,85% of total billed charges,2073.6,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,921.6,40,,,percent of total billed charges,40% of total billed charges,921.6,40,,,percent of total billed charges,40% of total billed charges,2073.6,90,,,percent of total billed charges,90% of total billed charges,1751.04,76,,,percent of total billed charges,76% of total billed charges,921.6,40,,,percent of total billed charges,40% of total billed charges,1958.4,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1843.2,80,,,percent of total billed charges,80% of total billed charges,893.95,38.8,,,percent of total billed charges,38.8% of total billed charges,1958.4,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2188.8,
59414 DELIVERY OF PLACENTA,31059414,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,261,208.8,,195.75,75,,,percent of total billed charges,75% of total billed charges,104.4,40,,,percent of total billed charges,40% of total billed charges,206.71,79.2,,,percent of total billed charges,79.2% of total billed charges,221.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,247.95,95,,,percent of total billed charges,95% of total billed charges,208.8,80,,,percent of total billed charges,80% of total billed charges,221.85,85,,,percent of total billed charges,85% of total billed charges,234.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,104.4,40,,,percent of total billed charges,40% of total billed charges,104.4,40,,,percent of total billed charges,40% of total billed charges,234.9,90,,,percent of total billed charges,90% of total billed charges,198.36,76,,,percent of total billed charges,76% of total billed charges,104.4,40,,,percent of total billed charges,40% of total billed charges,221.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,208.8,80,,,percent of total billed charges,80% of total billed charges,101.27,38.8,,,percent of total billed charges,38.8% of total billed charges,221.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,101.27,247.95,
65205 REM FB EYE CONJUNC SUPERF,31065205,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,85.1,68.08,,63.83,75,,,percent of total billed charges,75% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,67.4,79.2,,,percent of total billed charges,79.2% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,85.1,100,,,fee schedule,100% of CO APG rates,80.85,95,,,percent of total billed charges,95% of total billed charges,68.08,80,,,percent of total billed charges,80% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,85.1,100,,,fee schedule,100% of NM APC rate,34.04,40,,,percent of total billed charges,40% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,64.68,76,,,percent of total billed charges,76% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,68.08,80,,,percent of total billed charges,80% of total billed charges,33.02,38.8,,,percent of total billed charges,38.8% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,170.2,200,,,fee schedule,200% of CMS fee schedule,33.02,215.49,
65210 REM FB CONJ EMBEDDED LT,31065210,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,106,84.8,,79.5,75,,,percent of total billed charges,75% of total billed charges,42.4,40,,,percent of total billed charges,40% of total billed charges,83.95,79.2,,,percent of total billed charges,79.2% of total billed charges,90.1,85,,,percent of total billed charges,85% of total billed charges,106,100,,,fee schedule,100% of CO APG rates,100.7,95,,,percent of total billed charges,95% of total billed charges,84.8,80,,,percent of total billed charges,80% of total billed charges,90.1,85,,,percent of total billed charges,85% of total billed charges,95.4,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,106,100,,,fee schedule,100% of NM APC rate,42.4,40,,,percent of total billed charges,40% of total billed charges,42.4,40,,,percent of total billed charges,40% of total billed charges,95.4,90,,,percent of total billed charges,90% of total billed charges,80.56,76,,,percent of total billed charges,76% of total billed charges,42.4,40,,,percent of total billed charges,40% of total billed charges,90.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,84.8,80,,,percent of total billed charges,80% of total billed charges,41.13,38.8,,,percent of total billed charges,38.8% of total billed charges,90.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,212,200,,,fee schedule,200% of CMS fee schedule,41.13,215.49,
65220 REM FB CORNEAL W/O SLIT LAMP,31065220,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,119.8,95.84,,89.85,75,,,percent of total billed charges,75% of total billed charges,47.92,40,,,percent of total billed charges,40% of total billed charges,94.88,79.2,,,percent of total billed charges,79.2% of total billed charges,101.83,85,,,percent of total billed charges,85% of total billed charges,119.8,100,,,fee schedule,100% of CO APG rates,113.81,95,,,percent of total billed charges,95% of total billed charges,95.84,80,,,percent of total billed charges,80% of total billed charges,101.83,85,,,percent of total billed charges,85% of total billed charges,107.82,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,119.8,100,,,fee schedule,100% of NM APC rate,47.92,40,,,percent of total billed charges,40% of total billed charges,47.92,40,,,percent of total billed charges,40% of total billed charges,107.82,90,,,percent of total billed charges,90% of total billed charges,91.05,76,,,percent of total billed charges,76% of total billed charges,47.92,40,,,percent of total billed charges,40% of total billed charges,101.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,95.84,80,,,percent of total billed charges,80% of total billed charges,46.48,38.8,,,percent of total billed charges,38.8% of total billed charges,101.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,46.48,217.66,
65222 REM FB CORNEAL W/SLIT LAM,31065222,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,146.7,117.36,,110.03,75,,,percent of total billed charges,75% of total billed charges,58.68,40,,,percent of total billed charges,40% of total billed charges,116.19,79.2,,,percent of total billed charges,79.2% of total billed charges,124.7,85,,,percent of total billed charges,85% of total billed charges,146.7,100,,,fee schedule,100% of CO APG rates,139.37,95,,,percent of total billed charges,95% of total billed charges,117.36,80,,,percent of total billed charges,80% of total billed charges,124.7,85,,,percent of total billed charges,85% of total billed charges,132.03,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,146.7,100,,,fee schedule,100% of NM APC rate,58.68,40,,,percent of total billed charges,40% of total billed charges,58.68,40,,,percent of total billed charges,40% of total billed charges,132.03,90,,,percent of total billed charges,90% of total billed charges,111.49,76,,,percent of total billed charges,76% of total billed charges,58.68,40,,,percent of total billed charges,40% of total billed charges,124.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,117.36,80,,,percent of total billed charges,80% of total billed charges,56.92,38.8,,,percent of total billed charges,38.8% of total billed charges,124.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,56.92,217.66,
"92960 Cardioversion, elective, electrical conversion of arrh",46092960,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,889.1,711.28,,666.83,75,,,percent of total billed charges,75% of total billed charges,355.64,40,,,percent of total billed charges,40% of total billed charges,704.17,79.2,,,percent of total billed charges,79.2% of total billed charges,755.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,844.65,95,,,percent of total billed charges,95% of total billed charges,711.28,80,,,percent of total billed charges,80% of total billed charges,755.74,85,,,percent of total billed charges,85% of total billed charges,800.19,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,355.64,40,,,percent of total billed charges,40% of total billed charges,355.64,40,,,percent of total billed charges,40% of total billed charges,800.19,90,,,percent of total billed charges,90% of total billed charges,675.72,76,,,percent of total billed charges,76% of total billed charges,355.64,40,,,percent of total billed charges,40% of total billed charges,755.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,711.28,80,,,percent of total billed charges,80% of total billed charges,344.97,38.8,,,percent of total billed charges,38.8% of total billed charges,755.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,844.65,
93010 EKG Interp/Report - ER,31093010,CDM,981,RC,10060,HCPCS,OUTPATIENT,,,23.6,18.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
99281 Prob Foc-Straight Forward,31099281,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,33,26.4,,24.75,75,,,percent of total billed charges,75% of total billed charges,13.2,40,,,percent of total billed charges,40% of total billed charges,26.14,79.2,,,percent of total billed charges,79.2% of total billed charges,28.05,85,,,percent of total billed charges,85% of total billed charges,33,100,,,fee schedule,100% of CO APG rates,31.35,95,,,percent of total billed charges,95% of total billed charges,26.4,80,,,percent of total billed charges,80% of total billed charges,28.05,85,,,percent of total billed charges,85% of total billed charges,29.7,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,33,100,,,fee schedule,100% of NM APC rate,13.2,40,,,percent of total billed charges,40% of total billed charges,13.2,40,,,percent of total billed charges,40% of total billed charges,29.7,90,,,percent of total billed charges,90% of total billed charges,25.08,76,,,percent of total billed charges,76% of total billed charges,13.2,40,,,percent of total billed charges,40% of total billed charges,28.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,26.4,80,,,percent of total billed charges,80% of total billed charges,12.8,38.8,,,percent of total billed charges,38.8% of total billed charges,28.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,66,200,,,fee schedule,200% of CMS fee schedule,12.8,215.49,
99282 Exp Prob Foc-Low Complex,31099282,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,121.5,97.2,,91.13,75,,,percent of total billed charges,75% of total billed charges,48.6,40,,,percent of total billed charges,40% of total billed charges,96.23,79.2,,,percent of total billed charges,79.2% of total billed charges,103.28,85,,,percent of total billed charges,85% of total billed charges,121.5,100,,,fee schedule,100% of CO APG rates,115.43,95,,,percent of total billed charges,95% of total billed charges,97.2,80,,,percent of total billed charges,80% of total billed charges,103.28,85,,,percent of total billed charges,85% of total billed charges,109.35,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,121.5,100,,,fee schedule,100% of NM APC rate,48.6,40,,,percent of total billed charges,40% of total billed charges,48.6,40,,,percent of total billed charges,40% of total billed charges,109.35,90,,,percent of total billed charges,90% of total billed charges,92.34,76,,,percent of total billed charges,76% of total billed charges,48.6,40,,,percent of total billed charges,40% of total billed charges,103.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,97.2,80,,,percent of total billed charges,80% of total billed charges,47.14,38.8,,,percent of total billed charges,38.8% of total billed charges,103.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,47.14,217.66,
99283 Exp Prob Foc-Mod Complex,31099283,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,255.6,204.48,,191.7,75,,,percent of total billed charges,75% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,202.44,79.2,,,percent of total billed charges,79.2% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,242.82,95,,,percent of total billed charges,95% of total billed charges,204.48,80,,,percent of total billed charges,80% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,230.04,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,102.24,40,,,percent of total billed charges,40% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,230.04,90,,,percent of total billed charges,90% of total billed charges,194.26,76,,,percent of total billed charges,76% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,204.48,80,,,percent of total billed charges,80% of total billed charges,99.17,38.8,,,percent of total billed charges,38.8% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,99.17,242.82,
99284 Detailed-Mod Complex,31099284,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,349.5,279.6,,262.13,75,,,percent of total billed charges,75% of total billed charges,139.8,40,,,percent of total billed charges,40% of total billed charges,276.8,79.2,,,percent of total billed charges,79.2% of total billed charges,297.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,332.03,95,,,percent of total billed charges,95% of total billed charges,279.6,80,,,percent of total billed charges,80% of total billed charges,297.08,85,,,percent of total billed charges,85% of total billed charges,314.55,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,139.8,40,,,percent of total billed charges,40% of total billed charges,139.8,40,,,percent of total billed charges,40% of total billed charges,314.55,90,,,percent of total billed charges,90% of total billed charges,265.62,76,,,percent of total billed charges,76% of total billed charges,139.8,40,,,percent of total billed charges,40% of total billed charges,297.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,279.6,80,,,percent of total billed charges,80% of total billed charges,135.61,38.8,,,percent of total billed charges,38.8% of total billed charges,297.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,135.61,332.03,
99285 EMERGENCY RM LEV 5,31099285,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,506.5,405.2,,379.88,75,,,percent of total billed charges,75% of total billed charges,202.6,40,,,percent of total billed charges,40% of total billed charges,401.15,79.2,,,percent of total billed charges,79.2% of total billed charges,430.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,481.18,95,,,percent of total billed charges,95% of total billed charges,405.2,80,,,percent of total billed charges,80% of total billed charges,430.53,85,,,percent of total billed charges,85% of total billed charges,455.85,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,202.6,40,,,percent of total billed charges,40% of total billed charges,202.6,40,,,percent of total billed charges,40% of total billed charges,455.85,90,,,percent of total billed charges,90% of total billed charges,384.94,76,,,percent of total billed charges,76% of total billed charges,202.6,40,,,percent of total billed charges,40% of total billed charges,430.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,405.2,80,,,percent of total billed charges,80% of total billed charges,196.52,38.8,,,percent of total billed charges,38.8% of total billed charges,430.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,481.18,
99291 Critical Care First Hour,31099291,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1341.9,1073.52,,1006.43,75,,,percent of total billed charges,75% of total billed charges,536.76,40,,,percent of total billed charges,40% of total billed charges,1062.78,79.2,,,percent of total billed charges,79.2% of total billed charges,1140.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1274.81,95,,,percent of total billed charges,95% of total billed charges,1073.52,80,,,percent of total billed charges,80% of total billed charges,1140.62,85,,,percent of total billed charges,85% of total billed charges,1207.71,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,536.76,40,,,percent of total billed charges,40% of total billed charges,536.76,40,,,percent of total billed charges,40% of total billed charges,1207.71,90,,,percent of total billed charges,90% of total billed charges,1019.84,76,,,percent of total billed charges,76% of total billed charges,536.76,40,,,percent of total billed charges,40% of total billed charges,1140.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1073.52,80,,,percent of total billed charges,80% of total billed charges,520.66,38.8,,,percent of total billed charges,38.8% of total billed charges,1140.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1274.81,
99292 Critical Care Addtl  30 m,31099292,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,310.5,248.4,,232.88,75,,,percent of total billed charges,75% of total billed charges,124.2,40,,,percent of total billed charges,40% of total billed charges,245.92,79.2,,,percent of total billed charges,79.2% of total billed charges,263.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,294.98,95,,,percent of total billed charges,95% of total billed charges,248.4,80,,,percent of total billed charges,80% of total billed charges,263.93,85,,,percent of total billed charges,85% of total billed charges,279.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,124.2,40,,,percent of total billed charges,40% of total billed charges,124.2,40,,,percent of total billed charges,40% of total billed charges,279.45,90,,,percent of total billed charges,90% of total billed charges,235.98,76,,,percent of total billed charges,76% of total billed charges,124.2,40,,,percent of total billed charges,40% of total billed charges,263.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,248.4,80,,,percent of total billed charges,80% of total billed charges,120.47,38.8,,,percent of total billed charges,38.8% of total billed charges,263.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,120.47,294.98,
25337 Reconstruction For Stabilization Of Unstable Distal Ul,60000814,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2693.6,2154.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
13153 CMPLX RPR E/N/E/L ADDL 5CM/<,46013153,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,400.2,320.16,,300.15,75,,,percent of total billed charges,75% of total billed charges,160.08,40,,,percent of total billed charges,40% of total billed charges,316.96,79.2,,,percent of total billed charges,79.2% of total billed charges,340.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,380.19,95,,,percent of total billed charges,95% of total billed charges,320.16,80,,,percent of total billed charges,80% of total billed charges,340.17,85,,,percent of total billed charges,85% of total billed charges,360.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,160.08,40,,,percent of total billed charges,40% of total billed charges,160.08,40,,,percent of total billed charges,40% of total billed charges,360.18,90,,,percent of total billed charges,90% of total billed charges,304.15,76,,,percent of total billed charges,76% of total billed charges,160.08,40,,,percent of total billed charges,40% of total billed charges,340.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,320.16,80,,,percent of total billed charges,80% of total billed charges,155.28,38.8,,,percent of total billed charges,38.8% of total billed charges,340.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,155.28,380.19,
"26775 Closed Treatment Of Interphalangeal Joint Dislocation,",46026775,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1109.4,887.52,,832.05,75,,,percent of total billed charges,75% of total billed charges,443.76,40,,,percent of total billed charges,40% of total billed charges,878.64,79.2,,,percent of total billed charges,79.2% of total billed charges,942.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1053.93,95,,,percent of total billed charges,95% of total billed charges,887.52,80,,,percent of total billed charges,80% of total billed charges,942.99,85,,,percent of total billed charges,85% of total billed charges,998.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,443.76,40,,,percent of total billed charges,40% of total billed charges,443.76,40,,,percent of total billed charges,40% of total billed charges,998.46,90,,,percent of total billed charges,90% of total billed charges,843.14,76,,,percent of total billed charges,76% of total billed charges,443.76,40,,,percent of total billed charges,40% of total billed charges,942.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,887.52,80,,,percent of total billed charges,80% of total billed charges,430.45,38.8,,,percent of total billed charges,38.8% of total billed charges,942.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1053.93,
27552 Closed Treatment Of Knee Dislocation; Requiring Anesth,60000289,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1928.8,1543.04,,1446.6,75,,,percent of total billed charges,75% of total billed charges,771.52,40,,,percent of total billed charges,40% of total billed charges,1527.61,79.2,,,percent of total billed charges,79.2% of total billed charges,1639.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1832.36,95,,,percent of total billed charges,95% of total billed charges,1543.04,80,,,percent of total billed charges,80% of total billed charges,1639.48,85,,,percent of total billed charges,85% of total billed charges,1735.92,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,771.52,40,,,percent of total billed charges,40% of total billed charges,771.52,40,,,percent of total billed charges,40% of total billed charges,1735.92,90,,,percent of total billed charges,90% of total billed charges,1465.89,76,,,percent of total billed charges,76% of total billed charges,771.52,40,,,percent of total billed charges,40% of total billed charges,1639.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1543.04,80,,,percent of total billed charges,80% of total billed charges,748.37,38.8,,,percent of total billed charges,38.8% of total billed charges,1639.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1832.36,
28192 REMOV OF FOOT FOREIGN B-D,60000287,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,939.3,751.44,,704.48,75,,,percent of total billed charges,75% of total billed charges,375.72,40,,,percent of total billed charges,40% of total billed charges,743.93,79.2,,,percent of total billed charges,79.2% of total billed charges,798.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,892.34,95,,,percent of total billed charges,95% of total billed charges,751.44,80,,,percent of total billed charges,80% of total billed charges,798.41,85,,,percent of total billed charges,85% of total billed charges,845.37,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,375.72,40,,,percent of total billed charges,40% of total billed charges,375.72,40,,,percent of total billed charges,40% of total billed charges,845.37,90,,,percent of total billed charges,90% of total billed charges,713.87,76,,,percent of total billed charges,76% of total billed charges,375.72,40,,,percent of total billed charges,40% of total billed charges,798.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,751.44,80,,,percent of total billed charges,80% of total billed charges,364.45,38.8,,,percent of total billed charges,38.8% of total billed charges,798.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,892.34,
28193 REMOV OF FOOT FOREIGN B-C,60000399,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1097.3,877.84,,822.98,75,,,percent of total billed charges,75% of total billed charges,438.92,40,,,percent of total billed charges,40% of total billed charges,869.06,79.2,,,percent of total billed charges,79.2% of total billed charges,932.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1042.44,95,,,percent of total billed charges,95% of total billed charges,877.84,80,,,percent of total billed charges,80% of total billed charges,932.71,85,,,percent of total billed charges,85% of total billed charges,987.57,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,438.92,40,,,percent of total billed charges,40% of total billed charges,438.92,40,,,percent of total billed charges,40% of total billed charges,987.57,90,,,percent of total billed charges,90% of total billed charges,833.95,76,,,percent of total billed charges,76% of total billed charges,438.92,40,,,percent of total billed charges,40% of total billed charges,932.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,877.84,80,,,percent of total billed charges,80% of total billed charges,425.75,38.8,,,percent of total billed charges,38.8% of total billed charges,932.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1042.44,
28665 TX TOE DISLOC W/ANES,60000286,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,380,304,,285,75,,,percent of total billed charges,75% of total billed charges,152,40,,,percent of total billed charges,40% of total billed charges,300.96,79.2,,,percent of total billed charges,79.2% of total billed charges,323,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,361,95,,,percent of total billed charges,95% of total billed charges,304,80,,,percent of total billed charges,80% of total billed charges,323,85,,,percent of total billed charges,85% of total billed charges,342,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,152,40,,,percent of total billed charges,40% of total billed charges,152,40,,,percent of total billed charges,40% of total billed charges,342,90,,,percent of total billed charges,90% of total billed charges,288.8,76,,,percent of total billed charges,76% of total billed charges,152,40,,,percent of total billed charges,40% of total billed charges,323,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,304,80,,,percent of total billed charges,80% of total billed charges,147.44,38.8,,,percent of total billed charges,38.8% of total billed charges,323,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,147.44,361,
30310 RMVL NASAL FB W/GEN ANES,60000401,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,620.4,496.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
36405 BL DRAW <3 YRS SCALP VEIN,60000285,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,43.2,34.56,,32.4,75,,,percent of total billed charges,75% of total billed charges,17.28,40,,,percent of total billed charges,40% of total billed charges,34.21,79.2,,,percent of total billed charges,79.2% of total billed charges,36.72,85,,,percent of total billed charges,85% of total billed charges,43.2,100,,,fee schedule,100% of CO APG rates,41.04,95,,,percent of total billed charges,95% of total billed charges,34.56,80,,,percent of total billed charges,80% of total billed charges,36.72,85,,,percent of total billed charges,85% of total billed charges,38.88,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,43.2,100,,,fee schedule,100% of NM APC rate,17.28,40,,,percent of total billed charges,40% of total billed charges,17.28,40,,,percent of total billed charges,40% of total billed charges,38.88,90,,,percent of total billed charges,90% of total billed charges,32.83,76,,,percent of total billed charges,76% of total billed charges,17.28,40,,,percent of total billed charges,40% of total billed charges,36.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,34.56,80,,,percent of total billed charges,80% of total billed charges,16.76,38.8,,,percent of total billed charges,38.8% of total billed charges,36.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,86.4,200,,,fee schedule,200% of CMS fee schedule,16.76,215.49,
27780 Closed Tx Prox Fibula Clinic Charge,60000061,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,898.3,718.64,,673.73,75,,,percent of total billed charges,75% of total billed charges,359.32,40,,,percent of total billed charges,40% of total billed charges,711.45,79.2,,,percent of total billed charges,79.2% of total billed charges,763.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,853.39,95,,,percent of total billed charges,95% of total billed charges,718.64,80,,,percent of total billed charges,80% of total billed charges,763.56,85,,,percent of total billed charges,85% of total billed charges,808.47,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,359.32,40,,,percent of total billed charges,40% of total billed charges,359.32,40,,,percent of total billed charges,40% of total billed charges,808.47,90,,,percent of total billed charges,90% of total billed charges,682.71,76,,,percent of total billed charges,76% of total billed charges,359.32,40,,,percent of total billed charges,40% of total billed charges,763.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,718.64,80,,,percent of total billed charges,80% of total billed charges,348.54,38.8,,,percent of total billed charges,38.8% of total billed charges,763.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,853.39,
27808 Closed TX ankle FX w/o Man Clinic Charge,60000063,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,962.2,769.76,,721.65,75,,,percent of total billed charges,75% of total billed charges,384.88,40,,,percent of total billed charges,40% of total billed charges,762.06,79.2,,,percent of total billed charges,79.2% of total billed charges,817.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,914.09,95,,,percent of total billed charges,95% of total billed charges,769.76,80,,,percent of total billed charges,80% of total billed charges,817.87,85,,,percent of total billed charges,85% of total billed charges,865.98,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,384.88,40,,,percent of total billed charges,40% of total billed charges,384.88,40,,,percent of total billed charges,40% of total billed charges,865.98,90,,,percent of total billed charges,90% of total billed charges,731.27,76,,,percent of total billed charges,76% of total billed charges,384.88,40,,,percent of total billed charges,40% of total billed charges,817.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,769.76,80,,,percent of total billed charges,80% of total billed charges,373.33,38.8,,,percent of total billed charges,38.8% of total billed charges,817.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,914.09,
51705 Change of Cystostomy tube; simple,60000094,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,153.9,123.12,,115.43,75,,,percent of total billed charges,75% of total billed charges,61.56,40,,,percent of total billed charges,40% of total billed charges,121.89,79.2,,,percent of total billed charges,79.2% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,153.9,100,,,fee schedule,100% of CO APG rates,146.21,95,,,percent of total billed charges,95% of total billed charges,123.12,80,,,percent of total billed charges,80% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,138.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,153.9,100,,,fee schedule,100% of NM APC rate,61.56,40,,,percent of total billed charges,40% of total billed charges,61.56,40,,,percent of total billed charges,40% of total billed charges,138.51,90,,,percent of total billed charges,90% of total billed charges,116.96,76,,,percent of total billed charges,76% of total billed charges,61.56,40,,,percent of total billed charges,40% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,123.12,80,,,percent of total billed charges,80% of total billed charges,59.71,38.8,,,percent of total billed charges,38.8% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,59.71,217.66,
54700 DRAINAGE OF SCROTUM,31054700,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,636.2,508.96,,477.15,75,,,percent of total billed charges,75% of total billed charges,254.48,40,,,percent of total billed charges,40% of total billed charges,503.87,79.2,,,percent of total billed charges,79.2% of total billed charges,540.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,604.39,95,,,percent of total billed charges,95% of total billed charges,508.96,80,,,percent of total billed charges,80% of total billed charges,540.77,85,,,percent of total billed charges,85% of total billed charges,572.58,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,254.48,40,,,percent of total billed charges,40% of total billed charges,254.48,40,,,percent of total billed charges,40% of total billed charges,572.58,90,,,percent of total billed charges,90% of total billed charges,483.51,76,,,percent of total billed charges,76% of total billed charges,254.48,40,,,percent of total billed charges,40% of total billed charges,540.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,508.96,80,,,percent of total billed charges,80% of total billed charges,246.85,38.8,,,percent of total billed charges,38.8% of total billed charges,540.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,604.39,
20526 - INJ OF CARPAL TUNNEL CHARGE,46020526,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,167.1,133.68,,125.33,75,,,percent of total billed charges,75% of total billed charges,66.84,40,,,percent of total billed charges,40% of total billed charges,132.34,79.2,,,percent of total billed charges,79.2% of total billed charges,142.04,85,,,percent of total billed charges,85% of total billed charges,167.1,100,,,fee schedule,100% of CO APG rates,158.75,95,,,percent of total billed charges,95% of total billed charges,133.68,80,,,percent of total billed charges,80% of total billed charges,142.04,85,,,percent of total billed charges,85% of total billed charges,150.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,167.1,100,,,fee schedule,100% of NM APC rate,66.84,40,,,percent of total billed charges,40% of total billed charges,66.84,40,,,percent of total billed charges,40% of total billed charges,150.39,90,,,percent of total billed charges,90% of total billed charges,127,76,,,percent of total billed charges,76% of total billed charges,66.84,40,,,percent of total billed charges,40% of total billed charges,142.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,133.68,80,,,percent of total billed charges,80% of total billed charges,64.83,38.8,,,percent of total billed charges,38.8% of total billed charges,142.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,64.83,217.66,
23430 Tenodesis of long tendon of biceps,46023430,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2240.9,1792.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24655 Closed Treatment Of Radial Head Or Neck Fracture; With,46024655,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1259.4,1007.52,,944.55,75,,,percent of total billed charges,75% of total billed charges,503.76,40,,,percent of total billed charges,40% of total billed charges,997.44,79.2,,,percent of total billed charges,79.2% of total billed charges,1070.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1196.43,95,,,percent of total billed charges,95% of total billed charges,1007.52,80,,,percent of total billed charges,80% of total billed charges,1070.49,85,,,percent of total billed charges,85% of total billed charges,1133.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,503.76,40,,,percent of total billed charges,40% of total billed charges,503.76,40,,,percent of total billed charges,40% of total billed charges,1133.46,90,,,percent of total billed charges,90% of total billed charges,957.14,76,,,percent of total billed charges,76% of total billed charges,503.76,40,,,percent of total billed charges,40% of total billed charges,1070.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1007.52,80,,,percent of total billed charges,80% of total billed charges,488.65,38.8,,,percent of total billed charges,38.8% of total billed charges,1070.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1196.43,
25607 - TREAT FX RAD EXTRA-ARTICUL CHARGE,46025607,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2253.7,1802.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25608 - TREAT FX RAD INTRA-ARTICUL CHARGE,46025608,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2507.3,2005.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27130 - TOTAL HIP ARTHROPLASTY CHARGE,46027130,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3804.9,3043.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27513 - TREATMENT OF THIGH FX CHARGE,46027513,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3645.1,2916.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29827 - ARTHROSCOP ROTATOR CUFF RPR CHARGE,46029827,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3183.3,2546.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29877 - KNEE ARTHROSCOPY/SURGER CHARGE,46029877,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1875.4,1500.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29881 - KNEE ARTHROSCOPY/SURGERY CHARGE,46029881,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1639.1,1311.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
38740 - REMOVE ARMPIT LYMPH NODES CHARGE,46038740,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2074.7,1659.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43202 - ESOPHAGOSCOPY W/BIOPSY SINGLE OR MULTIPLE CHARGE,46043202,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,300.3,240.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43239 - EGD W/BIOPSY CHARGE,46043239,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,402.2,321.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43247 - EGD W/RMVL FOREIGN BODY CHARGE,46043247,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,512.1,409.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43450 - DILATE ESOPHAGUS CHARGE,46043450,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,234.1,187.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44204 - LAP COLECTOMY PRTL W/ANAS CHARGE,46044204,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,4461.1,3568.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44205 - LAP PRTL W/REM OF ILEUM CHARGE,46044205,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3878,3102.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44380 - ILESC THRU STOMA DX +-COL CHARGE,46044380,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,170.3,136.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44900 - DRAIN APP ABSCESS OPEN CHARGE,46044900,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2300.8,1840.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
47563 - LAP CHOLY W/CHOLANGIOGRAP CHARGE,46047563,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2115.2,1692.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49321 - LAPAROSCOPY BIOPSY CHARGE,46049321,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1017.5,814,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49525 - RPR INGUINAL HERNIA CHARGE,46049525,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1699.1,1359.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49553 - RPR FEM HERNIA INIT BLOCK CHARGE,46049553,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1868.9,1495.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
20670 - EXTREMITY REMOVAL OF IMPLANT SUPERFICIAL,46020670,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,437.7,350.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
23120 Claviculectomy; Partial,46023120,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1787,1429.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
23500 - CLOSED TREATMENT OF CLAVICULAR FRACTURE W/O MANIPULATION,46023500,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,726,580.8,,544.5,75,,,percent of total billed charges,75% of total billed charges,290.4,40,,,percent of total billed charges,40% of total billed charges,574.99,79.2,,,percent of total billed charges,79.2% of total billed charges,617.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.7,95,,,percent of total billed charges,95% of total billed charges,580.8,80,,,percent of total billed charges,80% of total billed charges,617.1,85,,,percent of total billed charges,85% of total billed charges,653.4,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.4,40,,,percent of total billed charges,40% of total billed charges,290.4,40,,,percent of total billed charges,40% of total billed charges,653.4,90,,,percent of total billed charges,90% of total billed charges,551.76,76,,,percent of total billed charges,76% of total billed charges,290.4,40,,,percent of total billed charges,40% of total billed charges,617.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.8,80,,,percent of total billed charges,80% of total billed charges,281.69,38.8,,,percent of total billed charges,38.8% of total billed charges,617.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.7,
23515 - OPEN TREATMENT OF CLAVICULAR FRACTURE INCLUDES INTERNAL FIXATION,46023515,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2175.1,1740.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24515 Open Treatment Of Humeral Shaft Fracture With Plate/Sc,46024515,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2647,2117.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"25000 Incision, Extensor Tendon Sheath, Wrist",46025000,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1072.6,858.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25505 Closed Treatment Of Radial Shaft Fracture; With Manipu,46025505,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1425.3,1140.24,,1068.98,75,,,percent of total billed charges,75% of total billed charges,570.12,40,,,percent of total billed charges,40% of total billed charges,1128.84,79.2,,,percent of total billed charges,79.2% of total billed charges,1211.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1354.04,95,,,percent of total billed charges,95% of total billed charges,1140.24,80,,,percent of total billed charges,80% of total billed charges,1211.51,85,,,percent of total billed charges,85% of total billed charges,1282.77,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,570.12,40,,,percent of total billed charges,40% of total billed charges,570.12,40,,,percent of total billed charges,40% of total billed charges,1282.77,90,,,percent of total billed charges,90% of total billed charges,1083.23,76,,,percent of total billed charges,76% of total billed charges,570.12,40,,,percent of total billed charges,40% of total billed charges,1211.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1140.24,80,,,percent of total billed charges,80% of total billed charges,553.02,38.8,,,percent of total billed charges,38.8% of total billed charges,1211.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1354.04,
25515 - OPEN TREATMENT OF RADIAL SHAFT FRACTURE W INTERNAL FIXATION,46025515,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2036,1628.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25560 - CLOSED TREATMENT OF RADIAL SHAFT FRACTURE W/O MANIPULATION,46025560,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,821.5,657.2,,616.13,75,,,percent of total billed charges,75% of total billed charges,328.6,40,,,percent of total billed charges,40% of total billed charges,650.63,79.2,,,percent of total billed charges,79.2% of total billed charges,698.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,780.43,95,,,percent of total billed charges,95% of total billed charges,657.2,80,,,percent of total billed charges,80% of total billed charges,698.28,85,,,percent of total billed charges,85% of total billed charges,739.35,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,328.6,40,,,percent of total billed charges,40% of total billed charges,328.6,40,,,percent of total billed charges,40% of total billed charges,739.35,90,,,percent of total billed charges,90% of total billed charges,624.34,76,,,percent of total billed charges,76% of total billed charges,328.6,40,,,percent of total billed charges,40% of total billed charges,698.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,657.2,80,,,percent of total billed charges,80% of total billed charges,318.74,38.8,,,percent of total billed charges,38.8% of total billed charges,698.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,780.43,
25565 - CLOSED TREATMENT OF RADIAL SHAFT FRACTURE W MANIPULA,46025565,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1428.4,1142.72,,1071.3,75,,,percent of total billed charges,75% of total billed charges,571.36,40,,,percent of total billed charges,40% of total billed charges,1131.29,79.2,,,percent of total billed charges,79.2% of total billed charges,1214.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1356.98,95,,,percent of total billed charges,95% of total billed charges,1142.72,80,,,percent of total billed charges,80% of total billed charges,1214.14,85,,,percent of total billed charges,85% of total billed charges,1285.56,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,571.36,40,,,percent of total billed charges,40% of total billed charges,571.36,40,,,percent of total billed charges,40% of total billed charges,1285.56,90,,,percent of total billed charges,90% of total billed charges,1085.58,76,,,percent of total billed charges,76% of total billed charges,571.36,40,,,percent of total billed charges,40% of total billed charges,1214.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1142.72,80,,,percent of total billed charges,80% of total billed charges,554.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1214.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1356.98,
25574 - OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES W/INTERNAL FIXATION,46025574,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2053.7,1642.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25609 - OPEN TREATMENT OF DISTAL RADIAL FRACTURE W INTERNAL FIXATION OF 3,46025609,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3175.1,2540.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26055 - TRIGGER FINGER RELEASE,46026055,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,903.1,722.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27244 - ORIF INTERTROCHANTERIC, PERITROCHANTERIC/SUBTROCHANTERIC FEMORAL FX W/PL",46027244,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3651.3,2921.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27245 - W.INTRAMEDULLARY IMPLANT W/WO INTERLOCKING SCREWS AND/OR CERCLAGE,46027245,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3646.7,2917.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27506 - OPEN TREATMENT OF FEMORAL SHAFT FRACTURE W/WO EXTERNAL FIXATION,46027506,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3981.7,3185.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27507 - OPEN TREATMENT OF FEMORAL SHAFT FRACTURE W/PLATE SCREWS W/WO CERCLAGE,46027507,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2878.5,2302.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27511 - OPEN TREATMENT OF FEMORAL SUPRACONDYLAR OR TRANS FRACTURE W/O INTERCONDY,46027511,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2950,2360,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27650 - REPAIR PRIMARY OPEN/PERCUTANEOUS RUPTURED ACHILLES TENDON,46027650,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1988.6,1590.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27695 - REPAIR, PRIMARY, DISRUPED LIGAMENT ANKLE COLLATERAL",46027695,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1471.7,1177.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27792 - OPEN TREATMENT OF DISTAL FIBULAR FRACTURE W INTERNAL FIXATION,46027792,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1941.2,1552.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27814 - OPEN TREATMENT OF BIMALLEOLAR ANKLE FRACTURE W/INTERNAL FIXATION,46027814,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2293.7,1834.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"29806 - ARTHROSCOPY, SHOULDER SURGICAL CAPSULORRHAPHY",46029806,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3160.7,2528.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29807 - REPAIR OF SLAP LESION,46029807,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3088.3,2470.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29822 - DEBRIDEMENT LIMITED,46029822,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1641.2,1312.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29826 - DECOMPRESSION OF SUBACROMIAL SPACE WITH PARTIAL ACROMIOPLASTY W/CORACOAC,46029826,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,500.2,400.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"29875 - SYNOVECTOMY, LIMITED",46029875,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1504.9,1203.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29888 Arthroscopically Aided Anterior Cruciate Ligament Repa,46029888,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2902.3,2321.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64718 - NEUROPLASTY AND/OR TRANSPOSTION ULNAR NERVE AT ELBOW,46064718,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1836.9,1469.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64721 - CARPAL TUNNEL RELEASE,46064721,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1335,1068,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26100 - ARTHROTOMY WITH BIOPSY; CARPOMETACARPAL JOINT, EACH",46026100,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1049.3,839.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26105 - ARTHROTOMY WITH BIOPSY; METACARPOPHALANGEAL JOINT, EACH",46026105,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1056,844.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26110 - ARTHROTOMY WITH BIOPSY; INTERPHALANGEAL JOINT, EACH",46026110,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1005.1,804.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26111 - EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND",46026111,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1266.8,1013.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26116 - EXCISION, TUMOR, SOFT TISSUE, OR VASCULAR MALFORMATION, OF HAND",46026116,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1603.4,1282.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26113 - EXCISION, TUMOR, SOFT TISSUE, OR VASCULAR MALFORMATION, OF HAND",46026113,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1667.4,1333.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26117 - RADICAL RESECTION OF TUMOR (EG, SARCOMA), SOFT TISSUE OF HAND",46026117,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2254.1,1803.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26118 - RADICAL RESECTION OF TUMOR (EG, SARCOMA), SOFT TISSUE OF HAND",46026118,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,3159.1,2527.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26121 - FASCIECTOMY, PALM ONLY, WITH OR WITHOUT Z-PLASTY, OTHER LOCAL",46026121,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1826.6,1461.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26123 - FASCIECTOMY, PARTIAL PALMAR WITH RELEASE OF SINGLE DIGIT INC",46026123,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2545.5,2036.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26125 - FASCIECTOMY, PARTIAL PALMAR WITH RELEASE OF SINGLE DIGIT INC",46026125,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,784.9,627.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26130 - SYNOVECTOMY, CARPOMETACARPAL JOINT",46026130,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1438.1,1150.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26135 - SYNOVECTOMY, METACARPOPHALANGEAL JOINT INCLUDING INTRINSIC R",46026153,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1691.7,1353.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26140 - SYNOVECTOMY, PROXIMAL INTERPHALANGEAL JOINT, INCLUDING EXTEN",46026140,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1554.2,1243.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26145 - SYNOVECTOMY, TENDON SHEATH, RADICAL (TENOSYNOVECTOMY), FLEXO",46026145,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1579.6,1263.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26160 - EXCISION OF LESION OF TENDON SHEATH OR JOINT CAPSULE,46026160,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,975.4,780.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26170 - EXCISION OF TENDON, PALM, FLEXOR OR EXTENSOR, SINGLE, EACH TENDON",46026170,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1252.7,1002.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26180 - EXCISION OF TENDON, FINGER, FLEXOR OR EXTENSOR, EACH TENDON",46026180,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1386.5,1109.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Open Reduction Internal Fixation (ORIF) both Tibia and Fibul,46027828,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3946.4,3157.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
CT Abscess Drainage Perc Visceral,41149405,CDM,360,RC,43215,HCPCS,OUTPATIENT,,,3190.1,2552.08,,2392.58,75,,,percent of total billed charges,75% of total billed charges,1276.04,40,,,percent of total billed charges,40% of total billed charges,2526.56,79.2,,,percent of total billed charges,79.2% of total billed charges,2711.59,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rates,3030.6,95,,,percent of total billed charges,95% of total billed charges,2552.08,80,,,percent of total billed charges,80% of total billed charges,2711.59,85,,,percent of total billed charges,85% of total billed charges,2871.09,90,,,percent of total billed charges,90% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rates,1260.54,100,,,fee schedule,100% of CO APG rates,1741.59,100,,,fee schedule,100% of NM APC rate,1276.04,40,,,percent of total billed charges,40% of total billed charges,1276.04,40,,,percent of total billed charges,40% of total billed charges,2871.09,90,,,percent of total billed charges,90% of total billed charges,2424.48,76,,,percent of total billed charges,76% of total billed charges,1276.04,40,,,percent of total billed charges,40% of total billed charges,2711.59,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rate,2552.08,80,,,percent of total billed charges,80% of total billed charges,1237.76,38.8,,,percent of total billed charges,38.8% of total billed charges,2711.59,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of APG fee schedule,281.54,200,,,fee schedule,200% of CMS fee schedule,281.54,3030.6,
"33016 - Pericardiocentesis, including imaging guidance",60000731,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,663.5,530.8,,497.63,75,,,percent of total billed charges,75% of total billed charges,265.4,40,,,percent of total billed charges,40% of total billed charges,525.49,79.2,,,percent of total billed charges,79.2% of total billed charges,563.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,630.33,95,,,percent of total billed charges,95% of total billed charges,530.8,80,,,percent of total billed charges,80% of total billed charges,563.98,85,,,percent of total billed charges,85% of total billed charges,597.15,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,265.4,40,,,percent of total billed charges,40% of total billed charges,265.4,40,,,percent of total billed charges,40% of total billed charges,597.15,90,,,percent of total billed charges,90% of total billed charges,504.26,76,,,percent of total billed charges,76% of total billed charges,265.4,40,,,percent of total billed charges,40% of total billed charges,563.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,530.8,80,,,percent of total billed charges,80% of total billed charges,257.44,38.8,,,percent of total billed charges,38.8% of total billed charges,563.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,630.33,
00103 ANESTH RECONSTRUCTIVE EYELID Charge,46200103,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00406 ANESTH INTEGUMENTARY SYSTEM Charge,46200406,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00450 ANESTH CLAVICLE AND SCAPULA Charge,46200450,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00522 ANESTH CHEST PROC NEEDLE BIOPSY Charge,46200522,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00560 ANESTH HEART PROC PERICARDIAL SAC Charge,46200560,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00770 ANESTH MAJOR ABDOMINAL BLOOD VSSL Charge,46200770,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00866 ANESTH EXTRAPERITONEAL PROC LOWER ABD Charge,46200866,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00952 ANESTH VAGINAL PROCEDURES Charge,46200952,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01112 ANESTH BONE MARROW ASPIRATION Charge,46201112,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01214 ANESTH OPEN PROC HIP JOINT Charge,46201214,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01270 ANESTH PROC ARTERIES UPPR LEG Charge,46201270,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01390 ANESTH CLSD PROC UPPER TIBIA Charge,46201390,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01392 ANESTH OPEN PROC UPPER TIBIA Charge,46201392,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01400 ANESTH ARTHOSCOPIC PROC KNEE JOINT Charge,46201400,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01630 ANESTH ARTHOSCOPIC PROC KNEE HEAD NECK Charge,46201630,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01730 ANESTH CLSD PROC HUMERUS ELBOW Charge,46201730,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01922 ANESTH NON-INVASIVE IMAGE RADIATION Charge,46201922,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
23570 Closed Treatment Of Scapular Fracture; Without Manipul,60000031,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,769.8,615.84,,577.35,75,,,percent of total billed charges,75% of total billed charges,307.92,40,,,percent of total billed charges,40% of total billed charges,609.68,79.2,,,percent of total billed charges,79.2% of total billed charges,654.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,731.31,95,,,percent of total billed charges,95% of total billed charges,615.84,80,,,percent of total billed charges,80% of total billed charges,654.33,85,,,percent of total billed charges,85% of total billed charges,692.82,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,307.92,40,,,percent of total billed charges,40% of total billed charges,307.92,40,,,percent of total billed charges,40% of total billed charges,692.82,90,,,percent of total billed charges,90% of total billed charges,585.05,76,,,percent of total billed charges,76% of total billed charges,307.92,40,,,percent of total billed charges,40% of total billed charges,654.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,615.84,80,,,percent of total billed charges,80% of total billed charges,298.68,38.8,,,percent of total billed charges,38.8% of total billed charges,654.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,731.31,
"10140 Incision And Drainage Of Hematoma, Seroma Or Fluid Col",60000007,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,356.3,285.04,,267.23,75,,,percent of total billed charges,75% of total billed charges,142.52,40,,,percent of total billed charges,40% of total billed charges,282.19,79.2,,,percent of total billed charges,79.2% of total billed charges,302.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,338.49,95,,,percent of total billed charges,95% of total billed charges,285.04,80,,,percent of total billed charges,80% of total billed charges,302.86,85,,,percent of total billed charges,85% of total billed charges,320.67,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,142.52,40,,,percent of total billed charges,40% of total billed charges,142.52,40,,,percent of total billed charges,40% of total billed charges,320.67,90,,,percent of total billed charges,90% of total billed charges,270.79,76,,,percent of total billed charges,76% of total billed charges,142.52,40,,,percent of total billed charges,40% of total billed charges,302.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,285.04,80,,,percent of total billed charges,80% of total billed charges,138.24,38.8,,,percent of total billed charges,38.8% of total billed charges,302.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,138.24,338.49,
20612 ASP/INJ GANGLION CYST,60000026,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,121.5,97.2,,91.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,96.23,79.2,,,percent of total billed charges,79.2% of total billed charges,103.28,85,,,percent of total billed charges,85% of total billed charges,121.5,100,,,fee schedule,100% of CO APG rates,115.43,95,,,percent of total billed charges,95% of total billed charges,97.2,80,,,percent of total billed charges,80% of total billed charges,103.28,85,,,percent of total billed charges,85% of total billed charges,109.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,121.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,109.35,90,,,percent of total billed charges,90% of total billed charges,92.34,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,103.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,97.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,103.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,625.2,100,,,case rate,pays based on per visit rate,91.13,625.2,
25500 Closed Treatment Of Radial Shaft Fracture; Without Man,60000042,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,817.6,654.08,,613.2,75,,,percent of total billed charges,75% of total billed charges,327.04,40,,,percent of total billed charges,40% of total billed charges,647.54,79.2,,,percent of total billed charges,79.2% of total billed charges,694.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,776.72,95,,,percent of total billed charges,95% of total billed charges,654.08,80,,,percent of total billed charges,80% of total billed charges,694.96,85,,,percent of total billed charges,85% of total billed charges,735.84,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,327.04,40,,,percent of total billed charges,40% of total billed charges,327.04,40,,,percent of total billed charges,40% of total billed charges,735.84,90,,,percent of total billed charges,90% of total billed charges,621.38,76,,,percent of total billed charges,76% of total billed charges,327.04,40,,,percent of total billed charges,40% of total billed charges,694.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,654.08,80,,,percent of total billed charges,80% of total billed charges,317.23,38.8,,,percent of total billed charges,38.8% of total billed charges,694.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,776.72,
29515 Application Of Short Leg Splint,60000072,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,149.5,119.6,,112.13,75,,,percent of total billed charges,75% of total billed charges,59.8,40,,,percent of total billed charges,40% of total billed charges,118.4,79.2,,,percent of total billed charges,79.2% of total billed charges,127.08,85,,,percent of total billed charges,85% of total billed charges,149.5,100,,,fee schedule,100% of CO APG rates,142.03,95,,,percent of total billed charges,95% of total billed charges,119.6,80,,,percent of total billed charges,80% of total billed charges,127.08,85,,,percent of total billed charges,85% of total billed charges,134.55,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,149.5,100,,,fee schedule,100% of NM APC rate,59.8,40,,,percent of total billed charges,40% of total billed charges,59.8,40,,,percent of total billed charges,40% of total billed charges,134.55,90,,,percent of total billed charges,90% of total billed charges,113.62,76,,,percent of total billed charges,76% of total billed charges,59.8,40,,,percent of total billed charges,40% of total billed charges,127.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,119.6,80,,,percent of total billed charges,80% of total billed charges,58.01,38.8,,,percent of total billed charges,38.8% of total billed charges,127.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,58.01,217.66,
29425 Application Of Short Leg Cast Walking,60000070,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,162.9,130.32,,122.18,75,,,percent of total billed charges,75% of total billed charges,65.16,40,,,percent of total billed charges,40% of total billed charges,129.02,79.2,,,percent of total billed charges,79.2% of total billed charges,138.47,85,,,percent of total billed charges,85% of total billed charges,162.9,100,,,fee schedule,100% of CO APG rates,154.76,95,,,percent of total billed charges,95% of total billed charges,130.32,80,,,percent of total billed charges,80% of total billed charges,138.47,85,,,percent of total billed charges,85% of total billed charges,146.61,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,162.9,100,,,fee schedule,100% of NM APC rate,65.16,40,,,percent of total billed charges,40% of total billed charges,65.16,40,,,percent of total billed charges,40% of total billed charges,146.61,90,,,percent of total billed charges,90% of total billed charges,123.8,76,,,percent of total billed charges,76% of total billed charges,65.16,40,,,percent of total billed charges,40% of total billed charges,138.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,130.32,80,,,percent of total billed charges,80% of total billed charges,63.21,38.8,,,percent of total billed charges,38.8% of total billed charges,138.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,63.21,217.66,
"24344 Reconstruction Lateral Collateral Ligament, Elbow, Wit",46024344,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3317.1,2653.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27750 Fx Tibia Shaft W/O Manipulation,60000004,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1011.2,808.96,,758.4,75,,,percent of total billed charges,75% of total billed charges,404.48,40,,,percent of total billed charges,40% of total billed charges,800.87,79.2,,,percent of total billed charges,79.2% of total billed charges,859.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,960.64,95,,,percent of total billed charges,95% of total billed charges,808.96,80,,,percent of total billed charges,80% of total billed charges,859.52,85,,,percent of total billed charges,85% of total billed charges,910.08,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,404.48,40,,,percent of total billed charges,40% of total billed charges,404.48,40,,,percent of total billed charges,40% of total billed charges,910.08,90,,,percent of total billed charges,90% of total billed charges,768.51,76,,,percent of total billed charges,76% of total billed charges,404.48,40,,,percent of total billed charges,40% of total billed charges,859.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,808.96,80,,,percent of total billed charges,80% of total billed charges,392.35,38.8,,,percent of total billed charges,38.8% of total billed charges,859.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,960.64,
27810 Fx Bimalleolar W/ Manip,60000064,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1318.5,1054.8,,988.88,75,,,percent of total billed charges,75% of total billed charges,527.4,40,,,percent of total billed charges,40% of total billed charges,1044.25,79.2,,,percent of total billed charges,79.2% of total billed charges,1120.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1252.58,95,,,percent of total billed charges,95% of total billed charges,1054.8,80,,,percent of total billed charges,80% of total billed charges,1120.73,85,,,percent of total billed charges,85% of total billed charges,1186.65,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,527.4,40,,,percent of total billed charges,40% of total billed charges,527.4,40,,,percent of total billed charges,40% of total billed charges,1186.65,90,,,percent of total billed charges,90% of total billed charges,1002.06,76,,,percent of total billed charges,76% of total billed charges,527.4,40,,,percent of total billed charges,40% of total billed charges,1120.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1054.8,80,,,percent of total billed charges,80% of total billed charges,511.58,38.8,,,percent of total billed charges,38.8% of total billed charges,1120.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1252.58,
27816 TX OF ANKLE FX W/O MANIP,60000288,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,923.7,738.96,,692.78,75,,,percent of total billed charges,75% of total billed charges,369.48,40,,,percent of total billed charges,40% of total billed charges,731.57,79.2,,,percent of total billed charges,79.2% of total billed charges,785.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,877.52,95,,,percent of total billed charges,95% of total billed charges,738.96,80,,,percent of total billed charges,80% of total billed charges,785.15,85,,,percent of total billed charges,85% of total billed charges,831.33,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,369.48,40,,,percent of total billed charges,40% of total billed charges,369.48,40,,,percent of total billed charges,40% of total billed charges,831.33,90,,,percent of total billed charges,90% of total billed charges,702.01,76,,,percent of total billed charges,76% of total billed charges,369.48,40,,,percent of total billed charges,40% of total billed charges,785.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,738.96,80,,,percent of total billed charges,80% of total billed charges,358.4,38.8,,,percent of total billed charges,38.8% of total billed charges,785.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,877.52,
25295 - Tenolysis single flexor charge,60000815,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1609.4,1287.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"28039 Exc Tumor, Soft Tissue Foot,Toe; 1.5Cm",60000065,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1008.7,806.96,,756.53,75,,,percent of total billed charges,75% of total billed charges,403.48,40,,,percent of total billed charges,40% of total billed charges,798.89,79.2,,,percent of total billed charges,79.2% of total billed charges,857.4,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,958.27,95,,,percent of total billed charges,95% of total billed charges,806.96,80,,,percent of total billed charges,80% of total billed charges,857.4,85,,,percent of total billed charges,85% of total billed charges,907.83,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,403.48,40,,,percent of total billed charges,40% of total billed charges,403.48,40,,,percent of total billed charges,40% of total billed charges,907.83,90,,,percent of total billed charges,90% of total billed charges,766.61,76,,,percent of total billed charges,76% of total billed charges,403.48,40,,,percent of total billed charges,40% of total billed charges,857.4,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,806.96,80,,,percent of total billed charges,80% of total billed charges,391.38,38.8,,,percent of total billed charges,38.8% of total billed charges,857.4,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,958.27,
"28043 Excision Tumor Foot, Sub Q",46028043,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,786.5,629.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28122 Partial Excision Tarsal/Metatarsal,46028122,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1325.2,1060.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26541 - Reconstruction, collateral ligament",60001033,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2520,2016,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"25440 Repair Of Nonunion, Scaphoid Carpal Bone, With Or With",60000783,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2320.6,1856.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26715 OPEN TREAT METACARPOPHALANGEAL DISLOC,46026715,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1754.3,1403.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43248 - EGD w insertion of guide wire followed by passage of,60001006,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,482.1,385.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"49550 REPAIR INITIAL FEMORAL HERNIA, ANY AGE",46049550,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1711.9,1369.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
10021 Fine needle aspiration; without imaging,60000005,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,160.8,128.64,,120.6,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,127.35,79.2,,,percent of total billed charges,79.2% of total billed charges,136.68,85,,,percent of total billed charges,85% of total billed charges,160.8,100,,,fee schedule,100% of CO APG rates,152.76,95,,,percent of total billed charges,95% of total billed charges,128.64,80,,,percent of total billed charges,80% of total billed charges,136.68,85,,,percent of total billed charges,85% of total billed charges,144.72,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,160.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,144.72,90,,,percent of total billed charges,90% of total billed charges,122.21,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,136.68,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,128.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,136.68,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,703.8,100,,,case rate,pays based on per visit rate,120.6,703.8,
"Repair, intermediate, wounds of neck, hands, feet and/or ext",60000017,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,584.5,467.6,,438.38,75,,,percent of total billed charges,75% of total billed charges,233.8,40,,,percent of total billed charges,40% of total billed charges,462.92,79.2,,,percent of total billed charges,79.2% of total billed charges,496.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,555.28,95,,,percent of total billed charges,95% of total billed charges,467.6,80,,,percent of total billed charges,80% of total billed charges,496.83,85,,,percent of total billed charges,85% of total billed charges,526.05,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,233.8,40,,,percent of total billed charges,40% of total billed charges,233.8,40,,,percent of total billed charges,40% of total billed charges,526.05,90,,,percent of total billed charges,90% of total billed charges,444.22,76,,,percent of total billed charges,76% of total billed charges,233.8,40,,,percent of total billed charges,40% of total billed charges,496.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,467.6,80,,,percent of total billed charges,80% of total billed charges,226.79,38.8,,,percent of total billed charges,38.8% of total billed charges,496.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,555.28,
15852 Dressing Change (For Other Than Burns) Under Anesthesi,60000603,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,129.3,103.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
20200 - Muscle biopsy,60000741,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,281.6,225.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
20527 - INJ DUPUYTREN CORD W/ENZYME,60000991,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,195,156,,146.25,75,,,percent of total billed charges,75% of total billed charges,78,40,,,percent of total billed charges,40% of total billed charges,154.44,79.2,,,percent of total billed charges,79.2% of total billed charges,165.75,85,,,percent of total billed charges,85% of total billed charges,195,100,,,fee schedule,100% of CO APG rates,185.25,95,,,percent of total billed charges,95% of total billed charges,156,80,,,percent of total billed charges,80% of total billed charges,165.75,85,,,percent of total billed charges,85% of total billed charges,175.5,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,195,100,,,fee schedule,100% of NM APC rate,78,40,,,percent of total billed charges,40% of total billed charges,78,40,,,percent of total billed charges,40% of total billed charges,175.5,90,,,percent of total billed charges,90% of total billed charges,148.2,76,,,percent of total billed charges,76% of total billed charges,78,40,,,percent of total billed charges,40% of total billed charges,165.75,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,156,80,,,percent of total billed charges,80% of total billed charges,75.66,38.8,,,percent of total billed charges,38.8% of total billed charges,165.75,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,390,200,,,fee schedule,200% of CMS fee schedule,75.66,2713.28,
"24575 Open Treatment Of Humeral Epicondylar Fracture, Medial",46024575,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2223,1778.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24650 CLOSED TREATMENT OF RADIAL NECK OR HEAD.,60000041,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,783.6,626.88,,587.7,75,,,percent of total billed charges,75% of total billed charges,313.44,40,,,percent of total billed charges,40% of total billed charges,620.61,79.2,,,percent of total billed charges,79.2% of total billed charges,666.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,744.42,95,,,percent of total billed charges,95% of total billed charges,626.88,80,,,percent of total billed charges,80% of total billed charges,666.06,85,,,percent of total billed charges,85% of total billed charges,705.24,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,313.44,40,,,percent of total billed charges,40% of total billed charges,313.44,40,,,percent of total billed charges,40% of total billed charges,705.24,90,,,percent of total billed charges,90% of total billed charges,595.54,76,,,percent of total billed charges,76% of total billed charges,313.44,40,,,percent of total billed charges,40% of total billed charges,666.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,626.88,80,,,percent of total billed charges,80% of total billed charges,304.04,38.8,,,percent of total billed charges,38.8% of total billed charges,666.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,744.42,
26115 EXCISION TUMOR OR VASCULAR MALFORMATION.,60000048,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1022,817.6,,766.5,75,,,percent of total billed charges,75% of total billed charges,408.8,40,,,percent of total billed charges,40% of total billed charges,809.42,79.2,,,percent of total billed charges,79.2% of total billed charges,868.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,970.9,95,,,percent of total billed charges,95% of total billed charges,817.6,80,,,percent of total billed charges,80% of total billed charges,868.7,85,,,percent of total billed charges,85% of total billed charges,919.8,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,408.8,40,,,percent of total billed charges,40% of total billed charges,408.8,40,,,percent of total billed charges,40% of total billed charges,919.8,90,,,percent of total billed charges,90% of total billed charges,776.72,76,,,percent of total billed charges,76% of total billed charges,408.8,40,,,percent of total billed charges,40% of total billed charges,868.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,817.6,80,,,percent of total billed charges,80% of total billed charges,396.54,38.8,,,percent of total billed charges,38.8% of total billed charges,868.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,970.9,
"26492 - Opponensplasty, Tendon Transplant",60001032,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2787.1,2229.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26600 CLOSED METACARPAL FX ONE BONE.,60000049,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,912.7,730.16,,684.53,75,,,percent of total billed charges,75% of total billed charges,365.08,40,,,percent of total billed charges,40% of total billed charges,722.86,79.2,,,percent of total billed charges,79.2% of total billed charges,775.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,867.07,95,,,percent of total billed charges,95% of total billed charges,730.16,80,,,percent of total billed charges,80% of total billed charges,775.8,85,,,percent of total billed charges,85% of total billed charges,821.43,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,365.08,40,,,percent of total billed charges,40% of total billed charges,365.08,40,,,percent of total billed charges,40% of total billed charges,821.43,90,,,percent of total billed charges,90% of total billed charges,693.65,76,,,percent of total billed charges,76% of total billed charges,365.08,40,,,percent of total billed charges,40% of total billed charges,775.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,730.16,80,,,percent of total billed charges,80% of total billed charges,354.13,38.8,,,percent of total billed charges,38.8% of total billed charges,775.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,867.07,
26605 CLOSED TREATMENT OF METACARPAL FRACTURE.,60000050,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,935.2,748.16,,701.4,75,,,percent of total billed charges,75% of total billed charges,374.08,40,,,percent of total billed charges,40% of total billed charges,740.68,79.2,,,percent of total billed charges,79.2% of total billed charges,794.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,888.44,95,,,percent of total billed charges,95% of total billed charges,748.16,80,,,percent of total billed charges,80% of total billed charges,794.92,85,,,percent of total billed charges,85% of total billed charges,841.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,374.08,40,,,percent of total billed charges,40% of total billed charges,374.08,40,,,percent of total billed charges,40% of total billed charges,841.68,90,,,percent of total billed charges,90% of total billed charges,710.75,76,,,percent of total billed charges,76% of total billed charges,374.08,40,,,percent of total billed charges,40% of total billed charges,794.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,748.16,80,,,percent of total billed charges,80% of total billed charges,362.86,38.8,,,percent of total billed charges,38.8% of total billed charges,794.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,888.44,
26750 CLOSED TREATMENT OF DISTAL PHALAGEAL FRA.,60000056,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,607.6,486.08,,455.7,75,,,percent of total billed charges,75% of total billed charges,243.04,40,,,percent of total billed charges,40% of total billed charges,481.22,79.2,,,percent of total billed charges,79.2% of total billed charges,516.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,577.22,95,,,percent of total billed charges,95% of total billed charges,486.08,80,,,percent of total billed charges,80% of total billed charges,516.46,85,,,percent of total billed charges,85% of total billed charges,546.84,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,243.04,40,,,percent of total billed charges,40% of total billed charges,243.04,40,,,percent of total billed charges,40% of total billed charges,546.84,90,,,percent of total billed charges,90% of total billed charges,461.78,76,,,percent of total billed charges,76% of total billed charges,243.04,40,,,percent of total billed charges,40% of total billed charges,516.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,486.08,80,,,percent of total billed charges,80% of total billed charges,235.75,38.8,,,percent of total billed charges,38.8% of total billed charges,516.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,577.22,
"27334 - Arthrotomy, With Synovectomy, Knee; Anterior Or Post",60000614,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2077.8,1662.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27786 CLOSED TREATMENT OF DISTAL FIBULAR FRACT.,60000062,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,897.9,718.32,,673.43,75,,,percent of total billed charges,75% of total billed charges,359.16,40,,,percent of total billed charges,40% of total billed charges,711.14,79.2,,,percent of total billed charges,79.2% of total billed charges,763.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,853.01,95,,,percent of total billed charges,95% of total billed charges,718.32,80,,,percent of total billed charges,80% of total billed charges,763.22,85,,,percent of total billed charges,85% of total billed charges,808.11,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,359.16,40,,,percent of total billed charges,40% of total billed charges,359.16,40,,,percent of total billed charges,40% of total billed charges,808.11,90,,,percent of total billed charges,90% of total billed charges,682.4,76,,,percent of total billed charges,76% of total billed charges,359.16,40,,,percent of total billed charges,40% of total billed charges,763.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,718.32,80,,,percent of total billed charges,80% of total billed charges,348.39,38.8,,,percent of total billed charges,38.8% of total billed charges,763.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,853.01,
28400 CLOSED TX CALCANEAL FRACTURE.,46028400,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,718.7,574.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28470 CLOSED TREATMENT OF METATARSAL FRACTURE.,60000066,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,642,513.6,,481.5,75,,,percent of total billed charges,75% of total billed charges,256.8,40,,,percent of total billed charges,40% of total billed charges,508.46,79.2,,,percent of total billed charges,79.2% of total billed charges,545.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,609.9,95,,,percent of total billed charges,95% of total billed charges,513.6,80,,,percent of total billed charges,80% of total billed charges,545.7,85,,,percent of total billed charges,85% of total billed charges,577.8,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,256.8,40,,,percent of total billed charges,40% of total billed charges,256.8,40,,,percent of total billed charges,40% of total billed charges,577.8,90,,,percent of total billed charges,90% of total billed charges,487.92,76,,,percent of total billed charges,76% of total billed charges,256.8,40,,,percent of total billed charges,40% of total billed charges,545.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,513.6,80,,,percent of total billed charges,80% of total billed charges,249.1,38.8,,,percent of total billed charges,38.8% of total billed charges,545.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,609.9,
28490 CLTX FX GRT TOE PHLY PHLG W/O MNPJ.,60000068,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,393,314.4,,294.75,75,,,percent of total billed charges,75% of total billed charges,157.2,40,,,percent of total billed charges,40% of total billed charges,311.26,79.2,,,percent of total billed charges,79.2% of total billed charges,334.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,373.35,95,,,percent of total billed charges,95% of total billed charges,314.4,80,,,percent of total billed charges,80% of total billed charges,334.05,85,,,percent of total billed charges,85% of total billed charges,353.7,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,157.2,40,,,percent of total billed charges,40% of total billed charges,157.2,40,,,percent of total billed charges,40% of total billed charges,353.7,90,,,percent of total billed charges,90% of total billed charges,298.68,76,,,percent of total billed charges,76% of total billed charges,157.2,40,,,percent of total billed charges,40% of total billed charges,334.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,314.4,80,,,percent of total billed charges,80% of total billed charges,152.48,38.8,,,percent of total billed charges,38.8% of total billed charges,334.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,152.48,373.35,
"28515 Cl Tx Fx phalanx, phalanges w/ manip",60000470,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,447.5,358,,335.63,75,,,percent of total billed charges,75% of total billed charges,179,40,,,percent of total billed charges,40% of total billed charges,354.42,79.2,,,percent of total billed charges,79.2% of total billed charges,380.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,425.13,95,,,percent of total billed charges,95% of total billed charges,358,80,,,percent of total billed charges,80% of total billed charges,380.38,85,,,percent of total billed charges,85% of total billed charges,402.75,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,179,40,,,percent of total billed charges,40% of total billed charges,179,40,,,percent of total billed charges,40% of total billed charges,402.75,90,,,percent of total billed charges,90% of total billed charges,340.1,76,,,percent of total billed charges,76% of total billed charges,179,40,,,percent of total billed charges,40% of total billed charges,380.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,358,80,,,percent of total billed charges,80% of total billed charges,173.63,38.8,,,percent of total billed charges,38.8% of total billed charges,380.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,173.63,425.13,
36556 Insert non-tunnel CV catheter.,60000076,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,242,193.6,,181.5,75,,,percent of total billed charges,75% of total billed charges,96.8,40,,,percent of total billed charges,40% of total billed charges,191.66,79.2,,,percent of total billed charges,79.2% of total billed charges,205.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,229.9,95,,,percent of total billed charges,95% of total billed charges,193.6,80,,,percent of total billed charges,80% of total billed charges,205.7,85,,,percent of total billed charges,85% of total billed charges,217.8,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,96.8,40,,,percent of total billed charges,40% of total billed charges,96.8,40,,,percent of total billed charges,40% of total billed charges,217.8,90,,,percent of total billed charges,90% of total billed charges,183.92,76,,,percent of total billed charges,76% of total billed charges,96.8,40,,,percent of total billed charges,40% of total billed charges,205.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,193.6,80,,,percent of total billed charges,80% of total billed charges,93.9,38.8,,,percent of total billed charges,38.8% of total billed charges,205.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,93.9,229.9,
36561 Insert tunnel CV cath w or wo sq port>5.,60000078,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,960,768,,720,75,,,percent of total billed charges,75% of total billed charges,384,40,,,percent of total billed charges,40% of total billed charges,760.32,79.2,,,percent of total billed charges,79.2% of total billed charges,816,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,912,95,,,percent of total billed charges,95% of total billed charges,768,80,,,percent of total billed charges,80% of total billed charges,816,85,,,percent of total billed charges,85% of total billed charges,864,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,384,40,,,percent of total billed charges,40% of total billed charges,384,40,,,percent of total billed charges,40% of total billed charges,864,90,,,percent of total billed charges,90% of total billed charges,729.6,76,,,percent of total billed charges,76% of total billed charges,384,40,,,percent of total billed charges,40% of total billed charges,816,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,768,80,,,percent of total billed charges,80% of total billed charges,372.48,38.8,,,percent of total billed charges,38.8% of total billed charges,816,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,912,
"46320 EXC OF THROMBOSED HEMORRHOID, EXTERNAL.",60000090,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,338.2,270.56,,253.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,267.85,79.2,,,percent of total billed charges,79.2% of total billed charges,287.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,321.29,95,,,percent of total billed charges,95% of total billed charges,270.56,80,,,percent of total billed charges,80% of total billed charges,287.47,85,,,percent of total billed charges,85% of total billed charges,304.38,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,338.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,304.38,90,,,percent of total billed charges,90% of total billed charges,257.03,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,287.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,270.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,287.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1058.6,100,,,case rate,pays based on per visit rate,253.65,1058.6,
51702 - Professional Fee - Insertion of temp bladder cathete,60000093,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,72.3,57.84,,54.23,75,,,percent of total billed charges,75% of total billed charges,28.92,40,,,percent of total billed charges,40% of total billed charges,57.26,79.2,,,percent of total billed charges,79.2% of total billed charges,61.46,85,,,percent of total billed charges,85% of total billed charges,72.3,100,,,fee schedule,100% of CO APG rates,68.69,95,,,percent of total billed charges,95% of total billed charges,57.84,80,,,percent of total billed charges,80% of total billed charges,61.46,85,,,percent of total billed charges,85% of total billed charges,65.07,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,72.3,100,,,fee schedule,100% of NM APC rate,28.92,40,,,percent of total billed charges,40% of total billed charges,28.92,40,,,percent of total billed charges,40% of total billed charges,65.07,90,,,percent of total billed charges,90% of total billed charges,54.95,76,,,percent of total billed charges,76% of total billed charges,28.92,40,,,percent of total billed charges,40% of total billed charges,61.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,57.84,80,,,percent of total billed charges,80% of total billed charges,28.05,38.8,,,percent of total billed charges,38.8% of total billed charges,61.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,144.6,200,,,fee schedule,200% of CMS fee schedule,28.05,215.49,
54150 CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK.,60000097,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,279.7,223.76,,209.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,221.52,79.2,,,percent of total billed charges,79.2% of total billed charges,237.75,85,,,percent of total billed charges,85% of total billed charges,279.7,100,,,fee schedule,100% of CO APG rates,265.72,95,,,percent of total billed charges,95% of total billed charges,223.76,80,,,percent of total billed charges,80% of total billed charges,237.75,85,,,percent of total billed charges,85% of total billed charges,251.73,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,279.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,251.73,90,,,percent of total billed charges,90% of total billed charges,212.57,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,237.75,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,223.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,237.75,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,941.6,100,,,case rate,pays based on per visit rate,209.78,941.6,
"64774 - Excision Of Neuroma; Cutaneous Nerve, Surgically Ide",60000683,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1292.1,1033.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"24560 Closed Treatment Of Humeral Epicondylar Fracture, Medi",60000039,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,928.2,742.56,,696.15,75,,,percent of total billed charges,75% of total billed charges,371.28,40,,,percent of total billed charges,40% of total billed charges,735.13,79.2,,,percent of total billed charges,79.2% of total billed charges,788.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,881.79,95,,,percent of total billed charges,95% of total billed charges,742.56,80,,,percent of total billed charges,80% of total billed charges,788.97,85,,,percent of total billed charges,85% of total billed charges,835.38,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,371.28,40,,,percent of total billed charges,40% of total billed charges,371.28,40,,,percent of total billed charges,40% of total billed charges,835.38,90,,,percent of total billed charges,90% of total billed charges,705.43,76,,,percent of total billed charges,76% of total billed charges,371.28,40,,,percent of total billed charges,40% of total billed charges,788.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,742.56,80,,,percent of total billed charges,80% of total billed charges,360.14,38.8,,,percent of total billed charges,38.8% of total billed charges,788.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,881.79,
23600 Closed Treatment Of Proximal Humeral Fracture; Without,60000032,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,999.7,799.76,,749.78,75,,,percent of total billed charges,75% of total billed charges,399.88,40,,,percent of total billed charges,40% of total billed charges,791.76,79.2,,,percent of total billed charges,79.2% of total billed charges,849.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,949.72,95,,,percent of total billed charges,95% of total billed charges,799.76,80,,,percent of total billed charges,80% of total billed charges,849.75,85,,,percent of total billed charges,85% of total billed charges,899.73,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,399.88,40,,,percent of total billed charges,40% of total billed charges,399.88,40,,,percent of total billed charges,40% of total billed charges,899.73,90,,,percent of total billed charges,90% of total billed charges,759.77,76,,,percent of total billed charges,76% of total billed charges,399.88,40,,,percent of total billed charges,40% of total billed charges,849.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,799.76,80,,,percent of total billed charges,80% of total billed charges,387.88,38.8,,,percent of total billed charges,38.8% of total billed charges,849.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,949.72,
Arthroscopy of knee with menisectomy,46029880,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1699.2,1359.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
10030 Image-Guided Fluid Collection Drainage By Catheter,46010030,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,389.3,311.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64788 - EXCISION OF NEUROFIBROMA CHARGE,46064788,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1231.4,985.12,,923.55,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,975.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1046.69,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1169.83,95,,,percent of total billed charges,95% of total billed charges,985.12,80,,,percent of total billed charges,80% of total billed charges,1046.69,85,,,percent of total billed charges,85% of total billed charges,1108.26,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1231.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1108.26,90,,,percent of total billed charges,90% of total billed charges,935.86,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1046.69,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,985.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1046.69,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
20520 - FOREIGN BODY REMOVAL MUSCLE/TENDON SHEATH CHARGE,60000394,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,446.2,356.96,,334.65,75,,,percent of total billed charges,75% of total billed charges,178.48,40,,,percent of total billed charges,40% of total billed charges,353.39,79.2,,,percent of total billed charges,79.2% of total billed charges,379.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,423.89,95,,,percent of total billed charges,95% of total billed charges,356.96,80,,,percent of total billed charges,80% of total billed charges,379.27,85,,,percent of total billed charges,85% of total billed charges,401.58,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,178.48,40,,,percent of total billed charges,40% of total billed charges,178.48,40,,,percent of total billed charges,40% of total billed charges,401.58,90,,,percent of total billed charges,90% of total billed charges,339.11,76,,,percent of total billed charges,76% of total billed charges,178.48,40,,,percent of total billed charges,40% of total billed charges,379.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,356.96,80,,,percent of total billed charges,80% of total billed charges,173.13,38.8,,,percent of total billed charges,38.8% of total billed charges,379.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,173.13,423.89,
"64416 - BRACHIAL PLEXUS, CONTINUOUS INFUSION BY CATHETER (IN",46264416,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,336.1,268.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64446 - SCIATIC NERVE, CONTINUOUS INFUSION BY CATHETER (INCL",46264446,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,336.1,268.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64449 - LUMBAR PLEXUS, POSTERIOR APPROACH, CONTINUOUS INFUSI",46264449,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,220.6,176.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64448 - FEMORAL NERVE, CONTINUOUS INFUSION BY CATHETER(INCLU",46264448,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,303.1,242.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64420 - INJECTION, ANESTHETIC AGENT, INTERCOSTAL NERVE, SING",46264420,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,466,372.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64421 - INJECTION, ANESTHETIC AGENT, INTERCOSTAL NERVES, MUL",46264421,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,595,476,,446.25,75,,,percent of total billed charges,75% of total billed charges,238,40,,,percent of total billed charges,40% of total billed charges,471.24,79.2,,,percent of total billed charges,79.2% of total billed charges,505.75,85,,,percent of total billed charges,85% of total billed charges,595,100,,,fee schedule,100% of CO APG rates,565.25,95,,,percent of total billed charges,95% of total billed charges,476,80,,,percent of total billed charges,80% of total billed charges,505.75,85,,,percent of total billed charges,85% of total billed charges,535.5,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,595,100,,,fee schedule,100% of NM APC rate,238,40,,,percent of total billed charges,40% of total billed charges,238,40,,,percent of total billed charges,40% of total billed charges,535.5,90,,,percent of total billed charges,90% of total billed charges,452.2,76,,,percent of total billed charges,76% of total billed charges,238,40,,,percent of total billed charges,40% of total billed charges,505.75,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,476,80,,,percent of total billed charges,80% of total billed charges,230.86,38.8,,,percent of total billed charges,38.8% of total billed charges,505.75,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,230.86,2713.28,
"64425 - INJECTION, ANESTHETIC AGENT, ILIOINGUINAL, ILIOHYPOG",46264425,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,558,446.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64520 - INJECTION, ANESTHETIC AGENT, LUMBAR OR THORACIC (PAR",46264520,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,526.3,421.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
21933 - BIOPSY SOFT TISSUE BACK OR FLANK 5 CM OR > CHARGE,46021933,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2187.6,1750.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"28060 - FASCIECTOMY, PLANTAR FASCIA, PARTIAL CHARGE",46028060,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1086.5,869.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27250 - CLOSED TX OF HIP DISLOCATION;TRAUMATIC,W/O ANESTHESI",46027250,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,516.5,413.2,,387.38,75,,,percent of total billed charges,75% of total billed charges,206.6,40,,,percent of total billed charges,40% of total billed charges,409.07,79.2,,,percent of total billed charges,79.2% of total billed charges,439.03,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,490.68,95,,,percent of total billed charges,95% of total billed charges,413.2,80,,,percent of total billed charges,80% of total billed charges,439.03,85,,,percent of total billed charges,85% of total billed charges,464.85,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,206.6,40,,,percent of total billed charges,40% of total billed charges,206.6,40,,,percent of total billed charges,40% of total billed charges,464.85,90,,,percent of total billed charges,90% of total billed charges,392.54,76,,,percent of total billed charges,76% of total billed charges,206.6,40,,,percent of total billed charges,40% of total billed charges,439.03,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,413.2,80,,,percent of total billed charges,80% of total billed charges,200.4,38.8,,,percent of total billed charges,38.8% of total billed charges,439.03,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,490.68,
28450 - TX  OF TARSAL BONE FRACTURE CHARGE,46028450,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,598.1,478.48,,448.58,75,,,percent of total billed charges,75% of total billed charges,239.24,40,,,percent of total billed charges,40% of total billed charges,473.7,79.2,,,percent of total billed charges,79.2% of total billed charges,508.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,568.2,95,,,percent of total billed charges,95% of total billed charges,478.48,80,,,percent of total billed charges,80% of total billed charges,508.39,85,,,percent of total billed charges,85% of total billed charges,538.29,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,239.24,40,,,percent of total billed charges,40% of total billed charges,239.24,40,,,percent of total billed charges,40% of total billed charges,538.29,90,,,percent of total billed charges,90% of total billed charges,454.56,76,,,percent of total billed charges,76% of total billed charges,239.24,40,,,percent of total billed charges,40% of total billed charges,508.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,478.48,80,,,percent of total billed charges,80% of total billed charges,232.06,38.8,,,percent of total billed charges,38.8% of total billed charges,508.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,568.2,
46230 - EXCISIONMULTIPLE PAPILLAE OR TAGS CHARGE,46046230,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,518.4,414.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26951 - AMPUTATION FINGER OR THUMB, PRIMARY OR SECONDARY; WI",46026951,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2133.9,1707.12,,1600.43,75,,,percent of total billed charges,75% of total billed charges,853.56,40,,,percent of total billed charges,40% of total billed charges,1690.05,79.2,,,percent of total billed charges,79.2% of total billed charges,1813.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2027.21,95,,,percent of total billed charges,95% of total billed charges,1707.12,80,,,percent of total billed charges,80% of total billed charges,1813.82,85,,,percent of total billed charges,85% of total billed charges,1920.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,853.56,40,,,percent of total billed charges,40% of total billed charges,853.56,40,,,percent of total billed charges,40% of total billed charges,1920.51,90,,,percent of total billed charges,90% of total billed charges,1621.76,76,,,percent of total billed charges,76% of total billed charges,853.56,40,,,percent of total billed charges,40% of total billed charges,1813.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1707.12,80,,,percent of total billed charges,80% of total billed charges,827.95,38.8,,,percent of total billed charges,38.8% of total billed charges,1813.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2027.21,
25600 - CLOSED TX OF DISTAL RADIAL FX; W/O MANIPULATION CHAR,46025600,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1031.6,825.28,,773.7,75,,,percent of total billed charges,75% of total billed charges,412.64,40,,,percent of total billed charges,40% of total billed charges,817.03,79.2,,,percent of total billed charges,79.2% of total billed charges,876.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,980.02,95,,,percent of total billed charges,95% of total billed charges,825.28,80,,,percent of total billed charges,80% of total billed charges,876.86,85,,,percent of total billed charges,85% of total billed charges,928.44,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,412.64,40,,,percent of total billed charges,40% of total billed charges,412.64,40,,,percent of total billed charges,40% of total billed charges,928.44,90,,,percent of total billed charges,90% of total billed charges,784.02,76,,,percent of total billed charges,76% of total billed charges,412.64,40,,,percent of total billed charges,40% of total billed charges,876.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,825.28,80,,,percent of total billed charges,80% of total billed charges,400.26,38.8,,,percent of total billed charges,38.8% of total billed charges,876.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,980.02,
"27137 - TOTAL HIP REPLACEMENT , ACETABULAR COMPONENT ONLY CH",46027137,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,4330.1,3464.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"24342 Reinsertion Of Ruptured Biceps Or Triceps Tendon, Dist",46024342,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2329.1,1863.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
STRESS TEST (without Imaging),42893017,CDM,482,RC,93017,HCPCS,OUTPATIENT,,,117.1,93.68,,87.83,75,,,percent of total billed charges,75% of total billed charges,46.84,40,,,percent of total billed charges,40% of total billed charges,92.74,79.2,,,percent of total billed charges,79.2% of total billed charges,99.54,85,,,percent of total billed charges,85% of total billed charges,117.1,100,,,fee schedule,100% of CO APG rates,111.25,95,,,percent of total billed charges,95% of total billed charges,93.68,80,,,percent of total billed charges,80% of total billed charges,99.54,85,,,percent of total billed charges,85% of total billed charges,105.39,90,,,percent of total billed charges,90% of total billed charges,220.84,100,,,fee schedule,100% of CO APG rates,220.84,100,,,fee schedule,100% of CO APG rates,117.1,100,,,fee schedule,100% of NM APC rate,46.84,40,,,percent of total billed charges,40% of total billed charges,46.84,40,,,percent of total billed charges,40% of total billed charges,105.39,90,,,percent of total billed charges,90% of total billed charges,89,76,,,percent of total billed charges,76% of total billed charges,46.84,40,,,percent of total billed charges,40% of total billed charges,99.54,85,,,percent of total billed charges,85% of total billed charges,220.84,100,,,fee schedule,100% of CO APG rate,93.68,80,,,percent of total billed charges,80% of total billed charges,45.43,38.8,,,percent of total billed charges,38.8% of total billed charges,99.54,85,,,percent of total billed charges,85% of total billed charges,220.84,100,,,fee schedule,100% of APG fee schedule,75.8,200,,,fee schedule,200% of CMS fee schedule,45.43,220.84,
"24675 Closed Treatment Of Ulnar Fracture, Proximal End",31024675,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1290.5,1032.4,,967.88,75,,,percent of total billed charges,75% of total billed charges,516.2,40,,,percent of total billed charges,40% of total billed charges,1022.08,79.2,,,percent of total billed charges,79.2% of total billed charges,1096.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1225.98,95,,,percent of total billed charges,95% of total billed charges,1032.4,80,,,percent of total billed charges,80% of total billed charges,1096.93,85,,,percent of total billed charges,85% of total billed charges,1161.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,516.2,40,,,percent of total billed charges,40% of total billed charges,516.2,40,,,percent of total billed charges,40% of total billed charges,1161.45,90,,,percent of total billed charges,90% of total billed charges,980.78,76,,,percent of total billed charges,76% of total billed charges,516.2,40,,,percent of total billed charges,40% of total billed charges,1096.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1032.4,80,,,percent of total billed charges,80% of total billed charges,500.71,38.8,,,percent of total billed charges,38.8% of total billed charges,1096.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1225.98,
25630 CO TX CARPAL W/O MANIP,31025630,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,897.6,718.08,,673.2,75,,,percent of total billed charges,75% of total billed charges,359.04,40,,,percent of total billed charges,40% of total billed charges,710.9,79.2,,,percent of total billed charges,79.2% of total billed charges,762.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,852.72,95,,,percent of total billed charges,95% of total billed charges,718.08,80,,,percent of total billed charges,80% of total billed charges,762.96,85,,,percent of total billed charges,85% of total billed charges,807.84,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,359.04,40,,,percent of total billed charges,40% of total billed charges,359.04,40,,,percent of total billed charges,40% of total billed charges,807.84,90,,,percent of total billed charges,90% of total billed charges,682.18,76,,,percent of total billed charges,76% of total billed charges,359.04,40,,,percent of total billed charges,40% of total billed charges,762.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,718.08,80,,,percent of total billed charges,80% of total billed charges,348.27,38.8,,,percent of total billed charges,38.8% of total billed charges,762.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,852.72,
"27472 - REPAIR, NONUNION MALUNION FEMUR, DISTAL HEAD AND NEC",40627472,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3760.6,3008.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"49320 - LAPAROSCOPY ABDOMEN, PERIONEUM AND OMENTUM DIAGNOSTI",40649320,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,975.5,780.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64640 - DESTRUCTION BY NEUROLYTIC AGENT, OTHER PERIPHERAL NE",40664640,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,356.6,285.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43241 - ESOPHAGOGASTRODUODENOSCOPY WITH INSERTION OF INTRALU,40643241,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,470.4,376.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"28080 - EXCISION, INTERDIGITAL (MORTON) NEUROMA, SINGLE, EAC",40628080,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1162.7,930.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29866 ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST,60000317,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3156.3,2525.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012032,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,570.2,456.16,,427.65,75,,,percent of total billed charges,75% of total billed charges,228.08,40,,,percent of total billed charges,40% of total billed charges,451.6,79.2,,,percent of total billed charges,79.2% of total billed charges,484.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,541.69,95,,,percent of total billed charges,95% of total billed charges,456.16,80,,,percent of total billed charges,80% of total billed charges,484.67,85,,,percent of total billed charges,85% of total billed charges,513.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,228.08,40,,,percent of total billed charges,40% of total billed charges,228.08,40,,,percent of total billed charges,40% of total billed charges,513.18,90,,,percent of total billed charges,90% of total billed charges,433.35,76,,,percent of total billed charges,76% of total billed charges,228.08,40,,,percent of total billed charges,40% of total billed charges,484.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,456.16,80,,,percent of total billed charges,80% of total billed charges,221.24,38.8,,,percent of total billed charges,38.8% of total billed charges,484.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,541.69,
25825 -Arthodesis wrist with autograph,60000812,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2402.3,1921.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27618 EXC TUMOR LEG/ANKLE SUBCU,60000058,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,924.3,739.44,,693.23,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,732.05,79.2,,,percent of total billed charges,79.2% of total billed charges,785.66,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,878.09,95,,,percent of total billed charges,95% of total billed charges,739.44,80,,,percent of total billed charges,80% of total billed charges,785.66,85,,,percent of total billed charges,85% of total billed charges,831.87,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,924.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,831.87,90,,,percent of total billed charges,90% of total billed charges,702.47,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,785.66,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,739.44,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,785.66,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
27831 CLOSED TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOC,98127831,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1266,1012.8,,949.5,75,,,percent of total billed charges,75% of total billed charges,506.4,40,,,percent of total billed charges,40% of total billed charges,1002.67,79.2,,,percent of total billed charges,79.2% of total billed charges,1076.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1202.7,95,,,percent of total billed charges,95% of total billed charges,1012.8,80,,,percent of total billed charges,80% of total billed charges,1076.1,85,,,percent of total billed charges,85% of total billed charges,1139.4,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,506.4,40,,,percent of total billed charges,40% of total billed charges,506.4,40,,,percent of total billed charges,40% of total billed charges,1139.4,90,,,percent of total billed charges,90% of total billed charges,962.16,76,,,percent of total billed charges,76% of total billed charges,506.4,40,,,percent of total billed charges,40% of total billed charges,1076.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1012.8,80,,,percent of total billed charges,80% of total billed charges,491.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1076.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1202.7,
27822 OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE INCLUDES,98127822,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2616.5,2093.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27600 DECOMPRESSION FASCIOTOMY, LEG;ANTERUIR AND/OR LATERAL",98127600,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1192.1,953.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
57180 INTRODUCTION OF ANY HEMOSTATIC AGENT OR PACK FOR SPONT,98157180,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,359.7,287.76,,269.78,75,,,percent of total billed charges,75% of total billed charges,143.88,40,,,percent of total billed charges,40% of total billed charges,284.88,79.2,,,percent of total billed charges,79.2% of total billed charges,305.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,341.72,95,,,percent of total billed charges,95% of total billed charges,287.76,80,,,percent of total billed charges,80% of total billed charges,305.75,85,,,percent of total billed charges,85% of total billed charges,323.73,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,143.88,40,,,percent of total billed charges,40% of total billed charges,143.88,40,,,percent of total billed charges,40% of total billed charges,323.73,90,,,percent of total billed charges,90% of total billed charges,273.37,76,,,percent of total billed charges,76% of total billed charges,143.88,40,,,percent of total billed charges,40% of total billed charges,305.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,287.76,80,,,percent of total billed charges,80% of total billed charges,139.56,38.8,,,percent of total billed charges,38.8% of total billed charges,305.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,139.56,341.72,
49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,98149083,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,308.8,247.04,,231.6,75,,,percent of total billed charges,75% of total billed charges,123.52,40,,,percent of total billed charges,40% of total billed charges,244.57,79.2,,,percent of total billed charges,79.2% of total billed charges,262.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,293.36,95,,,percent of total billed charges,95% of total billed charges,247.04,80,,,percent of total billed charges,80% of total billed charges,262.48,85,,,percent of total billed charges,85% of total billed charges,277.92,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,123.52,40,,,percent of total billed charges,40% of total billed charges,123.52,40,,,percent of total billed charges,40% of total billed charges,277.92,90,,,percent of total billed charges,90% of total billed charges,234.69,76,,,percent of total billed charges,76% of total billed charges,123.52,40,,,percent of total billed charges,40% of total billed charges,262.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,247.04,80,,,percent of total billed charges,80% of total billed charges,119.81,38.8,,,percent of total billed charges,38.8% of total billed charges,262.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,119.81,293.36,
"44186 LAPAROSCOPY, SURGICAL. JEJUNOSTOMY",98144186,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1912.6,1530.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28296 WITH METATARSAL OSTEOTOMY,98128296,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1551.9,1241.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"28820 AMPUTATION, TOE; METATARSOPHALANGEAL JOINT",98128820,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,520.5,416.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24587 Open Treatment Of Periarticular Fracture And/Or Disloc,98124587,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3246,2596.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00802 ANESTH FOR PROCEDURES ON LOWER ANTERIOR ABDOMINAL WALL,46200802,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01474 ANESTH GASTROCNEMIUS RECESSION Charge,46201474,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Debride of Nail(s) By Any Method(s); One to Five Charge,49111720,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,41.9,33.52,,31.43,75,,,percent of total billed charges,75% of total billed charges,16.76,40,,,percent of total billed charges,40% of total billed charges,33.18,79.2,,,percent of total billed charges,79.2% of total billed charges,35.62,85,,,percent of total billed charges,85% of total billed charges,41.9,100,,,fee schedule,100% of CO APG rates,39.81,95,,,percent of total billed charges,95% of total billed charges,33.52,80,,,percent of total billed charges,80% of total billed charges,35.62,85,,,percent of total billed charges,85% of total billed charges,37.71,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,41.9,100,,,fee schedule,100% of NM APC rate,16.76,40,,,percent of total billed charges,40% of total billed charges,16.76,40,,,percent of total billed charges,40% of total billed charges,37.71,90,,,percent of total billed charges,90% of total billed charges,31.84,76,,,percent of total billed charges,76% of total billed charges,16.76,40,,,percent of total billed charges,40% of total billed charges,35.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,33.52,80,,,percent of total billed charges,80% of total billed charges,16.26,38.8,,,percent of total billed charges,38.8% of total billed charges,35.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,83.8,200,,,fee schedule,200% of CMS fee schedule,16.26,215.49,
"24498 Prophylactic Treatment Humeral, Shaft With Or Without",46024498,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2588.8,2071.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24500 Closed Treatment Of Humeral Shaft Fracture; Without Ma,46024500,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1050.5,840.4,,787.88,75,,,percent of total billed charges,75% of total billed charges,420.2,40,,,percent of total billed charges,40% of total billed charges,832,79.2,,,percent of total billed charges,79.2% of total billed charges,892.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,997.98,95,,,percent of total billed charges,95% of total billed charges,840.4,80,,,percent of total billed charges,80% of total billed charges,892.93,85,,,percent of total billed charges,85% of total billed charges,945.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,420.2,40,,,percent of total billed charges,40% of total billed charges,420.2,40,,,percent of total billed charges,40% of total billed charges,945.45,90,,,percent of total billed charges,90% of total billed charges,798.38,76,,,percent of total billed charges,76% of total billed charges,420.2,40,,,percent of total billed charges,40% of total billed charges,892.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,840.4,80,,,percent of total billed charges,80% of total billed charges,407.59,38.8,,,percent of total billed charges,38.8% of total billed charges,892.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,997.98,
"OPEN TREATMENT OF METATARSAL FRACTURE, INCLUDES INTERNAL FIX",46028485,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1702.8,1362.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT",46028750,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1726,1380.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
AMPUTATION TRANSMETATARSAL,46028805,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2085.4,1668.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"AMPUTATION, METATARSAL, WITH TOE SINGLE",46028810,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1256.3,1005.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27768 CLOSED TREATMENT OF POSTERIOR MALLEOLUS FRACTUREL W/MA,31027768,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1386.3,1109.04,,1039.73,75,,,percent of total billed charges,75% of total billed charges,554.52,40,,,percent of total billed charges,40% of total billed charges,1097.95,79.2,,,percent of total billed charges,79.2% of total billed charges,1178.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1316.99,95,,,percent of total billed charges,95% of total billed charges,1109.04,80,,,percent of total billed charges,80% of total billed charges,1178.36,85,,,percent of total billed charges,85% of total billed charges,1247.67,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,554.52,40,,,percent of total billed charges,40% of total billed charges,554.52,40,,,percent of total billed charges,40% of total billed charges,1247.67,90,,,percent of total billed charges,90% of total billed charges,1053.59,76,,,percent of total billed charges,76% of total billed charges,554.52,40,,,percent of total billed charges,40% of total billed charges,1178.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1109.04,80,,,percent of total billed charges,80% of total billed charges,537.88,38.8,,,percent of total billed charges,38.8% of total billed charges,1178.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1316.99,
28430 closed treatment of talus fx; without manipulation,31028420,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,658.9,527.12,,494.18,75,,,percent of total billed charges,75% of total billed charges,263.56,40,,,percent of total billed charges,40% of total billed charges,521.85,79.2,,,percent of total billed charges,79.2% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,625.96,95,,,percent of total billed charges,95% of total billed charges,527.12,80,,,percent of total billed charges,80% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,593.01,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,263.56,40,,,percent of total billed charges,40% of total billed charges,263.56,40,,,percent of total billed charges,40% of total billed charges,593.01,90,,,percent of total billed charges,90% of total billed charges,500.76,76,,,percent of total billed charges,76% of total billed charges,263.56,40,,,percent of total billed charges,40% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,527.12,80,,,percent of total billed charges,80% of total billed charges,255.65,38.8,,,percent of total billed charges,38.8% of total billed charges,560.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,625.96,
"11004 - DBRD SKIN, SUBQ EXTERNAL CHARGE",46011004,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1635.6,1308.48,,1226.7,75,,,percent of total billed charges,75% of total billed charges,654.24,40,,,percent of total billed charges,40% of total billed charges,1295.4,79.2,,,percent of total billed charges,79.2% of total billed charges,1390.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1553.82,95,,,percent of total billed charges,95% of total billed charges,1308.48,80,,,percent of total billed charges,80% of total billed charges,1390.26,85,,,percent of total billed charges,85% of total billed charges,1472.04,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,654.24,40,,,percent of total billed charges,40% of total billed charges,654.24,40,,,percent of total billed charges,40% of total billed charges,1472.04,90,,,percent of total billed charges,90% of total billed charges,1243.06,76,,,percent of total billed charges,76% of total billed charges,654.24,40,,,percent of total billed charges,40% of total billed charges,1390.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1308.48,80,,,percent of total billed charges,80% of total billed charges,634.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1390.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1553.82,
11450 Ex cision of skin and subcutaneous tissue for hidraden,46011450,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,789.4,631.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
11451 Excision of skin and subcutaneous tissue for hidradeni,46011451,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,995.9,796.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
19030 Injection Procedure Only For Mammary Ductogram Or Gala,41519030,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,218.9,175.12,TC,164.18,75,,,percent of total billed charges,75% of total billed charges,87.56,40,,,percent of total billed charges,40% of total billed charges,173.37,79.2,,,percent of total billed charges,79.2% of total billed charges,186.07,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,207.96,95,,,percent of total billed charges,95% of total billed charges,175.12,80,,,percent of total billed charges,80% of total billed charges,186.07,85,,,percent of total billed charges,85% of total billed charges,197.01,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,218.9,100,,,fee schedule,100% of NM APC rate,87.56,40,,,percent of total billed charges,40% of total billed charges,87.56,40,,,percent of total billed charges,40% of total billed charges,197.01,90,,,percent of total billed charges,90% of total billed charges,166.36,76,,,percent of total billed charges,76% of total billed charges,87.56,40,,,percent of total billed charges,40% of total billed charges,186.07,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,175.12,80,,,percent of total billed charges,80% of total billed charges,84.93,38.8,,,percent of total billed charges,38.8% of total billed charges,186.07,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,84.93,218.9,
"19126 Excision of Breast Lesion, identified by Perioperative",46019126,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,459.8,367.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"19281 Placement Of Breast Localization Device, Percutaneous;",41519281,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,283.9,227.12,LT,212.93,75,,,percent of total billed charges,75% of total billed charges,113.56,40,,,percent of total billed charges,40% of total billed charges,224.85,79.2,,,percent of total billed charges,79.2% of total billed charges,241.32,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,269.71,95,,,percent of total billed charges,95% of total billed charges,227.12,80,,,percent of total billed charges,80% of total billed charges,241.32,85,,,percent of total billed charges,85% of total billed charges,255.51,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,113.56,40,,,percent of total billed charges,40% of total billed charges,113.56,40,,,percent of total billed charges,40% of total billed charges,255.51,90,,,percent of total billed charges,90% of total billed charges,215.76,76,,,percent of total billed charges,76% of total billed charges,113.56,40,,,percent of total billed charges,40% of total billed charges,241.32,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,227.12,80,,,percent of total billed charges,80% of total billed charges,110.15,38.8,,,percent of total billed charges,38.8% of total billed charges,241.32,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,110.15,269.71,
"19282 Placement Of Breast Localization Device, Percutaneous;",41519282,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,142.1,113.68,,106.58,75,,,percent of total billed charges,75% of total billed charges,56.84,40,,,percent of total billed charges,40% of total billed charges,112.54,79.2,,,percent of total billed charges,79.2% of total billed charges,120.79,85,,,percent of total billed charges,85% of total billed charges,142.1,100,,,fee schedule,100% of CO APG rates,135,95,,,percent of total billed charges,95% of total billed charges,113.68,80,,,percent of total billed charges,80% of total billed charges,120.79,85,,,percent of total billed charges,85% of total billed charges,127.89,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,142.1,100,,,fee schedule,100% of NM APC rate,56.84,40,,,percent of total billed charges,40% of total billed charges,56.84,40,,,percent of total billed charges,40% of total billed charges,127.89,90,,,percent of total billed charges,90% of total billed charges,108,76,,,percent of total billed charges,76% of total billed charges,56.84,40,,,percent of total billed charges,40% of total billed charges,120.79,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,113.68,80,,,percent of total billed charges,80% of total billed charges,55.13,38.8,,,percent of total billed charges,38.8% of total billed charges,120.79,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,55.13,159.09,
19285 US Breast needle Loc w/localization device placement;,41219285,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,242.5,194,TC,181.88,75,,,percent of total billed charges,75% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,192.06,79.2,,,percent of total billed charges,79.2% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,230.38,95,,,percent of total billed charges,95% of total billed charges,194,80,,,percent of total billed charges,80% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,218.25,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,97,40,,,percent of total billed charges,40% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,218.25,90,,,percent of total billed charges,90% of total billed charges,184.3,76,,,percent of total billed charges,76% of total billed charges,97,40,,,percent of total billed charges,40% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,194,80,,,percent of total billed charges,80% of total billed charges,94.09,38.8,,,percent of total billed charges,38.8% of total billed charges,206.13,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,230.38,
19286 US Breast needle Loc w/localization device placement;,41219286,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,121.2,96.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
23073 EXC SHOULDER TUM DEEP 5 CM/>,46023073,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2080.1,1664.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
23552 Open treatment of acromioclavicular dislocation,46023552,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1952.8,1562.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"25525 Open Treatment Of Radial Shaft Fracture, Includes Inte",60000405,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2390.7,1912.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27091 REMOVAL OF HIP PROTHESIS; COMPLICATED,46027091,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,4712.9,3770.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27134 Revise hip joint replacement .,46027134,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,5603.9,4483.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27310 Exploration of knee joint,46027310,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2209.1,1767.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27345 Removal of knee cyst .,46027345,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1489.4,1191.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27360 Partial removal leg bone(s) .,46027360,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2705.8,2164.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27488 Removal of knee prosthesis .,46027488,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3574.5,2859.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27590 Amputation, Thigh, Through Femur, Any Level;",46027590,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2265.5,1812.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27615 Resect leg/ankle tum < 5 cm .,46027615,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2994.8,2395.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27632 Exc leg/ankle les sc 3 cm/> .,46027632,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1226.6,981.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27880 Amputation of lower leg .,46027880,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2602.2,2081.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28072 Removal of foot joint lining .,46028072,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,985.1,788.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28118 - Removal of Heel Bone,60000164,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1281.6,1025.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28476 Treat metatarsal fracture .,46028476,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1201.8,961.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Open treatment of metatarsophalangeal joint dislocation, in",60000406,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1467.5,1174,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29828 Arthroscopy biceps tenodesis .,46029828,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2737.3,2189.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT,60000131,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3817.3,3053.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
36425 CUT DOWN,31036425,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,113.6,90.88,,85.2,75,,,percent of total billed charges,75% of total billed charges,45.44,40,,,percent of total billed charges,40% of total billed charges,89.97,79.2,,,percent of total billed charges,79.2% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,113.6,100,,,fee schedule,100% of CO APG rates,107.92,95,,,percent of total billed charges,95% of total billed charges,90.88,80,,,percent of total billed charges,80% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,102.24,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,113.6,100,,,fee schedule,100% of NM APC rate,45.44,40,,,percent of total billed charges,40% of total billed charges,45.44,40,,,percent of total billed charges,40% of total billed charges,102.24,90,,,percent of total billed charges,90% of total billed charges,86.34,76,,,percent of total billed charges,76% of total billed charges,45.44,40,,,percent of total billed charges,40% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,90.88,80,,,percent of total billed charges,80% of total billed charges,44.08,38.8,,,percent of total billed charges,38.8% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,44.08,217.66,
49451 Replace duod/jej tube perc .,46094951,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,253.3,202.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
61782 Stereotactic computer-assisted (navigational) procedur,60000476,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,764.4,611.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24685 - Opn  tx of ulna fx prox end include ORIF,46024685,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1985.2,1588.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29825 - arthroscopy shoulder w lysis  redsection adhesions,40129825,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1772.7,1418.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"25447 - Arthroplasty, interposition, intercarpal or cmc",60001072,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2422.6,1938.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27355 - EX/CURETTAGE OF BONE CYST/TUMOR FEMUR,46027355,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1848.1,1478.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27840 - CL TX OF ANKLE DISLOCATION W/O ANESTHESIA,46027840,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1193.3,954.64,,894.98,75,,,percent of total billed charges,75% of total billed charges,477.32,40,,,percent of total billed charges,40% of total billed charges,945.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1014.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1133.64,95,,,percent of total billed charges,95% of total billed charges,954.64,80,,,percent of total billed charges,80% of total billed charges,1014.31,85,,,percent of total billed charges,85% of total billed charges,1073.97,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,477.32,40,,,percent of total billed charges,40% of total billed charges,477.32,40,,,percent of total billed charges,40% of total billed charges,1073.97,90,,,percent of total billed charges,90% of total billed charges,906.91,76,,,percent of total billed charges,76% of total billed charges,477.32,40,,,percent of total billed charges,40% of total billed charges,1014.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,954.64,80,,,percent of total billed charges,80% of total billed charges,463,38.8,,,percent of total billed charges,38.8% of total billed charges,1014.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1133.64,
27769 - OP/TX OF POSTERIOR MALLEOLUS FX IN ORIF,46027769,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2184.3,1747.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28510 Closed treatment of FX phalanx or phalanges,60000069,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,379.9,303.92,,284.93,75,,,percent of total billed charges,75% of total billed charges,151.96,40,,,percent of total billed charges,40% of total billed charges,300.88,79.2,,,percent of total billed charges,79.2% of total billed charges,322.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,360.91,95,,,percent of total billed charges,95% of total billed charges,303.92,80,,,percent of total billed charges,80% of total billed charges,322.92,85,,,percent of total billed charges,85% of total billed charges,341.91,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,151.96,40,,,percent of total billed charges,40% of total billed charges,151.96,40,,,percent of total billed charges,40% of total billed charges,341.91,90,,,percent of total billed charges,90% of total billed charges,288.72,76,,,percent of total billed charges,76% of total billed charges,151.96,40,,,percent of total billed charges,40% of total billed charges,322.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,303.92,80,,,percent of total billed charges,80% of total billed charges,147.4,38.8,,,percent of total billed charges,38.8% of total billed charges,322.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,147.4,360.91,
ANESTHESIA PATIENT OF EXTREME AGE <1  > 70,46099100,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,149,119.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
ANESTHESIA COMPLICATED BY EMERGENCY CONDITIONS,46099140,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,149,119.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
69000 DRAIN EXTERNAL EAR LESION,31069000,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,376.9,301.52,,282.68,75,,,percent of total billed charges,75% of total billed charges,150.76,40,,,percent of total billed charges,40% of total billed charges,298.5,79.2,,,percent of total billed charges,79.2% of total billed charges,320.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,358.06,95,,,percent of total billed charges,95% of total billed charges,301.52,80,,,percent of total billed charges,80% of total billed charges,320.37,85,,,percent of total billed charges,85% of total billed charges,339.21,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,150.76,40,,,percent of total billed charges,40% of total billed charges,150.76,40,,,percent of total billed charges,40% of total billed charges,339.21,90,,,percent of total billed charges,90% of total billed charges,286.44,76,,,percent of total billed charges,76% of total billed charges,150.76,40,,,percent of total billed charges,40% of total billed charges,320.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,301.52,80,,,percent of total billed charges,80% of total billed charges,146.24,38.8,,,percent of total billed charges,38.8% of total billed charges,320.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,146.24,358.06,
51720 BLADDER INSTILLATION ANTICARCINOGENIC AGENT,60000193,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,127.4,101.92,,95.55,75,,,percent of total billed charges,75% of total billed charges,50.96,40,,,percent of total billed charges,40% of total billed charges,100.9,79.2,,,percent of total billed charges,79.2% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,127.4,100,,,fee schedule,100% of CO APG rates,121.03,95,,,percent of total billed charges,95% of total billed charges,101.92,80,,,percent of total billed charges,80% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,114.66,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,127.4,100,,,fee schedule,100% of NM APC rate,50.96,40,,,percent of total billed charges,40% of total billed charges,50.96,40,,,percent of total billed charges,40% of total billed charges,114.66,90,,,percent of total billed charges,90% of total billed charges,96.82,76,,,percent of total billed charges,76% of total billed charges,50.96,40,,,percent of total billed charges,40% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,101.92,80,,,percent of total billed charges,80% of total billed charges,49.43,38.8,,,percent of total billed charges,38.8% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,254.8,200,,,fee schedule,200% of CMS fee schedule,49.43,2713.28,
"00100 ANESTH PROCEDURES ON SALIVARY GLANDS, INCLUDING BIOPSY",60000436,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00120 ANESTH PROCEDURES ON EXTERNAL, MIDDLE, AND INNER EAR I",60000435,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00124 ANESTH OTOSCOPY,60000437,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00126 ANESTH TYPMANTOMY,60000438,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00160 ANESTH PROCEDURES ON NOSE AND ACCESSORY SINUSES,46200160,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00170 ANESTH INTRAORAL PROCEDURES, INCLUDING BIOPSY",46200170,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00352 ANESTH SIMPLE LIGATION,46200352,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00410 ANESTH ELECTRICAL CONVERSION OF ARRHYTHMIAS,46200410,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00730 ANESTH PROCEDURES ON UPPER POSTERIOR ABDOMINAL WALL,46200730,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00820 ANESTH PROCEDURES ON LOWER POSTERIOR ABDOMINAL WALL,46200820,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00848 ANESTH PELVIC EXENTERATION,46200848,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00851 ANESTH TUBAL LIGATION/TRANSECTION,46200851,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00920 ANESTH PROCEDURES ON MALE GENITALIA (INCLUDING OPEN UR,46200920,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00921 ANESTH VASECTOMY, UNILATERAL OR BILATERAL",46200921,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00924 ANESTH UNDESCENDED TESTIS, UNILATERAL OR BILATERAL",60000440,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00926 ANESTH RADICAL ORCHIECTOMY, INGUINAL",60000441,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00928 ANESTH RADICAL ORCHIECTOMY, ABDOMINAL",46200928,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00942 ANESTH COLPOTOMY, VAGINECTOMY, COLPORRHAPHY, AND OPEN",46200942,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00948 ANESTH CERVCIAL CERCLAGE,46200948,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00950 ANESTH CULDOSCOPY,46200950,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01120 ANESTH PROCEDURES ON BONY PELVIS,46201120,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01173 ANESTH OPEN REPAIR OF FRACTURE DISRUPTION OF PELVIS OR,46201173,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01200 ANESTH ALL CLOSED PROCEDURES INVOLVING HIP JOINT,46201200,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01202 ANESTH ARTHROSCOPIC PROCEDURES OF HIP JOINT,46201202,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01212 ANESTH HIP DISARTICULATION,46201212,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01215 ANESTH REVISION OF TOTAL HIP ARTHROPLASTY,46201215,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01220 ANESTH ALL CLOSED PROCEDURES INVOLVING UPPER TWO-THIRD,46201220,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"01320 ANESTH ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FAS",46201320,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01340 ANESTH ALL CLOSED PROCEDURES ON LOWER ONE-THIRD OF FEM,46201340,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01382 ANESTH DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF KNEE JOIN,46201382,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01402 ANESTH TOTAL KNEE ARTHROPLASTY,46201402,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"01420 ANESTH ALL CAST APPLICATION, REMOVAL, OR REPAIR INVOLV",60000432,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"01462 ANESTH ALL CLOSED PROCEDURES ON LOWER LEG, ANKLE, AND",46201462,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"01470 ANESTH PROCEDURES ON NERVES, MUSCLES, TENDSONS, AND FA",46201470,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"01472 ANESTH REPAIR OF RUPTURED ACHILLES TENDON, WITH OR WIT",46201472,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01484 ANESTH OSTEOTOMY OR OSTEOPLASTY OF TIBIA AND/OR FIBULA,46201484,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"01490 ANESTH LOWER LEG CAST APPLIACTION, REMVOAL, OR REPAIR",46201490,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01622 ANESTH DIASGNOSTIC ARTHROSCOPIC PROCEDURES OF SHOULDER,46201622,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"01712 ANESTH TENOTOMY, ELBOW TO SHOULDER, OPEN",46201712,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"01714 ANESTH TENOPLASTY, ELBOW TO SHOULDER",46201714,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"01716 ANESTH TENDOESIS, RUPTURE OF LONG TENDON OF BICEPS",46201716,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01732 ANESTH DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF ELBOW JOI,46201732,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01742 ANESTH OSTEOTOMY OF HUMERUS,46201742,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01744 ANESTH REPAIR OF NONUNION OR MALUNION OF HUMERUS,1744,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01758 ANESTH EXCISION OF CYST OR TUMOR OF HUMERUS,46201758,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01930 ANESTH THERAPEUTIC INTERVENTIONAL RADIOLOGICAL PROCEDU,46201930,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01991 ANESTH DIAGNOSTIC OR THERAPEUTIC NERVE BLOCKS AND INJE,46201991,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01992 ANESTH PRONE POSTION,46201992,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01999 ANESTH UNLISTED ANESTHESIA PROCEDURES,46201999,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01996 ANESTH DAILY HOSPITAL MANAGEMENT OF EPIDURAL OR SUBARA,46201996,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64445 ANESTH SCIATIC NERVE, SINGLE",46264445,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,1145.4,916.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64447 FEMORAL NERVE, SINGLE",46264447,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,1145.4,916.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01620 ANESTHESIA FOR ALL CLOSED PROCEDURES ON THE HUMERAL HE,46201620,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01740 ANESTHESIA FOR OPEN OR SURGICAL ARTHOSCOPIC PROCEDURES,46201740,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00162 ANESTHESIA FOR PROCEDURES ON NOSE AND ACCESSORY SINUSE,46200162,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
EXCISION OF RETROPHARYNGEAL TUMOR,46200174,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00176 ANESTHESIA FOR INTRAORAL PROCEDURES, INCLUDING BIOPSY;",46200176,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00216 ANESTHESIA FOR INTRACRANIAL PROCEDURES; VASCULAR PROCE,46200216,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
NEEDLE BIOPSY OF THYROID,46200322,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
BIOPSY OF CLAVICLE,46200454,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
PNEUMONCENTESIS,46200524,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00530 ANESTHESIA FOR PERMANENT TRANSVENOUS PACEMAKER INSERTI,530,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00542 ANESTHESIA FOR THORACOTOMY PROC INVOLVING LUNGS, PLEUR",46200542,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
PARTIAL HEPATECTOMY OR MANAGEMENT OF LIVER HEMORRHAGE,46200792,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00906 ANESTHESIA FOR VULVECTOMY,46200906,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00908 ANESTHESIA FOR PERINEAL PROSTATECTOMY,46200908,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01160 ANESTHESIA FOR CLOSED PROCEDURES INVOLVING SYMPHYSIS P,46201160,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,85.2,68.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01170 ANESTHESIA FOR OPEN PROCEDURES INVOLVING SYMPHYSIS PUB,46201170,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25705 EXC TUMOR SOFT TISSUE FOREARM /WRIST SUBQ 3CM,60000002,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,961.4,769.12,,721.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,761.43,79.2,,,percent of total billed charges,79.2% of total billed charges,817.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,913.33,95,,,percent of total billed charges,95% of total billed charges,769.12,80,,,percent of total billed charges,80% of total billed charges,817.19,85,,,percent of total billed charges,85% of total billed charges,865.26,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,961.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,865.26,90,,,percent of total billed charges,90% of total billed charges,730.66,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,817.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,769.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,817.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
27090 Removal Of Hip Prosthesis;,46027090,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2482.2,1985.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Insertion Of PICC line Age Greater han 5 years old,46036571,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,907.3,725.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Reconstruction of Lateral Collateral Ligament Knee,46027427,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2134.4,1707.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"24075 Excision, Tumor, Soft Tissue Of Upper Arm Or Elbow Are",46024075,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,999.3,799.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Percutaneous Pinning of Finger or Thumb Fracture,46026727,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1460.9,1168.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28285 CORRECTION HAMMERTOE; EA TOE,46028285,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1176.2,940.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"19125 Excision of Breast Lesion, identified by Perioperative",46019125,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1375.5,1100.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"49255 Omentectomy, Epiploectomy, Resection Of Omentum",46049255,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2341.5,1873.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Open Reduction Internal Fixation (ORIF) Finger or Thumb,46026840,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1816.8,1453.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27248 Open Reduction Internal Fixation (ORIF) of Greater Tro,46027248,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2226.7,1781.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Repair of Meniscus (Medial or Lateral),46029883,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2516.4,2013.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64415 - Brachial plexus, single",46264415,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,1189.1,951.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43215 ESOPHAGOSCOPY FLEX REMOVE FB,46043215,CDM,360,RC,43215,HCPCS,OUTPATIENT,,,412,329.6,,309,75,,,percent of total billed charges,75% of total billed charges,164.8,40,,,percent of total billed charges,40% of total billed charges,326.3,79.2,,,percent of total billed charges,79.2% of total billed charges,350.2,85,,,percent of total billed charges,85% of total billed charges,412,100,,,fee schedule,100% of CO APG rates,391.4,95,,,percent of total billed charges,95% of total billed charges,329.6,80,,,percent of total billed charges,80% of total billed charges,350.2,85,,,percent of total billed charges,85% of total billed charges,370.8,90,,,percent of total billed charges,90% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rates,1260.54,100,,,fee schedule,100% of CO APG rates,412,100,,,fee schedule,100% of NM APC rate,164.8,40,,,percent of total billed charges,40% of total billed charges,164.8,40,,,percent of total billed charges,40% of total billed charges,370.8,90,,,percent of total billed charges,90% of total billed charges,313.12,76,,,percent of total billed charges,76% of total billed charges,164.8,40,,,percent of total billed charges,40% of total billed charges,350.2,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rate,329.6,80,,,percent of total billed charges,80% of total billed charges,159.86,38.8,,,percent of total billed charges,38.8% of total billed charges,350.2,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of APG fee schedule,281.54,200,,,fee schedule,200% of CMS fee schedule,159.86,1260.54,
23545 CLOSED TREATMENT OF ACROMIOCLAVICULAR DISLCATION W/MAN,46023545,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1015.6,812.48,,761.7,75,,,percent of total billed charges,75% of total billed charges,406.24,40,,,percent of total billed charges,40% of total billed charges,804.36,79.2,,,percent of total billed charges,79.2% of total billed charges,863.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,964.82,95,,,percent of total billed charges,95% of total billed charges,812.48,80,,,percent of total billed charges,80% of total billed charges,863.26,85,,,percent of total billed charges,85% of total billed charges,914.04,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,406.24,40,,,percent of total billed charges,40% of total billed charges,406.24,40,,,percent of total billed charges,40% of total billed charges,914.04,90,,,percent of total billed charges,90% of total billed charges,771.86,76,,,percent of total billed charges,76% of total billed charges,406.24,40,,,percent of total billed charges,40% of total billed charges,863.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,812.48,80,,,percent of total billed charges,80% of total billed charges,394.05,38.8,,,percent of total billed charges,38.8% of total billed charges,863.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,964.82,
28660 CLD TX IP JT DIS W/O ANES,31028660,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,284.7,227.76,,213.53,75,,,percent of total billed charges,75% of total billed charges,113.88,40,,,percent of total billed charges,40% of total billed charges,225.48,79.2,,,percent of total billed charges,79.2% of total billed charges,242,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,270.47,95,,,percent of total billed charges,95% of total billed charges,227.76,80,,,percent of total billed charges,80% of total billed charges,242,85,,,percent of total billed charges,85% of total billed charges,256.23,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,113.88,40,,,percent of total billed charges,40% of total billed charges,113.88,40,,,percent of total billed charges,40% of total billed charges,256.23,90,,,percent of total billed charges,90% of total billed charges,216.37,76,,,percent of total billed charges,76% of total billed charges,113.88,40,,,percent of total billed charges,40% of total billed charges,242,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,227.76,80,,,percent of total billed charges,80% of total billed charges,110.46,38.8,,,percent of total billed charges,38.8% of total billed charges,242,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,110.46,270.47,
23625 Closed treatment of greater humeral tuberosity frac,31023625,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1086.3,869.04,,814.73,75,,,percent of total billed charges,75% of total billed charges,434.52,40,,,percent of total billed charges,40% of total billed charges,860.35,79.2,,,percent of total billed charges,79.2% of total billed charges,923.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1031.99,95,,,percent of total billed charges,95% of total billed charges,869.04,80,,,percent of total billed charges,80% of total billed charges,923.36,85,,,percent of total billed charges,85% of total billed charges,977.67,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,434.52,40,,,percent of total billed charges,40% of total billed charges,434.52,40,,,percent of total billed charges,40% of total billed charges,977.67,90,,,percent of total billed charges,90% of total billed charges,825.59,76,,,percent of total billed charges,76% of total billed charges,434.52,40,,,percent of total billed charges,40% of total billed charges,923.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,869.04,80,,,percent of total billed charges,80% of total billed charges,421.48,38.8,,,percent of total billed charges,38.8% of total billed charges,923.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1031.99,
64417 AXILLARY NERVE V. BLOCK,46264417,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,1271.1,1016.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64486 TAP BLOCK UNILATERAL; BY INJ(S); INC IMG GUID,46264486,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,173.3,138.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64487 TAP BLOCK UNILATERAL; BY CONT INFUSION(S); INC IMG GUI,46264487,CDM,370,RC,99152,HCPCS,OUTPATIENT,,,670.9,536.72,,503.18,75,,,percent of total billed charges,75% of total billed charges,268.36,40,,,percent of total billed charges,40% of total billed charges,531.35,79.2,,,percent of total billed charges,79.2% of total billed charges,570.27,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rates,637.36,95,,,percent of total billed charges,95% of total billed charges,536.72,80,,,percent of total billed charges,80% of total billed charges,570.27,85,,,percent of total billed charges,85% of total billed charges,603.81,90,,,percent of total billed charges,90% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rates,31.51,100,,,fee schedule,100% of CO APG rates,670.9,100,,,fee schedule,100% of NM fee schedule,268.36,40,,,percent of total billed charges,40% of total billed charges,268.36,40,,,percent of total billed charges,40% of total billed charges,603.81,90,,,percent of total billed charges,90% of total billed charges,509.88,76,,,percent of total billed charges,76% of total billed charges,268.36,40,,,percent of total billed charges,40% of total billed charges,570.27,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rate,536.72,80,,,percent of total billed charges,80% of total billed charges,260.31,38.8,,,percent of total billed charges,38.8% of total billed charges,570.27,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of APG fee schedule,24.88,200,,,fee schedule,200% of CMS fee schedule,24.88,670.9,
64488 TAP BLOCK BILATERAL; BY INJ(S); INC IMG GUID,46264488,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,981.8,785.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64489 TAP BLOCK BILATERAL; BY CONT INFUSION(S); INC IMG GUID,46264489,CDM,370,RC,99152,HCPCS,OUTPATIENT,,,933.4,746.72,,700.05,75,,,percent of total billed charges,75% of total billed charges,373.36,40,,,percent of total billed charges,40% of total billed charges,739.25,79.2,,,percent of total billed charges,79.2% of total billed charges,793.39,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rates,886.73,95,,,percent of total billed charges,95% of total billed charges,746.72,80,,,percent of total billed charges,80% of total billed charges,793.39,85,,,percent of total billed charges,85% of total billed charges,840.06,90,,,percent of total billed charges,90% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rates,31.51,100,,,fee schedule,100% of CO APG rates,933.4,100,,,fee schedule,100% of NM fee schedule,373.36,40,,,percent of total billed charges,40% of total billed charges,373.36,40,,,percent of total billed charges,40% of total billed charges,840.06,90,,,percent of total billed charges,90% of total billed charges,709.38,76,,,percent of total billed charges,76% of total billed charges,373.36,40,,,percent of total billed charges,40% of total billed charges,793.39,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rate,746.72,80,,,percent of total billed charges,80% of total billed charges,362.16,38.8,,,percent of total billed charges,38.8% of total billed charges,793.39,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of APG fee schedule,24.88,200,,,fee schedule,200% of CMS fee schedule,24.88,933.4,
27760 Closed Treatment of medial malleous fracture; without manipulation,60000060,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,968.5,774.8,,726.38,75,,,percent of total billed charges,75% of total billed charges,387.4,40,,,percent of total billed charges,40% of total billed charges,767.05,79.2,,,percent of total billed charges,79.2% of total billed charges,823.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,920.08,95,,,percent of total billed charges,95% of total billed charges,774.8,80,,,percent of total billed charges,80% of total billed charges,823.23,85,,,percent of total billed charges,85% of total billed charges,871.65,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,387.4,40,,,percent of total billed charges,40% of total billed charges,387.4,40,,,percent of total billed charges,40% of total billed charges,871.65,90,,,percent of total billed charges,90% of total billed charges,736.06,76,,,percent of total billed charges,76% of total billed charges,387.4,40,,,percent of total billed charges,40% of total billed charges,823.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,774.8,80,,,percent of total billed charges,80% of total billed charges,375.78,38.8,,,percent of total billed charges,38.8% of total billed charges,823.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,920.08,
Treatment of tibial shaft fractue (with or without fibular f,46027759,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2978.2,2382.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"32555 Thoracentesis, needle or catheter, aspiration of the p",60000075,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,313.5,250.8,,235.13,75,,,percent of total billed charges,75% of total billed charges,125.4,40,,,percent of total billed charges,40% of total billed charges,248.29,79.2,,,percent of total billed charges,79.2% of total billed charges,266.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,297.83,95,,,percent of total billed charges,95% of total billed charges,250.8,80,,,percent of total billed charges,80% of total billed charges,266.48,85,,,percent of total billed charges,85% of total billed charges,282.15,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,125.4,40,,,percent of total billed charges,40% of total billed charges,125.4,40,,,percent of total billed charges,40% of total billed charges,282.15,90,,,percent of total billed charges,90% of total billed charges,238.26,76,,,percent of total billed charges,76% of total billed charges,125.4,40,,,percent of total billed charges,40% of total billed charges,266.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,250.8,80,,,percent of total billed charges,80% of total billed charges,121.64,38.8,,,percent of total billed charges,38.8% of total billed charges,266.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,121.64,297.83,
"Gastrectomy, partial, distal with gastrojejunostomy",46043632,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,5913,4730.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Vagotomy when performed with distal gastrectomy,46043635,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,322.9,258.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"24358 Tenotomy, Elbow, Lateral Or Medial",46024358,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1620.7,1296.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Spirometry including graphic record, total and timed vital c",42294010,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,118.1,94.48,,88.58,75,,,percent of total billed charges,75% of total billed charges,47.24,40,,,percent of total billed charges,40% of total billed charges,93.54,79.2,,,percent of total billed charges,79.2% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,112.2,95,,,percent of total billed charges,95% of total billed charges,94.48,80,,,percent of total billed charges,80% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,106.29,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,47.24,40,,,percent of total billed charges,40% of total billed charges,47.24,40,,,percent of total billed charges,40% of total billed charges,106.29,90,,,percent of total billed charges,90% of total billed charges,89.76,76,,,percent of total billed charges,76% of total billed charges,47.24,40,,,percent of total billed charges,40% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,94.48,80,,,percent of total billed charges,80% of total billed charges,45.82,38.8,,,percent of total billed charges,38.8% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,45.82,116.11,
"Closed Treatment of Humeral Condylar Fracture, Medial or Lat",60000040,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,989,791.2,,741.75,75,,,percent of total billed charges,75% of total billed charges,395.6,40,,,percent of total billed charges,40% of total billed charges,783.29,79.2,,,percent of total billed charges,79.2% of total billed charges,840.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,939.55,95,,,percent of total billed charges,95% of total billed charges,791.2,80,,,percent of total billed charges,80% of total billed charges,840.65,85,,,percent of total billed charges,85% of total billed charges,890.1,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,395.6,40,,,percent of total billed charges,40% of total billed charges,395.6,40,,,percent of total billed charges,40% of total billed charges,890.1,90,,,percent of total billed charges,90% of total billed charges,751.64,76,,,percent of total billed charges,76% of total billed charges,395.6,40,,,percent of total billed charges,40% of total billed charges,840.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,791.2,80,,,percent of total billed charges,80% of total billed charges,383.73,38.8,,,percent of total billed charges,38.8% of total billed charges,840.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,939.55,
"Ostectomy, Partial, Exostectomy or Condylectomy, Metatarsal",24628288,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1317.7,1054.16,,988.28,75,,,percent of total billed charges,75% of total billed charges,527.08,40,,,percent of total billed charges,40% of total billed charges,1043.62,79.2,,,percent of total billed charges,79.2% of total billed charges,1120.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1251.82,95,,,percent of total billed charges,95% of total billed charges,1054.16,80,,,percent of total billed charges,80% of total billed charges,1120.05,85,,,percent of total billed charges,85% of total billed charges,1185.93,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,527.08,40,,,percent of total billed charges,40% of total billed charges,527.08,40,,,percent of total billed charges,40% of total billed charges,1185.93,90,,,percent of total billed charges,90% of total billed charges,1001.45,76,,,percent of total billed charges,76% of total billed charges,527.08,40,,,percent of total billed charges,40% of total billed charges,1120.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1054.16,80,,,percent of total billed charges,80% of total billed charges,511.27,38.8,,,percent of total billed charges,38.8% of total billed charges,1120.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1251.82,
"27535 Open Treatment Of Tibial Fracture, Proximal (Plateau);",46027535,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2665,2132,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Arthrtomy wuth exploration , drainage, or removal of loose f",46026080,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1231.2,984.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"10121 Incision And Removal Foreign Body, Subcut; Complicated",46010121,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,546.6,437.28,,409.95,75,,,percent of total billed charges,75% of total billed charges,218.64,40,,,percent of total billed charges,40% of total billed charges,432.91,79.2,,,percent of total billed charges,79.2% of total billed charges,464.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,519.27,95,,,percent of total billed charges,95% of total billed charges,437.28,80,,,percent of total billed charges,80% of total billed charges,464.61,85,,,percent of total billed charges,85% of total billed charges,491.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,218.64,40,,,percent of total billed charges,40% of total billed charges,218.64,40,,,percent of total billed charges,40% of total billed charges,491.94,90,,,percent of total billed charges,90% of total billed charges,415.42,76,,,percent of total billed charges,76% of total billed charges,218.64,40,,,percent of total billed charges,40% of total billed charges,464.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,437.28,80,,,percent of total billed charges,80% of total billed charges,212.08,38.8,,,percent of total billed charges,38.8% of total billed charges,464.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,519.27,
"10160 Puncture Aspiration Of Abscess, Hematoma, Bulla, Or Cy",46010160,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,290.4,232.32,,217.8,75,,,percent of total billed charges,75% of total billed charges,116.16,40,,,percent of total billed charges,40% of total billed charges,230,79.2,,,percent of total billed charges,79.2% of total billed charges,246.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,275.88,95,,,percent of total billed charges,95% of total billed charges,232.32,80,,,percent of total billed charges,80% of total billed charges,246.84,85,,,percent of total billed charges,85% of total billed charges,261.36,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,116.16,40,,,percent of total billed charges,40% of total billed charges,116.16,40,,,percent of total billed charges,40% of total billed charges,261.36,90,,,percent of total billed charges,90% of total billed charges,220.7,76,,,percent of total billed charges,76% of total billed charges,116.16,40,,,percent of total billed charges,40% of total billed charges,246.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,232.32,80,,,percent of total billed charges,80% of total billed charges,112.68,38.8,,,percent of total billed charges,38.8% of total billed charges,246.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,112.68,275.88,
11001 Debridement Of Extensive Eczematous Or Infected Skin;,46011001,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,43,34.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"11008 Removal Of Prosthetic Material Or Mesh, Abdominal Wall",46011008,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,779.9,623.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
11010 DEBRI OPEN FX/CLD SUBQ,31011010,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,816.7,653.36,,612.53,75,,,percent of total billed charges,75% of total billed charges,326.68,40,,,percent of total billed charges,40% of total billed charges,646.83,79.2,,,percent of total billed charges,79.2% of total billed charges,694.2,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,775.87,95,,,percent of total billed charges,95% of total billed charges,653.36,80,,,percent of total billed charges,80% of total billed charges,694.2,85,,,percent of total billed charges,85% of total billed charges,735.03,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,326.68,40,,,percent of total billed charges,40% of total billed charges,326.68,40,,,percent of total billed charges,40% of total billed charges,735.03,90,,,percent of total billed charges,90% of total billed charges,620.69,76,,,percent of total billed charges,76% of total billed charges,326.68,40,,,percent of total billed charges,40% of total billed charges,694.2,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,653.36,80,,,percent of total billed charges,80% of total billed charges,316.88,38.8,,,percent of total billed charges,38.8% of total billed charges,694.2,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,775.87,
11011 DEBRIDE SKIN/MUS FX O/DIS,31011011,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,873.7,698.96,,655.28,75,,,percent of total billed charges,75% of total billed charges,349.48,40,,,percent of total billed charges,40% of total billed charges,691.97,79.2,,,percent of total billed charges,79.2% of total billed charges,742.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,830.02,95,,,percent of total billed charges,95% of total billed charges,698.96,80,,,percent of total billed charges,80% of total billed charges,742.65,85,,,percent of total billed charges,85% of total billed charges,786.33,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,349.48,40,,,percent of total billed charges,40% of total billed charges,349.48,40,,,percent of total billed charges,40% of total billed charges,786.33,90,,,percent of total billed charges,90% of total billed charges,664.01,76,,,percent of total billed charges,76% of total billed charges,349.48,40,,,percent of total billed charges,40% of total billed charges,742.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,698.96,80,,,percent of total billed charges,80% of total billed charges,339,38.8,,,percent of total billed charges,38.8% of total billed charges,742.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,830.02,
"11045 Debridement, Subcutaneous Tissue; each Add 20 Sq cm",46011045,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,71.9,57.52,,53.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,56.94,79.2,,,percent of total billed charges,79.2% of total billed charges,61.12,85,,,percent of total billed charges,85% of total billed charges,71.9,100,,,fee schedule,100% of CO APG rates,68.31,95,,,percent of total billed charges,95% of total billed charges,57.52,80,,,percent of total billed charges,80% of total billed charges,61.12,85,,,percent of total billed charges,85% of total billed charges,64.71,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,71.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,64.71,90,,,percent of total billed charges,90% of total billed charges,54.64,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,61.12,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,57.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,61.12,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,526,100,,,case rate,pays based on per visit rate,53.93,526,
"11046 Debridement, Muscle And/Or Fascia; Each Add 20 Sq Cm",46011046,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,157.1,125.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"11044 Debridement, Bone; First 20 Sq Cm Or Less",46011044,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,655.7,524.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Excision of skin and subcutaneous tissue for hidradenitis, i",46011462,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,758.2,606.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Excision of skin and subcutaneous tissue for hidradenitis, i",46011463,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,991.4,793.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Excision of skin and subcutaneous tissue for hidradenitis, p",46011471,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1050.8,840.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Excision of skin and subcutaneous tissue for hidradenitis, p",46011470,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,861.9,689.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Excision, malignant lesion including margins, face, ears, ey",46011644,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,832.7,666.16,,624.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,659.5,79.2,,,percent of total billed charges,79.2% of total billed charges,707.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,791.07,95,,,percent of total billed charges,95% of total billed charges,666.16,80,,,percent of total billed charges,80% of total billed charges,707.8,85,,,percent of total billed charges,85% of total billed charges,749.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,832.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,749.43,90,,,percent of total billed charges,90% of total billed charges,632.85,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,707.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,666.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,707.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excision, malignant lesion including margins, face, ears, ey",46011646,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1143.4,914.72,,857.55,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,905.57,79.2,,,percent of total billed charges,79.2% of total billed charges,971.89,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1086.23,95,,,percent of total billed charges,95% of total billed charges,914.72,80,,,percent of total billed charges,80% of total billed charges,971.89,85,,,percent of total billed charges,85% of total billed charges,1029.06,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1143.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1029.06,90,,,percent of total billed charges,90% of total billed charges,868.98,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,971.89,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,914.72,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,971.89,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, pr",46011755,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,177.3,141.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
11762 Reconstruction Of Nail Bed With Graft,46011762,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,561.1,448.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
12020 Treatment Of Superficial Wound Dehiscence; Simple Clos,46012020,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,563.4,450.72,,422.55,75,,,percent of total billed charges,75% of total billed charges,225.36,40,,,percent of total billed charges,40% of total billed charges,446.21,79.2,,,percent of total billed charges,79.2% of total billed charges,478.89,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,535.23,95,,,percent of total billed charges,95% of total billed charges,450.72,80,,,percent of total billed charges,80% of total billed charges,478.89,85,,,percent of total billed charges,85% of total billed charges,507.06,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,225.36,40,,,percent of total billed charges,40% of total billed charges,225.36,40,,,percent of total billed charges,40% of total billed charges,507.06,90,,,percent of total billed charges,90% of total billed charges,428.18,76,,,percent of total billed charges,76% of total billed charges,225.36,40,,,percent of total billed charges,40% of total billed charges,478.89,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,450.72,80,,,percent of total billed charges,80% of total billed charges,218.6,38.8,,,percent of total billed charges,38.8% of total billed charges,478.89,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,535.23,
12021 Treatment Of Superficial Wound Dehiscence; With Packin,46012021,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,419.4,335.52,,314.55,75,,,percent of total billed charges,75% of total billed charges,167.76,40,,,percent of total billed charges,40% of total billed charges,332.16,79.2,,,percent of total billed charges,79.2% of total billed charges,356.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,398.43,95,,,percent of total billed charges,95% of total billed charges,335.52,80,,,percent of total billed charges,80% of total billed charges,356.49,85,,,percent of total billed charges,85% of total billed charges,377.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,167.76,40,,,percent of total billed charges,40% of total billed charges,167.76,40,,,percent of total billed charges,40% of total billed charges,377.46,90,,,percent of total billed charges,90% of total billed charges,318.74,76,,,percent of total billed charges,76% of total billed charges,167.76,40,,,percent of total billed charges,40% of total billed charges,356.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,335.52,80,,,percent of total billed charges,80% of total billed charges,162.73,38.8,,,percent of total billed charges,38.8% of total billed charges,356.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,162.73,398.43,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012037,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,965.9,772.72,,724.43,75,,,percent of total billed charges,75% of total billed charges,386.36,40,,,percent of total billed charges,40% of total billed charges,764.99,79.2,,,percent of total billed charges,79.2% of total billed charges,821.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,917.61,95,,,percent of total billed charges,95% of total billed charges,772.72,80,,,percent of total billed charges,80% of total billed charges,821.02,85,,,percent of total billed charges,85% of total billed charges,869.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,386.36,40,,,percent of total billed charges,40% of total billed charges,386.36,40,,,percent of total billed charges,40% of total billed charges,869.31,90,,,percent of total billed charges,90% of total billed charges,734.08,76,,,percent of total billed charges,76% of total billed charges,386.36,40,,,percent of total billed charges,40% of total billed charges,821.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,772.72,80,,,percent of total billed charges,80% of total billed charges,374.77,38.8,,,percent of total billed charges,38.8% of total billed charges,821.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,917.61,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012036,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,835.3,668.24,,626.48,75,,,percent of total billed charges,75% of total billed charges,334.12,40,,,percent of total billed charges,40% of total billed charges,661.56,79.2,,,percent of total billed charges,79.2% of total billed charges,710.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,793.54,95,,,percent of total billed charges,95% of total billed charges,668.24,80,,,percent of total billed charges,80% of total billed charges,710.01,85,,,percent of total billed charges,85% of total billed charges,751.77,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,334.12,40,,,percent of total billed charges,40% of total billed charges,334.12,40,,,percent of total billed charges,40% of total billed charges,751.77,90,,,percent of total billed charges,90% of total billed charges,634.83,76,,,percent of total billed charges,76% of total billed charges,334.12,40,,,percent of total billed charges,40% of total billed charges,710.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,668.24,80,,,percent of total billed charges,80% of total billed charges,324.1,38.8,,,percent of total billed charges,38.8% of total billed charges,710.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,793.54,
"Repair, intermediate, wounds of neck, hands, feet, and/or ex",46012041,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,434.5,347.6,,325.88,75,,,percent of total billed charges,75% of total billed charges,173.8,40,,,percent of total billed charges,40% of total billed charges,344.12,79.2,,,percent of total billed charges,79.2% of total billed charges,369.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,412.78,95,,,percent of total billed charges,95% of total billed charges,347.6,80,,,percent of total billed charges,80% of total billed charges,369.33,85,,,percent of total billed charges,85% of total billed charges,391.05,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,173.8,40,,,percent of total billed charges,40% of total billed charges,173.8,40,,,percent of total billed charges,40% of total billed charges,391.05,90,,,percent of total billed charges,90% of total billed charges,330.22,76,,,percent of total billed charges,76% of total billed charges,173.8,40,,,percent of total billed charges,40% of total billed charges,369.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,347.6,80,,,percent of total billed charges,80% of total billed charges,168.59,38.8,,,percent of total billed charges,38.8% of total billed charges,369.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,168.59,412.78,
"Repair, intermediate, wounds of neck, hands, feet, and/or ex",46012044,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,638.7,510.96,,479.03,75,,,percent of total billed charges,75% of total billed charges,255.48,40,,,percent of total billed charges,40% of total billed charges,505.85,79.2,,,percent of total billed charges,79.2% of total billed charges,542.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,606.77,95,,,percent of total billed charges,95% of total billed charges,510.96,80,,,percent of total billed charges,80% of total billed charges,542.9,85,,,percent of total billed charges,85% of total billed charges,574.83,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,255.48,40,,,percent of total billed charges,40% of total billed charges,255.48,40,,,percent of total billed charges,40% of total billed charges,574.83,90,,,percent of total billed charges,90% of total billed charges,485.41,76,,,percent of total billed charges,76% of total billed charges,255.48,40,,,percent of total billed charges,40% of total billed charges,542.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,510.96,80,,,percent of total billed charges,80% of total billed charges,247.82,38.8,,,percent of total billed charges,38.8% of total billed charges,542.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,606.77,
"Repair, intermediate, wounds of neck, hands, feet, and/or ex",46012045,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,810.1,648.08,,607.58,75,,,percent of total billed charges,75% of total billed charges,324.04,40,,,percent of total billed charges,40% of total billed charges,641.6,79.2,,,percent of total billed charges,79.2% of total billed charges,688.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,769.6,95,,,percent of total billed charges,95% of total billed charges,648.08,80,,,percent of total billed charges,80% of total billed charges,688.59,85,,,percent of total billed charges,85% of total billed charges,729.09,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,324.04,40,,,percent of total billed charges,40% of total billed charges,324.04,40,,,percent of total billed charges,40% of total billed charges,729.09,90,,,percent of total billed charges,90% of total billed charges,615.68,76,,,percent of total billed charges,76% of total billed charges,324.04,40,,,percent of total billed charges,40% of total billed charges,688.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,648.08,80,,,percent of total billed charges,80% of total billed charges,314.32,38.8,,,percent of total billed charges,38.8% of total billed charges,688.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,769.6,
"Repair, intermediate, wounds of neck, hands, feet, and/or ex",46012046,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,895.09,
"Repair, intermediate, wounds of neck, hands, feet, and/or ex",46012047,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1042.1,833.68,,781.58,75,,,percent of total billed charges,75% of total billed charges,416.84,40,,,percent of total billed charges,40% of total billed charges,825.34,79.2,,,percent of total billed charges,79.2% of total billed charges,885.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,990,95,,,percent of total billed charges,95% of total billed charges,833.68,80,,,percent of total billed charges,80% of total billed charges,885.79,85,,,percent of total billed charges,85% of total billed charges,937.89,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,416.84,40,,,percent of total billed charges,40% of total billed charges,416.84,40,,,percent of total billed charges,40% of total billed charges,937.89,90,,,percent of total billed charges,90% of total billed charges,792,76,,,percent of total billed charges,76% of total billed charges,416.84,40,,,percent of total billed charges,40% of total billed charges,885.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,833.68,80,,,percent of total billed charges,80% of total billed charges,404.33,38.8,,,percent of total billed charges,38.8% of total billed charges,885.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,990,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012054,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,651,520.8,,488.25,75,,,percent of total billed charges,75% of total billed charges,260.4,40,,,percent of total billed charges,40% of total billed charges,515.59,79.2,,,percent of total billed charges,79.2% of total billed charges,553.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,618.45,95,,,percent of total billed charges,95% of total billed charges,520.8,80,,,percent of total billed charges,80% of total billed charges,553.35,85,,,percent of total billed charges,85% of total billed charges,585.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,260.4,40,,,percent of total billed charges,40% of total billed charges,260.4,40,,,percent of total billed charges,40% of total billed charges,585.9,90,,,percent of total billed charges,90% of total billed charges,494.76,76,,,percent of total billed charges,76% of total billed charges,260.4,40,,,percent of total billed charges,40% of total billed charges,553.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,520.8,80,,,percent of total billed charges,80% of total billed charges,252.59,38.8,,,percent of total billed charges,38.8% of total billed charges,553.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,618.45,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012055,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,891.2,712.96,,668.4,75,,,percent of total billed charges,75% of total billed charges,356.48,40,,,percent of total billed charges,40% of total billed charges,705.83,79.2,,,percent of total billed charges,79.2% of total billed charges,757.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,846.64,95,,,percent of total billed charges,95% of total billed charges,712.96,80,,,percent of total billed charges,80% of total billed charges,757.52,85,,,percent of total billed charges,85% of total billed charges,802.08,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,356.48,40,,,percent of total billed charges,40% of total billed charges,356.48,40,,,percent of total billed charges,40% of total billed charges,802.08,90,,,percent of total billed charges,90% of total billed charges,677.31,76,,,percent of total billed charges,76% of total billed charges,356.48,40,,,percent of total billed charges,40% of total billed charges,757.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,712.96,80,,,percent of total billed charges,80% of total billed charges,345.79,38.8,,,percent of total billed charges,38.8% of total billed charges,757.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,846.64,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012056,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1144.8,915.84,,858.6,75,,,percent of total billed charges,75% of total billed charges,457.92,40,,,percent of total billed charges,40% of total billed charges,906.68,79.2,,,percent of total billed charges,79.2% of total billed charges,973.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1087.56,95,,,percent of total billed charges,95% of total billed charges,915.84,80,,,percent of total billed charges,80% of total billed charges,973.08,85,,,percent of total billed charges,85% of total billed charges,1030.32,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,457.92,40,,,percent of total billed charges,40% of total billed charges,457.92,40,,,percent of total billed charges,40% of total billed charges,1030.32,90,,,percent of total billed charges,90% of total billed charges,870.05,76,,,percent of total billed charges,76% of total billed charges,457.92,40,,,percent of total billed charges,40% of total billed charges,973.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,915.84,80,,,percent of total billed charges,80% of total billed charges,444.18,38.8,,,percent of total billed charges,38.8% of total billed charges,973.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1087.56,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012057,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1247.2,997.76,,935.4,75,,,percent of total billed charges,75% of total billed charges,498.88,40,,,percent of total billed charges,40% of total billed charges,987.78,79.2,,,percent of total billed charges,79.2% of total billed charges,1060.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1184.84,95,,,percent of total billed charges,95% of total billed charges,997.76,80,,,percent of total billed charges,80% of total billed charges,1060.12,85,,,percent of total billed charges,85% of total billed charges,1122.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,498.88,40,,,percent of total billed charges,40% of total billed charges,498.88,40,,,percent of total billed charges,40% of total billed charges,1122.48,90,,,percent of total billed charges,90% of total billed charges,947.87,76,,,percent of total billed charges,76% of total billed charges,498.88,40,,,percent of total billed charges,40% of total billed charges,1060.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,997.76,80,,,percent of total billed charges,80% of total billed charges,483.91,38.8,,,percent of total billed charges,38.8% of total billed charges,1060.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1184.84,
"13100 Repair, Complex, Trunk; 1.1 Cm To 2.5 Cm",46013100,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,595.5,476.4,,446.63,75,,,percent of total billed charges,75% of total billed charges,238.2,40,,,percent of total billed charges,40% of total billed charges,471.64,79.2,,,percent of total billed charges,79.2% of total billed charges,506.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,565.73,95,,,percent of total billed charges,95% of total billed charges,476.4,80,,,percent of total billed charges,80% of total billed charges,506.18,85,,,percent of total billed charges,85% of total billed charges,535.95,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,238.2,40,,,percent of total billed charges,40% of total billed charges,238.2,40,,,percent of total billed charges,40% of total billed charges,535.95,90,,,percent of total billed charges,90% of total billed charges,452.58,76,,,percent of total billed charges,76% of total billed charges,238.2,40,,,percent of total billed charges,40% of total billed charges,506.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,476.4,80,,,percent of total billed charges,80% of total billed charges,231.05,38.8,,,percent of total billed charges,38.8% of total billed charges,506.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,565.73,
"13101 Repair, Complex, Trunk; 2.6 Cm To 7.5 Cm",46013101,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,731.4,585.12,,548.55,75,,,percent of total billed charges,75% of total billed charges,292.56,40,,,percent of total billed charges,40% of total billed charges,579.27,79.2,,,percent of total billed charges,79.2% of total billed charges,621.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,694.83,95,,,percent of total billed charges,95% of total billed charges,585.12,80,,,percent of total billed charges,80% of total billed charges,621.69,85,,,percent of total billed charges,85% of total billed charges,658.26,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,292.56,40,,,percent of total billed charges,40% of total billed charges,292.56,40,,,percent of total billed charges,40% of total billed charges,658.26,90,,,percent of total billed charges,90% of total billed charges,555.86,76,,,percent of total billed charges,76% of total billed charges,292.56,40,,,percent of total billed charges,40% of total billed charges,621.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,585.12,80,,,percent of total billed charges,80% of total billed charges,283.78,38.8,,,percent of total billed charges,38.8% of total billed charges,621.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,694.83,
13120 CMPLX RPR S/A/L 1.1-2.5 CM,60000393,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,685.3,548.24,,513.98,75,,,percent of total billed charges,75% of total billed charges,274.12,40,,,percent of total billed charges,40% of total billed charges,542.76,79.2,,,percent of total billed charges,79.2% of total billed charges,582.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,651.04,95,,,percent of total billed charges,95% of total billed charges,548.24,80,,,percent of total billed charges,80% of total billed charges,582.51,85,,,percent of total billed charges,85% of total billed charges,616.77,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,274.12,40,,,percent of total billed charges,40% of total billed charges,274.12,40,,,percent of total billed charges,40% of total billed charges,616.77,90,,,percent of total billed charges,90% of total billed charges,520.83,76,,,percent of total billed charges,76% of total billed charges,274.12,40,,,percent of total billed charges,40% of total billed charges,582.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,548.24,80,,,percent of total billed charges,80% of total billed charges,265.9,38.8,,,percent of total billed charges,38.8% of total billed charges,582.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,651.04,
Introduction of long gastrointestinal tube - CHARGE,46044500,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,55.7,44.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"17250 Chemical cauterization of granulation tissue (proud flesh, sinus, or fistu",60000022,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,111.8,89.44,,83.85,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,88.55,79.2,,,percent of total billed charges,79.2% of total billed charges,95.03,85,,,percent of total billed charges,85% of total billed charges,111.8,100,,,fee schedule,100% of CO APG rates,106.21,95,,,percent of total billed charges,95% of total billed charges,89.44,80,,,percent of total billed charges,80% of total billed charges,95.03,85,,,percent of total billed charges,85% of total billed charges,100.62,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,111.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,100.62,90,,,percent of total billed charges,90% of total billed charges,84.97,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,95.03,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,89.44,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,95.03,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,605.8,100,,,case rate,pays based on per visit rate,83.85,605.8,
51701 Insertion of non dwelling bladder catheter (e.g. straight cath for residua,60000092,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,73.1,58.48,,54.83,75,,,percent of total billed charges,75% of total billed charges,29.24,40,,,percent of total billed charges,40% of total billed charges,57.9,79.2,,,percent of total billed charges,79.2% of total billed charges,62.14,85,,,percent of total billed charges,85% of total billed charges,73.1,100,,,fee schedule,100% of CO APG rates,69.45,95,,,percent of total billed charges,95% of total billed charges,58.48,80,,,percent of total billed charges,80% of total billed charges,62.14,85,,,percent of total billed charges,85% of total billed charges,65.79,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,73.1,100,,,fee schedule,100% of NM APC rate,29.24,40,,,percent of total billed charges,40% of total billed charges,29.24,40,,,percent of total billed charges,40% of total billed charges,65.79,90,,,percent of total billed charges,90% of total billed charges,55.56,76,,,percent of total billed charges,76% of total billed charges,29.24,40,,,percent of total billed charges,40% of total billed charges,62.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,58.48,80,,,percent of total billed charges,80% of total billed charges,28.36,38.8,,,percent of total billed charges,38.8% of total billed charges,62.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,146.2,200,,,fee schedule,200% of CMS fee schedule,28.36,215.49,
21012 Excision tumor soft tissue face or scalp 2cm or greater,60000028,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1020.7,816.56,,765.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,808.39,79.2,,,percent of total billed charges,79.2% of total billed charges,867.6,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,969.67,95,,,percent of total billed charges,95% of total billed charges,816.56,80,,,percent of total billed charges,80% of total billed charges,867.6,85,,,percent of total billed charges,85% of total billed charges,918.63,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1020.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,918.63,90,,,percent of total billed charges,90% of total billed charges,775.73,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,867.6,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,816.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,867.6,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
47490 CHOLECYSTOSTOMY PRQ W/IMAGING  CATHETER PLMT,46047490,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,977,781.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"11047 Debridement, Bone; Each Additional 20 Sq Cm",4601147,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,279.8,223.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
36558 Insertion of tunneled centrally inserted central venous catheter age 5 or,60000077,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,750.9,600.72,,563.18,75,,,percent of total billed charges,75% of total billed charges,300.36,40,,,percent of total billed charges,40% of total billed charges,594.71,79.2,,,percent of total billed charges,79.2% of total billed charges,638.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,713.36,95,,,percent of total billed charges,95% of total billed charges,600.72,80,,,percent of total billed charges,80% of total billed charges,638.27,85,,,percent of total billed charges,85% of total billed charges,675.81,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,300.36,40,,,percent of total billed charges,40% of total billed charges,300.36,40,,,percent of total billed charges,40% of total billed charges,675.81,90,,,percent of total billed charges,90% of total billed charges,570.68,76,,,percent of total billed charges,76% of total billed charges,300.36,40,,,percent of total billed charges,40% of total billed charges,638.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,600.72,80,,,percent of total billed charges,80% of total billed charges,291.35,38.8,,,percent of total billed charges,38.8% of total billed charges,638.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,713.36,
Removal of Foreign Body from Pharynx,49142809,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,375.9,300.72,,281.93,75,,,percent of total billed charges,75% of total billed charges,150.36,40,,,percent of total billed charges,40% of total billed charges,297.71,79.2,,,percent of total billed charges,79.2% of total billed charges,319.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,357.11,95,,,percent of total billed charges,95% of total billed charges,300.72,80,,,percent of total billed charges,80% of total billed charges,319.52,85,,,percent of total billed charges,85% of total billed charges,338.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,150.36,40,,,percent of total billed charges,40% of total billed charges,150.36,40,,,percent of total billed charges,40% of total billed charges,338.31,90,,,percent of total billed charges,90% of total billed charges,285.68,76,,,percent of total billed charges,76% of total billed charges,150.36,40,,,percent of total billed charges,40% of total billed charges,319.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,300.72,80,,,percent of total billed charges,80% of total billed charges,145.85,38.8,,,percent of total billed charges,38.8% of total billed charges,319.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,145.85,357.11,
27422 Reconstruction of dislocating patella; w/,46027422,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2241,1792.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"28119 Ostectomy, calcaneus; for spur w/wo plant",46028119,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1100.3,880.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27870 Arthrodesis, ankle, open",46027870,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3003.4,2402.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"24065 Biopsy, soft tissue of upper arm or elbow",46024065,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,489.1,391.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27536 Open Treatment Of Tibial Fracture, Proximal (Plateau);",46027536,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2665,2132,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"24516 - Treatment of humeral shaft fracture, with insertion",46024516,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2573.5,2058.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"28286 - Correction, cock-up fifth toe, with plastic skin clo",46028286,CDM,360,RC,43215,HCPCS,OUTPATIENT,,,892.6,714.08,,669.45,75,,,percent of total billed charges,75% of total billed charges,357.04,40,,,percent of total billed charges,40% of total billed charges,706.94,79.2,,,percent of total billed charges,79.2% of total billed charges,758.71,85,,,percent of total billed charges,85% of total billed charges,892.6,100,,,fee schedule,100% of CO APG rates,847.97,95,,,percent of total billed charges,95% of total billed charges,714.08,80,,,percent of total billed charges,80% of total billed charges,758.71,85,,,percent of total billed charges,85% of total billed charges,803.34,90,,,percent of total billed charges,90% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rates,1260.54,100,,,fee schedule,100% of CO APG rates,892.6,100,,,fee schedule,100% of NM APC rate,357.04,40,,,percent of total billed charges,40% of total billed charges,357.04,40,,,percent of total billed charges,40% of total billed charges,803.34,90,,,percent of total billed charges,90% of total billed charges,678.38,76,,,percent of total billed charges,76% of total billed charges,357.04,40,,,percent of total billed charges,40% of total billed charges,758.71,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rate,714.08,80,,,percent of total billed charges,80% of total billed charges,346.33,38.8,,,percent of total billed charges,38.8% of total billed charges,758.71,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of APG fee schedule,281.54,200,,,fee schedule,200% of CMS fee schedule,281.54,1260.54,
"28001 - Incision and Drainage, Bursa, Foot",46028001,CDM,360,RC,43215,HCPCS,OUTPATIENT,,,282,225.6,,211.5,75,,,percent of total billed charges,75% of total billed charges,112.8,40,,,percent of total billed charges,40% of total billed charges,223.34,79.2,,,percent of total billed charges,79.2% of total billed charges,239.7,85,,,percent of total billed charges,85% of total billed charges,282,100,,,fee schedule,100% of CO APG rates,267.9,95,,,percent of total billed charges,95% of total billed charges,225.6,80,,,percent of total billed charges,80% of total billed charges,239.7,85,,,percent of total billed charges,85% of total billed charges,253.8,90,,,percent of total billed charges,90% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rates,1260.54,100,,,fee schedule,100% of CO APG rates,282,100,,,fee schedule,100% of NM APC rate,112.8,40,,,percent of total billed charges,40% of total billed charges,112.8,40,,,percent of total billed charges,40% of total billed charges,253.8,90,,,percent of total billed charges,90% of total billed charges,214.32,76,,,percent of total billed charges,76% of total billed charges,112.8,40,,,percent of total billed charges,40% of total billed charges,239.7,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rate,225.6,80,,,percent of total billed charges,80% of total billed charges,109.42,38.8,,,percent of total billed charges,38.8% of total billed charges,239.7,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of APG fee schedule,281.54,200,,,fee schedule,200% of CMS fee schedule,109.42,1260.54,
"28003 - Incision and Drainage, Bursa, Foot, multiple areas",46028003,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,753,602.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
23615 - Open treatment of proximal humeral (surgical or anat,46023615,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2653.7,2122.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27327 - Excision, tumor, soft tissue of thigh or knee area,",46027327,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,952.2,761.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"32405 - Biopsy, lung or mediastinum, percutaneous needle",46032405,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1966.6,1573.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Partial excision of bone, tibia",46027640,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2475.6,1980.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27486 - Revision of total knee arthroplasty, with or without",46027486,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,4166.5,3333.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
23616 Open Treatment Of Proximal Humeral Fracture,46023616,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3670.6,2936.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"23550 - Open treatment of acromioclavicular dislocation, acu",46023550,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1732,1385.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27372 - Removal of foreign body deep, thigh or knee",60000397,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1214.7,971.76,,911.03,75,,,percent of total billed charges,75% of total billed charges,485.88,40,,,percent of total billed charges,40% of total billed charges,962.04,79.2,,,percent of total billed charges,79.2% of total billed charges,1032.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1153.97,95,,,percent of total billed charges,95% of total billed charges,971.76,80,,,percent of total billed charges,80% of total billed charges,1032.5,85,,,percent of total billed charges,85% of total billed charges,1093.23,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,485.88,40,,,percent of total billed charges,40% of total billed charges,485.88,40,,,percent of total billed charges,40% of total billed charges,1093.23,90,,,percent of total billed charges,90% of total billed charges,923.17,76,,,percent of total billed charges,76% of total billed charges,485.88,40,,,percent of total billed charges,40% of total billed charges,1032.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,971.76,80,,,percent of total billed charges,80% of total billed charges,471.3,38.8,,,percent of total billed charges,38.8% of total billed charges,1032.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1153.97,
38792 - Injection of radioisotope,46038792,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,92.7,74.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
38900 - Intraoperative identification (mapping) of sentinel,46038900,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,396.1,316.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"38525 - Excision, open, deep axillary node(s)",46038525,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1309.4,1047.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"28208 - Repair, tendon, extensor, foot; primary or secondary",46028208,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,969.8,775.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27603 - Incision and Drainage, leg or ankle, deep abscess or",46027603,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1167.5,934,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27829 - Open tx of distal tibiofibular joint (syndesmosis) d,46027829,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2123.2,1698.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
15220 SKIN FULL GRAFT SCLP/ARM/LEG,46015220,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1824.7,1459.76,,1368.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1445.16,79.2,,,percent of total billed charges,79.2% of total billed charges,1551,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1733.47,95,,,percent of total billed charges,95% of total billed charges,1459.76,80,,,percent of total billed charges,80% of total billed charges,1551,85,,,percent of total billed charges,85% of total billed charges,1642.23,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1824.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1642.23,90,,,percent of total billed charges,90% of total billed charges,1386.77,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1551,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1459.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1551,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1824.7,
"28041 - Excision tumor, soft tissue of foot or toe, subfasci",46028041,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1350.8,1080.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49421 - Insertion of tunneled intraperitoneal catheter,46049421,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,650.4,520.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27524 - Open tx of patellar fx w/internal fixation and/or pa,46027524,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2268.1,1814.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24586 Open tx of periarticular fracture and/or dislocation o,46024586,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3234.5,2587.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27825 Closed tx of fx of weight bearing articular portion of,46027825,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1507.9,1206.32,,1130.93,75,,,percent of total billed charges,75% of total billed charges,603.16,40,,,percent of total billed charges,40% of total billed charges,1194.26,79.2,,,percent of total billed charges,79.2% of total billed charges,1281.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1432.51,95,,,percent of total billed charges,95% of total billed charges,1206.32,80,,,percent of total billed charges,80% of total billed charges,1281.72,85,,,percent of total billed charges,85% of total billed charges,1357.11,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,603.16,40,,,percent of total billed charges,40% of total billed charges,603.16,40,,,percent of total billed charges,40% of total billed charges,1357.11,90,,,percent of total billed charges,90% of total billed charges,1146,76,,,percent of total billed charges,76% of total billed charges,603.16,40,,,percent of total billed charges,40% of total billed charges,1281.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1206.32,80,,,percent of total billed charges,80% of total billed charges,585.07,38.8,,,percent of total billed charges,38.8% of total billed charges,1281.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1432.51,
"24665 Open tx of radial head or neck fracture, includes inte",46024665,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2001.8,1601.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"29805-Arthroscopy, shoulder, diagnostic, with or without syn",46029805,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1428.4,1142.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"29871-Arthroscopy knee, surgical; for infection, lavage and",46029871,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1562.8,1250.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44640- Closure of intestinal cutaneous fistula,46044640,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,4051.1,3240.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27503- Closed treatment of supracondylar or transcondylar fe,46027503,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2404.3,1923.44,,1803.23,75,,,percent of total billed charges,75% of total billed charges,961.72,40,,,percent of total billed charges,40% of total billed charges,1904.21,79.2,,,percent of total billed charges,79.2% of total billed charges,2043.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2284.09,95,,,percent of total billed charges,95% of total billed charges,1923.44,80,,,percent of total billed charges,80% of total billed charges,2043.66,85,,,percent of total billed charges,85% of total billed charges,2163.87,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,961.72,40,,,percent of total billed charges,40% of total billed charges,961.72,40,,,percent of total billed charges,40% of total billed charges,2163.87,90,,,percent of total billed charges,90% of total billed charges,1827.27,76,,,percent of total billed charges,76% of total billed charges,961.72,40,,,percent of total billed charges,40% of total billed charges,2043.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1923.44,80,,,percent of total billed charges,80% of total billed charges,932.87,38.8,,,percent of total billed charges,38.8% of total billed charges,2043.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2284.09,
"19110-Nipple exploration, withor without excision of a solit",46019110,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1058.6,846.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26850 - Arthrodesis, metacarpophalangeal joint",60000795,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2216.9,1773.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27093 Injection Procedure For Hip Arthrography; Without Anes,41027093,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,198.2,158.56,,148.65,75,,,percent of total billed charges,75% of total billed charges,79.28,40,,,percent of total billed charges,40% of total billed charges,156.97,79.2,,,percent of total billed charges,79.2% of total billed charges,168.47,85,,,percent of total billed charges,85% of total billed charges,198.2,100,,,fee schedule,100% of CO APG rates,188.29,95,,,percent of total billed charges,95% of total billed charges,158.56,80,,,percent of total billed charges,80% of total billed charges,168.47,85,,,percent of total billed charges,85% of total billed charges,178.38,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,198.2,100,,,fee schedule,100% of NM APC rate,79.28,40,,,percent of total billed charges,40% of total billed charges,79.28,40,,,percent of total billed charges,40% of total billed charges,178.38,90,,,percent of total billed charges,90% of total billed charges,150.63,76,,,percent of total billed charges,76% of total billed charges,79.28,40,,,percent of total billed charges,40% of total billed charges,168.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,158.56,80,,,percent of total billed charges,80% of total billed charges,76.9,38.8,,,percent of total billed charges,38.8% of total billed charges,168.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,76.9,215.49,
"19083 Biopsy breast w/placement of localization device, including ultrasound gui",60019083,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,442.8,354.24,,332.1,75,,,percent of total billed charges,75% of total billed charges,177.12,40,,,percent of total billed charges,40% of total billed charges,350.7,79.2,,,percent of total billed charges,79.2% of total billed charges,376.38,85,,,percent of total billed charges,85% of total billed charges,442.8,100,,,fee schedule,100% of CO APG rates,420.66,95,,,percent of total billed charges,95% of total billed charges,354.24,80,,,percent of total billed charges,80% of total billed charges,376.38,85,,,percent of total billed charges,85% of total billed charges,398.52,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,442.8,100,,,fee schedule,100% of NM APC rate,177.12,40,,,percent of total billed charges,40% of total billed charges,177.12,40,,,percent of total billed charges,40% of total billed charges,398.52,90,,,percent of total billed charges,90% of total billed charges,336.53,76,,,percent of total billed charges,76% of total billed charges,177.12,40,,,percent of total billed charges,40% of total billed charges,376.38,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,354.24,80,,,percent of total billed charges,80% of total billed charges,171.81,38.8,,,percent of total billed charges,38.8% of total billed charges,376.38,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,171.81,2713.28,
"21011 Excision tumor soft tissue of face or scalp subcutaneous, less than 2 CM",60000027,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,794.8,635.84,,596.1,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,629.48,79.2,,,percent of total billed charges,79.2% of total billed charges,675.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,755.06,95,,,percent of total billed charges,95% of total billed charges,635.84,80,,,percent of total billed charges,80% of total billed charges,675.58,85,,,percent of total billed charges,85% of total billed charges,715.32,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,794.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,715.32,90,,,percent of total billed charges,90% of total billed charges,604.05,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,675.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,635.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,675.58,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
16020 DRESS/DEBRID P-THICK BURN S,60000018,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,166.7,133.36,,125.03,75,,,percent of total billed charges,75% of total billed charges,66.68,40,,,percent of total billed charges,40% of total billed charges,132.03,79.2,,,percent of total billed charges,79.2% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,166.7,100,,,fee schedule,100% of CO APG rates,158.37,95,,,percent of total billed charges,95% of total billed charges,133.36,80,,,percent of total billed charges,80% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,150.03,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,166.7,100,,,fee schedule,100% of NM APC rate,66.68,40,,,percent of total billed charges,40% of total billed charges,66.68,40,,,percent of total billed charges,40% of total billed charges,150.03,90,,,percent of total billed charges,90% of total billed charges,126.69,76,,,percent of total billed charges,76% of total billed charges,66.68,40,,,percent of total billed charges,40% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,133.36,80,,,percent of total billed charges,80% of total billed charges,64.68,38.8,,,percent of total billed charges,38.8% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,64.68,217.66,
"10120 Incision and removal of foreign body, subcutaneous tissue; simple",60000006,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,318.4,254.72,,238.8,75,,,percent of total billed charges,75% of total billed charges,127.36,40,,,percent of total billed charges,40% of total billed charges,252.17,79.2,,,percent of total billed charges,79.2% of total billed charges,270.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,302.48,95,,,percent of total billed charges,95% of total billed charges,254.72,80,,,percent of total billed charges,80% of total billed charges,270.64,85,,,percent of total billed charges,85% of total billed charges,286.56,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,127.36,40,,,percent of total billed charges,40% of total billed charges,127.36,40,,,percent of total billed charges,40% of total billed charges,286.56,90,,,percent of total billed charges,90% of total billed charges,241.98,76,,,percent of total billed charges,76% of total billed charges,127.36,40,,,percent of total billed charges,40% of total billed charges,270.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,254.72,80,,,percent of total billed charges,80% of total billed charges,123.54,38.8,,,percent of total billed charges,38.8% of total billed charges,270.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,123.54,302.48,
"11042 Debridement, Subcutaneous Tissue; First 20 Sq Cm Or Le",60000010,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,178.7,142.96,,134.03,75,,,percent of total billed charges,75% of total billed charges,71.48,40,,,percent of total billed charges,40% of total billed charges,141.53,79.2,,,percent of total billed charges,79.2% of total billed charges,151.9,85,,,percent of total billed charges,85% of total billed charges,178.7,100,,,fee schedule,100% of CO APG rates,169.77,95,,,percent of total billed charges,95% of total billed charges,142.96,80,,,percent of total billed charges,80% of total billed charges,151.9,85,,,percent of total billed charges,85% of total billed charges,160.83,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,178.7,100,,,fee schedule,100% of NM APC rate,71.48,40,,,percent of total billed charges,40% of total billed charges,71.48,40,,,percent of total billed charges,40% of total billed charges,160.83,90,,,percent of total billed charges,90% of total billed charges,135.81,76,,,percent of total billed charges,76% of total billed charges,71.48,40,,,percent of total billed charges,40% of total billed charges,151.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,142.96,80,,,percent of total billed charges,80% of total billed charges,69.34,38.8,,,percent of total billed charges,38.8% of total billed charges,151.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,69.34,217.66,
"20694 Removal, under anesthesia , of external fixation syste",46020694,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1042,833.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
REMOVAL OF TENDON FOR GRAFT,60000301,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1525.7,1220.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
23630 Open treatment of greater humeral tuberosity fractu,46023630,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2357.9,1886.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24340 Tenodesis of biceps tendon at elbow (separate proce,46024340,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1837.2,1469.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"24343 Repair lateral collateral ligament, elbow, with loc",46024343,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2176.7,1741.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27125 Hemiarthroplasty, hip, partial (eg, femoral stem pr",46027125,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3369.3,2695.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27596 Amputation, Thigh, Through Femur, Any Level; Re-Amputa",46027596,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2080.7,1664.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"46027635 Excision or curettage of bone cyst or benign tumor, tibia or fibula;",46027635,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1740.2,1392.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31028435 Closed treatment of talus fracture; with manipulation,31028435,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1023.3,818.64,,767.48,75,,,percent of total billed charges,75% of total billed charges,409.32,40,,,percent of total billed charges,40% of total billed charges,810.45,79.2,,,percent of total billed charges,79.2% of total billed charges,869.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,972.14,95,,,percent of total billed charges,95% of total billed charges,818.64,80,,,percent of total billed charges,80% of total billed charges,869.81,85,,,percent of total billed charges,85% of total billed charges,920.97,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,409.32,40,,,percent of total billed charges,40% of total billed charges,409.32,40,,,percent of total billed charges,40% of total billed charges,920.97,90,,,percent of total billed charges,90% of total billed charges,777.71,76,,,percent of total billed charges,76% of total billed charges,409.32,40,,,percent of total billed charges,40% of total billed charges,869.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,818.64,80,,,percent of total billed charges,80% of total billed charges,397.04,38.8,,,percent of total billed charges,38.8% of total billed charges,869.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,972.14,
"43251 Esophagogastroduodenoscopy, flexible, transoral; wi",46043251,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2337.9,1870.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"46043870 Closure of gastrostomy, surgical",46043870,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2082.1,1665.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"460440 Reduction of volvulus, intussusception, internal he",46044050,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2739.1,2191.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31055100 Drainage of scrotal wall abscess,31055100,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,503.6,402.88,,377.7,75,,,percent of total billed charges,75% of total billed charges,201.44,40,,,percent of total billed charges,40% of total billed charges,398.85,79.2,,,percent of total billed charges,79.2% of total billed charges,428.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,478.42,95,,,percent of total billed charges,95% of total billed charges,402.88,80,,,percent of total billed charges,80% of total billed charges,428.06,85,,,percent of total billed charges,85% of total billed charges,453.24,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,201.44,40,,,percent of total billed charges,40% of total billed charges,201.44,40,,,percent of total billed charges,40% of total billed charges,453.24,90,,,percent of total billed charges,90% of total billed charges,382.74,76,,,percent of total billed charges,76% of total billed charges,201.44,40,,,percent of total billed charges,40% of total billed charges,428.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,402.88,80,,,percent of total billed charges,80% of total billed charges,195.4,38.8,,,percent of total billed charges,38.8% of total billed charges,428.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,478.42,
"27138 - Revision of Total Hip Replacement-femoral component only, w/ or w/o allo",46027138,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,4496.1,3596.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"11770 - Excision of pilonidal cyst or sinus, simple",46011770,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,547.4,437.92,,410.55,75,,,percent of total billed charges,75% of total billed charges,218.96,40,,,percent of total billed charges,40% of total billed charges,433.54,79.2,,,percent of total billed charges,79.2% of total billed charges,465.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,520.03,95,,,percent of total billed charges,95% of total billed charges,437.92,80,,,percent of total billed charges,80% of total billed charges,465.29,85,,,percent of total billed charges,85% of total billed charges,492.66,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,218.96,40,,,percent of total billed charges,40% of total billed charges,218.96,40,,,percent of total billed charges,40% of total billed charges,492.66,90,,,percent of total billed charges,90% of total billed charges,416.02,76,,,percent of total billed charges,76% of total billed charges,218.96,40,,,percent of total billed charges,40% of total billed charges,465.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,437.92,80,,,percent of total billed charges,80% of total billed charges,212.39,38.8,,,percent of total billed charges,38.8% of total billed charges,465.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,520.03,
23412 - Chronic open repair of ruptured rotator cuff,46023412,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2557.6,2046.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
11771 - Excision pilonidal cyst or sinus; Extensive,46011771,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1342.4,1073.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
11772 - Excision pilonidal cyst or sinus; Complicated,46011772,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1729.1,1383.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
23071 EXC SHOULDER LES SC 3 CM/>,46023071,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1260.3,1008.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"21014 - Excision tumor, soft tissue of face or scalp, Subcut",46021014,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1563.2,1250.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
21932 EXC BACK TUM DEEP < 5 CM,46021932,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1979.2,1583.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"46050 - Incision and drainage, perineal abscess,superficial",46046050,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,306.1,244.88,,229.58,75,,,percent of total billed charges,75% of total billed charges,122.44,40,,,percent of total billed charges,40% of total billed charges,242.43,79.2,,,percent of total billed charges,79.2% of total billed charges,260.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,290.8,95,,,percent of total billed charges,95% of total billed charges,244.88,80,,,percent of total billed charges,80% of total billed charges,260.19,85,,,percent of total billed charges,85% of total billed charges,275.49,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,122.44,40,,,percent of total billed charges,40% of total billed charges,122.44,40,,,percent of total billed charges,40% of total billed charges,275.49,90,,,percent of total billed charges,90% of total billed charges,232.64,76,,,percent of total billed charges,76% of total billed charges,122.44,40,,,percent of total billed charges,40% of total billed charges,260.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,244.88,80,,,percent of total billed charges,80% of total billed charges,118.77,38.8,,,percent of total billed charges,38.8% of total billed charges,260.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,118.77,290.8,
"21013 - Excision tumor, face and scalp; subfascial, less tha",46021013,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1205.2,964.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24105 - Excision olecranon bursa,46024105,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1114.8,891.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27393 - Lengthening of hamstring tendon; single tendon,46027393,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1527,1221.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27380 - Suture of infrapatellar tendon; primary,46027380,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,1881.8,1505.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27827 Open treatment of fracture of weight bearing articular,46027827,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3353.2,2682.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25606 Percutaneous skeletal fixation of distal radial fractu,46025606,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2041.7,1633.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"20690 Application of a uniplane (pins or wires in 1 plane),",46020690,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1784.7,1427.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64450 Block Peripheral Nerve,60000114,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,338.9,271.12,,254.18,75,,,percent of total billed charges,75% of total billed charges,135.56,40,,,percent of total billed charges,40% of total billed charges,268.41,79.2,,,percent of total billed charges,79.2% of total billed charges,288.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,321.96,95,,,percent of total billed charges,95% of total billed charges,271.12,80,,,percent of total billed charges,80% of total billed charges,288.07,85,,,percent of total billed charges,85% of total billed charges,305.01,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,135.56,40,,,percent of total billed charges,40% of total billed charges,135.56,40,,,percent of total billed charges,40% of total billed charges,305.01,90,,,percent of total billed charges,90% of total billed charges,257.56,76,,,percent of total billed charges,76% of total billed charges,135.56,40,,,percent of total billed charges,40% of total billed charges,288.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,271.12,80,,,percent of total billed charges,80% of total billed charges,131.49,38.8,,,percent of total billed charges,38.8% of total billed charges,288.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,131.49,321.96,
"32554 Thoracentesis, needle or catheter, aspiration of the p",46532554,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,254.1,203.28,,190.58,75,,,percent of total billed charges,75% of total billed charges,101.64,40,,,percent of total billed charges,40% of total billed charges,201.25,79.2,,,percent of total billed charges,79.2% of total billed charges,215.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,241.4,95,,,percent of total billed charges,95% of total billed charges,203.28,80,,,percent of total billed charges,80% of total billed charges,215.99,85,,,percent of total billed charges,85% of total billed charges,228.69,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,101.64,40,,,percent of total billed charges,40% of total billed charges,101.64,40,,,percent of total billed charges,40% of total billed charges,228.69,90,,,percent of total billed charges,90% of total billed charges,193.12,76,,,percent of total billed charges,76% of total billed charges,101.64,40,,,percent of total billed charges,40% of total billed charges,215.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,203.28,80,,,percent of total billed charges,80% of total billed charges,98.59,38.8,,,percent of total billed charges,38.8% of total billed charges,215.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,98.59,241.4,
"26034 Incision, bone cortex, hand or finger - PSMC",46026034,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1688.7,1350.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27005 Tenotomy, hip flexor(s), open(separate procedure) - PS",46027005,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2174.7,1739.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"29874 Arthroscopy, knee, surgical; for removal of loose body",46029874,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1619.6,1295.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25520 Closed treatment of radial shaft fracture,31025520,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1681.4,1345.12,,1261.05,75,,,percent of total billed charges,75% of total billed charges,672.56,40,,,percent of total billed charges,40% of total billed charges,1331.67,79.2,,,percent of total billed charges,79.2% of total billed charges,1429.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1597.33,95,,,percent of total billed charges,95% of total billed charges,1345.12,80,,,percent of total billed charges,80% of total billed charges,1429.19,85,,,percent of total billed charges,85% of total billed charges,1513.26,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,672.56,40,,,percent of total billed charges,40% of total billed charges,672.56,40,,,percent of total billed charges,40% of total billed charges,1513.26,90,,,percent of total billed charges,90% of total billed charges,1277.86,76,,,percent of total billed charges,76% of total billed charges,672.56,40,,,percent of total billed charges,40% of total billed charges,1429.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1345.12,80,,,percent of total billed charges,80% of total billed charges,652.38,38.8,,,percent of total billed charges,38.8% of total billed charges,1429.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1597.33,
"69020 - Drainage external auditory canal, abscess",31069020,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,433.2,346.56,,324.9,75,,,percent of total billed charges,75% of total billed charges,173.28,40,,,percent of total billed charges,40% of total billed charges,343.09,79.2,,,percent of total billed charges,79.2% of total billed charges,368.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,411.54,95,,,percent of total billed charges,95% of total billed charges,346.56,80,,,percent of total billed charges,80% of total billed charges,368.22,85,,,percent of total billed charges,85% of total billed charges,389.88,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,173.28,40,,,percent of total billed charges,40% of total billed charges,173.28,40,,,percent of total billed charges,40% of total billed charges,389.88,90,,,percent of total billed charges,90% of total billed charges,329.23,76,,,percent of total billed charges,76% of total billed charges,173.28,40,,,percent of total billed charges,40% of total billed charges,368.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,346.56,80,,,percent of total billed charges,80% of total billed charges,168.08,38.8,,,percent of total billed charges,38.8% of total billed charges,368.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,168.08,411.54,
"46220 - Fissurectomy, including sphincterotomy when performe",46046220,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,364.7,291.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"23700 Manipulation Under Anesthesia, Shoulder Joint, Includi",46023700,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,593,474.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"30520 Septoplasty or submucous resection, with or without cartilage scoring, cou",46030520,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2012.1,1609.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
30560 Lysis intranasal synechia,46030560,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,453.8,363.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
30580 Repair fistula; oromaxillary (combine with 30130 if antrotomy is included),46030580,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1391.1,1112.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
30600 Repair fistula; oronasal,46030600,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1168.8,935.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"30801 Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any",46030801,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,452.4,361.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"30802 Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any",46030802,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,601.7,481.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31070 Sinusotomy, Frontal",46031070,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1428.2,1142.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31075 Sinusotomy transorbital, unilateral (for mucocele or osteoma, Lynch type)",46031075,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2467.4,1973.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31080 Sinusotomy obliterative without ostoplastic flap, brow incision (includes",46031080,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3242.3,2593.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31081 Sinusotomy obliterative without ostoplastic flap, coronal incision (includ",46031081,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3471.3,2777.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31084 Sinusotomy obliterative with ostoplastic flap, brow incision",46031084,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3589.7,2871.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31085 Sinusotomy obliterative with ostoplastic flap, coronal incision",46031085,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3698.9,2959.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31086 Sinusotomy nonobliterative with ostoplastic flap, brow incision",46031086,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3498.5,2798.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31087 Sinusotomy nonobliterative with ostoplastic flap, coronal incision",46031087,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3331.4,2665.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31090 Sinusotomy, unilateral, 3 or  more paranasal sinuses (frontal, maxillary,",46031090,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3300.2,2640.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31200 Ethmoidectomy; intranasal, anterior",46031200,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1880.1,1504.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31201 Ethmoidectomy; intranasal, total",46031201,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2325.1,1860.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31205 Ethmoidectomy; extranasal, total",46031205,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2806.9,2245.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31225 Maxillectomy; without orbital exenteration,46031225,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,5325.1,4260.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31230 Maxillectomy; with orbital exenteration (en bloc),46031230,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,5929.2,4743.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)",46031231,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,188.9,151.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31233 Nasal/sinus endoscopy, diagnostic with maxillary sinusoscopy (via inferior",46031233,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,398.8,319.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31235 Nasal/sinus endoscopy, diagnostic with sphenoid sinusoscopy (via puncture",46031235,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,473.5,378.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31237 Nasal /sinus endoscopy, surgical; with biopsy, polypectomy or debridement",46031237,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,473.6,378.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31238 Nasal /sinus endoscopy, surgical; with control of nasal hemorrhage",46031238,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,493.5,394.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31240 Nasal /sinus endoscopy, surgical; with concha bullosa resection",46031240,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,469.5,375.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior)",46031254,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,711.9,569.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31255 Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and p",46031255,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,944,755.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31256 Nasal/sinus endoscopy, surgical with maxillary antrostomy;",46031256,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,530.7,424.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31267 Nasal/sinus endoscopy, surgical with maxillary antrostomy; with removal of",46031267,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,775.2,620.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31276 Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or wi",46031276,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1103.7,882.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31287 Nasal/sinus endoscopy, surgical, with sphenoidotomy;",46031287,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,589.9,471.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31288 Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissu",46031288,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,685.2,548.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31290 Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak;",46031290,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3373.1,2698.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31291 Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak;",46031291,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3601.7,2881.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31292 Nasal/sinus endoscopy, surgical; with medial or inferior orbital wall deco",46031292,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2916.5,2333.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31293 Nasal/sinus endoscopy, surgical; with medial orbital wall and inferior orb",46031293,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3155.9,2524.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31295 Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (",46031295,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,464,371.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31296 Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg",46031296,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,529,423.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31297 Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (e",46031297,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,422.9,338.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31300 Laryngotomy (thyrotomy, laryngofissure): with removal of tumor or laryngoc",46031300,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3718.9,2975.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31510 Laryngoscopy, indirect; diagnostic; with biopsy",46031510,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,359.5,287.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31511 Laryngoscopy, indirect; diagnostic; with removal of foreign body",46031511,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,395.8,316.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31512 Laryngoscopy, indirect; diagnostic; with removal of lesion",46031512,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,382.1,305.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31513 Laryngoscopy, indirect; diagnostic; with vocal cord injection",46031513,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,387.1,309.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31515 Laryngoscopy direct, with or without tracheoscopy; for aspiration",46031515,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,328.5,262.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31525 Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newb",46031525,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,471.5,377.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31526 Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operat",46031526,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,463.6,370.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31527 Laryngoscopy direct, with or without tracheoscopy; with insertion of obtur",46031527,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,573.8,459.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31528 Laryngoscopy direct, with or without tracheoscopy; with dilation, initial",46031528,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,425.5,340.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31529 Laryngoscopy direct, with or without tracheoscopy; with dilation,subsequen",46031529,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,473.3,378.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31531 Laryngoscopy direct, operative, with foreign body removal; with operating",46031531,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,617.7,494.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31535 Laryngoscopy direct, operative, with biopsy;",46031535,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,557.1,445.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31536 Laryngoscopy direct, operative, with biopsy; with operating microscope or",46031536,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,616.1,492.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31540 Laryngoscopy direct, operative, with excision of tumor and/or stripping of",46031540,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,706.6,565.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31541 Laryngoscopy direct, operative, with excision of tumor and/or stripping of",46031541,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,769.2,615.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31545 Laryngoscopy direct, operative, with operating microscope or telescope, wi",46031545,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1054.3,843.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31546 Laryngoscopy direct, operative, with operating microscope or telescope, wi",46031546,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1596.2,1276.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31560 Laryngoscopy direct, operative, with arytenoidectomy",46031560,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,912,729.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31561 Laryngoscopy direct, operative, with arytenoidectomy; with operating micro",46031561,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,994.2,795.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31570 Laryngoscopy direct, with injection into vocal cord(s), therapeutic;",46031570,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,671.8,537.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31571 Laryngoscopy direct, with injection into vocal cord(s), therapeutic; with",46031571,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,728.9,583.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31576 Laryngoscopy, flexible fiberoptic; with biopsy",46031576,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,354.5,283.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31577 Laryngoscopy, flexible fiberoptic; with removal of foreign body",46031577,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,394,315.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31578 Laryngoscopy, flexible fiberoptic; with removal of lesion",46031578,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,440.3,352.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31579 Laryngoscopy, flexible or rigid fiberoptic; with stroboscopy",46031579,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,355.2,284.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"38520 Biopsy or excision of lymph node(s): open, deep cervical node(s) with exci",46038520,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1393.2,1114.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
40490 Biopsy of lip.,46040490,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,204.4,163.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"40650 Repair lip, full thickness; vermilion only",46040650,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1162.4,929.92,,871.8,75,,,percent of total billed charges,75% of total billed charges,464.96,40,,,percent of total billed charges,40% of total billed charges,920.62,79.2,,,percent of total billed charges,79.2% of total billed charges,988.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1104.28,95,,,percent of total billed charges,95% of total billed charges,929.92,80,,,percent of total billed charges,80% of total billed charges,988.04,85,,,percent of total billed charges,85% of total billed charges,1046.16,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,464.96,40,,,percent of total billed charges,40% of total billed charges,464.96,40,,,percent of total billed charges,40% of total billed charges,1046.16,90,,,percent of total billed charges,90% of total billed charges,883.42,76,,,percent of total billed charges,76% of total billed charges,464.96,40,,,percent of total billed charges,40% of total billed charges,988.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,929.92,80,,,percent of total billed charges,80% of total billed charges,451.01,38.8,,,percent of total billed charges,38.8% of total billed charges,988.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1104.28,
"40652 Repair lip, full thickness; up to half vertical height",46040652,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1352.1,1081.68,,1014.08,75,,,percent of total billed charges,75% of total billed charges,540.84,40,,,percent of total billed charges,40% of total billed charges,1070.86,79.2,,,percent of total billed charges,79.2% of total billed charges,1149.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1284.5,95,,,percent of total billed charges,95% of total billed charges,1081.68,80,,,percent of total billed charges,80% of total billed charges,1149.29,85,,,percent of total billed charges,85% of total billed charges,1216.89,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,540.84,40,,,percent of total billed charges,40% of total billed charges,540.84,40,,,percent of total billed charges,40% of total billed charges,1216.89,90,,,percent of total billed charges,90% of total billed charges,1027.6,76,,,percent of total billed charges,76% of total billed charges,540.84,40,,,percent of total billed charges,40% of total billed charges,1149.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1081.68,80,,,percent of total billed charges,80% of total billed charges,524.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1149.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1284.5,
"40654 Repair lip, full thickness; over one-half vertical height, or complex",46040654,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4900.9,3920.72,,3675.68,75,,,percent of total billed charges,75% of total billed charges,1960.36,40,,,percent of total billed charges,40% of total billed charges,3881.51,79.2,,,percent of total billed charges,79.2% of total billed charges,4165.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4655.86,95,,,percent of total billed charges,95% of total billed charges,3920.72,80,,,percent of total billed charges,80% of total billed charges,4165.77,85,,,percent of total billed charges,85% of total billed charges,4410.81,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1960.36,40,,,percent of total billed charges,40% of total billed charges,1960.36,40,,,percent of total billed charges,40% of total billed charges,4410.81,90,,,percent of total billed charges,90% of total billed charges,3724.68,76,,,percent of total billed charges,76% of total billed charges,1960.36,40,,,percent of total billed charges,40% of total billed charges,4165.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3920.72,80,,,percent of total billed charges,80% of total billed charges,1901.55,38.8,,,percent of total billed charges,38.8% of total billed charges,4165.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4655.86,
"40831 Closure of laceration, vestibule of mouth; over 2.5 cm",46040831,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,610.8,488.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"41000 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or",46041000,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,322.7,258.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"41005 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or",46041005,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,356.8,285.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"41006 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or",46041006,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,704.5,563.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"41007 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or",46041007,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,674.5,539.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"41008 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or",46041008,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,790.8,632.64,,593.1,75,,,percent of total billed charges,75% of total billed charges,316.32,40,,,percent of total billed charges,40% of total billed charges,626.31,79.2,,,percent of total billed charges,79.2% of total billed charges,672.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,751.26,95,,,percent of total billed charges,95% of total billed charges,632.64,80,,,percent of total billed charges,80% of total billed charges,672.18,85,,,percent of total billed charges,85% of total billed charges,711.72,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,316.32,40,,,percent of total billed charges,40% of total billed charges,316.32,40,,,percent of total billed charges,40% of total billed charges,711.72,90,,,percent of total billed charges,90% of total billed charges,601.01,76,,,percent of total billed charges,76% of total billed charges,316.32,40,,,percent of total billed charges,40% of total billed charges,672.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,632.64,80,,,percent of total billed charges,80% of total billed charges,306.83,38.8,,,percent of total billed charges,38.8% of total billed charges,672.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,751.26,
"41009 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or",46041009,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,866.2,692.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
41010 Incision of lingual frenum (frenotomy),46041010,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,330.9,264.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
42400 Biopsy of salivary gland; needle,46042400,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,497.1,397.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
42405 Biopsy of salivary gland; incisional,46042405,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1408.2,1126.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"43300 Esophagoplasty (plastic repair or reconstruction), cervical approach; with",46043300,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1872.9,1498.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"43305 Esophagoplasty (plastic repair or reconstruction), cervical approach; with",46043305,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,3239.6,2591.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"47480 - Cholecystotomy or Cholecystostomy, open, w/explorati",46047480,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2590.8,2072.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25575 - Open treatment of radial AND ulner shaft fx w/intern,46025575,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2727.4,2181.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"43233 - Esophagogastroduodenoscopy, flexible, transoral; w/d",46043233,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,662,529.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26765 Open treatment of distal phalangeal fracture, finger o",31026765,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1546.2,1236.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"32556 Pleural drainage, percutaneous, w/insertion of indwell",31032556,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,357.8,286.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27509 - Closed reduction, percutaneous pin fixation of dista",46027509,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2044.9,1635.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27337 - Biopsy soft tissue of thigh or knee area, 3 cm or gr",46027337,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1259.3,1007.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
32550 Insertion of indwelling tunneled pleural catheter w/cu,46032550,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,586.6,469.28,,439.95,75,,,percent of total billed charges,75% of total billed charges,234.64,40,,,percent of total billed charges,40% of total billed charges,464.59,79.2,,,percent of total billed charges,79.2% of total billed charges,498.61,85,,,percent of total billed charges,85% of total billed charges,586.6,100,,,fee schedule,100% of CO APG rates,557.27,95,,,percent of total billed charges,95% of total billed charges,469.28,80,,,percent of total billed charges,80% of total billed charges,498.61,85,,,percent of total billed charges,85% of total billed charges,527.94,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,586.6,100,,,fee schedule,100% of NM APC rate,234.64,40,,,percent of total billed charges,40% of total billed charges,234.64,40,,,percent of total billed charges,40% of total billed charges,527.94,90,,,percent of total billed charges,90% of total billed charges,445.82,76,,,percent of total billed charges,76% of total billed charges,234.64,40,,,percent of total billed charges,40% of total billed charges,498.61,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,469.28,80,,,percent of total billed charges,80% of total billed charges,227.6,38.8,,,percent of total billed charges,38.8% of total billed charges,498.61,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,227.6,2713.28,
27487 - Revision of total knee arthroplasty w/ or w/o allogr,46027487,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,5176.2,4140.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49418 - Insertion of tunneled intraperitoneal catheter (ie d,46049418,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,578,462.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49422 - Removal of tunneled intraperitoneal catheter,46049422,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,635.7,508.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26320 - Removal Of Implant From Finger Or Hand,60000740,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1075.9,860.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"23665 Closed Treatment Of Shoulder Dislocation, With Fractur",31023665,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1242.2,993.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
47537 Removal of biliary drainage catheter with fluoroscopic,46047537,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,277.2,221.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26615 Open treatment of metacarpal fracture including intern,46026615,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1761.5,1409.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"62320 Inj(s), of diag or therap substance(s), including need",46262320,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,289.1,231.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"62322 Lumbar or sacral Inj(s), of diag or therap substance(s",46262311,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,228.8,183.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27514 Open Tx Femur Fx, distal end, includes internal fixati",46027514,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2867.1,2293.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
11000 Debridement of extensive eczematous or infected skin; up to 10% of body su,60000009,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,78.2,62.56,,58.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,61.93,79.2,,,percent of total billed charges,79.2% of total billed charges,66.47,85,,,percent of total billed charges,85% of total billed charges,78.2,100,,,fee schedule,100% of CO APG rates,74.29,95,,,percent of total billed charges,95% of total billed charges,62.56,80,,,percent of total billed charges,80% of total billed charges,66.47,85,,,percent of total billed charges,85% of total billed charges,70.38,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,78.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,70.38,90,,,percent of total billed charges,90% of total billed charges,59.43,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,66.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,62.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,66.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,538.6,100,,,case rate,pays based on per visit rate,58.65,538.6,
"62323 Injection interlaminar epidural or subarachnoid, lumba",46062323,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,291.9,233.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64405 Injection; anesthetic agent; greater occipital nerve,46264405,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,981.8,785.44,,736.35,75,,,percent of total billed charges,75% of total billed charges,392.72,40,,,percent of total billed charges,40% of total billed charges,777.59,79.2,,,percent of total billed charges,79.2% of total billed charges,834.53,85,,,percent of total billed charges,85% of total billed charges,981.8,100,,,fee schedule,100% of CO APG rates,932.71,95,,,percent of total billed charges,95% of total billed charges,785.44,80,,,percent of total billed charges,80% of total billed charges,834.53,85,,,percent of total billed charges,85% of total billed charges,883.62,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,981.8,100,,,fee schedule,100% of NM APC rate,392.72,40,,,percent of total billed charges,40% of total billed charges,392.72,40,,,percent of total billed charges,40% of total billed charges,883.62,90,,,percent of total billed charges,90% of total billed charges,746.17,76,,,percent of total billed charges,76% of total billed charges,392.72,40,,,percent of total billed charges,40% of total billed charges,834.53,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,785.44,80,,,percent of total billed charges,80% of total billed charges,380.94,38.8,,,percent of total billed charges,38.8% of total billed charges,834.53,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,380.94,2713.28,
64418 Injection; anesthetic agent; suprascapular nerve,46264418,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,592.2,473.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"62321 Injection interlaminar epidural or subarachnoid, cervi",46262321,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1015.8,812.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
19000 Puncture aspiration of cyst of breast,46519000,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,123.5,98.8,,92.63,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,97.81,79.2,,,percent of total billed charges,79.2% of total billed charges,104.98,85,,,percent of total billed charges,85% of total billed charges,123.5,100,,,fee schedule,100% of CO APG rates,117.33,95,,,percent of total billed charges,95% of total billed charges,98.8,80,,,percent of total billed charges,80% of total billed charges,104.98,85,,,percent of total billed charges,85% of total billed charges,111.15,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,123.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,111.15,90,,,percent of total billed charges,90% of total billed charges,93.86,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,104.98,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,98.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,104.98,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,629.2,100,,,case rate,pays based on per visit rate,92.63,629.2,
27826 - OPEN TX FXDISTAL TIBIA FIBULA W FIXATION,46027826,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2558.5,2046.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
45171 - EXC RECTAL TUMOR TRANSANAL PARTIAL,46045171,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1842.6,1474.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
43245 - EGD DILATE STRICTURE,46043245,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,511.7,409.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29887 - REPAIR OF KNEE JOINT WITH BONE GRAFT AND HARDWARE US,60000055,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2273.3,1818.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29505 Application Of Long Leg Splint,60000071,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,158.6,126.88,,118.95,75,,,percent of total billed charges,75% of total billed charges,63.44,40,,,percent of total billed charges,40% of total billed charges,125.61,79.2,,,percent of total billed charges,79.2% of total billed charges,134.81,85,,,percent of total billed charges,85% of total billed charges,158.6,100,,,fee schedule,100% of CO APG rates,150.67,95,,,percent of total billed charges,95% of total billed charges,126.88,80,,,percent of total billed charges,80% of total billed charges,134.81,85,,,percent of total billed charges,85% of total billed charges,142.74,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,158.6,100,,,fee schedule,100% of NM APC rate,63.44,40,,,percent of total billed charges,40% of total billed charges,63.44,40,,,percent of total billed charges,40% of total billed charges,142.74,90,,,percent of total billed charges,90% of total billed charges,120.54,76,,,percent of total billed charges,76% of total billed charges,63.44,40,,,percent of total billed charges,40% of total billed charges,134.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,126.88,80,,,percent of total billed charges,80% of total billed charges,61.54,38.8,,,percent of total billed charges,38.8% of total billed charges,134.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,61.54,217.66,
46060 - Incision and drainage of ischiorectal,60000748,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1466.4,1173.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28160 - HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE,60000127,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,810.6,648.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26641 - Closed Treatment of Carpometacarpal dislocation,60000628,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1194.8,955.84,,896.1,75,,,percent of total billed charges,75% of total billed charges,477.92,40,,,percent of total billed charges,40% of total billed charges,946.28,79.2,,,percent of total billed charges,79.2% of total billed charges,1015.58,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1135.06,95,,,percent of total billed charges,95% of total billed charges,955.84,80,,,percent of total billed charges,80% of total billed charges,1015.58,85,,,percent of total billed charges,85% of total billed charges,1075.32,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,477.92,40,,,percent of total billed charges,40% of total billed charges,477.92,40,,,percent of total billed charges,40% of total billed charges,1075.32,90,,,percent of total billed charges,90% of total billed charges,908.05,76,,,percent of total billed charges,76% of total billed charges,477.92,40,,,percent of total billed charges,40% of total billed charges,1015.58,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,955.84,80,,,percent of total billed charges,80% of total billed charges,463.58,38.8,,,percent of total billed charges,38.8% of total billed charges,1015.58,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1135.06,
27415 - OSTEOCHONDRAL ALLOGRAFT KNEE OPEN,60000130,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,4089.1,3271.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
62273 - INJECTION EPIDURAL BLOOD/CLOT PATCH,60000129,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,332.4,265.92,,249.3,75,,,percent of total billed charges,75% of total billed charges,132.96,40,,,percent of total billed charges,40% of total billed charges,263.26,79.2,,,percent of total billed charges,79.2% of total billed charges,282.54,85,,,percent of total billed charges,85% of total billed charges,332.4,100,,,fee schedule,100% of CO APG rates,315.78,95,,,percent of total billed charges,95% of total billed charges,265.92,80,,,percent of total billed charges,80% of total billed charges,282.54,85,,,percent of total billed charges,85% of total billed charges,299.16,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,332.4,100,,,fee schedule,100% of NM APC rate,132.96,40,,,percent of total billed charges,40% of total billed charges,132.96,40,,,percent of total billed charges,40% of total billed charges,299.16,90,,,percent of total billed charges,90% of total billed charges,252.62,76,,,percent of total billed charges,76% of total billed charges,132.96,40,,,percent of total billed charges,40% of total billed charges,282.54,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,265.92,80,,,percent of total billed charges,80% of total billed charges,128.97,38.8,,,percent of total billed charges,38.8% of total billed charges,282.54,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,128.97,2713.28,
"24345 Repair Medial Collateral Ligament, Elbow, With Local T",60000120,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,2155.3,1724.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
45005 ID SUBMUCOSAL ABSCESS RECTUM,60000140,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,503.2,402.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24538 Percutaneous Skeletal Fixation Of Supracondylar Or Tra,60000141,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2382.4,1905.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
22900 EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM,60000142,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1689.5,1351.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29580 Strapping; Unna Boot,46029580,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,76,60.8,,57,75,,,percent of total billed charges,75% of total billed charges,30.4,40,,,percent of total billed charges,40% of total billed charges,60.19,79.2,,,percent of total billed charges,79.2% of total billed charges,64.6,85,,,percent of total billed charges,85% of total billed charges,76,100,,,fee schedule,100% of CO APG rates,72.2,95,,,percent of total billed charges,95% of total billed charges,60.8,80,,,percent of total billed charges,80% of total billed charges,64.6,85,,,percent of total billed charges,85% of total billed charges,68.4,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,76,100,,,fee schedule,100% of NM APC rate,30.4,40,,,percent of total billed charges,40% of total billed charges,30.4,40,,,percent of total billed charges,40% of total billed charges,68.4,90,,,percent of total billed charges,90% of total billed charges,57.76,76,,,percent of total billed charges,76% of total billed charges,30.4,40,,,percent of total billed charges,40% of total billed charges,64.6,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,60.8,80,,,percent of total billed charges,80% of total billed charges,29.49,38.8,,,percent of total billed charges,38.8% of total billed charges,64.6,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,152,200,,,fee schedule,200% of CMS fee schedule,29.49,215.49,
DRAINAGE TENDON SHEATH DIGIT/PALM EACH,60000148,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1698.2,1358.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
EXC/CURTG CST/B9 TUM PHALANGES FOOT,60000149,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,876.8,701.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"29355 Application of long leg cast (thigh to toes), walker",60000150,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,315.2,252.16,,236.4,75,,,percent of total billed charges,75% of total billed charges,126.08,40,,,percent of total billed charges,40% of total billed charges,249.64,79.2,,,percent of total billed charges,79.2% of total billed charges,267.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,299.44,95,,,percent of total billed charges,95% of total billed charges,252.16,80,,,percent of total billed charges,80% of total billed charges,267.92,85,,,percent of total billed charges,85% of total billed charges,283.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,126.08,40,,,percent of total billed charges,40% of total billed charges,126.08,40,,,percent of total billed charges,40% of total billed charges,283.68,90,,,percent of total billed charges,90% of total billed charges,239.55,76,,,percent of total billed charges,76% of total billed charges,126.08,40,,,percent of total billed charges,40% of total billed charges,267.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,252.16,80,,,percent of total billed charges,80% of total billed charges,122.3,38.8,,,percent of total billed charges,38.8% of total billed charges,267.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,122.3,299.44,
27385 - Suture of ruptured muscle of thigh,60000155,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1839.3,1471.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29879 Abrasion Arthroplasty of Maltiple Drilling or Microfra,46029876,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1995.6,1596.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Anesthesia - ASA Level III,60000418,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Anesthesia - ASA Level IV,60000419,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Anesthesia - ASA Level V,60000420,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Anesthesia - Age Extremes Charge,60000421,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
ANESTHESIA - EMERGENCY CASE,46099140,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Anesthesia - Time Unit Charge,60000445,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
38220 Marrow Aspiration Only,60000191,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,197.9,158.32,,148.43,75,,,percent of total billed charges,75% of total billed charges,79.16,40,,,percent of total billed charges,40% of total billed charges,156.74,79.2,,,percent of total billed charges,79.2% of total billed charges,168.22,85,,,percent of total billed charges,85% of total billed charges,197.9,100,,,fee schedule,100% of CO APG rates,188.01,95,,,percent of total billed charges,95% of total billed charges,158.32,80,,,percent of total billed charges,80% of total billed charges,168.22,85,,,percent of total billed charges,85% of total billed charges,178.11,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,197.9,100,,,fee schedule,100% of NM APC rate,79.16,40,,,percent of total billed charges,40% of total billed charges,79.16,40,,,percent of total billed charges,40% of total billed charges,178.11,90,,,percent of total billed charges,90% of total billed charges,150.4,76,,,percent of total billed charges,76% of total billed charges,79.16,40,,,percent of total billed charges,40% of total billed charges,168.22,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,158.32,80,,,percent of total billed charges,80% of total billed charges,76.79,38.8,,,percent of total billed charges,38.8% of total billed charges,168.22,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,395.8,200,,,fee schedule,200% of CMS fee schedule,76.79,2713.28,
27724 - Rpr non/mal tibia w/iliac/othagrft,60000202,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3713.3,2970.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
36582 - RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,60000181,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,830.8,664.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
39501 - Repair Diaphragm Laceration,60001062,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2484.7,1987.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00731 Anesthesia for upper GI endoscopic proc, proximal to d",60000165,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00732 Anesthesia for upper GI endoscopic proc, endoscope int",60000166,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00811 - Anesthesia for lower intestinal endoscopic procedure,60000167,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"00812 - Anesthesia for lower intestinal endoscopic proc, int",60000168,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00813 - Anesthesia upper  lower GI endoscope introduced pro,60000169,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
96450 - CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,60000201,CDM,331,RC,96402,HCPCS,OUTPATIENT,,,328.1,262.48,,246.08,75,,,percent of total billed charges,75% of total billed charges,131.24,40,,,percent of total billed charges,40% of total billed charges,259.86,79.2,,,percent of total billed charges,79.2% of total billed charges,278.89,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,311.7,95,,,percent of total billed charges,95% of total billed charges,262.48,80,,,percent of total billed charges,80% of total billed charges,278.89,85,,,percent of total billed charges,85% of total billed charges,295.29,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,131.24,40,,,percent of total billed charges,40% of total billed charges,131.24,40,,,percent of total billed charges,40% of total billed charges,295.29,90,,,percent of total billed charges,90% of total billed charges,249.36,76,,,percent of total billed charges,76% of total billed charges,131.24,40,,,percent of total billed charges,40% of total billed charges,278.89,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,262.48,80,,,percent of total billed charges,80% of total billed charges,127.3,38.8,,,percent of total billed charges,38.8% of total billed charges,278.89,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,70.94,200,,,fee schedule,200% of CMS fee schedule,58.22,311.7,
96440 - CHEMOTX ADMN PLEURAL CAVITY REQW/THORACNTS,60000199,CDM,331,RC,96402,HCPCS,OUTPATIENT,,,514.9,411.92,,386.18,75,,,percent of total billed charges,75% of total billed charges,205.96,40,,,percent of total billed charges,40% of total billed charges,407.8,79.2,,,percent of total billed charges,79.2% of total billed charges,437.67,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,489.16,95,,,percent of total billed charges,95% of total billed charges,411.92,80,,,percent of total billed charges,80% of total billed charges,437.67,85,,,percent of total billed charges,85% of total billed charges,463.41,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,205.96,40,,,percent of total billed charges,40% of total billed charges,205.96,40,,,percent of total billed charges,40% of total billed charges,463.41,90,,,percent of total billed charges,90% of total billed charges,391.32,76,,,percent of total billed charges,76% of total billed charges,205.96,40,,,percent of total billed charges,40% of total billed charges,437.67,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,411.92,80,,,percent of total billed charges,80% of total billed charges,199.78,38.8,,,percent of total billed charges,38.8% of total billed charges,437.67,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,70.94,200,,,fee schedule,200% of CMS fee schedule,58.22,489.16,
96446 - CHEMOTX ADMN PRTL CAVITY PORT/CATH,60000200,CDM,331,RC,96402,HCPCS,OUTPATIENT,,,119.9,95.92,,89.93,75,,,percent of total billed charges,75% of total billed charges,47.96,40,,,percent of total billed charges,40% of total billed charges,94.96,79.2,,,percent of total billed charges,79.2% of total billed charges,101.92,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,113.91,95,,,percent of total billed charges,95% of total billed charges,95.92,80,,,percent of total billed charges,80% of total billed charges,101.92,85,,,percent of total billed charges,85% of total billed charges,107.91,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,47.96,40,,,percent of total billed charges,40% of total billed charges,47.96,40,,,percent of total billed charges,40% of total billed charges,107.91,90,,,percent of total billed charges,90% of total billed charges,91.12,76,,,percent of total billed charges,76% of total billed charges,47.96,40,,,percent of total billed charges,40% of total billed charges,101.92,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,95.92,80,,,percent of total billed charges,80% of total billed charges,46.52,38.8,,,percent of total billed charges,38.8% of total billed charges,101.92,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,70.94,200,,,fee schedule,200% of CMS fee schedule,46.52,113.91,
01260 ANESTH UPPER LEG VEINS SURG Charge,60000442,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
42700 DRAINAGE OF TONSIL ABSCES,31042700,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,410.9,328.72,,308.18,75,,,percent of total billed charges,75% of total billed charges,164.36,40,,,percent of total billed charges,40% of total billed charges,325.43,79.2,,,percent of total billed charges,79.2% of total billed charges,349.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,390.36,95,,,percent of total billed charges,95% of total billed charges,328.72,80,,,percent of total billed charges,80% of total billed charges,349.27,85,,,percent of total billed charges,85% of total billed charges,369.81,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,164.36,40,,,percent of total billed charges,40% of total billed charges,164.36,40,,,percent of total billed charges,40% of total billed charges,369.81,90,,,percent of total billed charges,90% of total billed charges,312.28,76,,,percent of total billed charges,76% of total billed charges,164.36,40,,,percent of total billed charges,40% of total billed charges,349.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,328.72,80,,,percent of total billed charges,80% of total billed charges,159.43,38.8,,,percent of total billed charges,38.8% of total billed charges,349.27,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,159.43,390.36,
26350 - Repair or Adv flexor tendon,60000797,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2255.8,1804.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26608 Treat metacarpal fracture .,46026608,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1479.6,1183.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26650 Percutaneous skeletal fixation of carpometacarpal frac,60000613,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1488,1190.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"26842 - Arthrodesis, carpometacarpal joint thumb",60001099,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2504.9,2003.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27030 - ARTHROMY, HIP INCLUDING EXPLORATION OR REMOVVAL OF L",40627030,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2793.9,2235.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27235 - PERCUTANEOUS TX OF FEMORAL FRACTURE CHARGE,46027235,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2711.1,2168.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27236 - TREAT THIGH FX CHARGE,46027236,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3549.6,2839.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27238 CLOSED TRMT FEMORAL FX,31027238,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1432.1,1145.68,,1074.08,75,,,percent of total billed charges,75% of total billed charges,572.84,40,,,percent of total billed charges,40% of total billed charges,1134.22,79.2,,,percent of total billed charges,79.2% of total billed charges,1217.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1360.5,95,,,percent of total billed charges,95% of total billed charges,1145.68,80,,,percent of total billed charges,80% of total billed charges,1217.29,85,,,percent of total billed charges,85% of total billed charges,1288.89,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,572.84,40,,,percent of total billed charges,40% of total billed charges,572.84,40,,,percent of total billed charges,40% of total billed charges,1288.89,90,,,percent of total billed charges,90% of total billed charges,1088.4,76,,,percent of total billed charges,76% of total billed charges,572.84,40,,,percent of total billed charges,40% of total billed charges,1217.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1145.68,80,,,percent of total billed charges,80% of total billed charges,555.65,38.8,,,percent of total billed charges,38.8% of total billed charges,1217.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1360.5,
"27240 Closed treatment of intertrochanteric, peritrochanteri",60000396,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2855.8,2284.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27265 TREAT HIP DISLOC W/O ANES,60000290,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1282.4,1025.92,,961.8,75,,,percent of total billed charges,75% of total billed charges,512.96,40,,,percent of total billed charges,40% of total billed charges,1015.66,79.2,,,percent of total billed charges,79.2% of total billed charges,1090.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1218.28,95,,,percent of total billed charges,95% of total billed charges,1025.92,80,,,percent of total billed charges,80% of total billed charges,1090.04,85,,,percent of total billed charges,85% of total billed charges,1154.16,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,512.96,40,,,percent of total billed charges,40% of total billed charges,512.96,40,,,percent of total billed charges,40% of total billed charges,1154.16,90,,,percent of total billed charges,90% of total billed charges,974.62,76,,,percent of total billed charges,76% of total billed charges,512.96,40,,,percent of total billed charges,40% of total billed charges,1090.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1025.92,80,,,percent of total billed charges,80% of total billed charges,497.57,38.8,,,percent of total billed charges,38.8% of total billed charges,1090.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1218.28,
27266 Closed treatment of post hip arthroplasty dislocation;,31027266,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1757.6,1406.08,,1318.2,75,,,percent of total billed charges,75% of total billed charges,703.04,40,,,percent of total billed charges,40% of total billed charges,1392.02,79.2,,,percent of total billed charges,79.2% of total billed charges,1493.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1669.72,95,,,percent of total billed charges,95% of total billed charges,1406.08,80,,,percent of total billed charges,80% of total billed charges,1493.96,85,,,percent of total billed charges,85% of total billed charges,1581.84,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,703.04,40,,,percent of total billed charges,40% of total billed charges,703.04,40,,,percent of total billed charges,40% of total billed charges,1581.84,90,,,percent of total billed charges,90% of total billed charges,1335.78,76,,,percent of total billed charges,76% of total billed charges,703.04,40,,,percent of total billed charges,40% of total billed charges,1493.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1406.08,80,,,percent of total billed charges,80% of total billed charges,681.95,38.8,,,percent of total billed charges,38.8% of total billed charges,1493.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1669.72,
"Arthrotomy with meniscus repair, knee",60000978,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1953.3,1562.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27405 Repair of knee ligament .,46027405,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2042.2,1633.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27447 - ARTHOPLASTY KNEE,46027447,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3800,3040,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27470 Repair of nonunion or malunion of femur below trochant,46027470,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3515.9,2812.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27508 Closed treatment of femoral fracture, distal end, medi",60000398,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1526.3,1221.04,,1144.73,75,,,percent of total billed charges,75% of total billed charges,610.52,40,,,percent of total billed charges,40% of total billed charges,1208.83,79.2,,,percent of total billed charges,79.2% of total billed charges,1297.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1449.99,95,,,percent of total billed charges,95% of total billed charges,1221.04,80,,,percent of total billed charges,80% of total billed charges,1297.36,85,,,percent of total billed charges,85% of total billed charges,1373.67,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,610.52,40,,,percent of total billed charges,40% of total billed charges,610.52,40,,,percent of total billed charges,40% of total billed charges,1373.67,90,,,percent of total billed charges,90% of total billed charges,1159.99,76,,,percent of total billed charges,76% of total billed charges,610.52,40,,,percent of total billed charges,40% of total billed charges,1297.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1221.04,80,,,percent of total billed charges,80% of total billed charges,592.2,38.8,,,percent of total billed charges,38.8% of total billed charges,1297.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1449.99,
CLOSED TREATMENT OF PATELLAR FRACTURE W/O MANIPULATION,46027520,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,947.4,757.92,,710.55,75,,,percent of total billed charges,75% of total billed charges,378.96,40,,,percent of total billed charges,40% of total billed charges,750.34,79.2,,,percent of total billed charges,79.2% of total billed charges,805.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,900.03,95,,,percent of total billed charges,95% of total billed charges,757.92,80,,,percent of total billed charges,80% of total billed charges,805.29,85,,,percent of total billed charges,85% of total billed charges,852.66,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,378.96,40,,,percent of total billed charges,40% of total billed charges,378.96,40,,,percent of total billed charges,40% of total billed charges,852.66,90,,,percent of total billed charges,90% of total billed charges,720.02,76,,,percent of total billed charges,76% of total billed charges,378.96,40,,,percent of total billed charges,40% of total billed charges,805.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,757.92,80,,,percent of total billed charges,80% of total billed charges,367.59,38.8,,,percent of total billed charges,38.8% of total billed charges,805.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,900.03,
27540 Open Treatment Of Intercondylar Spine(S) And/Or Tubero,60000654,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2449.7,1959.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
00813 ANESTH FOR COMBINED UPPER AND LOWER GASTROINTESTINAL E,60000439,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27726 - Repair Of Fibula Nonunion And/Or Malunion,60000688,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2858,2286.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27762 - Closed Treatment Of Medial Malleolus Fracture; With,60000661,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1347.8,1078.24,,1010.85,75,,,percent of total billed charges,75% of total billed charges,539.12,40,,,percent of total billed charges,40% of total billed charges,1067.46,79.2,,,percent of total billed charges,79.2% of total billed charges,1145.63,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1280.41,95,,,percent of total billed charges,95% of total billed charges,1078.24,80,,,percent of total billed charges,80% of total billed charges,1145.63,85,,,percent of total billed charges,85% of total billed charges,1213.02,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,539.12,40,,,percent of total billed charges,40% of total billed charges,539.12,40,,,percent of total billed charges,40% of total billed charges,1213.02,90,,,percent of total billed charges,90% of total billed charges,1024.33,76,,,percent of total billed charges,76% of total billed charges,539.12,40,,,percent of total billed charges,40% of total billed charges,1145.63,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1078.24,80,,,percent of total billed charges,80% of total billed charges,522.95,38.8,,,percent of total billed charges,38.8% of total billed charges,1145.63,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1280.41,
28635 Closed treatment of metatarsophalangeal joint dislocat,31028635,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,395.6,316.48,,296.7,75,,,percent of total billed charges,75% of total billed charges,158.24,40,,,percent of total billed charges,40% of total billed charges,313.32,79.2,,,percent of total billed charges,79.2% of total billed charges,336.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,375.82,95,,,percent of total billed charges,95% of total billed charges,316.48,80,,,percent of total billed charges,80% of total billed charges,336.26,85,,,percent of total billed charges,85% of total billed charges,356.04,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,158.24,40,,,percent of total billed charges,40% of total billed charges,158.24,40,,,percent of total billed charges,40% of total billed charges,356.04,90,,,percent of total billed charges,90% of total billed charges,300.66,76,,,percent of total billed charges,76% of total billed charges,158.24,40,,,percent of total billed charges,40% of total billed charges,336.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,316.48,80,,,percent of total billed charges,80% of total billed charges,153.49,38.8,,,percent of total billed charges,38.8% of total billed charges,336.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,153.49,375.82,
29824 - Distal claviculectomy,60000996,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2044.3,1635.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
30630 - REPAIR NASAL SEPTAL PERFORATION,60001038,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1994.5,1595.6,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"30903 Control nasal hemorrhage, anterior, complex (extensive",31030903,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,164,131.2,,123,75,,,percent of total billed charges,75% of total billed charges,65.6,40,,,percent of total billed charges,40% of total billed charges,129.89,79.2,,,percent of total billed charges,79.2% of total billed charges,139.4,85,,,percent of total billed charges,85% of total billed charges,164,100,,,fee schedule,100% of CO APG rates,155.8,95,,,percent of total billed charges,95% of total billed charges,131.2,80,,,percent of total billed charges,80% of total billed charges,139.4,85,,,percent of total billed charges,85% of total billed charges,147.6,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,164,100,,,fee schedule,100% of NM APC rate,65.6,40,,,percent of total billed charges,40% of total billed charges,65.6,40,,,percent of total billed charges,40% of total billed charges,147.6,90,,,percent of total billed charges,90% of total billed charges,124.64,76,,,percent of total billed charges,76% of total billed charges,65.6,40,,,percent of total billed charges,40% of total billed charges,139.4,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,131.2,80,,,percent of total billed charges,80% of total billed charges,63.63,38.8,,,percent of total billed charges,38.8% of total billed charges,139.4,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,63.63,217.66,
30905 CNTRL NSAL HMRR-POSTER,31030905,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,224.4,179.52,,168.3,75,,,percent of total billed charges,75% of total billed charges,89.76,40,,,percent of total billed charges,40% of total billed charges,177.72,79.2,,,percent of total billed charges,79.2% of total billed charges,190.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,213.18,95,,,percent of total billed charges,95% of total billed charges,179.52,80,,,percent of total billed charges,80% of total billed charges,190.74,85,,,percent of total billed charges,85% of total billed charges,201.96,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,89.76,40,,,percent of total billed charges,40% of total billed charges,89.76,40,,,percent of total billed charges,40% of total billed charges,201.96,90,,,percent of total billed charges,90% of total billed charges,170.54,76,,,percent of total billed charges,76% of total billed charges,89.76,40,,,percent of total billed charges,40% of total billed charges,190.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,179.52,80,,,percent of total billed charges,80% of total billed charges,87.07,38.8,,,percent of total billed charges,38.8% of total billed charges,190.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,87.07,217.66,
30906 CNTRL NSAL HMRR-PSTR SUBS,31030906,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,309.5,247.6,,232.13,75,,,percent of total billed charges,75% of total billed charges,123.8,40,,,percent of total billed charges,40% of total billed charges,245.12,79.2,,,percent of total billed charges,79.2% of total billed charges,263.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,294.03,95,,,percent of total billed charges,95% of total billed charges,247.6,80,,,percent of total billed charges,80% of total billed charges,263.08,85,,,percent of total billed charges,85% of total billed charges,278.55,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,123.8,40,,,percent of total billed charges,40% of total billed charges,123.8,40,,,percent of total billed charges,40% of total billed charges,278.55,90,,,percent of total billed charges,90% of total billed charges,235.22,76,,,percent of total billed charges,76% of total billed charges,123.8,40,,,percent of total billed charges,40% of total billed charges,263.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,247.6,80,,,percent of total billed charges,80% of total billed charges,120.09,38.8,,,percent of total billed charges,38.8% of total billed charges,263.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,120.09,294.03,
"20611 Arthrocentesis, aspiration and/or injection, W/US",60000685,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,172.6,138.08,,129.45,75,,,percent of total billed charges,75% of total billed charges,69.04,40,,,percent of total billed charges,40% of total billed charges,136.7,79.2,,,percent of total billed charges,79.2% of total billed charges,146.71,85,,,percent of total billed charges,85% of total billed charges,172.6,100,,,fee schedule,100% of CO APG rates,163.97,95,,,percent of total billed charges,95% of total billed charges,138.08,80,,,percent of total billed charges,80% of total billed charges,146.71,85,,,percent of total billed charges,85% of total billed charges,155.34,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,172.6,100,,,fee schedule,100% of NM APC rate,69.04,40,,,percent of total billed charges,40% of total billed charges,69.04,40,,,percent of total billed charges,40% of total billed charges,155.34,90,,,percent of total billed charges,90% of total billed charges,131.18,76,,,percent of total billed charges,76% of total billed charges,69.04,40,,,percent of total billed charges,40% of total billed charges,146.71,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,138.08,80,,,percent of total billed charges,80% of total billed charges,66.97,38.8,,,percent of total billed charges,38.8% of total billed charges,146.71,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,345.2,200,,,fee schedule,200% of CMS fee schedule,66.97,2713.28,
"29876 Arthroscopy knee, synovectomy 2/> compartments",60000400,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1969.2,1575.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
62270 - SPINAL PUNCTURE LUMBAR DIAGNOSTIC,60000205,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,309.9,247.92,,232.43,75,,,percent of total billed charges,75% of total billed charges,123.96,40,,,percent of total billed charges,40% of total billed charges,245.44,79.2,,,percent of total billed charges,79.2% of total billed charges,263.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,294.41,95,,,percent of total billed charges,95% of total billed charges,247.92,80,,,percent of total billed charges,80% of total billed charges,263.42,85,,,percent of total billed charges,85% of total billed charges,278.91,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,123.96,40,,,percent of total billed charges,40% of total billed charges,123.96,40,,,percent of total billed charges,40% of total billed charges,278.91,90,,,percent of total billed charges,90% of total billed charges,235.52,76,,,percent of total billed charges,76% of total billed charges,123.96,40,,,percent of total billed charges,40% of total billed charges,263.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,247.92,80,,,percent of total billed charges,80% of total billed charges,120.24,38.8,,,percent of total billed charges,38.8% of total billed charges,263.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,120.24,294.41,
62272 - SPINAL PUNCTURE THER DRAIN CEREBROSPINAL FLUID,60000206,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,269.3,215.44,,201.98,75,,,percent of total billed charges,75% of total billed charges,107.72,40,,,percent of total billed charges,40% of total billed charges,213.29,79.2,,,percent of total billed charges,79.2% of total billed charges,228.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,255.84,95,,,percent of total billed charges,95% of total billed charges,215.44,80,,,percent of total billed charges,80% of total billed charges,228.91,85,,,percent of total billed charges,85% of total billed charges,242.37,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,107.72,40,,,percent of total billed charges,40% of total billed charges,107.72,40,,,percent of total billed charges,40% of total billed charges,242.37,90,,,percent of total billed charges,90% of total billed charges,204.67,76,,,percent of total billed charges,76% of total billed charges,107.72,40,,,percent of total billed charges,40% of total billed charges,228.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,215.44,80,,,percent of total billed charges,80% of total billed charges,104.49,38.8,,,percent of total billed charges,38.8% of total billed charges,228.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,104.49,255.84,
56405 I  D OF VULVA/PERINEUM.,31056405,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,381,304.8,,285.75,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,301.75,79.2,,,percent of total billed charges,79.2% of total billed charges,323.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,361.95,95,,,percent of total billed charges,95% of total billed charges,304.8,80,,,percent of total billed charges,80% of total billed charges,323.85,85,,,percent of total billed charges,85% of total billed charges,342.9,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,381,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,342.9,90,,,percent of total billed charges,90% of total billed charges,289.56,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,323.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,304.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,323.85,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1144.2,100,,,case rate,pays based on per visit rate,285.75,1144.2,
28292 - CORRJ HALLUX VALGUS W/SESMDC W/RESCJ PROX PHAL,60000219,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1469.9,1175.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27420 - RCNSTJ DISLOCATING PATELLA,60000218,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2250.2,1800.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26990 - ID PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA,60000222,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2044.9,1635.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28008 - FASCIOTOMY FOOT/TOE,60000221,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,890.4,712.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28250 - DIVISION PLANTAR FASCIA  MUSCLE SPX,60000223,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1247.7,998.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Bone Marrow Biopsy and Aspiration,60000451,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,217.7,174.16,,163.28,75,,,percent of total billed charges,75% of total billed charges,87.08,40,,,percent of total billed charges,40% of total billed charges,172.42,79.2,,,percent of total billed charges,79.2% of total billed charges,185.05,85,,,percent of total billed charges,85% of total billed charges,217.7,100,,,fee schedule,100% of CO APG rates,206.82,95,,,percent of total billed charges,95% of total billed charges,174.16,80,,,percent of total billed charges,80% of total billed charges,185.05,85,,,percent of total billed charges,85% of total billed charges,195.93,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,217.7,100,,,fee schedule,100% of NM APC rate,87.08,40,,,percent of total billed charges,40% of total billed charges,87.08,40,,,percent of total billed charges,40% of total billed charges,195.93,90,,,percent of total billed charges,90% of total billed charges,165.45,76,,,percent of total billed charges,76% of total billed charges,87.08,40,,,percent of total billed charges,40% of total billed charges,185.05,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,174.16,80,,,percent of total billed charges,80% of total billed charges,84.47,38.8,,,percent of total billed charges,38.8% of total billed charges,185.05,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,435.4,200,,,fee schedule,200% of CMS fee schedule,84.47,2713.28,
29848 - WRIST ENDOSCOPY/SURGERY,60000990,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1565.2,1252.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28090 - EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT,60000225,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,935,748,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
44202 - LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ  ANA,60000226,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,6108.9,4887.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29819 - ARTHROSCOPY SHOULDER SURGICAL REMOVAL LOOSE/FB,60000229,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1771.5,1417.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
54161 - CIRCUM 28 DAYS OR OLDER,60000230,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,586.8,469.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
36566 - INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,60000243,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1030.3,824.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46257 - HEMORRHOID NTRNL  XTRNL 1 COLUMN W/FISSURECTO,60000242,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1255.2,1004.16,,941.4,75,,,percent of total billed charges,75% of total billed charges,502.08,40,,,percent of total billed charges,40% of total billed charges,994.12,79.2,,,percent of total billed charges,79.2% of total billed charges,1066.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1192.44,95,,,percent of total billed charges,95% of total billed charges,1004.16,80,,,percent of total billed charges,80% of total billed charges,1066.92,85,,,percent of total billed charges,85% of total billed charges,1129.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,502.08,40,,,percent of total billed charges,40% of total billed charges,502.08,40,,,percent of total billed charges,40% of total billed charges,1129.68,90,,,percent of total billed charges,90% of total billed charges,953.95,76,,,percent of total billed charges,76% of total billed charges,502.08,40,,,percent of total billed charges,40% of total billed charges,1066.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1004.16,80,,,percent of total billed charges,80% of total billed charges,487.02,38.8,,,percent of total billed charges,38.8% of total billed charges,1066.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1192.44,
"23040 Arthrotomy, Glenohumeral Joint, Including Exploration,",60000261,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2161.3,1729.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49082 - ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,60000236,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,213.4,170.72,,160.05,75,,,percent of total billed charges,75% of total billed charges,85.36,40,,,percent of total billed charges,40% of total billed charges,169.01,79.2,,,percent of total billed charges,79.2% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,213.4,100,,,fee schedule,100% of CO APG rates,202.73,95,,,percent of total billed charges,95% of total billed charges,170.72,80,,,percent of total billed charges,80% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,192.06,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,213.4,100,,,fee schedule,100% of NM APC rate,85.36,40,,,percent of total billed charges,40% of total billed charges,85.36,40,,,percent of total billed charges,40% of total billed charges,192.06,90,,,percent of total billed charges,90% of total billed charges,162.18,76,,,percent of total billed charges,76% of total billed charges,85.36,40,,,percent of total billed charges,40% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,170.72,80,,,percent of total billed charges,80% of total billed charges,82.8,38.8,,,percent of total billed charges,38.8% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,426.8,200,,,fee schedule,200% of CMS fee schedule,82.8,2713.28,
"99157 Moderate sedation, other health care pro performing di",46299157,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,166.4,133.12,,124.8,75,,,percent of total billed charges,75% of total billed charges,66.56,40,,,percent of total billed charges,40% of total billed charges,131.79,79.2,,,percent of total billed charges,79.2% of total billed charges,141.44,85,,,percent of total billed charges,85% of total billed charges,166.4,100,,,fee schedule,100% of CO APG rates,158.08,95,,,percent of total billed charges,95% of total billed charges,133.12,80,,,percent of total billed charges,80% of total billed charges,141.44,85,,,percent of total billed charges,85% of total billed charges,149.76,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,166.4,100,,,fee schedule,100% of NM APC rate,66.56,40,,,percent of total billed charges,40% of total billed charges,66.56,40,,,percent of total billed charges,40% of total billed charges,149.76,90,,,percent of total billed charges,90% of total billed charges,126.46,76,,,percent of total billed charges,76% of total billed charges,66.56,40,,,percent of total billed charges,40% of total billed charges,141.44,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,133.12,80,,,percent of total billed charges,80% of total billed charges,64.56,38.8,,,percent of total billed charges,38.8% of total billed charges,141.44,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,64.56,217.66,
23472 ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER,60000407,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,4277.6,3422.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
20680 - EXTREMITY REMOVAL OF IMPLANT DEEP,46020680,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1259.3,1007.44,,944.48,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,997.37,79.2,,,percent of total billed charges,79.2% of total billed charges,1070.41,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1196.34,95,,,percent of total billed charges,95% of total billed charges,1007.44,80,,,percent of total billed charges,80% of total billed charges,1070.41,85,,,percent of total billed charges,85% of total billed charges,1133.37,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1259.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1133.37,90,,,percent of total billed charges,90% of total billed charges,957.07,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1070.41,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1007.44,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1070.41,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1259.3,
93272 EVENT MONITOR PRO FEE,42293272,CDM,985,RC,93010,HCPCS,OUTPATIENT,,,69.8,55.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"25651 Insertion of hardware broken bone of forearm at wrist,",60000263,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1506,1204.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01520 ANESTHESIA VEINS OF LOWER LEG NOS,60000319,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
54450 Repositioning of foreskin including scar tissue remova,60000380,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,166.6,133.28,,124.95,75,,,percent of total billed charges,75% of total billed charges,66.64,40,,,percent of total billed charges,40% of total billed charges,131.95,79.2,,,percent of total billed charges,79.2% of total billed charges,141.61,85,,,percent of total billed charges,85% of total billed charges,166.6,100,,,fee schedule,100% of CO APG rates,158.27,95,,,percent of total billed charges,95% of total billed charges,133.28,80,,,percent of total billed charges,80% of total billed charges,141.61,85,,,percent of total billed charges,85% of total billed charges,149.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,166.6,100,,,fee schedule,100% of NM APC rate,66.64,40,,,percent of total billed charges,40% of total billed charges,66.64,40,,,percent of total billed charges,40% of total billed charges,149.94,90,,,percent of total billed charges,90% of total billed charges,126.62,76,,,percent of total billed charges,76% of total billed charges,66.64,40,,,percent of total billed charges,40% of total billed charges,141.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,133.28,80,,,percent of total billed charges,80% of total billed charges,64.64,38.8,,,percent of total billed charges,38.8% of total billed charges,141.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,64.64,217.66,
28525 Open treatment of broken toe,60000384,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1219.9,975.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46080 - INCISION OF ANAL SPHINCTER,60000385,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,468.5,374.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"28496 Percutaneous skeletal fixation of fracture great toe,",60000386,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,850.6,680.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27340 - Excision, Prepatellar Bursa",60000713,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1152.7,922.16,,864.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,912.94,79.2,,,percent of total billed charges,79.2% of total billed charges,979.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1095.07,95,,,percent of total billed charges,95% of total billed charges,922.16,80,,,percent of total billed charges,80% of total billed charges,979.8,85,,,percent of total billed charges,85% of total billed charges,1037.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1152.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1037.43,90,,,percent of total billed charges,90% of total billed charges,876.05,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,979.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,922.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,979.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
64633 - Destruction Paravertebral Facet Joint Nerve;Cervical,60000716,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,568.5,454.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
85060 peripheral smear review,40085060,CDM,971,RC,85060,HCPCS,OUTPATIENT,,,83.3,66.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
88104 cyto wash brushing,40088104,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,97.4,77.92,,73.05,75,,,percent of total billed charges,75% of total billed charges,38.96,40,,,percent of total billed charges,40% of total billed charges,77.14,79.2,,,percent of total billed charges,79.2% of total billed charges,82.79,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,92.53,95,,,percent of total billed charges,95% of total billed charges,77.92,80,,,percent of total billed charges,80% of total billed charges,82.79,85,,,percent of total billed charges,85% of total billed charges,87.66,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,38.96,40,,,percent of total billed charges,40% of total billed charges,38.96,40,,,percent of total billed charges,40% of total billed charges,87.66,90,,,percent of total billed charges,90% of total billed charges,74.02,76,,,percent of total billed charges,76% of total billed charges,38.96,40,,,percent of total billed charges,40% of total billed charges,82.79,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,77.92,80,,,percent of total billed charges,80% of total billed charges,37.79,38.8,,,percent of total billed charges,38.8% of total billed charges,82.79,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,92.53,
88108 concentration,40088108,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,77.8,62.24,,58.35,75,,,percent of total billed charges,75% of total billed charges,31.12,40,,,percent of total billed charges,40% of total billed charges,61.62,79.2,,,percent of total billed charges,79.2% of total billed charges,66.13,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,73.91,95,,,percent of total billed charges,95% of total billed charges,62.24,80,,,percent of total billed charges,80% of total billed charges,66.13,85,,,percent of total billed charges,85% of total billed charges,70.02,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,31.12,40,,,percent of total billed charges,40% of total billed charges,31.12,40,,,percent of total billed charges,40% of total billed charges,70.02,90,,,percent of total billed charges,90% of total billed charges,59.13,76,,,percent of total billed charges,76% of total billed charges,31.12,40,,,percent of total billed charges,40% of total billed charges,66.13,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,62.24,80,,,percent of total billed charges,80% of total billed charges,30.19,38.8,,,percent of total billed charges,38.8% of total billed charges,66.13,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,73.91,
88160 cyto other source,40088160,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,88.7,70.96,,66.53,75,,,percent of total billed charges,75% of total billed charges,35.48,40,,,percent of total billed charges,40% of total billed charges,70.25,79.2,,,percent of total billed charges,79.2% of total billed charges,75.4,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,84.27,95,,,percent of total billed charges,95% of total billed charges,70.96,80,,,percent of total billed charges,80% of total billed charges,75.4,85,,,percent of total billed charges,85% of total billed charges,79.83,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,35.48,40,,,percent of total billed charges,40% of total billed charges,35.48,40,,,percent of total billed charges,40% of total billed charges,79.83,90,,,percent of total billed charges,90% of total billed charges,67.41,76,,,percent of total billed charges,76% of total billed charges,35.48,40,,,percent of total billed charges,40% of total billed charges,75.4,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,70.96,80,,,percent of total billed charges,80% of total billed charges,34.42,38.8,,,percent of total billed charges,38.8% of total billed charges,75.4,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,84.27,
88161 fna 1-5 slides,40088161,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,85.4,68.32,,64.05,75,,,percent of total billed charges,75% of total billed charges,34.16,40,,,percent of total billed charges,40% of total billed charges,67.64,79.2,,,percent of total billed charges,79.2% of total billed charges,72.59,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,81.13,95,,,percent of total billed charges,95% of total billed charges,68.32,80,,,percent of total billed charges,80% of total billed charges,72.59,85,,,percent of total billed charges,85% of total billed charges,76.86,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,34.16,40,,,percent of total billed charges,40% of total billed charges,34.16,40,,,percent of total billed charges,40% of total billed charges,76.86,90,,,percent of total billed charges,90% of total billed charges,64.9,76,,,percent of total billed charges,76% of total billed charges,34.16,40,,,percent of total billed charges,40% of total billed charges,72.59,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,68.32,80,,,percent of total billed charges,80% of total billed charges,33.14,38.8,,,percent of total billed charges,38.8% of total billed charges,72.59,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,81.13,
88162 fna multi,40088162,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,400.4,320.32,,300.3,75,,,percent of total billed charges,75% of total billed charges,160.16,40,,,percent of total billed charges,40% of total billed charges,317.12,79.2,,,percent of total billed charges,79.2% of total billed charges,340.34,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,380.38,95,,,percent of total billed charges,95% of total billed charges,320.32,80,,,percent of total billed charges,80% of total billed charges,340.34,85,,,percent of total billed charges,85% of total billed charges,360.36,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,160.16,40,,,percent of total billed charges,40% of total billed charges,160.16,40,,,percent of total billed charges,40% of total billed charges,360.36,90,,,percent of total billed charges,90% of total billed charges,304.3,76,,,percent of total billed charges,76% of total billed charges,160.16,40,,,percent of total billed charges,40% of total billed charges,340.34,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,320.32,80,,,percent of total billed charges,80% of total billed charges,155.36,38.8,,,percent of total billed charges,38.8% of total billed charges,340.34,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,380.38,
88173 fine needle interp and report,40088173,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,243.4,194.72,,182.55,75,,,percent of total billed charges,75% of total billed charges,97.36,40,,,percent of total billed charges,40% of total billed charges,192.77,79.2,,,percent of total billed charges,79.2% of total billed charges,206.89,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,231.23,95,,,percent of total billed charges,95% of total billed charges,194.72,80,,,percent of total billed charges,80% of total billed charges,206.89,85,,,percent of total billed charges,85% of total billed charges,219.06,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,97.36,40,,,percent of total billed charges,40% of total billed charges,97.36,40,,,percent of total billed charges,40% of total billed charges,219.06,90,,,percent of total billed charges,90% of total billed charges,184.98,76,,,percent of total billed charges,76% of total billed charges,97.36,40,,,percent of total billed charges,40% of total billed charges,206.89,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,194.72,80,,,percent of total billed charges,80% of total billed charges,94.44,38.8,,,percent of total billed charges,38.8% of total billed charges,206.89,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,231.23,
88300 level 1 gross exam only,40088300,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,15.1,12.08,,11.33,75,,,percent of total billed charges,75% of total billed charges,6.04,40,,,percent of total billed charges,40% of total billed charges,11.96,79.2,,,percent of total billed charges,79.2% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,15.1,100,,,fee schedule,100% of CO APG rates,14.35,95,,,percent of total billed charges,95% of total billed charges,12.08,80,,,percent of total billed charges,80% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,13.59,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,6.04,40,,,percent of total billed charges,40% of total billed charges,6.04,40,,,percent of total billed charges,40% of total billed charges,13.59,90,,,percent of total billed charges,90% of total billed charges,11.48,76,,,percent of total billed charges,76% of total billed charges,6.04,40,,,percent of total billed charges,40% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,12.08,80,,,percent of total billed charges,80% of total billed charges,5.86,38.8,,,percent of total billed charges,38.8% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,5.86,53.22,
88302 level II surgical histo,40088302,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,24.8,19.84,,18.6,75,,,percent of total billed charges,75% of total billed charges,9.92,40,,,percent of total billed charges,40% of total billed charges,19.64,79.2,,,percent of total billed charges,79.2% of total billed charges,21.08,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,23.56,95,,,percent of total billed charges,95% of total billed charges,19.84,80,,,percent of total billed charges,80% of total billed charges,21.08,85,,,percent of total billed charges,85% of total billed charges,22.32,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,9.92,40,,,percent of total billed charges,40% of total billed charges,9.92,40,,,percent of total billed charges,40% of total billed charges,22.32,90,,,percent of total billed charges,90% of total billed charges,18.85,76,,,percent of total billed charges,76% of total billed charges,9.92,40,,,percent of total billed charges,40% of total billed charges,21.08,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,19.84,80,,,percent of total billed charges,80% of total billed charges,9.62,38.8,,,percent of total billed charges,38.8% of total billed charges,21.08,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,9.62,53.22,
88304 level III surg histo,40088304,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,40,32,,30,75,,,percent of total billed charges,75% of total billed charges,16,40,,,percent of total billed charges,40% of total billed charges,31.68,79.2,,,percent of total billed charges,79.2% of total billed charges,34,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,38,95,,,percent of total billed charges,95% of total billed charges,32,80,,,percent of total billed charges,80% of total billed charges,34,85,,,percent of total billed charges,85% of total billed charges,36,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,16,40,,,percent of total billed charges,40% of total billed charges,16,40,,,percent of total billed charges,40% of total billed charges,36,90,,,percent of total billed charges,90% of total billed charges,30.4,76,,,percent of total billed charges,76% of total billed charges,16,40,,,percent of total billed charges,40% of total billed charges,34,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,32,80,,,percent of total billed charges,80% of total billed charges,15.52,38.8,,,percent of total billed charges,38.8% of total billed charges,34,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,15.52,53.22,
88305 cell block,40088305,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,129.8,103.84,,97.35,75,,,percent of total billed charges,75% of total billed charges,51.92,40,,,percent of total billed charges,40% of total billed charges,102.8,79.2,,,percent of total billed charges,79.2% of total billed charges,110.33,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,123.31,95,,,percent of total billed charges,95% of total billed charges,103.84,80,,,percent of total billed charges,80% of total billed charges,110.33,85,,,percent of total billed charges,85% of total billed charges,116.82,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,51.92,40,,,percent of total billed charges,40% of total billed charges,51.92,40,,,percent of total billed charges,40% of total billed charges,116.82,90,,,percent of total billed charges,90% of total billed charges,98.65,76,,,percent of total billed charges,76% of total billed charges,51.92,40,,,percent of total billed charges,40% of total billed charges,110.33,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,103.84,80,,,percent of total billed charges,80% of total billed charges,50.36,38.8,,,percent of total billed charges,38.8% of total billed charges,110.33,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,123.31,
88307 level V surg histo,40088307,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,286.2,228.96,,214.65,75,,,percent of total billed charges,75% of total billed charges,114.48,40,,,percent of total billed charges,40% of total billed charges,226.67,79.2,,,percent of total billed charges,79.2% of total billed charges,243.27,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,271.89,95,,,percent of total billed charges,95% of total billed charges,228.96,80,,,percent of total billed charges,80% of total billed charges,243.27,85,,,percent of total billed charges,85% of total billed charges,257.58,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,114.48,40,,,percent of total billed charges,40% of total billed charges,114.48,40,,,percent of total billed charges,40% of total billed charges,257.58,90,,,percent of total billed charges,90% of total billed charges,217.51,76,,,percent of total billed charges,76% of total billed charges,114.48,40,,,percent of total billed charges,40% of total billed charges,243.27,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,228.96,80,,,percent of total billed charges,80% of total billed charges,111.05,38.8,,,percent of total billed charges,38.8% of total billed charges,243.27,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,271.89,
88309 level VI surg histo,40088309,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,508.5,406.8,,381.38,75,,,percent of total billed charges,75% of total billed charges,203.4,40,,,percent of total billed charges,40% of total billed charges,402.73,79.2,,,percent of total billed charges,79.2% of total billed charges,432.23,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,483.08,95,,,percent of total billed charges,95% of total billed charges,406.8,80,,,percent of total billed charges,80% of total billed charges,432.23,85,,,percent of total billed charges,85% of total billed charges,457.65,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,203.4,40,,,percent of total billed charges,40% of total billed charges,203.4,40,,,percent of total billed charges,40% of total billed charges,457.65,90,,,percent of total billed charges,90% of total billed charges,386.46,76,,,percent of total billed charges,76% of total billed charges,203.4,40,,,percent of total billed charges,40% of total billed charges,432.23,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,406.8,80,,,percent of total billed charges,80% of total billed charges,197.3,38.8,,,percent of total billed charges,38.8% of total billed charges,432.23,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,483.08,
88311 decalcification,40088311,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,16.8,53.22,
"88312 special stain, organism",40088312,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,91.9,73.52,,68.93,75,,,percent of total billed charges,75% of total billed charges,36.76,40,,,percent of total billed charges,40% of total billed charges,72.78,79.2,,,percent of total billed charges,79.2% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,87.31,95,,,percent of total billed charges,95% of total billed charges,73.52,80,,,percent of total billed charges,80% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,82.71,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,36.76,40,,,percent of total billed charges,40% of total billed charges,36.76,40,,,percent of total billed charges,40% of total billed charges,82.71,90,,,percent of total billed charges,90% of total billed charges,69.84,76,,,percent of total billed charges,76% of total billed charges,36.76,40,,,percent of total billed charges,40% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,73.52,80,,,percent of total billed charges,80% of total billed charges,35.66,38.8,,,percent of total billed charges,38.8% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,87.31,
88313 special stain all others,40088313,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,41.1,32.88,,30.83,75,,,percent of total billed charges,75% of total billed charges,16.44,40,,,percent of total billed charges,40% of total billed charges,32.55,79.2,,,percent of total billed charges,79.2% of total billed charges,34.94,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,39.05,95,,,percent of total billed charges,95% of total billed charges,32.88,80,,,percent of total billed charges,80% of total billed charges,34.94,85,,,percent of total billed charges,85% of total billed charges,36.99,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,16.44,40,,,percent of total billed charges,40% of total billed charges,16.44,40,,,percent of total billed charges,40% of total billed charges,36.99,90,,,percent of total billed charges,90% of total billed charges,31.24,76,,,percent of total billed charges,76% of total billed charges,16.44,40,,,percent of total billed charges,40% of total billed charges,34.94,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,32.88,80,,,percent of total billed charges,80% of total billed charges,15.95,38.8,,,percent of total billed charges,38.8% of total billed charges,34.94,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,15.95,53.22,
88314 histochem spec stain,40088314,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,77.3,61.84,,57.98,75,,,percent of total billed charges,75% of total billed charges,30.92,40,,,percent of total billed charges,40% of total billed charges,61.22,79.2,,,percent of total billed charges,79.2% of total billed charges,65.71,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,73.44,95,,,percent of total billed charges,95% of total billed charges,61.84,80,,,percent of total billed charges,80% of total billed charges,65.71,85,,,percent of total billed charges,85% of total billed charges,69.57,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,30.92,40,,,percent of total billed charges,40% of total billed charges,30.92,40,,,percent of total billed charges,40% of total billed charges,69.57,90,,,percent of total billed charges,90% of total billed charges,58.75,76,,,percent of total billed charges,76% of total billed charges,30.92,40,,,percent of total billed charges,40% of total billed charges,65.71,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,61.84,80,,,percent of total billed charges,80% of total billed charges,29.99,38.8,,,percent of total billed charges,38.8% of total billed charges,65.71,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,73.44,
88319 enzyme spec stain,40088319,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,91.9,73.52,,68.93,75,,,percent of total billed charges,75% of total billed charges,36.76,40,,,percent of total billed charges,40% of total billed charges,72.78,79.2,,,percent of total billed charges,79.2% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,87.31,95,,,percent of total billed charges,95% of total billed charges,73.52,80,,,percent of total billed charges,80% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,82.71,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,36.76,40,,,percent of total billed charges,40% of total billed charges,36.76,40,,,percent of total billed charges,40% of total billed charges,82.71,90,,,percent of total billed charges,90% of total billed charges,69.84,76,,,percent of total billed charges,76% of total billed charges,36.76,40,,,percent of total billed charges,40% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,73.52,80,,,percent of total billed charges,80% of total billed charges,35.66,38.8,,,percent of total billed charges,38.8% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,87.31,
88325 path consult,40088325,CDM,971,RC,85060,HCPCS,OUTPATIENT,,,391.4,313.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
88329 path consult,40088329,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,124.8,99.84,,93.6,75,,,percent of total billed charges,75% of total billed charges,49.92,40,,,percent of total billed charges,40% of total billed charges,98.84,79.2,,,percent of total billed charges,79.2% of total billed charges,106.08,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,118.56,95,,,percent of total billed charges,95% of total billed charges,99.84,80,,,percent of total billed charges,80% of total billed charges,106.08,85,,,percent of total billed charges,85% of total billed charges,112.32,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,49.92,40,,,percent of total billed charges,40% of total billed charges,49.92,40,,,percent of total billed charges,40% of total billed charges,112.32,90,,,percent of total billed charges,90% of total billed charges,94.85,76,,,percent of total billed charges,76% of total billed charges,49.92,40,,,percent of total billed charges,40% of total billed charges,106.08,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,99.84,80,,,percent of total billed charges,80% of total billed charges,48.42,38.8,,,percent of total billed charges,38.8% of total billed charges,106.08,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,118.56,
88331 frozen section,40088331,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,217.4,173.92,,163.05,75,,,percent of total billed charges,75% of total billed charges,86.96,40,,,percent of total billed charges,40% of total billed charges,172.18,79.2,,,percent of total billed charges,79.2% of total billed charges,184.79,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,206.53,95,,,percent of total billed charges,95% of total billed charges,173.92,80,,,percent of total billed charges,80% of total billed charges,184.79,85,,,percent of total billed charges,85% of total billed charges,195.66,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,86.96,40,,,percent of total billed charges,40% of total billed charges,86.96,40,,,percent of total billed charges,40% of total billed charges,195.66,90,,,percent of total billed charges,90% of total billed charges,165.22,76,,,percent of total billed charges,76% of total billed charges,86.96,40,,,percent of total billed charges,40% of total billed charges,184.79,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,173.92,80,,,percent of total billed charges,80% of total billed charges,84.35,38.8,,,percent of total billed charges,38.8% of total billed charges,184.79,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,206.53,
88332 additional froz sect same visit,40088332,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,107,85.6,,80.25,75,,,percent of total billed charges,75% of total billed charges,42.8,40,,,percent of total billed charges,40% of total billed charges,84.74,79.2,,,percent of total billed charges,79.2% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,101.65,95,,,percent of total billed charges,95% of total billed charges,85.6,80,,,percent of total billed charges,80% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,96.3,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,42.8,40,,,percent of total billed charges,40% of total billed charges,42.8,40,,,percent of total billed charges,40% of total billed charges,96.3,90,,,percent of total billed charges,90% of total billed charges,81.32,76,,,percent of total billed charges,76% of total billed charges,42.8,40,,,percent of total billed charges,40% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,85.6,80,,,percent of total billed charges,80% of total billed charges,41.52,38.8,,,percent of total billed charges,38.8% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,101.65,
88333 touch prep,40088333,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,223.9,179.12,,167.93,75,,,percent of total billed charges,75% of total billed charges,89.56,40,,,percent of total billed charges,40% of total billed charges,177.33,79.2,,,percent of total billed charges,79.2% of total billed charges,190.32,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,212.71,95,,,percent of total billed charges,95% of total billed charges,179.12,80,,,percent of total billed charges,80% of total billed charges,190.32,85,,,percent of total billed charges,85% of total billed charges,201.51,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,89.56,40,,,percent of total billed charges,40% of total billed charges,89.56,40,,,percent of total billed charges,40% of total billed charges,201.51,90,,,percent of total billed charges,90% of total billed charges,170.16,76,,,percent of total billed charges,76% of total billed charges,89.56,40,,,percent of total billed charges,40% of total billed charges,190.32,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,179.12,80,,,percent of total billed charges,80% of total billed charges,86.87,38.8,,,percent of total billed charges,38.8% of total billed charges,190.32,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,212.71,
88341 IHC stain each additional,40088341,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,107,85.6,,80.25,75,,,percent of total billed charges,75% of total billed charges,42.8,40,,,percent of total billed charges,40% of total billed charges,84.74,79.2,,,percent of total billed charges,79.2% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,101.65,95,,,percent of total billed charges,95% of total billed charges,85.6,80,,,percent of total billed charges,80% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,96.3,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,42.8,40,,,percent of total billed charges,40% of total billed charges,42.8,40,,,percent of total billed charges,40% of total billed charges,96.3,90,,,percent of total billed charges,90% of total billed charges,81.32,76,,,percent of total billed charges,76% of total billed charges,42.8,40,,,percent of total billed charges,40% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,85.6,80,,,percent of total billed charges,80% of total billed charges,41.52,38.8,,,percent of total billed charges,38.8% of total billed charges,90.95,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,101.65,
88342 immunohistochemistry,40088342,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,122.2,97.76,,91.65,75,,,percent of total billed charges,75% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,96.78,79.2,,,percent of total billed charges,79.2% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,116.09,95,,,percent of total billed charges,95% of total billed charges,97.76,80,,,percent of total billed charges,80% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,109.98,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,48.88,40,,,percent of total billed charges,40% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,109.98,90,,,percent of total billed charges,90% of total billed charges,92.87,76,,,percent of total billed charges,76% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,97.76,80,,,percent of total billed charges,80% of total billed charges,47.41,38.8,,,percent of total billed charges,38.8% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,116.09,
88348 electron microscopy,40088348,CDM,319,RC,88348,HCPCS,OUTPATIENT,,,260.7,208.56,,195.53,75,,,percent of total billed charges,75% of total billed charges,104.28,40,,,percent of total billed charges,40% of total billed charges,206.47,79.2,,,percent of total billed charges,79.2% of total billed charges,221.6,85,,,percent of total billed charges,85% of total billed charges,53.26,100,,,fee schedule,100% of CO APG rates,247.67,95,,,percent of total billed charges,95% of total billed charges,208.56,80,,,percent of total billed charges,80% of total billed charges,221.6,85,,,percent of total billed charges,85% of total billed charges,234.63,90,,,percent of total billed charges,90% of total billed charges,53.26,100,,,fee schedule,100% of CO APG rates,53.26,100,,,fee schedule,100% of CO APG rates,260.7,100,,,fee schedule,100% of NM APC rate,104.28,40,,,percent of total billed charges,40% of total billed charges,104.28,40,,,percent of total billed charges,40% of total billed charges,234.63,90,,,percent of total billed charges,90% of total billed charges,198.13,76,,,percent of total billed charges,76% of total billed charges,104.28,40,,,percent of total billed charges,40% of total billed charges,221.6,85,,,percent of total billed charges,85% of total billed charges,53.26,100,,,fee schedule,100% of CO APG rate,208.56,80,,,percent of total billed charges,80% of total billed charges,101.15,38.8,,,percent of total billed charges,38.8% of total billed charges,221.6,85,,,percent of total billed charges,85% of total billed charges,53.26,100,,,fee schedule,100% of APG fee schedule,521.4,200,,,fee schedule,200% of CMS fee schedule,53.26,521.4,
88360 quant IHC,40088360,CDM,312,RC,88341,HCPCS,OUTPATIENT,,,152.5,122,,114.38,75,,,percent of total billed charges,75% of total billed charges,61,40,,,percent of total billed charges,40% of total billed charges,120.78,79.2,,,percent of total billed charges,79.2% of total billed charges,129.63,85,,,percent of total billed charges,85% of total billed charges,29.14,100,,,fee schedule,100% of CO APG rates,144.88,95,,,percent of total billed charges,95% of total billed charges,122,80,,,percent of total billed charges,80% of total billed charges,129.63,85,,,percent of total billed charges,85% of total billed charges,137.25,90,,,percent of total billed charges,90% of total billed charges,29.14,100,,,fee schedule,100% of CO APG rates,29.14,100,,,fee schedule,100% of CO APG rates,152.5,100,,,fee schedule,100% of NM fee schedule,61,40,,,percent of total billed charges,40% of total billed charges,61,40,,,percent of total billed charges,40% of total billed charges,137.25,90,,,percent of total billed charges,90% of total billed charges,115.9,76,,,percent of total billed charges,76% of total billed charges,61,40,,,percent of total billed charges,40% of total billed charges,129.63,85,,,percent of total billed charges,85% of total billed charges,29.14,100,,,fee schedule,100% of CO APG rate,122,80,,,percent of total billed charges,80% of total billed charges,59.17,38.8,,,percent of total billed charges,38.8% of total billed charges,129.63,85,,,percent of total billed charges,85% of total billed charges,29.14,100,,,fee schedule,100% of APG fee schedule,181,200,,,fee schedule,200% of CMS fee schedule,29.14,181,
88365 in situ hybridization,40088365,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,528.9,423.12,,396.68,75,,,percent of total billed charges,75% of total billed charges,211.56,40,,,percent of total billed charges,40% of total billed charges,418.89,79.2,,,percent of total billed charges,79.2% of total billed charges,449.57,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,502.46,95,,,percent of total billed charges,95% of total billed charges,423.12,80,,,percent of total billed charges,80% of total billed charges,449.57,85,,,percent of total billed charges,85% of total billed charges,476.01,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,211.56,40,,,percent of total billed charges,40% of total billed charges,211.56,40,,,percent of total billed charges,40% of total billed charges,476.01,90,,,percent of total billed charges,90% of total billed charges,401.96,76,,,percent of total billed charges,76% of total billed charges,211.56,40,,,percent of total billed charges,40% of total billed charges,449.57,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,423.12,80,,,percent of total billed charges,80% of total billed charges,205.21,38.8,,,percent of total billed charges,38.8% of total billed charges,449.57,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,502.46,
01952 ANESTH FOR BURNS BETWEEN 4% AND 9% OF TOTAL BODY AREA,60000433,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01953 ANESTH FOR BURNS EACH ADDITIONAL 9% TOTAL BODY SURFACE,60000434,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"01860 ANESTH FOR FOREARM, WRIST, OR HAND CAST APPLICATION, R",60000443,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
67700 - Drainage of Eyelid Abscess,60000648,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,347.9,278.32,,260.93,75,,,percent of total billed charges,75% of total billed charges,139.16,40,,,percent of total billed charges,40% of total billed charges,275.54,79.2,,,percent of total billed charges,79.2% of total billed charges,295.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,330.51,95,,,percent of total billed charges,95% of total billed charges,278.32,80,,,percent of total billed charges,80% of total billed charges,295.72,85,,,percent of total billed charges,85% of total billed charges,313.11,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,139.16,40,,,percent of total billed charges,40% of total billed charges,139.16,40,,,percent of total billed charges,40% of total billed charges,313.11,90,,,percent of total billed charges,90% of total billed charges,264.4,76,,,percent of total billed charges,76% of total billed charges,139.16,40,,,percent of total billed charges,40% of total billed charges,295.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,278.32,80,,,percent of total billed charges,80% of total billed charges,134.99,38.8,,,percent of total billed charges,38.8% of total billed charges,295.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,134.99,330.51,
"62325 - Injection; interlaminar epidural or subarachnoid, ce",60000687,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,318.5,254.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64636 - Destruction, Paravertebral Facet Joint Nerve(S), Lum",60000719,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,172.1,137.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"10011 Fine needle aspiration biopsy, including MR guidance;",6000466,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,313.3,250.64,,234.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,248.13,79.2,,,percent of total billed charges,79.2% of total billed charges,266.31,85,,,percent of total billed charges,85% of total billed charges,313.3,100,,,fee schedule,100% of CO APG rates,297.64,95,,,percent of total billed charges,95% of total billed charges,250.64,80,,,percent of total billed charges,80% of total billed charges,266.31,85,,,percent of total billed charges,85% of total billed charges,281.97,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,313.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,281.97,90,,,percent of total billed charges,90% of total billed charges,238.11,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,266.31,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,250.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,266.31,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1008.8,100,,,case rate,pays based on per visit rate,234.98,1008.8,
11102 Tangential biopsy of skin; single lesion,60000452,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,110.3,88.24,,82.73,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,87.36,79.2,,,percent of total billed charges,79.2% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,110.3,100,,,fee schedule,100% of CO APG rates,104.79,95,,,percent of total billed charges,95% of total billed charges,88.24,80,,,percent of total billed charges,80% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,99.27,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,110.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,99.27,90,,,percent of total billed charges,90% of total billed charges,83.83,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,93.76,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,88.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,93.76,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,602.8,100,,,case rate,pays based on per visit rate,82.73,602.8,
11103 Tangential biopsy of skin; each additional lesion,60000453,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,63.9,51.12,,47.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,50.61,79.2,,,percent of total billed charges,79.2% of total billed charges,54.32,85,,,percent of total billed charges,85% of total billed charges,63.9,100,,,fee schedule,100% of CO APG rates,60.71,95,,,percent of total billed charges,95% of total billed charges,51.12,80,,,percent of total billed charges,80% of total billed charges,54.32,85,,,percent of total billed charges,85% of total billed charges,57.51,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,63.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,57.51,90,,,percent of total billed charges,90% of total billed charges,48.56,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,54.32,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,51.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,54.32,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,510,100,,,case rate,pays based on per visit rate,47.93,510,
"11104 Punch biopsy of skin (including simple closure, when p",60000454,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,137.3,109.84,,102.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,108.74,79.2,,,percent of total billed charges,79.2% of total billed charges,116.71,85,,,percent of total billed charges,85% of total billed charges,137.3,100,,,fee schedule,100% of CO APG rates,130.44,95,,,percent of total billed charges,95% of total billed charges,109.84,80,,,percent of total billed charges,80% of total billed charges,116.71,85,,,percent of total billed charges,85% of total billed charges,123.57,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,137.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,123.57,90,,,percent of total billed charges,90% of total billed charges,104.35,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,116.71,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,109.84,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,116.71,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,656.8,100,,,case rate,pays based on per visit rate,102.98,656.8,
"11105 Punch biopsy of skin (including simple closure, when p",60000455,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,74.4,59.52,,55.8,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,58.92,79.2,,,percent of total billed charges,79.2% of total billed charges,63.24,85,,,percent of total billed charges,85% of total billed charges,74.4,100,,,fee schedule,100% of CO APG rates,70.68,95,,,percent of total billed charges,95% of total billed charges,59.52,80,,,percent of total billed charges,80% of total billed charges,63.24,85,,,percent of total billed charges,85% of total billed charges,66.96,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,74.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,66.96,90,,,percent of total billed charges,90% of total billed charges,56.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,63.24,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,59.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,63.24,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,531,100,,,case rate,pays based on per visit rate,55.8,531,
11106 Incisional biopsy of skin; single lesion,60000456,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,165.4,132.32,,124.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,131,79.2,,,percent of total billed charges,79.2% of total billed charges,140.59,85,,,percent of total billed charges,85% of total billed charges,165.4,100,,,fee schedule,100% of CO APG rates,157.13,95,,,percent of total billed charges,95% of total billed charges,132.32,80,,,percent of total billed charges,80% of total billed charges,140.59,85,,,percent of total billed charges,85% of total billed charges,148.86,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,165.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,148.86,90,,,percent of total billed charges,90% of total billed charges,125.7,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,140.59,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,132.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,140.59,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,713,100,,,case rate,pays based on per visit rate,124.05,713,
11107 Incisional biopsy of skin; each additional lesion,60000457,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,89.3,71.44,,66.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,70.73,79.2,,,percent of total billed charges,79.2% of total billed charges,75.91,85,,,percent of total billed charges,85% of total billed charges,89.3,100,,,fee schedule,100% of CO APG rates,84.84,95,,,percent of total billed charges,95% of total billed charges,71.44,80,,,percent of total billed charges,80% of total billed charges,75.91,85,,,percent of total billed charges,85% of total billed charges,80.37,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,89.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,80.37,90,,,percent of total billed charges,90% of total billed charges,67.87,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,75.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,71.44,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,75.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,560.8,100,,,case rate,pays based on per visit rate,66.98,560.8,
"10008 Fine needle aspiration biopsy, including fluoroscopic",60000463,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,149.7,119.76,,112.28,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,118.56,79.2,,,percent of total billed charges,79.2% of total billed charges,127.25,85,,,percent of total billed charges,85% of total billed charges,149.7,100,,,fee schedule,100% of CO APG rates,142.22,95,,,percent of total billed charges,95% of total billed charges,119.76,80,,,percent of total billed charges,80% of total billed charges,127.25,85,,,percent of total billed charges,85% of total billed charges,134.73,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,149.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,134.73,90,,,percent of total billed charges,90% of total billed charges,113.77,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,127.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,119.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,127.25,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,681.6,100,,,case rate,pays based on per visit rate,112.28,681.6,
"10009 Fine needle aspiration biopsy, including CT guidance;",6000464,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,313.3,250.64,,234.98,75,,,percent of total billed charges,75% of total billed charges,125.32,40,,,percent of total billed charges,40% of total billed charges,248.13,79.2,,,percent of total billed charges,79.2% of total billed charges,266.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,297.64,95,,,percent of total billed charges,95% of total billed charges,250.64,80,,,percent of total billed charges,80% of total billed charges,266.31,85,,,percent of total billed charges,85% of total billed charges,281.97,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,125.32,40,,,percent of total billed charges,40% of total billed charges,125.32,40,,,percent of total billed charges,40% of total billed charges,281.97,90,,,percent of total billed charges,90% of total billed charges,238.11,76,,,percent of total billed charges,76% of total billed charges,125.32,40,,,percent of total billed charges,40% of total billed charges,266.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,250.64,80,,,percent of total billed charges,80% of total billed charges,121.56,38.8,,,percent of total billed charges,38.8% of total billed charges,266.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,121.56,297.64,
"10010 Fine needle aspiration biopsy, including CT guidance;",6000465,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,207.9,166.32,,155.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,164.66,79.2,,,percent of total billed charges,79.2% of total billed charges,176.72,85,,,percent of total billed charges,85% of total billed charges,207.9,100,,,fee schedule,100% of CO APG rates,197.51,95,,,percent of total billed charges,95% of total billed charges,166.32,80,,,percent of total billed charges,80% of total billed charges,176.72,85,,,percent of total billed charges,85% of total billed charges,187.11,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,207.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,187.11,90,,,percent of total billed charges,90% of total billed charges,158,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,176.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,166.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,176.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,798,100,,,case rate,pays based on per visit rate,155.93,798,
"10006 Fine needle aspiration biopsy, including ultrasound gu",60000461,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,144.7,115.76,,108.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,114.6,79.2,,,percent of total billed charges,79.2% of total billed charges,123,85,,,percent of total billed charges,85% of total billed charges,144.7,100,,,fee schedule,100% of CO APG rates,137.47,95,,,percent of total billed charges,95% of total billed charges,115.76,80,,,percent of total billed charges,80% of total billed charges,123,85,,,percent of total billed charges,85% of total billed charges,130.23,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,144.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,130.23,90,,,percent of total billed charges,90% of total billed charges,109.97,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,123,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,115.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,123,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,671.6,100,,,case rate,pays based on per visit rate,108.53,671.6,
"10005 Fine needle aspiration biopsy, ultrasound guidance fir",60000460,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,211.9,169.52,,158.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,167.82,79.2,,,percent of total billed charges,79.2% of total billed charges,180.12,85,,,percent of total billed charges,85% of total billed charges,211.9,100,,,fee schedule,100% of CO APG rates,201.31,95,,,percent of total billed charges,95% of total billed charges,169.52,80,,,percent of total billed charges,80% of total billed charges,180.12,85,,,percent of total billed charges,85% of total billed charges,190.71,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,211.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,190.71,90,,,percent of total billed charges,90% of total billed charges,161.04,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,180.12,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,169.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,180.12,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,806,100,,,case rate,pays based on per visit rate,158.93,806,
"10007 Fine needle aspiration biopsy, including fluoroscopic",60000462,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,258.9,207.12,,194.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,205.05,79.2,,,percent of total billed charges,79.2% of total billed charges,220.07,85,,,percent of total billed charges,85% of total billed charges,258.9,100,,,fee schedule,100% of CO APG rates,245.96,95,,,percent of total billed charges,95% of total billed charges,207.12,80,,,percent of total billed charges,80% of total billed charges,220.07,85,,,percent of total billed charges,85% of total billed charges,233.01,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,258.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,233.01,90,,,percent of total billed charges,90% of total billed charges,196.76,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,220.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,207.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,220.07,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,900,100,,,case rate,pays based on per visit rate,194.18,900,
43763 Replacement of stomach stoma tube accessed through ski,60000459,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,256.4,205.12,,192.3,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,203.07,79.2,,,percent of total billed charges,79.2% of total billed charges,217.94,85,,,percent of total billed charges,85% of total billed charges,256.4,100,,,fee schedule,100% of CO APG rates,243.58,95,,,percent of total billed charges,95% of total billed charges,205.12,80,,,percent of total billed charges,80% of total billed charges,217.94,85,,,percent of total billed charges,85% of total billed charges,230.76,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,256.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,230.76,90,,,percent of total billed charges,90% of total billed charges,194.86,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,217.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,205.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,217.94,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,895,100,,,case rate,pays based on per visit rate,192.3,895,
"43762 Replacement of gastrostomy tube, percutan, includes re",60000458,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,107.9,86.32,,80.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,85.46,79.2,,,percent of total billed charges,79.2% of total billed charges,91.72,85,,,percent of total billed charges,85% of total billed charges,107.9,100,,,fee schedule,100% of CO APG rates,102.51,95,,,percent of total billed charges,95% of total billed charges,86.32,80,,,percent of total billed charges,80% of total billed charges,91.72,85,,,percent of total billed charges,85% of total billed charges,97.11,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,107.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,97.11,90,,,percent of total billed charges,90% of total billed charges,82,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,91.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,86.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,91.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,598,100,,,case rate,pays based on per visit rate,80.93,598,
"10012 Fine needle aspiration biopsy, including MR guidance;",6000467,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,207.9,166.32,,155.93,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,164.66,79.2,,,percent of total billed charges,79.2% of total billed charges,176.72,85,,,percent of total billed charges,85% of total billed charges,207.9,100,,,fee schedule,100% of CO APG rates,197.51,95,,,percent of total billed charges,95% of total billed charges,166.32,80,,,percent of total billed charges,80% of total billed charges,176.72,85,,,percent of total billed charges,85% of total billed charges,187.11,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,207.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,187.11,90,,,percent of total billed charges,90% of total billed charges,158,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,176.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,166.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,176.72,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,798,100,,,case rate,pays based on per visit rate,155.93,798,
"33286 - Removal, subcutaneous cardiac rhythm monitor",60000692,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,244.5,195.6,,183.38,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,193.64,79.2,,,percent of total billed charges,79.2% of total billed charges,207.83,85,,,percent of total billed charges,85% of total billed charges,244.5,100,,,fee schedule,100% of CO APG rates,232.28,95,,,percent of total billed charges,95% of total billed charges,195.6,80,,,percent of total billed charges,80% of total billed charges,207.83,85,,,percent of total billed charges,85% of total billed charges,220.05,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,244.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,220.05,90,,,percent of total billed charges,90% of total billed charges,185.82,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,207.83,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,195.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,207.83,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,871.2,100,,,case rate,pays based on per visit rate,183.38,871.2,
31257 ethmoidectomy total including sphenoidotomy,60000665,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1299.9,1039.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46200 Removal of Anal Fissure,60000487,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1029.8,823.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
69100 Biopsy external ear,60000491,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,135.7,108.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28322 Repair of metatarsals,60000488,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1735.1,1388.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27704 - Removal of ankle implant,60000662,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1703,1362.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26785 Open treatment of dislocated finger joint,60000499,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1682.7,1346.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64400 ANESTH Injection, trigeminal nerve, any division or br",60000500,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,300,240,,225,75,,,percent of total billed charges,75% of total billed charges,120,40,,,percent of total billed charges,40% of total billed charges,237.6,79.2,,,percent of total billed charges,79.2% of total billed charges,255,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,285,95,,,percent of total billed charges,95% of total billed charges,240,80,,,percent of total billed charges,80% of total billed charges,255,85,,,percent of total billed charges,85% of total billed charges,270,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,120,40,,,percent of total billed charges,40% of total billed charges,120,40,,,percent of total billed charges,40% of total billed charges,270,90,,,percent of total billed charges,90% of total billed charges,228,76,,,percent of total billed charges,76% of total billed charges,120,40,,,percent of total billed charges,40% of total billed charges,255,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,240,80,,,percent of total billed charges,80% of total billed charges,116.4,38.8,,,percent of total billed charges,38.8% of total billed charges,255,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,116.4,285,
"24147 Partial excision (craterization, saucerization, or dia",60000519,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1913.5,1530.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Open treatment of proximal fibula or shaft fracture, include",60000518,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2140.3,1712.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"11900 Injection, Intralesional; Up To And Including 7 Lesion",60000521,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,86.6,69.28,,64.95,75,,,percent of total billed charges,75% of total billed charges,34.64,40,,,percent of total billed charges,40% of total billed charges,68.59,79.2,,,percent of total billed charges,79.2% of total billed charges,73.61,85,,,percent of total billed charges,85% of total billed charges,86.6,100,,,fee schedule,100% of CO APG rates,82.27,95,,,percent of total billed charges,95% of total billed charges,69.28,80,,,percent of total billed charges,80% of total billed charges,73.61,85,,,percent of total billed charges,85% of total billed charges,77.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,86.6,100,,,fee schedule,100% of NM APC rate,34.64,40,,,percent of total billed charges,40% of total billed charges,34.64,40,,,percent of total billed charges,40% of total billed charges,77.94,90,,,percent of total billed charges,90% of total billed charges,65.82,76,,,percent of total billed charges,76% of total billed charges,34.64,40,,,percent of total billed charges,40% of total billed charges,73.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,69.28,80,,,percent of total billed charges,80% of total billed charges,33.6,38.8,,,percent of total billed charges,38.8% of total billed charges,73.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,173.2,200,,,fee schedule,200% of CMS fee schedule,33.6,215.49,
"24073 Excision, Tumor, Soft Tissue Of Upper Arm Or Elbow Are",60000524,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2070.9,1656.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"24076 Excision, Tumor, Soft Tissue Of Upper Arm Or Elbow Are",60000518,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1650.5,1320.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24545 Open Treatment Humeral Supracondylar Or Transcondylar,60000526,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2786.9,2229.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24546 Open Treatment Humeral Supracondylar Or Transcondylar,60000527,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3106.7,2485.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25685 Open Treatment Of Trans-Scaphoperilunar Type Of Fractu,60000528,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2218.9,1775.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Percutaneous Skeletal Fixation fo Distal Phalangeal Fracture,60000529,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1308.9,1047.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27132 Conversion Of Previous Hip Surgery To Total Hip Arthro,60000530,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,4938.2,3950.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27823 Orif Trimalleolar Ankle Fracture, Medial And/Or Latera",60000531,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2942.2,2353.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"30115 Excision, Nasal Polyp(S), Extensive",60000532,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1398.4,1118.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"30110 Excision, Nasal Polyp(S), Simple",60000533,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,401.3,321.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"30117 Excision Or Destruction (Eg, Laser), Intranasal Lesion",60000534,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1233.6,986.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"30118 Excision Or Destruction (Eg, Laser), Intranasal Lesion",60000535,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2108.7,1686.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"30140 - resection inferior turbinate, partial or complete,",60000536,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,526,420.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"31253 Nasal endoscopy, ethmoidectomy; total, front",60000537,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1456.7,1165.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"36400 Venipuncture, Younger 3 Years, Nec Skill Of A Physicia",60000538,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,53.9,43.12,,40.43,75,,,percent of total billed charges,75% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,42.69,79.2,,,percent of total billed charges,79.2% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,53.9,100,,,fee schedule,100% of CO APG rates,51.21,95,,,percent of total billed charges,95% of total billed charges,43.12,80,,,percent of total billed charges,80% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,48.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,53.9,100,,,fee schedule,100% of NM APC rate,21.56,40,,,percent of total billed charges,40% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,48.51,90,,,percent of total billed charges,90% of total billed charges,40.96,76,,,percent of total billed charges,76% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,43.12,80,,,percent of total billed charges,80% of total billed charges,20.91,38.8,,,percent of total billed charges,38.8% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,107.8,200,,,fee schedule,200% of CMS fee schedule,20.91,215.49,
"36410 Venipuncture, 3 Or Older",60000539,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,26.4,21.12,,19.8,75,,,percent of total billed charges,75% of total billed charges,10.56,40,,,percent of total billed charges,40% of total billed charges,20.91,79.2,,,percent of total billed charges,79.2% of total billed charges,22.44,85,,,percent of total billed charges,85% of total billed charges,26.4,100,,,fee schedule,100% of CO APG rates,25.08,95,,,percent of total billed charges,95% of total billed charges,21.12,80,,,percent of total billed charges,80% of total billed charges,22.44,85,,,percent of total billed charges,85% of total billed charges,23.76,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,26.4,100,,,fee schedule,100% of NM APC rate,10.56,40,,,percent of total billed charges,40% of total billed charges,10.56,40,,,percent of total billed charges,40% of total billed charges,23.76,90,,,percent of total billed charges,90% of total billed charges,20.06,76,,,percent of total billed charges,76% of total billed charges,10.56,40,,,percent of total billed charges,40% of total billed charges,22.44,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,21.12,80,,,percent of total billed charges,80% of total billed charges,10.24,38.8,,,percent of total billed charges,38.8% of total billed charges,22.44,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,52.8,200,,,fee schedule,200% of CMS fee schedule,10.24,215.49,
"36573 Insertion of PICC, w/o subq port or pump, inc image gu",60000540,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,240.2,192.16,,180.15,75,,,percent of total billed charges,75% of total billed charges,96.08,40,,,percent of total billed charges,40% of total billed charges,190.24,79.2,,,percent of total billed charges,79.2% of total billed charges,204.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,228.19,95,,,percent of total billed charges,95% of total billed charges,192.16,80,,,percent of total billed charges,80% of total billed charges,204.17,85,,,percent of total billed charges,85% of total billed charges,216.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,96.08,40,,,percent of total billed charges,40% of total billed charges,96.08,40,,,percent of total billed charges,40% of total billed charges,216.18,90,,,percent of total billed charges,90% of total billed charges,182.55,76,,,percent of total billed charges,76% of total billed charges,96.08,40,,,percent of total billed charges,40% of total billed charges,204.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,192.16,80,,,percent of total billed charges,80% of total billed charges,93.2,38.8,,,percent of total billed charges,38.8% of total billed charges,204.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,93.2,228.19,
"36584 Replacement, Complete, Of A PICC, Without Subcutaneous",60000541,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,169.7,135.76,,127.28,75,,,percent of total billed charges,75% of total billed charges,67.88,40,,,percent of total billed charges,40% of total billed charges,134.4,79.2,,,percent of total billed charges,79.2% of total billed charges,144.25,85,,,percent of total billed charges,85% of total billed charges,169.7,100,,,fee schedule,100% of CO APG rates,161.22,95,,,percent of total billed charges,95% of total billed charges,135.76,80,,,percent of total billed charges,80% of total billed charges,144.25,85,,,percent of total billed charges,85% of total billed charges,152.73,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,169.7,100,,,fee schedule,100% of NM APC rate,67.88,40,,,percent of total billed charges,40% of total billed charges,67.88,40,,,percent of total billed charges,40% of total billed charges,152.73,90,,,percent of total billed charges,90% of total billed charges,128.97,76,,,percent of total billed charges,76% of total billed charges,67.88,40,,,percent of total billed charges,40% of total billed charges,144.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,135.76,80,,,percent of total billed charges,80% of total billed charges,65.84,38.8,,,percent of total billed charges,38.8% of total billed charges,144.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,65.84,215.49,
"36585 Replacement, Complete, Of A PICC, With Subcu",60000542,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,891.5,713.2,,668.63,75,,,percent of total billed charges,75% of total billed charges,356.6,40,,,percent of total billed charges,40% of total billed charges,706.07,79.2,,,percent of total billed charges,79.2% of total billed charges,757.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,846.93,95,,,percent of total billed charges,95% of total billed charges,713.2,80,,,percent of total billed charges,80% of total billed charges,757.78,85,,,percent of total billed charges,85% of total billed charges,802.35,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,356.6,40,,,percent of total billed charges,40% of total billed charges,356.6,40,,,percent of total billed charges,40% of total billed charges,802.35,90,,,percent of total billed charges,90% of total billed charges,677.54,76,,,percent of total billed charges,76% of total billed charges,356.6,40,,,percent of total billed charges,40% of total billed charges,757.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,713.2,80,,,percent of total billed charges,80% of total billed charges,345.9,38.8,,,percent of total billed charges,38.8% of total billed charges,757.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,846.93,
"43255 Esophagogastroduodenoscopy, Flexible, Transoral; With",60000543,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,581.2,464.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46614 Anoscopy; With Control Of Bleeding,60000544,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,191.4,153.12,,143.55,75,,,percent of total billed charges,75% of total billed charges,76.56,40,,,percent of total billed charges,40% of total billed charges,151.59,79.2,,,percent of total billed charges,79.2% of total billed charges,162.69,85,,,percent of total billed charges,85% of total billed charges,191.4,100,,,fee schedule,100% of CO APG rates,181.83,95,,,percent of total billed charges,95% of total billed charges,153.12,80,,,percent of total billed charges,80% of total billed charges,162.69,85,,,percent of total billed charges,85% of total billed charges,172.26,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,76.56,40,,,percent of total billed charges,40% of total billed charges,76.56,40,,,percent of total billed charges,40% of total billed charges,172.26,90,,,percent of total billed charges,90% of total billed charges,145.46,76,,,percent of total billed charges,76% of total billed charges,76.56,40,,,percent of total billed charges,40% of total billed charges,162.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,153.12,80,,,percent of total billed charges,80% of total billed charges,74.26,38.8,,,percent of total billed charges,38.8% of total billed charges,162.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,74.26,217.66,
69205 Removal Foreign Body From External Auditory Canal; Wit,60000546,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,141.2,112.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64634 - Destruction, Paravertebral Facet Joint Nerve(S), Cer",60000717,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,195.8,156.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64635 - Destruction, Paravertebral Facet Joint Nerve(S); Lum",60000718,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,568.7,454.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64625 - Radiofrequency ablation, nerves innervating the sacr",60000715,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,580.8,464.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27253 Open Treatment Of Hip Dislocation, Traumatic, Without",60000587,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2805.2,2244.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27254 OT Of Hip Dislocation, Traumatic, W/ Acetabular Wall",60000588,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3775.9,3020.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64451 NJX AA/STRD NRV NRVTG SI JT,60000591,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,319.4,255.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64454 NJX AA/STRD GNCLR NRV BRNCH,60000592,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,255.6,204.48,,191.7,75,,,percent of total billed charges,75% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,202.44,79.2,,,percent of total billed charges,79.2% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,255.6,100,,,fee schedule,100% of CO APG rates,242.82,95,,,percent of total billed charges,95% of total billed charges,204.48,80,,,percent of total billed charges,80% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,230.04,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,255.6,100,,,fee schedule,100% of NM APC rate,102.24,40,,,percent of total billed charges,40% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,230.04,90,,,percent of total billed charges,90% of total billed charges,194.26,76,,,percent of total billed charges,76% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,204.48,80,,,percent of total billed charges,80% of total billed charges,99.17,38.8,,,percent of total billed charges,38.8% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,99.17,2713.28,
64645 - Chemodenervation 1 Extremity Ea Addl 5/> Muscles,60001077,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,236,188.8,,177,75,,,percent of total billed charges,75% of total billed charges,94.4,40,,,percent of total billed charges,40% of total billed charges,186.91,79.2,,,percent of total billed charges,79.2% of total billed charges,200.6,85,,,percent of total billed charges,85% of total billed charges,236,100,,,fee schedule,100% of CO APG rates,224.2,95,,,percent of total billed charges,95% of total billed charges,188.8,80,,,percent of total billed charges,80% of total billed charges,200.6,85,,,percent of total billed charges,85% of total billed charges,212.4,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,236,100,,,fee schedule,100% of NM APC rate,94.4,40,,,percent of total billed charges,40% of total billed charges,94.4,40,,,percent of total billed charges,40% of total billed charges,212.4,90,,,percent of total billed charges,90% of total billed charges,179.36,76,,,percent of total billed charges,76% of total billed charges,94.4,40,,,percent of total billed charges,40% of total billed charges,200.6,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,188.8,80,,,percent of total billed charges,80% of total billed charges,91.57,38.8,,,percent of total billed charges,38.8% of total billed charges,200.6,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,91.57,2713.28,
64644 -Chemodenervation 1 Extremity 5 Or More Muscles,60001076,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,340.9,272.72,,255.68,75,,,percent of total billed charges,75% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,269.99,79.2,,,percent of total billed charges,79.2% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,340.9,100,,,fee schedule,100% of CO APG rates,323.86,95,,,percent of total billed charges,95% of total billed charges,272.72,80,,,percent of total billed charges,80% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,306.81,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,340.9,100,,,fee schedule,100% of NM APC rate,136.36,40,,,percent of total billed charges,40% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,306.81,90,,,percent of total billed charges,90% of total billed charges,259.08,76,,,percent of total billed charges,76% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,272.72,80,,,percent of total billed charges,80% of total billed charges,132.27,38.8,,,percent of total billed charges,38.8% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,132.27,2713.28,
64643 - Chemodenervation 1 Extremity Ea Addl 1-4 Muscle,60001080,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,202.2,161.76,,151.65,75,,,percent of total billed charges,75% of total billed charges,80.88,40,,,percent of total billed charges,40% of total billed charges,160.14,79.2,,,percent of total billed charges,79.2% of total billed charges,171.87,85,,,percent of total billed charges,85% of total billed charges,202.2,100,,,fee schedule,100% of CO APG rates,192.09,95,,,percent of total billed charges,95% of total billed charges,161.76,80,,,percent of total billed charges,80% of total billed charges,171.87,85,,,percent of total billed charges,85% of total billed charges,181.98,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,202.2,100,,,fee schedule,100% of NM APC rate,80.88,40,,,percent of total billed charges,40% of total billed charges,80.88,40,,,percent of total billed charges,40% of total billed charges,181.98,90,,,percent of total billed charges,90% of total billed charges,153.67,76,,,percent of total billed charges,76% of total billed charges,80.88,40,,,percent of total billed charges,40% of total billed charges,171.87,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,161.76,80,,,percent of total billed charges,80% of total billed charges,78.45,38.8,,,percent of total billed charges,38.8% of total billed charges,171.87,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,404.4,200,,,fee schedule,200% of CMS fee schedule,78.45,2713.28,
64642Chemodenervation One Extremity 1-4 Muscle,60001079,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,314.3,251.44,,235.73,75,,,percent of total billed charges,75% of total billed charges,125.72,40,,,percent of total billed charges,40% of total billed charges,248.93,79.2,,,percent of total billed charges,79.2% of total billed charges,267.16,85,,,percent of total billed charges,85% of total billed charges,314.3,100,,,fee schedule,100% of CO APG rates,298.59,95,,,percent of total billed charges,95% of total billed charges,251.44,80,,,percent of total billed charges,80% of total billed charges,267.16,85,,,percent of total billed charges,85% of total billed charges,282.87,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,314.3,100,,,fee schedule,100% of NM APC rate,125.72,40,,,percent of total billed charges,40% of total billed charges,125.72,40,,,percent of total billed charges,40% of total billed charges,282.87,90,,,percent of total billed charges,90% of total billed charges,238.87,76,,,percent of total billed charges,76% of total billed charges,125.72,40,,,percent of total billed charges,40% of total billed charges,267.16,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,251.44,80,,,percent of total billed charges,80% of total billed charges,121.95,38.8,,,percent of total billed charges,38.8% of total billed charges,267.16,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,121.95,2713.28,
64646 - Chemodenervation Of Trunk Muscle 1-5 Muscles,60001078,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,340.9,272.72,,255.68,75,,,percent of total billed charges,75% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,269.99,79.2,,,percent of total billed charges,79.2% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,340.9,100,,,fee schedule,100% of CO APG rates,323.86,95,,,percent of total billed charges,95% of total billed charges,272.72,80,,,percent of total billed charges,80% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,306.81,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,340.9,100,,,fee schedule,100% of NM APC rate,136.36,40,,,percent of total billed charges,40% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,306.81,90,,,percent of total billed charges,90% of total billed charges,259.08,76,,,percent of total billed charges,76% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,272.72,80,,,percent of total billed charges,80% of total billed charges,132.27,38.8,,,percent of total billed charges,38.8% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,132.27,2713.28,
"64479 - Inj, Transforaminal,  W Image Guide; Crv Thr Level",60000754,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,477.6,382.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64624 - Destruction by neurolytic agent, genicular nerve bra",60000714,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,434.7,347.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64480 - NJX AA/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,60000755,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,225.9,180.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Anesthesia for percutaneous image-guided injection, drainage",60000771,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Anesthesia for percutaneous image-guided injection, drainage",60000772,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Anesthesia for percutaneous image-guided destruction procedu,60000773,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01940 - ANES NULYT AGT LMBR/SAC,60000774,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01638 - ANESTH SHOULDER REPLACEMENT,60000808,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64510 - Injection, Anesthetic Agent; Stellate Gang",60000813,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,273.6,218.88,,205.2,75,,,percent of total billed charges,75% of total billed charges,109.44,40,,,percent of total billed charges,40% of total billed charges,216.69,79.2,,,percent of total billed charges,79.2% of total billed charges,232.56,85,,,percent of total billed charges,85% of total billed charges,273.6,100,,,fee schedule,100% of CO APG rates,259.92,95,,,percent of total billed charges,95% of total billed charges,218.88,80,,,percent of total billed charges,80% of total billed charges,232.56,85,,,percent of total billed charges,85% of total billed charges,246.24,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,273.6,100,,,fee schedule,100% of NM APC rate,109.44,40,,,percent of total billed charges,40% of total billed charges,109.44,40,,,percent of total billed charges,40% of total billed charges,246.24,90,,,percent of total billed charges,90% of total billed charges,207.94,76,,,percent of total billed charges,76% of total billed charges,109.44,40,,,percent of total billed charges,40% of total billed charges,232.56,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,218.88,80,,,percent of total billed charges,80% of total billed charges,106.16,38.8,,,percent of total billed charges,38.8% of total billed charges,232.56,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,106.16,2713.28,
49593 - RPR AA HERNIA 1ST 3-10 CM REDUCIBLE,60001014,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1661.9,1329.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49594 - RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED,60001015,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2160.5,1728.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49596 - RPR AA HERNIA 1ST > NCRC8/STRANGULATED,60001017,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2972.8,2378.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49616 - RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED,60001021,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2485.8,1988.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49618 - RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED,60001023,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,3602.7,2882.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49621 -RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE,60001024,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2184.3,1747.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49622 - RPR PARASTOMAL HRNA AST/RECR NCRC8/STRANGULATED,60001025,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2713.3,2170.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
RT Pre Post BD Spiro Charge,60000976,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,118.1,94.48,,88.58,75,,,percent of total billed charges,75% of total billed charges,47.24,40,,,percent of total billed charges,40% of total billed charges,93.54,79.2,,,percent of total billed charges,79.2% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,112.2,95,,,percent of total billed charges,95% of total billed charges,94.48,80,,,percent of total billed charges,80% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,106.29,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,118.1,100,,,fee schedule,100% of NM APC rate,47.24,40,,,percent of total billed charges,40% of total billed charges,47.24,40,,,percent of total billed charges,40% of total billed charges,106.29,90,,,percent of total billed charges,90% of total billed charges,89.76,76,,,percent of total billed charges,76% of total billed charges,47.24,40,,,percent of total billed charges,40% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,94.48,80,,,percent of total billed charges,80% of total billed charges,45.82,38.8,,,percent of total billed charges,38.8% of total billed charges,100.39,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,118.1,
49592 - RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED,60001013,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1381.7,1105.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49595 - RPR AA HERNIA 1ST > 10 CM REDUCIBLE,60001016,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2240.9,1792.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49614 - RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED,60001019,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1657.3,1325.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49615 - RPR AA HERNIA RECR 3-10 CM REDUCIBLE,60001020,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1853.1,1482.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49617 - RPR AA HERNIA RECR > 10 CM REDUCIBLE,60001022,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2575,2060,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49591 - RPR AA HERNIA 1ST < 3 CM,60001012,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,995.3,796.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49613 - RPR AA HERNIA RECR < 3 CM REDUCIBLE,60001018,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1223.8,979.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
49623 - RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR,60001026,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,584.9,467.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"69145 -Excision soft tissue lesion, external auditory canal",60001051,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,772.6,618.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"25390 Osteoplasty, Radius Or Ulna; Shortening",60001052,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2319.9,1855.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Blood Glucose Monitoring POC,30082948,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,25.5,20.4,,19.13,75,,,percent of total billed charges,75% of total billed charges,10.2,40,,,percent of total billed charges,40% of total billed charges,20.2,79.2,,,percent of total billed charges,79.2% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,24.23,95,,,percent of total billed charges,95% of total billed charges,20.4,80,,,percent of total billed charges,80% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,22.95,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,10.2,40,,,percent of total billed charges,40% of total billed charges,10.2,40,,,percent of total billed charges,40% of total billed charges,22.95,90,,,percent of total billed charges,90% of total billed charges,19.38,76,,,percent of total billed charges,76% of total billed charges,10.2,40,,,percent of total billed charges,40% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,20.4,80,,,percent of total billed charges,80% of total billed charges,9.89,38.8,,,percent of total billed charges,38.8% of total billed charges,21.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,33.06,
Stool for Occult Blood Card POC,30082270,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,30.7,24.56,,23.03,75,,,percent of total billed charges,75% of total billed charges,12.28,40,,,percent of total billed charges,40% of total billed charges,24.31,79.2,,,percent of total billed charges,79.2% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,29.17,95,,,percent of total billed charges,95% of total billed charges,24.56,80,,,percent of total billed charges,80% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,27.63,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,12.28,40,,,percent of total billed charges,40% of total billed charges,12.28,40,,,percent of total billed charges,40% of total billed charges,27.63,90,,,percent of total billed charges,90% of total billed charges,23.33,76,,,percent of total billed charges,76% of total billed charges,12.28,40,,,percent of total billed charges,40% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,24.56,80,,,percent of total billed charges,80% of total billed charges,11.91,38.8,,,percent of total billed charges,38.8% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,33.06,
Urine Dipstick POC,30081003,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,35,28,,26.25,75,,,percent of total billed charges,75% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,27.72,79.2,,,percent of total billed charges,79.2% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,33.25,95,,,percent of total billed charges,95% of total billed charges,28,80,,,percent of total billed charges,80% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,14,40,,,percent of total billed charges,40% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,26.6,76,,,percent of total billed charges,76% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,28,80,,,percent of total billed charges,80% of total billed charges,13.58,38.8,,,percent of total billed charges,38.8% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,33.25,
Urine Pregnancy Test POC,30081025,CDM,307,RC,81002,HCPCS,OUTPATIENT,,,62.5,50,,46.88,75,,,percent of total billed charges,75% of total billed charges,25,40,,,percent of total billed charges,40% of total billed charges,49.5,79.2,,,percent of total billed charges,79.2% of total billed charges,53.13,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,59.38,95,,,percent of total billed charges,95% of total billed charges,50,80,,,percent of total billed charges,80% of total billed charges,53.13,85,,,percent of total billed charges,85% of total billed charges,56.25,90,,,percent of total billed charges,90% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,3.61,100,,,fee schedule,100% of CO APG rates,3.27,100,,,fee schedule,100% of NM fee schedule,25,40,,,percent of total billed charges,40% of total billed charges,25,40,,,percent of total billed charges,40% of total billed charges,56.25,90,,,percent of total billed charges,90% of total billed charges,47.5,76,,,percent of total billed charges,76% of total billed charges,25,40,,,percent of total billed charges,40% of total billed charges,53.13,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rate,50,80,,,percent of total billed charges,80% of total billed charges,24.25,38.8,,,percent of total billed charges,38.8% of total billed charges,53.13,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of APG fee schedule,6.96,200,,,fee schedule,200% of CMS fee schedule,3.27,59.38,
Stool for Occult Blood Card POC,49182274,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,30.7,24.56,,23.03,75,,,percent of total billed charges,75% of total billed charges,12.28,40,,,percent of total billed charges,40% of total billed charges,24.31,79.2,,,percent of total billed charges,79.2% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,29.17,95,,,percent of total billed charges,95% of total billed charges,24.56,80,,,percent of total billed charges,80% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,27.63,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.28,40,,,percent of total billed charges,40% of total billed charges,12.28,40,,,percent of total billed charges,40% of total billed charges,27.63,90,,,percent of total billed charges,90% of total billed charges,23.33,76,,,percent of total billed charges,76% of total billed charges,12.28,40,,,percent of total billed charges,40% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,24.56,80,,,percent of total billed charges,80% of total billed charges,11.91,38.8,,,percent of total billed charges,38.8% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,29.17,
Urine Pregnancy Test POC,30081025,CDM,307,RC,81002,HCPCS,OUTPATIENT,,,54.1,43.28,,40.58,75,,,percent of total billed charges,75% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,42.85,79.2,,,percent of total billed charges,79.2% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,51.4,95,,,percent of total billed charges,95% of total billed charges,43.28,80,,,percent of total billed charges,80% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,3.61,100,,,fee schedule,100% of CO APG rates,3.27,100,,,fee schedule,100% of NM fee schedule,21.64,40,,,percent of total billed charges,40% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,41.12,76,,,percent of total billed charges,76% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rate,43.28,80,,,percent of total billed charges,80% of total billed charges,20.99,38.8,,,percent of total billed charges,38.8% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of APG fee schedule,6.96,200,,,fee schedule,200% of CMS fee schedule,3.27,51.4,
Amylase Level,40082150,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Glucose Level,40082947,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Gentamycin Level Random,40080170,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,131.8,105.44,,98.85,75,,,percent of total billed charges,75% of total billed charges,52.72,40,,,percent of total billed charges,40% of total billed charges,104.39,79.2,,,percent of total billed charges,79.2% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,125.21,95,,,percent of total billed charges,95% of total billed charges,105.44,80,,,percent of total billed charges,80% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,118.62,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,52.72,40,,,percent of total billed charges,40% of total billed charges,52.72,40,,,percent of total billed charges,40% of total billed charges,118.62,90,,,percent of total billed charges,90% of total billed charges,100.17,76,,,percent of total billed charges,76% of total billed charges,52.72,40,,,percent of total billed charges,40% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,105.44,80,,,percent of total billed charges,80% of total billed charges,51.14,38.8,,,percent of total billed charges,38.8% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,125.21,
Glucose Urine,40082945,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Glucose Cerebrospinal Fluid,40082945,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Blood Urea Nitrogen,40084520,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Creatinine Level,40082565,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,53.3,42.64,,39.98,75,,,percent of total billed charges,75% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,42.21,79.2,,,percent of total billed charges,79.2% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,50.64,95,,,percent of total billed charges,95% of total billed charges,42.64,80,,,percent of total billed charges,80% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,47.97,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,21.32,40,,,percent of total billed charges,40% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,47.97,90,,,percent of total billed charges,90% of total billed charges,40.51,76,,,percent of total billed charges,76% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,42.64,80,,,percent of total billed charges,80% of total billed charges,20.68,38.8,,,percent of total billed charges,38.8% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,50.64,
Creatinine Level Urine,40082570,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,60.42,
Electrolytes,40080051,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,66,52.8,,49.5,75,,,percent of total billed charges,75% of total billed charges,26.4,40,,,percent of total billed charges,40% of total billed charges,52.27,79.2,,,percent of total billed charges,79.2% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,62.7,95,,,percent of total billed charges,95% of total billed charges,52.8,80,,,percent of total billed charges,80% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,59.4,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,26.4,40,,,percent of total billed charges,40% of total billed charges,26.4,40,,,percent of total billed charges,40% of total billed charges,59.4,90,,,percent of total billed charges,90% of total billed charges,50.16,76,,,percent of total billed charges,76% of total billed charges,26.4,40,,,percent of total billed charges,40% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,52.8,80,,,percent of total billed charges,80% of total billed charges,25.61,38.8,,,percent of total billed charges,38.8% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,62.7,
Sodium Level,40084295,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Sodium Level 24 Hour Urine,40084300,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,91.2,72.96,,68.4,75,,,percent of total billed charges,75% of total billed charges,36.48,40,,,percent of total billed charges,40% of total billed charges,72.23,79.2,,,percent of total billed charges,79.2% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,86.64,95,,,percent of total billed charges,95% of total billed charges,72.96,80,,,percent of total billed charges,80% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,82.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,36.48,40,,,percent of total billed charges,40% of total billed charges,36.48,40,,,percent of total billed charges,40% of total billed charges,82.08,90,,,percent of total billed charges,90% of total billed charges,69.31,76,,,percent of total billed charges,76% of total billed charges,36.48,40,,,percent of total billed charges,40% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,72.96,80,,,percent of total billed charges,80% of total billed charges,35.39,38.8,,,percent of total billed charges,38.8% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,86.64,
Potassium Level,40084132,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Potassium Level 24 Hour Urine,40084133,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,82.7,66.16,,62.03,75,,,percent of total billed charges,75% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,65.5,79.2,,,percent of total billed charges,79.2% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,78.57,95,,,percent of total billed charges,95% of total billed charges,66.16,80,,,percent of total billed charges,80% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,74.43,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,33.08,40,,,percent of total billed charges,40% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,74.43,90,,,percent of total billed charges,90% of total billed charges,62.85,76,,,percent of total billed charges,76% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,66.16,80,,,percent of total billed charges,80% of total billed charges,32.09,38.8,,,percent of total billed charges,38.8% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,78.57,
Chloride Level,40082435,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Carbon Dioxide Level,40082374,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Alanine Aminotransferase,40084460,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Aspartate Aminotransferase,40084450,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Albumin Level,40082040,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Albumin Level Urine,40082042,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Alkaline Phosphatase,40084075,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,70.3,56.24,,52.73,75,,,percent of total billed charges,75% of total billed charges,28.12,40,,,percent of total billed charges,40% of total billed charges,55.68,79.2,,,percent of total billed charges,79.2% of total billed charges,59.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,66.79,95,,,percent of total billed charges,95% of total billed charges,56.24,80,,,percent of total billed charges,80% of total billed charges,59.76,85,,,percent of total billed charges,85% of total billed charges,63.27,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,28.12,40,,,percent of total billed charges,40% of total billed charges,28.12,40,,,percent of total billed charges,40% of total billed charges,63.27,90,,,percent of total billed charges,90% of total billed charges,53.43,76,,,percent of total billed charges,76% of total billed charges,28.12,40,,,percent of total billed charges,40% of total billed charges,59.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,56.24,80,,,percent of total billed charges,80% of total billed charges,27.28,38.8,,,percent of total billed charges,38.8% of total billed charges,59.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,66.79,
Amphetamine Screen Urine,40080324,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,161.3,129.04,,120.98,75,,,percent of total billed charges,75% of total billed charges,64.52,40,,,percent of total billed charges,40% of total billed charges,127.75,79.2,,,percent of total billed charges,79.2% of total billed charges,137.11,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,153.24,95,,,percent of total billed charges,95% of total billed charges,129.04,80,,,percent of total billed charges,80% of total billed charges,137.11,85,,,percent of total billed charges,85% of total billed charges,145.17,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,64.52,40,,,percent of total billed charges,40% of total billed charges,64.52,40,,,percent of total billed charges,40% of total billed charges,145.17,90,,,percent of total billed charges,90% of total billed charges,122.59,76,,,percent of total billed charges,76% of total billed charges,64.52,40,,,percent of total billed charges,40% of total billed charges,137.11,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,129.04,80,,,percent of total billed charges,80% of total billed charges,62.58,38.8,,,percent of total billed charges,38.8% of total billed charges,137.11,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,153.24,
Barbiturate Screen Urine,40080306,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,33.7,26.96,,25.28,75,,,percent of total billed charges,75% of total billed charges,13.48,40,,,percent of total billed charges,40% of total billed charges,26.69,79.2,,,percent of total billed charges,79.2% of total billed charges,28.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,32.02,95,,,percent of total billed charges,95% of total billed charges,26.96,80,,,percent of total billed charges,80% of total billed charges,28.65,85,,,percent of total billed charges,85% of total billed charges,30.33,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,13.48,40,,,percent of total billed charges,40% of total billed charges,13.48,40,,,percent of total billed charges,40% of total billed charges,30.33,90,,,percent of total billed charges,90% of total billed charges,25.61,76,,,percent of total billed charges,76% of total billed charges,13.48,40,,,percent of total billed charges,40% of total billed charges,28.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,26.96,80,,,percent of total billed charges,80% of total billed charges,13.08,38.8,,,percent of total billed charges,38.8% of total billed charges,28.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,33.06,
Benzodiazepine Screen Urine,40063900,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,111.4,89.12,,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,105.83,
Bilirubin Direct,40082248,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Bilirubin Total,40082247,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Calcium Level 24 Hour Urine,40082340,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,59.4,47.52,,44.55,75,,,percent of total billed charges,75% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,47.04,79.2,,,percent of total billed charges,79.2% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,56.43,95,,,percent of total billed charges,95% of total billed charges,47.52,80,,,percent of total billed charges,80% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,23.76,40,,,percent of total billed charges,40% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,45.14,76,,,percent of total billed charges,76% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,47.52,80,,,percent of total billed charges,80% of total billed charges,23.05,38.8,,,percent of total billed charges,38.8% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,56.43,
Calcium Level,40082310,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Cannabinoid Screen Urine,40080307,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,111.4,89.12,,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,105.83,
Carbamazepine Level,40080156,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,124.4,99.52,,93.3,75,,,percent of total billed charges,75% of total billed charges,49.76,40,,,percent of total billed charges,40% of total billed charges,98.52,79.2,,,percent of total billed charges,79.2% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,118.18,95,,,percent of total billed charges,95% of total billed charges,99.52,80,,,percent of total billed charges,80% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,111.96,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,49.76,40,,,percent of total billed charges,40% of total billed charges,49.76,40,,,percent of total billed charges,40% of total billed charges,111.96,90,,,percent of total billed charges,90% of total billed charges,94.54,76,,,percent of total billed charges,76% of total billed charges,49.76,40,,,percent of total billed charges,40% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,99.52,80,,,percent of total billed charges,80% of total billed charges,48.27,38.8,,,percent of total billed charges,38.8% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,118.18,
Carcinoembryonic Antigen,40082378,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,159.5,127.6,,119.63,75,,,percent of total billed charges,75% of total billed charges,63.8,40,,,percent of total billed charges,40% of total billed charges,126.32,79.2,,,percent of total billed charges,79.2% of total billed charges,135.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,151.53,95,,,percent of total billed charges,95% of total billed charges,127.6,80,,,percent of total billed charges,80% of total billed charges,135.58,85,,,percent of total billed charges,85% of total billed charges,143.55,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,63.8,40,,,percent of total billed charges,40% of total billed charges,63.8,40,,,percent of total billed charges,40% of total billed charges,143.55,90,,,percent of total billed charges,90% of total billed charges,121.22,76,,,percent of total billed charges,76% of total billed charges,63.8,40,,,percent of total billed charges,40% of total billed charges,135.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,127.6,80,,,percent of total billed charges,80% of total billed charges,61.89,38.8,,,percent of total billed charges,38.8% of total billed charges,135.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,151.53,
Cholesterol High Density Lipid,40083718,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,74.5,59.6,,55.88,75,,,percent of total billed charges,75% of total billed charges,29.8,40,,,percent of total billed charges,40% of total billed charges,59,79.2,,,percent of total billed charges,79.2% of total billed charges,63.33,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,70.78,95,,,percent of total billed charges,95% of total billed charges,59.6,80,,,percent of total billed charges,80% of total billed charges,63.33,85,,,percent of total billed charges,85% of total billed charges,67.05,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.8,40,,,percent of total billed charges,40% of total billed charges,29.8,40,,,percent of total billed charges,40% of total billed charges,67.05,90,,,percent of total billed charges,90% of total billed charges,56.62,76,,,percent of total billed charges,76% of total billed charges,29.8,40,,,percent of total billed charges,40% of total billed charges,63.33,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,59.6,80,,,percent of total billed charges,80% of total billed charges,28.91,38.8,,,percent of total billed charges,38.8% of total billed charges,63.33,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,70.78,
Cholesterol Total,40082465,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Cocaine Screen Urine,40037750,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,111.4,89.12,,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,105.83,
Creatine Kinase,40082550,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,89.4,71.52,,67.05,75,,,percent of total billed charges,75% of total billed charges,35.76,40,,,percent of total billed charges,40% of total billed charges,70.8,79.2,,,percent of total billed charges,79.2% of total billed charges,75.99,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,84.93,95,,,percent of total billed charges,95% of total billed charges,71.52,80,,,percent of total billed charges,80% of total billed charges,75.99,85,,,percent of total billed charges,85% of total billed charges,80.46,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,35.76,40,,,percent of total billed charges,40% of total billed charges,35.76,40,,,percent of total billed charges,40% of total billed charges,80.46,90,,,percent of total billed charges,90% of total billed charges,67.94,76,,,percent of total billed charges,76% of total billed charges,35.76,40,,,percent of total billed charges,40% of total billed charges,75.99,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,71.52,80,,,percent of total billed charges,80% of total billed charges,34.69,38.8,,,percent of total billed charges,38.8% of total billed charges,75.99,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,84.93,
C-Reactive Protein,40086140,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,112.8,90.24,,84.6,75,,,percent of total billed charges,75% of total billed charges,45.12,40,,,percent of total billed charges,40% of total billed charges,89.34,79.2,,,percent of total billed charges,79.2% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,107.16,95,,,percent of total billed charges,95% of total billed charges,90.24,80,,,percent of total billed charges,80% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,101.52,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,45.12,40,,,percent of total billed charges,40% of total billed charges,45.12,40,,,percent of total billed charges,40% of total billed charges,101.52,90,,,percent of total billed charges,90% of total billed charges,85.73,76,,,percent of total billed charges,76% of total billed charges,45.12,40,,,percent of total billed charges,40% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,90.24,80,,,percent of total billed charges,80% of total billed charges,43.77,38.8,,,percent of total billed charges,38.8% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,107.16,
D-Dimer,40085379,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,270.8,216.64,,203.1,75,,,percent of total billed charges,75% of total billed charges,108.32,40,,,percent of total billed charges,40% of total billed charges,214.47,79.2,,,percent of total billed charges,79.2% of total billed charges,230.18,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,257.26,95,,,percent of total billed charges,95% of total billed charges,216.64,80,,,percent of total billed charges,80% of total billed charges,230.18,85,,,percent of total billed charges,85% of total billed charges,243.72,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,108.32,40,,,percent of total billed charges,40% of total billed charges,108.32,40,,,percent of total billed charges,40% of total billed charges,243.72,90,,,percent of total billed charges,90% of total billed charges,205.81,76,,,percent of total billed charges,76% of total billed charges,108.32,40,,,percent of total billed charges,40% of total billed charges,230.18,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,216.64,80,,,percent of total billed charges,80% of total billed charges,105.07,38.8,,,percent of total billed charges,38.8% of total billed charges,230.18,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,257.26,
Digoxin Level,40080162,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,126.5,101.2,,94.88,75,,,percent of total billed charges,75% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,100.19,79.2,,,percent of total billed charges,79.2% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,120.18,95,,,percent of total billed charges,95% of total billed charges,101.2,80,,,percent of total billed charges,80% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,113.85,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,50.6,40,,,percent of total billed charges,40% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,113.85,90,,,percent of total billed charges,90% of total billed charges,96.14,76,,,percent of total billed charges,76% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,101.2,80,,,percent of total billed charges,80% of total billed charges,49.08,38.8,,,percent of total billed charges,38.8% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,120.18,
Eosinophils Urine,40089050,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,60.42,
Estradiol Level,40082670,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,217.7,174.16,,163.28,75,,,percent of total billed charges,75% of total billed charges,87.08,40,,,percent of total billed charges,40% of total billed charges,172.42,79.2,,,percent of total billed charges,79.2% of total billed charges,185.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,206.82,95,,,percent of total billed charges,95% of total billed charges,174.16,80,,,percent of total billed charges,80% of total billed charges,185.05,85,,,percent of total billed charges,85% of total billed charges,195.93,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,87.08,40,,,percent of total billed charges,40% of total billed charges,87.08,40,,,percent of total billed charges,40% of total billed charges,195.93,90,,,percent of total billed charges,90% of total billed charges,165.45,76,,,percent of total billed charges,76% of total billed charges,87.08,40,,,percent of total billed charges,40% of total billed charges,185.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,174.16,80,,,percent of total billed charges,80% of total billed charges,84.47,38.8,,,percent of total billed charges,38.8% of total billed charges,185.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,206.82,
Gamma Glutamyl Transferase,40082977,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,89.4,71.52,,67.05,75,,,percent of total billed charges,75% of total billed charges,35.76,40,,,percent of total billed charges,40% of total billed charges,70.8,79.2,,,percent of total billed charges,79.2% of total billed charges,75.99,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,84.93,95,,,percent of total billed charges,95% of total billed charges,71.52,80,,,percent of total billed charges,80% of total billed charges,75.99,85,,,percent of total billed charges,85% of total billed charges,80.46,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,35.76,40,,,percent of total billed charges,40% of total billed charges,35.76,40,,,percent of total billed charges,40% of total billed charges,80.46,90,,,percent of total billed charges,90% of total billed charges,67.94,76,,,percent of total billed charges,76% of total billed charges,35.76,40,,,percent of total billed charges,40% of total billed charges,75.99,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,71.52,80,,,percent of total billed charges,80% of total billed charges,34.69,38.8,,,percent of total billed charges,38.8% of total billed charges,75.99,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,84.93,
Hemoglobin,40085018,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,50.1,40.08,,37.58,75,,,percent of total billed charges,75% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,39.68,79.2,,,percent of total billed charges,79.2% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,47.6,95,,,percent of total billed charges,95% of total billed charges,40.08,80,,,percent of total billed charges,80% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,45.09,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,20.04,40,,,percent of total billed charges,40% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,45.09,90,,,percent of total billed charges,90% of total billed charges,38.08,76,,,percent of total billed charges,76% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,40.08,80,,,percent of total billed charges,80% of total billed charges,19.44,38.8,,,percent of total billed charges,38.8% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,47.6,
Hematocrit,40085014,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,51.1,40.88,,38.33,75,,,percent of total billed charges,75% of total billed charges,20.44,40,,,percent of total billed charges,40% of total billed charges,40.47,79.2,,,percent of total billed charges,79.2% of total billed charges,43.44,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,48.55,95,,,percent of total billed charges,95% of total billed charges,40.88,80,,,percent of total billed charges,80% of total billed charges,43.44,85,,,percent of total billed charges,85% of total billed charges,45.99,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,20.44,40,,,percent of total billed charges,40% of total billed charges,20.44,40,,,percent of total billed charges,40% of total billed charges,45.99,90,,,percent of total billed charges,90% of total billed charges,38.84,76,,,percent of total billed charges,76% of total billed charges,20.44,40,,,percent of total billed charges,40% of total billed charges,43.44,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,40.88,80,,,percent of total billed charges,80% of total billed charges,19.83,38.8,,,percent of total billed charges,38.8% of total billed charges,43.44,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,48.55,
Hemoglobin A1c,40083036,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,97.9,78.32,QW,73.43,75,,,percent of total billed charges,75% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,77.54,79.2,,,percent of total billed charges,79.2% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,93.01,95,,,percent of total billed charges,95% of total billed charges,78.32,80,,,percent of total billed charges,80% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,39.16,40,,,percent of total billed charges,40% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,74.4,76,,,percent of total billed charges,76% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,78.32,80,,,percent of total billed charges,80% of total billed charges,37.99,38.8,,,percent of total billed charges,38.8% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,93.01,
Hepatitis Panel (4),40080074,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,384.5,307.6,,288.38,75,,,percent of total billed charges,75% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,304.52,79.2,,,percent of total billed charges,79.2% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,365.28,95,,,percent of total billed charges,95% of total billed charges,307.6,80,,,percent of total billed charges,80% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,346.05,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,153.8,40,,,percent of total billed charges,40% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,346.05,90,,,percent of total billed charges,90% of total billed charges,292.22,76,,,percent of total billed charges,76% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,307.6,80,,,percent of total billed charges,80% of total billed charges,149.19,38.8,,,percent of total billed charges,38.8% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,365.28,
Iron  TIBC 1,40083540,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,84.1,67.28,,63.08,75,,,percent of total billed charges,75% of total billed charges,33.64,40,,,percent of total billed charges,40% of total billed charges,66.61,79.2,,,percent of total billed charges,79.2% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,79.9,95,,,percent of total billed charges,95% of total billed charges,67.28,80,,,percent of total billed charges,80% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,75.69,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,33.64,40,,,percent of total billed charges,40% of total billed charges,33.64,40,,,percent of total billed charges,40% of total billed charges,75.69,90,,,percent of total billed charges,90% of total billed charges,63.92,76,,,percent of total billed charges,76% of total billed charges,33.64,40,,,percent of total billed charges,40% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,67.28,80,,,percent of total billed charges,80% of total billed charges,32.63,38.8,,,percent of total billed charges,38.8% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,79.9,
Lactic Acid,40083605,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,121.2,96.96,,90.9,75,,,percent of total billed charges,75% of total billed charges,48.48,40,,,percent of total billed charges,40% of total billed charges,95.99,79.2,,,percent of total billed charges,79.2% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,115.14,95,,,percent of total billed charges,95% of total billed charges,96.96,80,,,percent of total billed charges,80% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,109.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,48.48,40,,,percent of total billed charges,40% of total billed charges,48.48,40,,,percent of total billed charges,40% of total billed charges,109.08,90,,,percent of total billed charges,90% of total billed charges,92.11,76,,,percent of total billed charges,76% of total billed charges,48.48,40,,,percent of total billed charges,40% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,96.96,80,,,percent of total billed charges,80% of total billed charges,47.03,38.8,,,percent of total billed charges,38.8% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,115.14,
Lactate Dehydrogenase,40083615,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Lipase Level,40083690,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,72.4,57.92,,54.3,75,,,percent of total billed charges,75% of total billed charges,28.96,40,,,percent of total billed charges,40% of total billed charges,57.34,79.2,,,percent of total billed charges,79.2% of total billed charges,61.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,68.78,95,,,percent of total billed charges,95% of total billed charges,57.92,80,,,percent of total billed charges,80% of total billed charges,61.54,85,,,percent of total billed charges,85% of total billed charges,65.16,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,28.96,40,,,percent of total billed charges,40% of total billed charges,28.96,40,,,percent of total billed charges,40% of total billed charges,65.16,90,,,percent of total billed charges,90% of total billed charges,55.02,76,,,percent of total billed charges,76% of total billed charges,28.96,40,,,percent of total billed charges,40% of total billed charges,61.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,57.92,80,,,percent of total billed charges,80% of total billed charges,28.09,38.8,,,percent of total billed charges,38.8% of total billed charges,61.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,68.78,
Lithium Level,40080178,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,93.6,74.88,,70.2,75,,,percent of total billed charges,75% of total billed charges,37.44,40,,,percent of total billed charges,40% of total billed charges,74.13,79.2,,,percent of total billed charges,79.2% of total billed charges,79.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,88.92,95,,,percent of total billed charges,95% of total billed charges,74.88,80,,,percent of total billed charges,80% of total billed charges,79.56,85,,,percent of total billed charges,85% of total billed charges,84.24,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,37.44,40,,,percent of total billed charges,40% of total billed charges,37.44,40,,,percent of total billed charges,40% of total billed charges,84.24,90,,,percent of total billed charges,90% of total billed charges,71.14,76,,,percent of total billed charges,76% of total billed charges,37.44,40,,,percent of total billed charges,40% of total billed charges,79.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,74.88,80,,,percent of total billed charges,80% of total billed charges,36.32,38.8,,,percent of total billed charges,38.8% of total billed charges,79.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,88.92,
Magnesium Level,40083735,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,97.9,78.32,,73.43,75,,,percent of total billed charges,75% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,77.54,79.2,,,percent of total billed charges,79.2% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,93.01,95,,,percent of total billed charges,95% of total billed charges,78.32,80,,,percent of total billed charges,80% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,39.16,40,,,percent of total billed charges,40% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,74.4,76,,,percent of total billed charges,76% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,78.32,80,,,percent of total billed charges,80% of total billed charges,37.99,38.8,,,percent of total billed charges,38.8% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,93.01,
Malaria Smear,40087207,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,249.4,199.52,,187.05,75,,,percent of total billed charges,75% of total billed charges,99.76,40,,,percent of total billed charges,40% of total billed charges,197.52,79.2,,,percent of total billed charges,79.2% of total billed charges,211.99,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,236.93,95,,,percent of total billed charges,95% of total billed charges,199.52,80,,,percent of total billed charges,80% of total billed charges,211.99,85,,,percent of total billed charges,85% of total billed charges,224.46,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,99.76,40,,,percent of total billed charges,40% of total billed charges,99.76,40,,,percent of total billed charges,40% of total billed charges,224.46,90,,,percent of total billed charges,90% of total billed charges,189.54,76,,,percent of total billed charges,76% of total billed charges,99.76,40,,,percent of total billed charges,40% of total billed charges,211.99,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,199.52,80,,,percent of total billed charges,80% of total billed charges,96.77,38.8,,,percent of total billed charges,38.8% of total billed charges,211.99,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,236.93,
Prothrombin Time,40085610,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,69.83,
Partial Thromboplastin Time,40085730,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,85.1,68.08,,63.83,75,,,percent of total billed charges,75% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,67.4,79.2,,,percent of total billed charges,79.2% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,80.85,95,,,percent of total billed charges,95% of total billed charges,68.08,80,,,percent of total billed charges,80% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,34.04,40,,,percent of total billed charges,40% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,64.68,76,,,percent of total billed charges,76% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,68.08,80,,,percent of total billed charges,80% of total billed charges,33.02,38.8,,,percent of total billed charges,38.8% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,80.85,
pH Body Fluid,40083986,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,26.5,21.2,,19.88,75,,,percent of total billed charges,75% of total billed charges,10.6,40,,,percent of total billed charges,40% of total billed charges,20.99,79.2,,,percent of total billed charges,79.2% of total billed charges,22.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,25.18,95,,,percent of total billed charges,95% of total billed charges,21.2,80,,,percent of total billed charges,80% of total billed charges,22.53,85,,,percent of total billed charges,85% of total billed charges,23.85,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,10.6,40,,,percent of total billed charges,40% of total billed charges,10.6,40,,,percent of total billed charges,40% of total billed charges,23.85,90,,,percent of total billed charges,90% of total billed charges,20.14,76,,,percent of total billed charges,76% of total billed charges,10.6,40,,,percent of total billed charges,40% of total billed charges,22.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,21.2,80,,,percent of total billed charges,80% of total billed charges,10.28,38.8,,,percent of total billed charges,38.8% of total billed charges,22.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,25.18,
Phosphorus Level,40084100,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Platelet Count,40085049,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,103.2,82.56,,77.4,75,,,percent of total billed charges,75% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,81.73,79.2,,,percent of total billed charges,79.2% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,98.04,95,,,percent of total billed charges,95% of total billed charges,82.56,80,,,percent of total billed charges,80% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,41.28,40,,,percent of total billed charges,40% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,78.43,76,,,percent of total billed charges,76% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,82.56,80,,,percent of total billed charges,80% of total billed charges,40.04,38.8,,,percent of total billed charges,38.8% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,98.04,
Protein Level 24 Hour Urine,40084156,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,60.42,
Protein Cerebrospinal Fluid,40084157,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Protein Total,40084155,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Protein Level Urine,40084156,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,60.42,
Sedimentation Rate,40085652,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,57.5,46,,43.13,75,,,percent of total billed charges,75% of total billed charges,23,40,,,percent of total billed charges,40% of total billed charges,45.54,79.2,,,percent of total billed charges,79.2% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,54.63,95,,,percent of total billed charges,95% of total billed charges,46,80,,,percent of total billed charges,80% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,51.75,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,23,40,,,percent of total billed charges,40% of total billed charges,23,40,,,percent of total billed charges,40% of total billed charges,51.75,90,,,percent of total billed charges,90% of total billed charges,43.7,76,,,percent of total billed charges,76% of total billed charges,23,40,,,percent of total billed charges,40% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,46,80,,,percent of total billed charges,80% of total billed charges,22.31,38.8,,,percent of total billed charges,38.8% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,54.63,
Thyroid Stimulating Hormone,40084443,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,138.2,110.56,,103.65,75,,,percent of total billed charges,75% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,109.45,79.2,,,percent of total billed charges,79.2% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,131.29,95,,,percent of total billed charges,95% of total billed charges,110.56,80,,,percent of total billed charges,80% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,55.28,40,,,percent of total billed charges,40% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,105.03,76,,,percent of total billed charges,76% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,110.56,80,,,percent of total billed charges,80% of total billed charges,53.62,38.8,,,percent of total billed charges,38.8% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,131.29,
Triglycerides,40084478,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Troponin-I,40084484,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,191.3,153.04,,143.48,75,,,percent of total billed charges,75% of total billed charges,76.52,40,,,percent of total billed charges,40% of total billed charges,151.51,79.2,,,percent of total billed charges,79.2% of total billed charges,162.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,181.74,95,,,percent of total billed charges,95% of total billed charges,153.04,80,,,percent of total billed charges,80% of total billed charges,162.61,85,,,percent of total billed charges,85% of total billed charges,172.17,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,76.52,40,,,percent of total billed charges,40% of total billed charges,76.52,40,,,percent of total billed charges,40% of total billed charges,172.17,90,,,percent of total billed charges,90% of total billed charges,145.39,76,,,percent of total billed charges,76% of total billed charges,76.52,40,,,percent of total billed charges,40% of total billed charges,162.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,153.04,80,,,percent of total billed charges,80% of total billed charges,74.22,38.8,,,percent of total billed charges,38.8% of total billed charges,162.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,181.74,
Urea Nitrogen Urine,40084540,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,39.3,31.44,,29.48,75,,,percent of total billed charges,75% of total billed charges,15.72,40,,,percent of total billed charges,40% of total billed charges,31.13,79.2,,,percent of total billed charges,79.2% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,37.34,95,,,percent of total billed charges,95% of total billed charges,31.44,80,,,percent of total billed charges,80% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,35.37,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,15.72,40,,,percent of total billed charges,40% of total billed charges,15.72,40,,,percent of total billed charges,40% of total billed charges,35.37,90,,,percent of total billed charges,90% of total billed charges,29.87,76,,,percent of total billed charges,76% of total billed charges,15.72,40,,,percent of total billed charges,40% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,31.44,80,,,percent of total billed charges,80% of total billed charges,15.25,38.8,,,percent of total billed charges,38.8% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,37.34,
Uric Acid,40084550,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Uric Acid Level 24 Hour Urine,40084560,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,82.7,66.16,,62.03,75,,,percent of total billed charges,75% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,65.5,79.2,,,percent of total billed charges,79.2% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,78.57,95,,,percent of total billed charges,95% of total billed charges,66.16,80,,,percent of total billed charges,80% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,74.43,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,33.08,40,,,percent of total billed charges,40% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,74.43,90,,,percent of total billed charges,90% of total billed charges,62.85,76,,,percent of total billed charges,76% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,66.16,80,,,percent of total billed charges,80% of total billed charges,32.09,38.8,,,percent of total billed charges,38.8% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,78.57,
Uric Acid Urine,40084560,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Valproic Acid Level,40080164,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,140.4,112.32,,105.3,75,,,percent of total billed charges,75% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,111.2,79.2,,,percent of total billed charges,79.2% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,133.38,95,,,percent of total billed charges,95% of total billed charges,112.32,80,,,percent of total billed charges,80% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,126.36,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,56.16,40,,,percent of total billed charges,40% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,126.36,90,,,percent of total billed charges,90% of total billed charges,106.7,76,,,percent of total billed charges,76% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,112.32,80,,,percent of total billed charges,80% of total billed charges,54.48,38.8,,,percent of total billed charges,38.8% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,133.38,
Vitamin B12 Level,40082607,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,142.4,113.92,,106.8,75,,,percent of total billed charges,75% of total billed charges,56.96,40,,,percent of total billed charges,40% of total billed charges,112.78,79.2,,,percent of total billed charges,79.2% of total billed charges,121.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,135.28,95,,,percent of total billed charges,95% of total billed charges,113.92,80,,,percent of total billed charges,80% of total billed charges,121.04,85,,,percent of total billed charges,85% of total billed charges,128.16,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,56.96,40,,,percent of total billed charges,40% of total billed charges,56.96,40,,,percent of total billed charges,40% of total billed charges,128.16,90,,,percent of total billed charges,90% of total billed charges,108.22,76,,,percent of total billed charges,76% of total billed charges,56.96,40,,,percent of total billed charges,40% of total billed charges,121.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,113.92,80,,,percent of total billed charges,80% of total billed charges,55.25,38.8,,,percent of total billed charges,38.8% of total billed charges,121.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,135.28,
White Blood Count,40085048,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,53.3,42.64,,39.98,75,,,percent of total billed charges,75% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,42.21,79.2,,,percent of total billed charges,79.2% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,50.64,95,,,percent of total billed charges,95% of total billed charges,42.64,80,,,percent of total billed charges,80% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,47.97,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,21.32,40,,,percent of total billed charges,40% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,47.97,90,,,percent of total billed charges,90% of total billed charges,40.51,76,,,percent of total billed charges,76% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,42.64,80,,,percent of total billed charges,80% of total billed charges,20.68,38.8,,,percent of total billed charges,38.8% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,50.64,
Varicella Virus Vaccine POC,49190716,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,247.1,197.68,,185.33,75,,,percent of total billed charges,75% of total billed charges,98.84,40,,,percent of total billed charges,40% of total billed charges,195.7,79.2,,,percent of total billed charges,79.2% of total billed charges,210.04,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,234.75,95,,,percent of total billed charges,95% of total billed charges,197.68,80,,,percent of total billed charges,80% of total billed charges,210.04,85,,,percent of total billed charges,85% of total billed charges,222.39,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,247.1,100,,,fee schedule,100% of NM fee schedule,98.84,40,,,percent of total billed charges,40% of total billed charges,98.84,40,,,percent of total billed charges,40% of total billed charges,222.39,90,,,percent of total billed charges,90% of total billed charges,187.8,76,,,percent of total billed charges,76% of total billed charges,98.84,40,,,percent of total billed charges,40% of total billed charges,210.04,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,197.68,80,,,percent of total billed charges,80% of total billed charges,95.87,38.8,,,percent of total billed charges,38.8% of total billed charges,210.04,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,247.1,
"Hepatitis B Vaccine, Adult",49190746,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,91.5,73.2,,68.63,75,,,percent of total billed charges,75% of total billed charges,36.6,40,,,percent of total billed charges,40% of total billed charges,72.47,79.2,,,percent of total billed charges,79.2% of total billed charges,77.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,86.93,95,,,percent of total billed charges,95% of total billed charges,73.2,80,,,percent of total billed charges,80% of total billed charges,77.78,85,,,percent of total billed charges,85% of total billed charges,82.35,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,91.5,100,,,fee schedule,100% of NM fee schedule,36.6,40,,,percent of total billed charges,40% of total billed charges,36.6,40,,,percent of total billed charges,40% of total billed charges,82.35,90,,,percent of total billed charges,90% of total billed charges,69.54,76,,,percent of total billed charges,76% of total billed charges,36.6,40,,,percent of total billed charges,40% of total billed charges,77.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,73.2,80,,,percent of total billed charges,80% of total billed charges,35.5,38.8,,,percent of total billed charges,38.8% of total billed charges,77.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.5,91.5,
Community/Work Reintegration Charges,60000265,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,120.4,96.32,GO,90.3,75,,,percent of total billed charges,75% of total billed charges,48.16,40,,,percent of total billed charges,40% of total billed charges,95.36,79.2,,,percent of total billed charges,79.2% of total billed charges,102.34,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,114.38,95,,,percent of total billed charges,95% of total billed charges,96.32,80,,,percent of total billed charges,80% of total billed charges,102.34,85,,,percent of total billed charges,85% of total billed charges,108.36,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,48.16,40,,,percent of total billed charges,40% of total billed charges,48.16,40,,,percent of total billed charges,40% of total billed charges,108.36,90,,,percent of total billed charges,90% of total billed charges,91.5,76,,,percent of total billed charges,76% of total billed charges,48.16,40,,,percent of total billed charges,40% of total billed charges,102.34,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,96.32,80,,,percent of total billed charges,80% of total billed charges,46.72,38.8,,,percent of total billed charges,38.8% of total billed charges,102.34,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,114.38,
Therapeutic Activities Charges,42797530,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,177.7,142.16,GO,133.28,75,,,percent of total billed charges,75% of total billed charges,71.08,40,,,percent of total billed charges,40% of total billed charges,140.74,79.2,,,percent of total billed charges,79.2% of total billed charges,151.05,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,168.82,95,,,percent of total billed charges,95% of total billed charges,142.16,80,,,percent of total billed charges,80% of total billed charges,151.05,85,,,percent of total billed charges,85% of total billed charges,159.93,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,71.08,40,,,percent of total billed charges,40% of total billed charges,71.08,40,,,percent of total billed charges,40% of total billed charges,159.93,90,,,percent of total billed charges,90% of total billed charges,135.05,76,,,percent of total billed charges,76% of total billed charges,71.08,40,,,percent of total billed charges,40% of total billed charges,151.05,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,142.16,80,,,percent of total billed charges,80% of total billed charges,68.95,38.8,,,percent of total billed charges,38.8% of total billed charges,151.05,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,168.82,
OT Therapeutic Exercise Charges,42797110,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,119.3,95.44,GO,89.48,75,,,percent of total billed charges,75% of total billed charges,47.72,40,,,percent of total billed charges,40% of total billed charges,94.49,79.2,,,percent of total billed charges,79.2% of total billed charges,101.41,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,113.34,95,,,percent of total billed charges,95% of total billed charges,95.44,80,,,percent of total billed charges,80% of total billed charges,101.41,85,,,percent of total billed charges,85% of total billed charges,107.37,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,47.72,40,,,percent of total billed charges,40% of total billed charges,47.72,40,,,percent of total billed charges,40% of total billed charges,107.37,90,,,percent of total billed charges,90% of total billed charges,90.67,76,,,percent of total billed charges,76% of total billed charges,47.72,40,,,percent of total billed charges,40% of total billed charges,101.41,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,95.44,80,,,percent of total billed charges,80% of total billed charges,46.29,38.8,,,percent of total billed charges,38.8% of total billed charges,101.41,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,113.34,
Ultrasound Charges,60000266,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,48.4,38.72,GO,36.3,75,,,percent of total billed charges,75% of total billed charges,19.36,40,,,percent of total billed charges,40% of total billed charges,38.33,79.2,,,percent of total billed charges,79.2% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,48.4,100,,,fee schedule,100% of CO APG rates,45.98,95,,,percent of total billed charges,95% of total billed charges,38.72,80,,,percent of total billed charges,80% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,43.56,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,19.36,40,,,percent of total billed charges,40% of total billed charges,19.36,40,,,percent of total billed charges,40% of total billed charges,43.56,90,,,percent of total billed charges,90% of total billed charges,36.78,76,,,percent of total billed charges,76% of total billed charges,19.36,40,,,percent of total billed charges,40% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,38.72,80,,,percent of total billed charges,80% of total billed charges,18.78,38.8,,,percent of total billed charges,38.8% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,18.78,65.96,
OT Neuromuscular Reeducation Charges,42797112,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,176.6,141.28,GO,132.45,75,,,percent of total billed charges,75% of total billed charges,70.64,40,,,percent of total billed charges,40% of total billed charges,139.87,79.2,,,percent of total billed charges,79.2% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,167.77,95,,,percent of total billed charges,95% of total billed charges,141.28,80,,,percent of total billed charges,80% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,158.94,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,70.64,40,,,percent of total billed charges,40% of total billed charges,70.64,40,,,percent of total billed charges,40% of total billed charges,158.94,90,,,percent of total billed charges,90% of total billed charges,134.22,76,,,percent of total billed charges,76% of total billed charges,70.64,40,,,percent of total billed charges,40% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,141.28,80,,,percent of total billed charges,80% of total billed charges,68.52,38.8,,,percent of total billed charges,38.8% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,167.77,
Massage Charge Units,60000267,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,112.5,90,GO,84.38,75,,,percent of total billed charges,75% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,89.1,79.2,,,percent of total billed charges,79.2% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,106.88,95,,,percent of total billed charges,95% of total billed charges,90,80,,,percent of total billed charges,80% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,45,40,,,percent of total billed charges,40% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,85.5,76,,,percent of total billed charges,76% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,90,80,,,percent of total billed charges,80% of total billed charges,43.65,38.8,,,percent of total billed charges,38.8% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,106.88,
Manual Therapy Charge Units,60000268,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,111.4,89.12,GO,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,105.83,
Attended E-Stim Charges,43297032,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,69.8,55.84,GO,52.35,75,,,percent of total billed charges,75% of total billed charges,27.92,40,,,percent of total billed charges,40% of total billed charges,55.28,79.2,,,percent of total billed charges,79.2% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,66.31,95,,,percent of total billed charges,95% of total billed charges,55.84,80,,,percent of total billed charges,80% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,62.82,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,27.92,40,,,percent of total billed charges,40% of total billed charges,27.92,40,,,percent of total billed charges,40% of total billed charges,62.82,90,,,percent of total billed charges,90% of total billed charges,53.05,76,,,percent of total billed charges,76% of total billed charges,27.92,40,,,percent of total billed charges,40% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,55.84,80,,,percent of total billed charges,80% of total billed charges,27.08,38.8,,,percent of total billed charges,38.8% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,66.31,
ADL Training Charges,60000269,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,139.1,111.28,GO,104.33,75,,,percent of total billed charges,75% of total billed charges,55.64,40,,,percent of total billed charges,40% of total billed charges,110.17,79.2,,,percent of total billed charges,79.2% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,132.15,95,,,percent of total billed charges,95% of total billed charges,111.28,80,,,percent of total billed charges,80% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,125.19,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,55.64,40,,,percent of total billed charges,40% of total billed charges,55.64,40,,,percent of total billed charges,40% of total billed charges,125.19,90,,,percent of total billed charges,90% of total billed charges,105.72,76,,,percent of total billed charges,76% of total billed charges,55.64,40,,,percent of total billed charges,40% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,111.28,80,,,percent of total billed charges,80% of total billed charges,53.97,38.8,,,percent of total billed charges,38.8% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,132.15,
PT Therapeutic Exercise Charges,42597110,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,119.3,95.44,GP,89.48,75,,,percent of total billed charges,75% of total billed charges,47.72,40,,,percent of total billed charges,40% of total billed charges,94.49,79.2,,,percent of total billed charges,79.2% of total billed charges,101.41,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,113.34,95,,,percent of total billed charges,95% of total billed charges,95.44,80,,,percent of total billed charges,80% of total billed charges,101.41,85,,,percent of total billed charges,85% of total billed charges,107.37,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,47.72,40,,,percent of total billed charges,40% of total billed charges,47.72,40,,,percent of total billed charges,40% of total billed charges,107.37,90,,,percent of total billed charges,90% of total billed charges,90.67,76,,,percent of total billed charges,76% of total billed charges,47.72,40,,,percent of total billed charges,40% of total billed charges,101.41,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,95.44,80,,,percent of total billed charges,80% of total billed charges,46.29,38.8,,,percent of total billed charges,38.8% of total billed charges,101.41,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,113.34,
PT Ultrasound Charges,42597035,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,48.4,38.72,GP,36.3,75,,,percent of total billed charges,75% of total billed charges,19.36,40,,,percent of total billed charges,40% of total billed charges,38.33,79.2,,,percent of total billed charges,79.2% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,48.4,100,,,fee schedule,100% of CO APG rates,45.98,95,,,percent of total billed charges,95% of total billed charges,38.72,80,,,percent of total billed charges,80% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,43.56,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,19.36,40,,,percent of total billed charges,40% of total billed charges,19.36,40,,,percent of total billed charges,40% of total billed charges,43.56,90,,,percent of total billed charges,90% of total billed charges,36.78,76,,,percent of total billed charges,76% of total billed charges,19.36,40,,,percent of total billed charges,40% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,38.72,80,,,percent of total billed charges,80% of total billed charges,18.78,38.8,,,percent of total billed charges,38.8% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,18.78,61.06,
PT Neuromuscular Reeducation Charges,42597112,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,176.6,141.28,GP,132.45,75,,,percent of total billed charges,75% of total billed charges,70.64,40,,,percent of total billed charges,40% of total billed charges,139.87,79.2,,,percent of total billed charges,79.2% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,167.77,95,,,percent of total billed charges,95% of total billed charges,141.28,80,,,percent of total billed charges,80% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,158.94,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,70.64,40,,,percent of total billed charges,40% of total billed charges,70.64,40,,,percent of total billed charges,40% of total billed charges,158.94,90,,,percent of total billed charges,90% of total billed charges,134.22,76,,,percent of total billed charges,76% of total billed charges,70.64,40,,,percent of total billed charges,40% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,141.28,80,,,percent of total billed charges,80% of total billed charges,68.52,38.8,,,percent of total billed charges,38.8% of total billed charges,150.11,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,167.77,
PT Wheelchair Management Charges,42597542,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,114.7,91.76,GP,86.03,75,,,percent of total billed charges,75% of total billed charges,45.88,40,,,percent of total billed charges,40% of total billed charges,90.84,79.2,,,percent of total billed charges,79.2% of total billed charges,97.5,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,108.97,95,,,percent of total billed charges,95% of total billed charges,91.76,80,,,percent of total billed charges,80% of total billed charges,97.5,85,,,percent of total billed charges,85% of total billed charges,103.23,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,45.88,40,,,percent of total billed charges,40% of total billed charges,45.88,40,,,percent of total billed charges,40% of total billed charges,103.23,90,,,percent of total billed charges,90% of total billed charges,87.17,76,,,percent of total billed charges,76% of total billed charges,45.88,40,,,percent of total billed charges,40% of total billed charges,97.5,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,91.76,80,,,percent of total billed charges,80% of total billed charges,44.5,38.8,,,percent of total billed charges,38.8% of total billed charges,97.5,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,108.97,
Therapeutic Activities Charge,60000270,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,177.7,142.16,GP,133.28,75,,,percent of total billed charges,75% of total billed charges,71.08,40,,,percent of total billed charges,40% of total billed charges,140.74,79.2,,,percent of total billed charges,79.2% of total billed charges,151.05,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,168.82,95,,,percent of total billed charges,95% of total billed charges,142.16,80,,,percent of total billed charges,80% of total billed charges,151.05,85,,,percent of total billed charges,85% of total billed charges,159.93,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,71.08,40,,,percent of total billed charges,40% of total billed charges,71.08,40,,,percent of total billed charges,40% of total billed charges,159.93,90,,,percent of total billed charges,90% of total billed charges,135.05,76,,,percent of total billed charges,76% of total billed charges,71.08,40,,,percent of total billed charges,40% of total billed charges,151.05,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,142.16,80,,,percent of total billed charges,80% of total billed charges,68.95,38.8,,,percent of total billed charges,38.8% of total billed charges,151.05,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,168.82,
PT Gait Training Charges,42597116,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,104.6,83.68,GP,78.45,75,,,percent of total billed charges,75% of total billed charges,41.84,40,,,percent of total billed charges,40% of total billed charges,82.84,79.2,,,percent of total billed charges,79.2% of total billed charges,88.91,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,99.37,95,,,percent of total billed charges,95% of total billed charges,83.68,80,,,percent of total billed charges,80% of total billed charges,88.91,85,,,percent of total billed charges,85% of total billed charges,94.14,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,41.84,40,,,percent of total billed charges,40% of total billed charges,41.84,40,,,percent of total billed charges,40% of total billed charges,94.14,90,,,percent of total billed charges,90% of total billed charges,79.5,76,,,percent of total billed charges,76% of total billed charges,41.84,40,,,percent of total billed charges,40% of total billed charges,88.91,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,83.68,80,,,percent of total billed charges,80% of total billed charges,40.58,38.8,,,percent of total billed charges,38.8% of total billed charges,88.91,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,99.37,
Manual Therapy Charge Units,42597140,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,111.4,89.12,GP,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,105.83,
PT Attended E-Stim Charges,42597032,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,67.5,54,,50.63,75,,,percent of total billed charges,75% of total billed charges,27,40,,,percent of total billed charges,40% of total billed charges,53.46,79.2,,,percent of total billed charges,79.2% of total billed charges,57.38,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,64.13,95,,,percent of total billed charges,95% of total billed charges,54,80,,,percent of total billed charges,80% of total billed charges,57.38,85,,,percent of total billed charges,85% of total billed charges,60.75,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,27,40,,,percent of total billed charges,40% of total billed charges,27,40,,,percent of total billed charges,40% of total billed charges,60.75,90,,,percent of total billed charges,90% of total billed charges,51.3,76,,,percent of total billed charges,76% of total billed charges,27,40,,,percent of total billed charges,40% of total billed charges,57.38,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,54,80,,,percent of total billed charges,80% of total billed charges,26.19,38.8,,,percent of total billed charges,38.8% of total billed charges,57.38,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,26.19,64.13,
10060 Incision And Drainage Of Abscess Simple,49110060,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,613.8,491.04,,460.35,75,,,percent of total billed charges,75% of total billed charges,245.52,40,,,percent of total billed charges,40% of total billed charges,486.13,79.2,,,percent of total billed charges,79.2% of total billed charges,521.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,583.11,95,,,percent of total billed charges,95% of total billed charges,491.04,80,,,percent of total billed charges,80% of total billed charges,521.73,85,,,percent of total billed charges,85% of total billed charges,552.42,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,245.52,40,,,percent of total billed charges,40% of total billed charges,245.52,40,,,percent of total billed charges,40% of total billed charges,552.42,90,,,percent of total billed charges,90% of total billed charges,466.49,76,,,percent of total billed charges,76% of total billed charges,245.52,40,,,percent of total billed charges,40% of total billed charges,521.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,491.04,80,,,percent of total billed charges,80% of total billed charges,238.15,38.8,,,percent of total billed charges,38.8% of total billed charges,521.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,583.11,
10061 Incision And Drainage Of Abscess Complicated Or Multip,49110061,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1042.7,834.16,,782.03,75,,,percent of total billed charges,75% of total billed charges,417.08,40,,,percent of total billed charges,40% of total billed charges,825.82,79.2,,,percent of total billed charges,79.2% of total billed charges,886.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,990.57,95,,,percent of total billed charges,95% of total billed charges,834.16,80,,,percent of total billed charges,80% of total billed charges,886.3,85,,,percent of total billed charges,85% of total billed charges,938.43,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,417.08,40,,,percent of total billed charges,40% of total billed charges,417.08,40,,,percent of total billed charges,40% of total billed charges,938.43,90,,,percent of total billed charges,90% of total billed charges,792.45,76,,,percent of total billed charges,76% of total billed charges,417.08,40,,,percent of total billed charges,40% of total billed charges,886.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,834.16,80,,,percent of total billed charges,80% of total billed charges,404.57,38.8,,,percent of total billed charges,38.8% of total billed charges,886.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,990.57,
"Remove Lesion, Trunk/Arm/Leg <.5 cm Charge",49111400,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2110.7,1688.56,,1583.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1671.67,79.2,,,percent of total billed charges,79.2% of total billed charges,1794.1,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,2005.17,95,,,percent of total billed charges,95% of total billed charges,1688.56,80,,,percent of total billed charges,80% of total billed charges,1794.1,85,,,percent of total billed charges,85% of total billed charges,1899.63,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2110.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1899.63,90,,,percent of total billed charges,90% of total billed charges,1604.13,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1794.1,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1688.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1794.1,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2110.7,
"Remove Lesion, Trunk/Arm/Leg .6 to 1.0 cm Charge",49111401,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1106.9,885.52,,830.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,876.66,79.2,,,percent of total billed charges,79.2% of total billed charges,940.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1051.56,95,,,percent of total billed charges,95% of total billed charges,885.52,80,,,percent of total billed charges,80% of total billed charges,940.87,85,,,percent of total billed charges,85% of total billed charges,996.21,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1106.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,996.21,90,,,percent of total billed charges,90% of total billed charges,841.24,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,940.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,885.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,940.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Trunk/Arm/Leg 1.1 to 2.0 cm Charge",49111402,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"Remove Lesion, Trunk/Arm/Leg 2.1 to 3.0 cm Charge",49111403,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"Remove Lesion, Trunk/Arm/Leg 3.1 to 4.0 cm Charge",49111404,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"Remove Lesion, Trunk/Arm/Leg >4.0 cm Charge",49111406,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"Remove Lesion, Scalp/Neck/Hand/Foot < .5 cm Charge",49111420,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,4802.7,3842.16,,3602.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,3803.74,79.2,,,percent of total billed charges,79.2% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,4562.57,95,,,percent of total billed charges,95% of total billed charges,3842.16,80,,,percent of total billed charges,80% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,4322.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,4802.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,4322.43,90,,,percent of total billed charges,90% of total billed charges,3650.05,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,3842.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,4802.7,
"Remove Lesion, Scalp/Neck/Hand/Foot .6 to 1.0 cm Charge",49111421,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,513.1,410.48,,384.83,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,406.38,79.2,,,percent of total billed charges,79.2% of total billed charges,436.14,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,487.45,95,,,percent of total billed charges,95% of total billed charges,410.48,80,,,percent of total billed charges,80% of total billed charges,436.14,85,,,percent of total billed charges,85% of total billed charges,461.79,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,513.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,461.79,90,,,percent of total billed charges,90% of total billed charges,389.96,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,436.14,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,410.48,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,436.14,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Scalp/Neck/Hand/Foot 1.1 to 2.0 cm Charge",49111422,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,4802.7,3842.16,,3602.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,3803.74,79.2,,,percent of total billed charges,79.2% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,4562.57,95,,,percent of total billed charges,95% of total billed charges,3842.16,80,,,percent of total billed charges,80% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,4322.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,4802.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,4322.43,90,,,percent of total billed charges,90% of total billed charges,3650.05,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,3842.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,4802.7,
"Remove Lesion, Scalp/Neck/Hand/Foot 2.1 to 3.0 cm Charge",49111423,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,4802.7,3842.16,,3602.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,3803.74,79.2,,,percent of total billed charges,79.2% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,4562.57,95,,,percent of total billed charges,95% of total billed charges,3842.16,80,,,percent of total billed charges,80% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,4322.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,4802.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,4322.43,90,,,percent of total billed charges,90% of total billed charges,3650.05,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,3842.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,4802.7,
"Remove Lesion, Scalp/Neck/Hand/Foot 3.1 to 4.0 cm Charge",49111424,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,749.3,599.44,,561.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,593.45,79.2,,,percent of total billed charges,79.2% of total billed charges,636.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,711.84,95,,,percent of total billed charges,95% of total billed charges,599.44,80,,,percent of total billed charges,80% of total billed charges,636.91,85,,,percent of total billed charges,85% of total billed charges,674.37,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,749.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,674.37,90,,,percent of total billed charges,90% of total billed charges,569.47,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,636.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,599.44,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,636.91,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Scalp/Neck/Hand/Foot >4.0 cm Charge",49111426,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,8586.2,6868.96,,6439.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,6800.27,79.2,,,percent of total billed charges,79.2% of total billed charges,7298.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,8156.89,95,,,percent of total billed charges,95% of total billed charges,6868.96,80,,,percent of total billed charges,80% of total billed charges,7298.27,85,,,percent of total billed charges,85% of total billed charges,7727.58,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,8586.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,7727.58,90,,,percent of total billed charges,90% of total billed charges,6525.51,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,7298.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,6868.96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,7298.27,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,8586.2,
"Remove Lesion, Face/Lid/Ear/Nose/Lip <.5 cm Charge",49111440,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"Remove Lesion, Face/Lid/Ear/Nose/Lip .6 to 1.0 cm Charge",49111441,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,546.3,437.04,,409.73,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,432.67,79.2,,,percent of total billed charges,79.2% of total billed charges,464.36,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,518.99,95,,,percent of total billed charges,95% of total billed charges,437.04,80,,,percent of total billed charges,80% of total billed charges,464.36,85,,,percent of total billed charges,85% of total billed charges,491.67,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,546.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,491.67,90,,,percent of total billed charges,90% of total billed charges,415.19,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,464.36,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,437.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,464.36,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Lesion, Face/Lid/Ear/Nose/Lip 1.1 to 2.0 cm Charge",49111442,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"Remove Lesion, Face/Lid/Ear/Nose/Lip 2.1 to 3.0 cm Charge",49111443,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,723.3,578.64,,542.48,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,572.85,79.2,,,percent of total billed charges,79.2% of total billed charges,614.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,687.14,95,,,percent of total billed charges,95% of total billed charges,578.64,80,,,percent of total billed charges,80% of total billed charges,614.81,85,,,percent of total billed charges,85% of total billed charges,650.97,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,723.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,650.97,90,,,percent of total billed charges,90% of total billed charges,549.71,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,614.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,578.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,614.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Arthrocentesis Intermed Joint, Wrist, Elbow, Ankle Charge",49120605,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,904.8,723.84,,678.6,75,,,percent of total billed charges,75% of total billed charges,361.92,40,,,percent of total billed charges,40% of total billed charges,716.6,79.2,,,percent of total billed charges,79.2% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,859.56,95,,,percent of total billed charges,95% of total billed charges,723.84,80,,,percent of total billed charges,80% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,814.32,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,361.92,40,,,percent of total billed charges,40% of total billed charges,361.92,40,,,percent of total billed charges,40% of total billed charges,814.32,90,,,percent of total billed charges,90% of total billed charges,687.65,76,,,percent of total billed charges,76% of total billed charges,361.92,40,,,percent of total billed charges,40% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,723.84,80,,,percent of total billed charges,80% of total billed charges,351.06,38.8,,,percent of total billed charges,38.8% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,859.56,
"Arthrocentesis Major Joint, Shoulder, Hip, Knee Charge",49120610,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,855.9,684.72,,641.93,75,,,percent of total billed charges,75% of total billed charges,342.36,40,,,percent of total billed charges,40% of total billed charges,677.87,79.2,,,percent of total billed charges,79.2% of total billed charges,727.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,813.11,95,,,percent of total billed charges,95% of total billed charges,684.72,80,,,percent of total billed charges,80% of total billed charges,727.52,85,,,percent of total billed charges,85% of total billed charges,770.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,342.36,40,,,percent of total billed charges,40% of total billed charges,342.36,40,,,percent of total billed charges,40% of total billed charges,770.31,90,,,percent of total billed charges,90% of total billed charges,650.48,76,,,percent of total billed charges,76% of total billed charges,342.36,40,,,percent of total billed charges,40% of total billed charges,727.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,684.72,80,,,percent of total billed charges,80% of total billed charges,332.09,38.8,,,percent of total billed charges,38.8% of total billed charges,727.52,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,813.11,
"Remove Other Benign Lesion w/Margins , Face/Ears/Eyelids/Nose/Lips; Diam 3.1 to",49111444,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,901.4,721.12,,676.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,713.91,79.2,,,percent of total billed charges,79.2% of total billed charges,766.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,856.33,95,,,percent of total billed charges,95% of total billed charges,721.12,80,,,percent of total billed charges,80% of total billed charges,766.19,85,,,percent of total billed charges,85% of total billed charges,811.26,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,901.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,811.26,90,,,percent of total billed charges,90% of total billed charges,685.06,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,766.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,721.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,766.19,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Other Benign Lesion w/Margins , Face/Ears/Eyelids/Nose/Lips; Diam 4.0+ cm",49111446,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1243.3,994.64,,932.48,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,984.69,79.2,,,percent of total billed charges,79.2% of total billed charges,1056.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1181.14,95,,,percent of total billed charges,95% of total billed charges,994.64,80,,,percent of total billed charges,80% of total billed charges,1056.81,85,,,percent of total billed charges,85% of total billed charges,1118.97,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1243.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1118.97,90,,,percent of total billed charges,90% of total billed charges,944.91,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1056.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,994.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1056.81,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Remove Malig Lesion w/Margins, Trunk, Arms, or Legs; Diam 4.0+ cm Charge",49111606,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,4860,3888,,3645,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,3849.12,79.2,,,percent of total billed charges,79.2% of total billed charges,4131,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,4617,95,,,percent of total billed charges,95% of total billed charges,3888,80,,,percent of total billed charges,80% of total billed charges,4131,85,,,percent of total billed charges,85% of total billed charges,4374,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,4860,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,4374,90,,,percent of total billed charges,90% of total billed charges,3693.6,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,4131,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,3888,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,4131,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,4860,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 0.5 cm >",49111620,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,4802.7,3842.16,,3602.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,3803.74,79.2,,,percent of total billed charges,79.2% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,4562.57,95,,,percent of total billed charges,95% of total billed charges,3842.16,80,,,percent of total billed charges,80% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,4322.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,4802.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,4322.43,90,,,percent of total billed charges,90% of total billed charges,3650.05,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,3842.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,4802.7,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 0.6 to 1.",49111621,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 1.1 to 2.",49111622,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2040.2,1632.16,,1530.15,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1615.84,79.2,,,percent of total billed charges,79.2% of total billed charges,1734.17,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1938.19,95,,,percent of total billed charges,95% of total billed charges,1632.16,80,,,percent of total billed charges,80% of total billed charges,1734.17,85,,,percent of total billed charges,85% of total billed charges,1836.18,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2040.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1836.18,90,,,percent of total billed charges,90% of total billed charges,1550.55,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1734.17,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1632.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1734.17,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2040.2,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 2.1 to 3.",49111623,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,4802.7,3842.16,,3602.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,3803.74,79.2,,,percent of total billed charges,79.2% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,4562.57,95,,,percent of total billed charges,95% of total billed charges,3842.16,80,,,percent of total billed charges,80% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,4322.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,4802.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,4322.43,90,,,percent of total billed charges,90% of total billed charges,3650.05,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,3842.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,4802.7,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 3.1 to 4.",49111624,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,4802.7,3842.16,,3602.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,3803.74,79.2,,,percent of total billed charges,79.2% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,4562.57,95,,,percent of total billed charges,95% of total billed charges,3842.16,80,,,percent of total billed charges,80% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,4322.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,4802.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,4322.43,90,,,percent of total billed charges,90% of total billed charges,3650.05,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,3842.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,4802.7,
"Remove Malig Lesion w/Margins, Scalp, Neck, Hands, Feet, Genital; Diam 4.0+ cm C",49111626,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1313.5,1050.8,,985.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1040.29,79.2,,,percent of total billed charges,79.2% of total billed charges,1116.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1247.83,95,,,percent of total billed charges,95% of total billed charges,1050.8,80,,,percent of total billed charges,80% of total billed charges,1116.48,85,,,percent of total billed charges,85% of total billed charges,1182.15,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1313.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1182.15,90,,,percent of total billed charges,90% of total billed charges,998.26,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1116.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1050.8,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1116.48,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1313.5,
"Remove Malig Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Diam 2.1 to 3.0",49111643,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,4802.7,3842.16,,3602.03,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,3803.74,79.2,,,percent of total billed charges,79.2% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,4562.57,95,,,percent of total billed charges,95% of total billed charges,3842.16,80,,,percent of total billed charges,80% of total billed charges,4082.3,85,,,percent of total billed charges,85% of total billed charges,4322.43,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,4802.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,4322.43,90,,,percent of total billed charges,90% of total billed charges,3650.05,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,3842.16,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,4082.3,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,4802.7,
"Repair Simple  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.5 cm >",49112001,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,688.5,550.8,,516.38,75,,,percent of total billed charges,75% of total billed charges,275.4,40,,,percent of total billed charges,40% of total billed charges,545.29,79.2,,,percent of total billed charges,79.2% of total billed charges,585.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,654.08,95,,,percent of total billed charges,95% of total billed charges,550.8,80,,,percent of total billed charges,80% of total billed charges,585.23,85,,,percent of total billed charges,85% of total billed charges,619.65,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,275.4,40,,,percent of total billed charges,40% of total billed charges,275.4,40,,,percent of total billed charges,40% of total billed charges,619.65,90,,,percent of total billed charges,90% of total billed charges,523.26,76,,,percent of total billed charges,76% of total billed charges,275.4,40,,,percent of total billed charges,40% of total billed charges,585.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,550.8,80,,,percent of total billed charges,80% of total billed charges,267.14,38.8,,,percent of total billed charges,38.8% of total billed charges,585.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,654.08,
"Simple Repair  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.6 cm t",49112002,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,566.9,453.52,,425.18,75,,,percent of total billed charges,75% of total billed charges,226.76,40,,,percent of total billed charges,40% of total billed charges,448.98,79.2,,,percent of total billed charges,79.2% of total billed charges,481.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,538.56,95,,,percent of total billed charges,95% of total billed charges,453.52,80,,,percent of total billed charges,80% of total billed charges,481.87,85,,,percent of total billed charges,85% of total billed charges,510.21,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,226.76,40,,,percent of total billed charges,40% of total billed charges,226.76,40,,,percent of total billed charges,40% of total billed charges,510.21,90,,,percent of total billed charges,90% of total billed charges,430.84,76,,,percent of total billed charges,76% of total billed charges,226.76,40,,,percent of total billed charges,40% of total billed charges,481.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,453.52,80,,,percent of total billed charges,80% of total billed charges,219.96,38.8,,,percent of total billed charges,38.8% of total billed charges,481.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,538.56,
"Simple Repair Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 7.6 cm to",49112004,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,650,520,,487.5,75,,,percent of total billed charges,75% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,514.8,79.2,,,percent of total billed charges,79.2% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,617.5,95,,,percent of total billed charges,95% of total billed charges,520,80,,,percent of total billed charges,80% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,585,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,260,40,,,percent of total billed charges,40% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,585,90,,,percent of total billed charges,90% of total billed charges,494,76,,,percent of total billed charges,76% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,520,80,,,percent of total billed charges,80% of total billed charges,252.2,38.8,,,percent of total billed charges,38.8% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,617.5,
"Simple repair of superficial wounds of scalp, neck, axillae,",49112005,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1125.3,900.24,,843.98,75,,,percent of total billed charges,75% of total billed charges,450.12,40,,,percent of total billed charges,40% of total billed charges,891.24,79.2,,,percent of total billed charges,79.2% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1069.04,95,,,percent of total billed charges,95% of total billed charges,900.24,80,,,percent of total billed charges,80% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,1012.77,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,450.12,40,,,percent of total billed charges,40% of total billed charges,450.12,40,,,percent of total billed charges,40% of total billed charges,1012.77,90,,,percent of total billed charges,90% of total billed charges,855.23,76,,,percent of total billed charges,76% of total billed charges,450.12,40,,,percent of total billed charges,40% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,900.24,80,,,percent of total billed charges,80% of total billed charges,436.62,38.8,,,percent of total billed charges,38.8% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1069.04,
"Repair Simple  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 20.1 cm",49112006,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1125.3,900.24,,843.98,75,,,percent of total billed charges,75% of total billed charges,450.12,40,,,percent of total billed charges,40% of total billed charges,891.24,79.2,,,percent of total billed charges,79.2% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1069.04,95,,,percent of total billed charges,95% of total billed charges,900.24,80,,,percent of total billed charges,80% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,1012.77,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,450.12,40,,,percent of total billed charges,40% of total billed charges,450.12,40,,,percent of total billed charges,40% of total billed charges,1012.77,90,,,percent of total billed charges,90% of total billed charges,855.23,76,,,percent of total billed charges,76% of total billed charges,450.12,40,,,percent of total billed charges,40% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,900.24,80,,,percent of total billed charges,80% of total billed charges,436.62,38.8,,,percent of total billed charges,38.8% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1069.04,
"Repair Simple  Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 30.0+ cm",49112007,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,650,520,,487.5,75,,,percent of total billed charges,75% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,514.8,79.2,,,percent of total billed charges,79.2% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,617.5,95,,,percent of total billed charges,95% of total billed charges,520,80,,,percent of total billed charges,80% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,585,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,260,40,,,percent of total billed charges,40% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,585,90,,,percent of total billed charges,90% of total billed charges,494,76,,,percent of total billed charges,76% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,520,80,,,percent of total billed charges,80% of total billed charges,252.2,38.8,,,percent of total billed charges,38.8% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,617.5,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112011,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,587.6,470.08,,440.7,75,,,percent of total billed charges,75% of total billed charges,235.04,40,,,percent of total billed charges,40% of total billed charges,465.38,79.2,,,percent of total billed charges,79.2% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,558.22,95,,,percent of total billed charges,95% of total billed charges,470.08,80,,,percent of total billed charges,80% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,528.84,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,235.04,40,,,percent of total billed charges,40% of total billed charges,235.04,40,,,percent of total billed charges,40% of total billed charges,528.84,90,,,percent of total billed charges,90% of total billed charges,446.58,76,,,percent of total billed charges,76% of total billed charges,235.04,40,,,percent of total billed charges,40% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,470.08,80,,,percent of total billed charges,80% of total billed charges,227.99,38.8,,,percent of total billed charges,38.8% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,558.22,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112013,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,587.6,470.08,,440.7,75,,,percent of total billed charges,75% of total billed charges,235.04,40,,,percent of total billed charges,40% of total billed charges,465.38,79.2,,,percent of total billed charges,79.2% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,558.22,95,,,percent of total billed charges,95% of total billed charges,470.08,80,,,percent of total billed charges,80% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,528.84,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,235.04,40,,,percent of total billed charges,40% of total billed charges,235.04,40,,,percent of total billed charges,40% of total billed charges,528.84,90,,,percent of total billed charges,90% of total billed charges,446.58,76,,,percent of total billed charges,76% of total billed charges,235.04,40,,,percent of total billed charges,40% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,470.08,80,,,percent of total billed charges,80% of total billed charges,227.99,38.8,,,percent of total billed charges,38.8% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,558.22,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112014,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,650,520,,487.5,75,,,percent of total billed charges,75% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,514.8,79.2,,,percent of total billed charges,79.2% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,617.5,95,,,percent of total billed charges,95% of total billed charges,520,80,,,percent of total billed charges,80% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,585,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,260,40,,,percent of total billed charges,40% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,585,90,,,percent of total billed charges,90% of total billed charges,494,76,,,percent of total billed charges,76% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,520,80,,,percent of total billed charges,80% of total billed charges,252.2,38.8,,,percent of total billed charges,38.8% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,617.5,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112015,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,587.6,470.08,,440.7,75,,,percent of total billed charges,75% of total billed charges,235.04,40,,,percent of total billed charges,40% of total billed charges,465.38,79.2,,,percent of total billed charges,79.2% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,558.22,95,,,percent of total billed charges,95% of total billed charges,470.08,80,,,percent of total billed charges,80% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,528.84,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,235.04,40,,,percent of total billed charges,40% of total billed charges,235.04,40,,,percent of total billed charges,40% of total billed charges,528.84,90,,,percent of total billed charges,90% of total billed charges,446.58,76,,,percent of total billed charges,76% of total billed charges,235.04,40,,,percent of total billed charges,40% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,470.08,80,,,percent of total billed charges,80% of total billed charges,227.99,38.8,,,percent of total billed charges,38.8% of total billed charges,499.46,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,558.22,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112016,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1193.9,955.12,,895.43,75,,,percent of total billed charges,75% of total billed charges,477.56,40,,,percent of total billed charges,40% of total billed charges,945.57,79.2,,,percent of total billed charges,79.2% of total billed charges,1014.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1134.21,95,,,percent of total billed charges,95% of total billed charges,955.12,80,,,percent of total billed charges,80% of total billed charges,1014.82,85,,,percent of total billed charges,85% of total billed charges,1074.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,477.56,40,,,percent of total billed charges,40% of total billed charges,477.56,40,,,percent of total billed charges,40% of total billed charges,1074.51,90,,,percent of total billed charges,90% of total billed charges,907.36,76,,,percent of total billed charges,76% of total billed charges,477.56,40,,,percent of total billed charges,40% of total billed charges,1014.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,955.12,80,,,percent of total billed charges,80% of total billed charges,463.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1014.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1134.21,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112017,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1193.9,955.12,,895.43,75,,,percent of total billed charges,75% of total billed charges,477.56,40,,,percent of total billed charges,40% of total billed charges,945.57,79.2,,,percent of total billed charges,79.2% of total billed charges,1014.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1134.21,95,,,percent of total billed charges,95% of total billed charges,955.12,80,,,percent of total billed charges,80% of total billed charges,1014.82,85,,,percent of total billed charges,85% of total billed charges,1074.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,477.56,40,,,percent of total billed charges,40% of total billed charges,477.56,40,,,percent of total billed charges,40% of total billed charges,1074.51,90,,,percent of total billed charges,90% of total billed charges,907.36,76,,,percent of total billed charges,76% of total billed charges,477.56,40,,,percent of total billed charges,40% of total billed charges,1014.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,955.12,80,,,percent of total billed charges,80% of total billed charges,463.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1014.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1134.21,
"Simple Repair Of Superficial Wounds Of Face, Ears, Eyelids, Nose, Lips And/Or Mu",49112018,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,650,520,,487.5,75,,,percent of total billed charges,75% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,514.8,79.2,,,percent of total billed charges,79.2% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,617.5,95,,,percent of total billed charges,95% of total billed charges,520,80,,,percent of total billed charges,80% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,585,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,260,40,,,percent of total billed charges,40% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,585,90,,,percent of total billed charges,90% of total billed charges,494,76,,,percent of total billed charges,76% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,520,80,,,percent of total billed charges,80% of total billed charges,252.2,38.8,,,percent of total billed charges,38.8% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,617.5,
"11200 Removal Of Skin Tags, Up To And Including 15 Lesions",49111200,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,602.1,481.68,,451.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,476.86,79.2,,,percent of total billed charges,79.2% of total billed charges,511.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,572,95,,,percent of total billed charges,95% of total billed charges,481.68,80,,,percent of total billed charges,80% of total billed charges,511.79,85,,,percent of total billed charges,85% of total billed charges,541.89,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,602.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,541.89,90,,,percent of total billed charges,90% of total billed charges,457.6,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,511.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,481.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,511.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"11201 Removal of Skin Tags, Mult Fibrocutaneous Tags, Ea Add",49111201,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,72.4,57.92,,54.3,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,57.34,79.2,,,percent of total billed charges,79.2% of total billed charges,61.54,85,,,percent of total billed charges,85% of total billed charges,72.4,100,,,fee schedule,100% of CO APG rates,68.78,95,,,percent of total billed charges,95% of total billed charges,57.92,80,,,percent of total billed charges,80% of total billed charges,61.54,85,,,percent of total billed charges,85% of total billed charges,65.16,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,72.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,65.16,90,,,percent of total billed charges,90% of total billed charges,55.02,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,61.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,57.92,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,61.54,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,527,100,,,case rate,pays based on per visit rate,54.3,527,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 0.5 cm or Le",49111600,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,626.9,501.52,,470.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,496.5,79.2,,,percent of total billed charges,79.2% of total billed charges,532.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,595.56,95,,,percent of total billed charges,95% of total billed charges,501.52,80,,,percent of total billed charges,80% of total billed charges,532.87,85,,,percent of total billed charges,85% of total billed charges,564.21,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,626.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,564.21,90,,,percent of total billed charges,90% of total billed charges,476.44,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,532.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,501.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,532.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 0.6 to 1.0 c",49111601,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 1.1 to 2.0 c",49111602,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1106.9,885.52,,830.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,876.66,79.2,,,percent of total billed charges,79.2% of total billed charges,940.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1051.56,95,,,percent of total billed charges,95% of total billed charges,885.52,80,,,percent of total billed charges,80% of total billed charges,940.87,85,,,percent of total billed charges,85% of total billed charges,996.21,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1106.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,996.21,90,,,percent of total billed charges,90% of total billed charges,841.24,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,940.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,885.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,940.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 c",49111603,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 3.1 to 4.0 c",49111604,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1017.8,814.24,,763.35,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,806.1,79.2,,,percent of total billed charges,79.2% of total billed charges,865.13,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,966.91,95,,,percent of total billed charges,95% of total billed charges,814.24,80,,,percent of total billed charges,80% of total billed charges,865.13,85,,,percent of total billed charges,85% of total billed charges,916.02,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1017.8,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,916.02,90,,,percent of total billed charges,90% of total billed charges,773.53,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,865.13,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,814.24,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,865.13,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Excised diam 0",49111640,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"Excise, Malign Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Excised diam 0",49111641,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,877.6,702.08,,658.2,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,695.06,79.2,,,percent of total billed charges,79.2% of total billed charges,745.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,833.72,95,,,percent of total billed charges,95% of total billed charges,702.08,80,,,percent of total billed charges,80% of total billed charges,745.96,85,,,percent of total billed charges,85% of total billed charges,789.84,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,877.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,789.84,90,,,percent of total billed charges,90% of total billed charges,666.98,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,745.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,702.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,745.96,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"Excise, Malign Lesion w/Margins, Face, Ears, Eyelids, Nose, Lips; Excised diam 1",49111642,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
Debride of Nail(s) By Any Method(s); Six or More Charge,49111721,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,178.2,142.56,,133.65,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,141.13,79.2,,,percent of total billed charges,79.2% of total billed charges,151.47,85,,,percent of total billed charges,85% of total billed charges,178.2,100,,,fee schedule,100% of CO APG rates,169.29,95,,,percent of total billed charges,95% of total billed charges,142.56,80,,,percent of total billed charges,80% of total billed charges,151.47,85,,,percent of total billed charges,85% of total billed charges,160.38,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,178.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,160.38,90,,,percent of total billed charges,90% of total billed charges,135.43,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,151.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,142.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,151.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,738.6,100,,,case rate,pays based on per visit rate,133.65,738.6,
"Avulsion of Nail Plate, Partial or Complete, Simple; Single Charge",49111730,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,650,520,,487.5,75,,,percent of total billed charges,75% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,514.8,79.2,,,percent of total billed charges,79.2% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,617.5,95,,,percent of total billed charges,95% of total billed charges,520,80,,,percent of total billed charges,80% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,585,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,260,40,,,percent of total billed charges,40% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,585,90,,,percent of total billed charges,90% of total billed charges,494,76,,,percent of total billed charges,76% of total billed charges,260,40,,,percent of total billed charges,40% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,520,80,,,percent of total billed charges,80% of total billed charges,252.2,38.8,,,percent of total billed charges,38.8% of total billed charges,552.5,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,617.5,
"Avulsion of Nail Plate, Partial or Complete, Simple; each Addtl Nail Plate Charg",49111732,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,121.7,97.36,,91.28,75,,,percent of total billed charges,75% of total billed charges,48.68,40,,,percent of total billed charges,40% of total billed charges,96.39,79.2,,,percent of total billed charges,79.2% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,121.7,100,,,fee schedule,100% of CO APG rates,115.62,95,,,percent of total billed charges,95% of total billed charges,97.36,80,,,percent of total billed charges,80% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,109.53,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,121.7,100,,,fee schedule,100% of NM APC rate,48.68,40,,,percent of total billed charges,40% of total billed charges,48.68,40,,,percent of total billed charges,40% of total billed charges,109.53,90,,,percent of total billed charges,90% of total billed charges,92.49,76,,,percent of total billed charges,76% of total billed charges,48.68,40,,,percent of total billed charges,40% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,97.36,80,,,percent of total billed charges,80% of total billed charges,47.22,38.8,,,percent of total billed charges,38.8% of total billed charges,103.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,47.22,217.66,
"Inj(s); Single Tendon Sheath, or Ligament, Aponeurosis (eg, Planterar ''''Fascia''''",49120550,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,839.3,671.44,,629.48,75,,,percent of total billed charges,75% of total billed charges,335.72,40,,,percent of total billed charges,40% of total billed charges,664.73,79.2,,,percent of total billed charges,79.2% of total billed charges,713.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,797.34,95,,,percent of total billed charges,95% of total billed charges,671.44,80,,,percent of total billed charges,80% of total billed charges,713.41,85,,,percent of total billed charges,85% of total billed charges,755.37,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,335.72,40,,,percent of total billed charges,40% of total billed charges,335.72,40,,,percent of total billed charges,40% of total billed charges,755.37,90,,,percent of total billed charges,90% of total billed charges,637.87,76,,,percent of total billed charges,76% of total billed charges,335.72,40,,,percent of total billed charges,40% of total billed charges,713.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,671.44,80,,,percent of total billed charges,80% of total billed charges,325.65,38.8,,,percent of total billed charges,38.8% of total billed charges,713.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,797.34,
Inj(s); Single Tendon or igin/Insert Charge,49120551,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,807.2,645.76,,605.4,75,,,percent of total billed charges,75% of total billed charges,322.88,40,,,percent of total billed charges,40% of total billed charges,639.3,79.2,,,percent of total billed charges,79.2% of total billed charges,686.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,766.84,95,,,percent of total billed charges,95% of total billed charges,645.76,80,,,percent of total billed charges,80% of total billed charges,686.12,85,,,percent of total billed charges,85% of total billed charges,726.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,322.88,40,,,percent of total billed charges,40% of total billed charges,322.88,40,,,percent of total billed charges,40% of total billed charges,726.48,90,,,percent of total billed charges,90% of total billed charges,613.47,76,,,percent of total billed charges,76% of total billed charges,322.88,40,,,percent of total billed charges,40% of total billed charges,686.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,645.76,80,,,percent of total billed charges,80% of total billed charges,313.19,38.8,,,percent of total billed charges,38.8% of total billed charges,686.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,766.84,
"Inj(s); Single or Mult Trigger Point(S), One or Two Muscle(s",30020552,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,904.8,723.84,,678.6,75,,,percent of total billed charges,75% of total billed charges,361.92,40,,,percent of total billed charges,40% of total billed charges,716.6,79.2,,,percent of total billed charges,79.2% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,859.56,95,,,percent of total billed charges,95% of total billed charges,723.84,80,,,percent of total billed charges,80% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,814.32,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,361.92,40,,,percent of total billed charges,40% of total billed charges,361.92,40,,,percent of total billed charges,40% of total billed charges,814.32,90,,,percent of total billed charges,90% of total billed charges,687.65,76,,,percent of total billed charges,76% of total billed charges,361.92,40,,,percent of total billed charges,40% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,723.84,80,,,percent of total billed charges,80% of total billed charges,351.06,38.8,,,percent of total billed charges,38.8% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,859.56,
"Inj(s); Single or Mult Trigger Point(S), Three or More Muscle(s) Charge",49120553,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1154.4,923.52,,865.8,75,,,percent of total billed charges,75% of total billed charges,461.76,40,,,percent of total billed charges,40% of total billed charges,914.28,79.2,,,percent of total billed charges,79.2% of total billed charges,981.24,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1096.68,95,,,percent of total billed charges,95% of total billed charges,923.52,80,,,percent of total billed charges,80% of total billed charges,981.24,85,,,percent of total billed charges,85% of total billed charges,1038.96,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,461.76,40,,,percent of total billed charges,40% of total billed charges,461.76,40,,,percent of total billed charges,40% of total billed charges,1038.96,90,,,percent of total billed charges,90% of total billed charges,877.34,76,,,percent of total billed charges,76% of total billed charges,461.76,40,,,percent of total billed charges,40% of total billed charges,981.24,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,923.52,80,,,percent of total billed charges,80% of total billed charges,447.91,38.8,,,percent of total billed charges,38.8% of total billed charges,981.24,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1096.68,
"Arthrocentesis, Aspirtn and/or Inj; Small Joint or Bursa (eg, Fingers, toes) Cha",49120600,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,885.5,708.4,,664.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,701.32,79.2,,,percent of total billed charges,79.2% of total billed charges,752.68,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,841.23,95,,,percent of total billed charges,95% of total billed charges,708.4,80,,,percent of total billed charges,80% of total billed charges,752.68,85,,,percent of total billed charges,85% of total billed charges,796.95,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,885.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,796.95,90,,,percent of total billed charges,90% of total billed charges,672.98,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,752.68,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,708.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,752.68,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
23620 Closed Treatment Of Greater Humeral Tuberosity Fractur,60000033,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,822.6,658.08,,616.95,75,,,percent of total billed charges,75% of total billed charges,329.04,40,,,percent of total billed charges,40% of total billed charges,651.5,79.2,,,percent of total billed charges,79.2% of total billed charges,699.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,781.47,95,,,percent of total billed charges,95% of total billed charges,658.08,80,,,percent of total billed charges,80% of total billed charges,699.21,85,,,percent of total billed charges,85% of total billed charges,740.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,329.04,40,,,percent of total billed charges,40% of total billed charges,329.04,40,,,percent of total billed charges,40% of total billed charges,740.34,90,,,percent of total billed charges,90% of total billed charges,625.18,76,,,percent of total billed charges,76% of total billed charges,329.04,40,,,percent of total billed charges,40% of total billed charges,699.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,658.08,80,,,percent of total billed charges,80% of total billed charges,319.17,38.8,,,percent of total billed charges,38.8% of total billed charges,699.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,781.47,
25622 Closed Treatment Of Carpal Scaphoid w/o Manipulation,60000003,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,767.5,614,,575.63,75,,,percent of total billed charges,75% of total billed charges,307,40,,,percent of total billed charges,40% of total billed charges,607.86,79.2,,,percent of total billed charges,79.2% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,729.13,95,,,percent of total billed charges,95% of total billed charges,614,80,,,percent of total billed charges,80% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,690.75,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,307,40,,,percent of total billed charges,40% of total billed charges,307,40,,,percent of total billed charges,40% of total billed charges,690.75,90,,,percent of total billed charges,90% of total billed charges,583.3,76,,,percent of total billed charges,76% of total billed charges,307,40,,,percent of total billed charges,40% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,614,80,,,percent of total billed charges,80% of total billed charges,297.79,38.8,,,percent of total billed charges,38.8% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,729.13,
"Closed Trtmt of Metatarsal Fx; w/Manipulation, each Charge",60000067,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,945.4,756.32,,709.05,75,,,percent of total billed charges,75% of total billed charges,378.16,40,,,percent of total billed charges,40% of total billed charges,748.76,79.2,,,percent of total billed charges,79.2% of total billed charges,803.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,898.13,95,,,percent of total billed charges,95% of total billed charges,756.32,80,,,percent of total billed charges,80% of total billed charges,803.59,85,,,percent of total billed charges,85% of total billed charges,850.86,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,378.16,40,,,percent of total billed charges,40% of total billed charges,378.16,40,,,percent of total billed charges,40% of total billed charges,850.86,90,,,percent of total billed charges,90% of total billed charges,718.5,76,,,percent of total billed charges,76% of total billed charges,378.16,40,,,percent of total billed charges,40% of total billed charges,803.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,756.32,80,,,percent of total billed charges,80% of total billed charges,366.82,38.8,,,percent of total billed charges,38.8% of total billed charges,803.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,898.13,
"Applic, Cast; Shoulder to Hand (Long Arm) Charge",49129065,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,459.7,367.76,,344.78,75,,,percent of total billed charges,75% of total billed charges,183.88,40,,,percent of total billed charges,40% of total billed charges,364.08,79.2,,,percent of total billed charges,79.2% of total billed charges,390.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,436.72,95,,,percent of total billed charges,95% of total billed charges,367.76,80,,,percent of total billed charges,80% of total billed charges,390.75,85,,,percent of total billed charges,85% of total billed charges,413.73,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,183.88,40,,,percent of total billed charges,40% of total billed charges,183.88,40,,,percent of total billed charges,40% of total billed charges,413.73,90,,,percent of total billed charges,90% of total billed charges,349.37,76,,,percent of total billed charges,76% of total billed charges,183.88,40,,,percent of total billed charges,40% of total billed charges,390.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,367.76,80,,,percent of total billed charges,80% of total billed charges,178.36,38.8,,,percent of total billed charges,38.8% of total billed charges,390.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,178.36,436.72,
"Applic, Cast; Elbow to Finger (Short Arm) Charge",49129075,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,177.8,142.24,,133.35,75,,,percent of total billed charges,75% of total billed charges,71.12,40,,,percent of total billed charges,40% of total billed charges,140.82,79.2,,,percent of total billed charges,79.2% of total billed charges,151.13,85,,,percent of total billed charges,85% of total billed charges,177.8,100,,,fee schedule,100% of CO APG rates,168.91,95,,,percent of total billed charges,95% of total billed charges,142.24,80,,,percent of total billed charges,80% of total billed charges,151.13,85,,,percent of total billed charges,85% of total billed charges,160.02,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,177.8,100,,,fee schedule,100% of NM APC rate,71.12,40,,,percent of total billed charges,40% of total billed charges,71.12,40,,,percent of total billed charges,40% of total billed charges,160.02,90,,,percent of total billed charges,90% of total billed charges,135.13,76,,,percent of total billed charges,76% of total billed charges,71.12,40,,,percent of total billed charges,40% of total billed charges,151.13,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,142.24,80,,,percent of total billed charges,80% of total billed charges,68.99,38.8,,,percent of total billed charges,38.8% of total billed charges,151.13,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,68.99,217.66,
Applic of Long Arm Splint (Shoulder to Hand) Charge,49129105,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,459.7,367.76,,344.78,75,,,percent of total billed charges,75% of total billed charges,183.88,40,,,percent of total billed charges,40% of total billed charges,364.08,79.2,,,percent of total billed charges,79.2% of total billed charges,390.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,436.72,95,,,percent of total billed charges,95% of total billed charges,367.76,80,,,percent of total billed charges,80% of total billed charges,390.75,85,,,percent of total billed charges,85% of total billed charges,413.73,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,183.88,40,,,percent of total billed charges,40% of total billed charges,183.88,40,,,percent of total billed charges,40% of total billed charges,413.73,90,,,percent of total billed charges,90% of total billed charges,349.37,76,,,percent of total billed charges,76% of total billed charges,183.88,40,,,percent of total billed charges,40% of total billed charges,390.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,367.76,80,,,percent of total billed charges,80% of total billed charges,178.36,38.8,,,percent of total billed charges,38.8% of total billed charges,390.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,178.36,436.72,
29125 Application Of Short Arm Splint,49129125,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,420.2,336.16,,315.15,75,,,percent of total billed charges,75% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,332.8,79.2,,,percent of total billed charges,79.2% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,399.19,95,,,percent of total billed charges,95% of total billed charges,336.16,80,,,percent of total billed charges,80% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,378.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,168.08,40,,,percent of total billed charges,40% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,378.18,90,,,percent of total billed charges,90% of total billed charges,319.35,76,,,percent of total billed charges,76% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,336.16,80,,,percent of total billed charges,80% of total billed charges,163.04,38.8,,,percent of total billed charges,38.8% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,163.04,399.19,
29130 Application Of Finger Splint; Static,49129130,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,207.4,165.92,,155.55,75,,,percent of total billed charges,75% of total billed charges,82.96,40,,,percent of total billed charges,40% of total billed charges,164.26,79.2,,,percent of total billed charges,79.2% of total billed charges,176.29,85,,,percent of total billed charges,85% of total billed charges,207.4,100,,,fee schedule,100% of CO APG rates,197.03,95,,,percent of total billed charges,95% of total billed charges,165.92,80,,,percent of total billed charges,80% of total billed charges,176.29,85,,,percent of total billed charges,85% of total billed charges,186.66,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,82.96,40,,,percent of total billed charges,40% of total billed charges,82.96,40,,,percent of total billed charges,40% of total billed charges,186.66,90,,,percent of total billed charges,90% of total billed charges,157.62,76,,,percent of total billed charges,76% of total billed charges,82.96,40,,,percent of total billed charges,40% of total billed charges,176.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,165.92,80,,,percent of total billed charges,80% of total billed charges,80.47,38.8,,,percent of total billed charges,38.8% of total billed charges,176.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,80.47,217.66,
29345 Application Of Long Leg Cast,49129345,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,848.6,678.88,,636.45,75,,,percent of total billed charges,75% of total billed charges,339.44,40,,,percent of total billed charges,40% of total billed charges,672.09,79.2,,,percent of total billed charges,79.2% of total billed charges,721.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,806.17,95,,,percent of total billed charges,95% of total billed charges,678.88,80,,,percent of total billed charges,80% of total billed charges,721.31,85,,,percent of total billed charges,85% of total billed charges,763.74,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,339.44,40,,,percent of total billed charges,40% of total billed charges,339.44,40,,,percent of total billed charges,40% of total billed charges,763.74,90,,,percent of total billed charges,90% of total billed charges,644.94,76,,,percent of total billed charges,76% of total billed charges,339.44,40,,,percent of total billed charges,40% of total billed charges,721.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,678.88,80,,,percent of total billed charges,80% of total billed charges,329.26,38.8,,,percent of total billed charges,38.8% of total billed charges,721.31,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,806.17,
29405 Application Of Short Leg Cast,49129405,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,418.1,334.48,,313.58,75,,,percent of total billed charges,75% of total billed charges,167.24,40,,,percent of total billed charges,40% of total billed charges,331.14,79.2,,,percent of total billed charges,79.2% of total billed charges,355.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,397.2,95,,,percent of total billed charges,95% of total billed charges,334.48,80,,,percent of total billed charges,80% of total billed charges,355.39,85,,,percent of total billed charges,85% of total billed charges,376.29,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,167.24,40,,,percent of total billed charges,40% of total billed charges,167.24,40,,,percent of total billed charges,40% of total billed charges,376.29,90,,,percent of total billed charges,90% of total billed charges,317.76,76,,,percent of total billed charges,76% of total billed charges,167.24,40,,,percent of total billed charges,40% of total billed charges,355.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,334.48,80,,,percent of total billed charges,80% of total billed charges,162.22,38.8,,,percent of total billed charges,38.8% of total billed charges,355.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,162.22,397.2,
"Control Nasal Hemorrhage, Anterior, Simple (Limited Cautery And/Or Packing) Any",49130901,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,420.2,336.16,,315.15,75,,,percent of total billed charges,75% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,332.8,79.2,,,percent of total billed charges,79.2% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,399.19,95,,,percent of total billed charges,95% of total billed charges,336.16,80,,,percent of total billed charges,80% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,378.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,168.08,40,,,percent of total billed charges,40% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,378.18,90,,,percent of total billed charges,90% of total billed charges,319.35,76,,,percent of total billed charges,76% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,336.16,80,,,percent of total billed charges,80% of total billed charges,163.04,38.8,,,percent of total billed charges,38.8% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,163.04,399.19,
"11976 Removal, Implantable Contraceptive Capsules",60000013,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1883.5,1506.8,,1412.63,75,,,percent of total billed charges,75% of total billed charges,753.4,40,,,percent of total billed charges,40% of total billed charges,1491.73,79.2,,,percent of total billed charges,79.2% of total billed charges,1600.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1789.33,95,,,percent of total billed charges,95% of total billed charges,1506.8,80,,,percent of total billed charges,80% of total billed charges,1600.98,85,,,percent of total billed charges,85% of total billed charges,1695.15,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,753.4,40,,,percent of total billed charges,40% of total billed charges,753.4,40,,,percent of total billed charges,40% of total billed charges,1695.15,90,,,percent of total billed charges,90% of total billed charges,1431.46,76,,,percent of total billed charges,76% of total billed charges,753.4,40,,,percent of total billed charges,40% of total billed charges,1600.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1506.8,80,,,percent of total billed charges,80% of total billed charges,730.8,38.8,,,percent of total billed charges,38.8% of total billed charges,1600.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1789.33,
"Excise of Nail  matrix, Part. or Complete, for Permanent Removal Charge",49111750,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1106.9,885.52,,830.18,75,,,percent of total billed charges,75% of total billed charges,442.76,40,,,percent of total billed charges,40% of total billed charges,876.66,79.2,,,percent of total billed charges,79.2% of total billed charges,940.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1051.56,95,,,percent of total billed charges,95% of total billed charges,885.52,80,,,percent of total billed charges,80% of total billed charges,940.87,85,,,percent of total billed charges,85% of total billed charges,996.21,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,442.76,40,,,percent of total billed charges,40% of total billed charges,442.76,40,,,percent of total billed charges,40% of total billed charges,996.21,90,,,percent of total billed charges,90% of total billed charges,841.24,76,,,percent of total billed charges,76% of total billed charges,442.76,40,,,percent of total billed charges,40% of total billed charges,940.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,885.52,80,,,percent of total billed charges,80% of total billed charges,429.48,38.8,,,percent of total billed charges,38.8% of total billed charges,940.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1051.56,
69200 Removal Foreign Body From External Auditory Canal; Wit,49169200,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,349.3,279.44,,261.98,75,,,percent of total billed charges,75% of total billed charges,139.72,40,,,percent of total billed charges,40% of total billed charges,276.65,79.2,,,percent of total billed charges,79.2% of total billed charges,296.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,331.84,95,,,percent of total billed charges,95% of total billed charges,279.44,80,,,percent of total billed charges,80% of total billed charges,296.91,85,,,percent of total billed charges,85% of total billed charges,314.37,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,139.72,40,,,percent of total billed charges,40% of total billed charges,139.72,40,,,percent of total billed charges,40% of total billed charges,314.37,90,,,percent of total billed charges,90% of total billed charges,265.47,76,,,percent of total billed charges,76% of total billed charges,139.72,40,,,percent of total billed charges,40% of total billed charges,296.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,279.44,80,,,percent of total billed charges,80% of total billed charges,135.53,38.8,,,percent of total billed charges,38.8% of total billed charges,296.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,135.53,331.84,
ANA Titer Manual Charge,60000762,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,103.2,82.56,,77.4,75,,,percent of total billed charges,75% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,81.73,79.2,,,percent of total billed charges,79.2% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,98.04,95,,,percent of total billed charges,95% of total billed charges,82.56,80,,,percent of total billed charges,80% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,41.28,40,,,percent of total billed charges,40% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,78.43,76,,,percent of total billed charges,76% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,82.56,80,,,percent of total billed charges,80% of total billed charges,40.04,38.8,,,percent of total billed charges,38.8% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,98.04,
Glucose Tolerance Test 3 Hr Request,40082951,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
"Tetanus, diphtheria toxoids  acellular pertussis vaccine (TdaP), 7 years or old",49190715,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,59.5,47.6,,44.63,75,,,percent of total billed charges,75% of total billed charges,23.8,40,,,percent of total billed charges,40% of total billed charges,47.12,79.2,,,percent of total billed charges,79.2% of total billed charges,50.58,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,56.53,95,,,percent of total billed charges,95% of total billed charges,47.6,80,,,percent of total billed charges,80% of total billed charges,50.58,85,,,percent of total billed charges,85% of total billed charges,53.55,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,59.5,100,,,fee schedule,100% of NM fee schedule,23.8,40,,,percent of total billed charges,40% of total billed charges,23.8,40,,,percent of total billed charges,40% of total billed charges,53.55,90,,,percent of total billed charges,90% of total billed charges,45.22,76,,,percent of total billed charges,76% of total billed charges,23.8,40,,,percent of total billed charges,40% of total billed charges,50.58,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,47.6,80,,,percent of total billed charges,80% of total billed charges,23.09,38.8,,,percent of total billed charges,38.8% of total billed charges,50.58,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,23.09,59.5,
RSV POC,30087420,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,94.4,75.52,,70.8,75,,,percent of total billed charges,75% of total billed charges,37.76,40,,,percent of total billed charges,40% of total billed charges,74.76,79.2,,,percent of total billed charges,79.2% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,89.68,95,,,percent of total billed charges,95% of total billed charges,75.52,80,,,percent of total billed charges,80% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,84.96,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,37.76,40,,,percent of total billed charges,40% of total billed charges,37.76,40,,,percent of total billed charges,40% of total billed charges,84.96,90,,,percent of total billed charges,90% of total billed charges,71.74,76,,,percent of total billed charges,76% of total billed charges,37.76,40,,,percent of total billed charges,40% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,75.52,80,,,percent of total billed charges,80% of total billed charges,36.63,38.8,,,percent of total billed charges,38.8% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,89.68,
Sensory integrative techniques to enhance sensory processing,60000353,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,117,93.6,GN,87.75,75,,,percent of total billed charges,75% of total billed charges,46.8,40,,,percent of total billed charges,40% of total billed charges,92.66,79.2,,,percent of total billed charges,79.2% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,111.15,95,,,percent of total billed charges,95% of total billed charges,93.6,80,,,percent of total billed charges,80% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,105.3,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,46.8,40,,,percent of total billed charges,40% of total billed charges,46.8,40,,,percent of total billed charges,40% of total billed charges,105.3,90,,,percent of total billed charges,90% of total billed charges,88.92,76,,,percent of total billed charges,76% of total billed charges,46.8,40,,,percent of total billed charges,40% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,93.6,80,,,percent of total billed charges,80% of total billed charges,45.4,38.8,,,percent of total billed charges,38.8% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,133.56,
Standardized Aphasia Assessment Charge,30096105,CDM,444,RC,96105,HCPCS,OUTPATIENT,,,1117,893.6,GN,837.75,75,,,percent of total billed charges,75% of total billed charges,446.8,40,,,percent of total billed charges,40% of total billed charges,884.66,79.2,,,percent of total billed charges,79.2% of total billed charges,949.45,85,,,percent of total billed charges,85% of total billed charges,763.08,100,,,fee schedule,100% of CO APG rates,1061.15,95,,,percent of total billed charges,95% of total billed charges,893.6,80,,,percent of total billed charges,80% of total billed charges,949.45,85,,,percent of total billed charges,85% of total billed charges,1005.3,90,,,percent of total billed charges,90% of total billed charges,763.08,100,,,fee schedule,100% of CO APG rates,763.08,100,,,fee schedule,100% of CO APG rates,58.84,100,,,fee schedule,100% of NM fee schedule,446.8,40,,,percent of total billed charges,40% of total billed charges,446.8,40,,,percent of total billed charges,40% of total billed charges,1005.3,90,,,percent of total billed charges,90% of total billed charges,848.92,76,,,percent of total billed charges,76% of total billed charges,446.8,40,,,percent of total billed charges,40% of total billed charges,949.45,85,,,percent of total billed charges,85% of total billed charges,763.08,100,,,fee schedule,100% of CO APG rate,893.6,80,,,percent of total billed charges,80% of total billed charges,433.4,38.8,,,percent of total billed charges,38.8% of total billed charges,949.45,85,,,percent of total billed charges,85% of total billed charges,763.08,100,,,fee schedule,100% of APG fee schedule,199.32,200,,,fee schedule,200% of CMS fee schedule,58.84,1061.15,
Brain Natriuretic Peptide (BNP),40083880,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,250.7,200.56,,188.03,75,,,percent of total billed charges,75% of total billed charges,100.28,40,,,percent of total billed charges,40% of total billed charges,198.55,79.2,,,percent of total billed charges,79.2% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,238.17,95,,,percent of total billed charges,95% of total billed charges,200.56,80,,,percent of total billed charges,80% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,225.63,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,100.28,40,,,percent of total billed charges,40% of total billed charges,100.28,40,,,percent of total billed charges,40% of total billed charges,225.63,90,,,percent of total billed charges,90% of total billed charges,190.53,76,,,percent of total billed charges,76% of total billed charges,100.28,40,,,percent of total billed charges,40% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,200.56,80,,,percent of total billed charges,80% of total billed charges,97.27,38.8,,,percent of total billed charges,38.8% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,238.17,
Creatine Kinase-MB,40082553,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,197.6,158.08,,148.2,75,,,percent of total billed charges,75% of total billed charges,79.04,40,,,percent of total billed charges,40% of total billed charges,156.5,79.2,,,percent of total billed charges,79.2% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,187.72,95,,,percent of total billed charges,95% of total billed charges,158.08,80,,,percent of total billed charges,80% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,177.84,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,79.04,40,,,percent of total billed charges,40% of total billed charges,79.04,40,,,percent of total billed charges,40% of total billed charges,177.84,90,,,percent of total billed charges,90% of total billed charges,150.18,76,,,percent of total billed charges,76% of total billed charges,79.04,40,,,percent of total billed charges,40% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,158.08,80,,,percent of total billed charges,80% of total billed charges,76.67,38.8,,,percent of total billed charges,38.8% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,187.72,
T3 Free,40084481,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,288.9,231.12,,216.68,75,,,percent of total billed charges,75% of total billed charges,115.56,40,,,percent of total billed charges,40% of total billed charges,228.81,79.2,,,percent of total billed charges,79.2% of total billed charges,245.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,274.46,95,,,percent of total billed charges,95% of total billed charges,231.12,80,,,percent of total billed charges,80% of total billed charges,245.57,85,,,percent of total billed charges,85% of total billed charges,260.01,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,115.56,40,,,percent of total billed charges,40% of total billed charges,115.56,40,,,percent of total billed charges,40% of total billed charges,260.01,90,,,percent of total billed charges,90% of total billed charges,219.56,76,,,percent of total billed charges,76% of total billed charges,115.56,40,,,percent of total billed charges,40% of total billed charges,245.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,231.12,80,,,percent of total billed charges,80% of total billed charges,112.09,38.8,,,percent of total billed charges,38.8% of total billed charges,245.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,274.46,
Influenza A/B POC,30087804,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,112.4,89.92,,84.3,75,,,percent of total billed charges,75% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,89.02,79.2,,,percent of total billed charges,79.2% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,106.78,95,,,percent of total billed charges,95% of total billed charges,89.92,80,,,percent of total billed charges,80% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,101.16,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,44.96,40,,,percent of total billed charges,40% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,101.16,90,,,percent of total billed charges,90% of total billed charges,85.42,76,,,percent of total billed charges,76% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,89.92,80,,,percent of total billed charges,80% of total billed charges,43.61,38.8,,,percent of total billed charges,38.8% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,106.78,
COLLECTION: Venous Draw,40036415,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,5.04,33.06,
COLLECTION: Arterial Draw,42236600,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,130.9,104.72,,98.18,75,,,percent of total billed charges,75% of total billed charges,52.36,40,,,percent of total billed charges,40% of total billed charges,103.67,79.2,,,percent of total billed charges,79.2% of total billed charges,111.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,124.36,95,,,percent of total billed charges,95% of total billed charges,104.72,80,,,percent of total billed charges,80% of total billed charges,111.27,85,,,percent of total billed charges,85% of total billed charges,117.81,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,52.36,40,,,percent of total billed charges,40% of total billed charges,52.36,40,,,percent of total billed charges,40% of total billed charges,117.81,90,,,percent of total billed charges,90% of total billed charges,99.48,76,,,percent of total billed charges,76% of total billed charges,52.36,40,,,percent of total billed charges,40% of total billed charges,111.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,104.72,80,,,percent of total billed charges,80% of total billed charges,50.79,38.8,,,percent of total billed charges,38.8% of total billed charges,111.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,124.36,
COLLECTION: Venous Draw,40036415,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,5.04,33.06,
Hemoglobin and Hematocrit,40085018,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,50.1,40.08,,37.58,75,,,percent of total billed charges,75% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,39.68,79.2,,,percent of total billed charges,79.2% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,47.6,95,,,percent of total billed charges,95% of total billed charges,40.08,80,,,percent of total billed charges,80% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,45.09,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,20.04,40,,,percent of total billed charges,40% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,45.09,90,,,percent of total billed charges,90% of total billed charges,38.08,76,,,percent of total billed charges,76% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,40.08,80,,,percent of total billed charges,80% of total billed charges,19.44,38.8,,,percent of total billed charges,38.8% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,47.6,
Thyroxine Binding Globulin LC,40084442,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,43.5,34.8,,32.63,75,,,percent of total billed charges,75% of total billed charges,17.4,40,,,percent of total billed charges,40% of total billed charges,34.45,79.2,,,percent of total billed charges,79.2% of total billed charges,36.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,41.33,95,,,percent of total billed charges,95% of total billed charges,34.8,80,,,percent of total billed charges,80% of total billed charges,36.98,85,,,percent of total billed charges,85% of total billed charges,39.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,17.4,40,,,percent of total billed charges,40% of total billed charges,17.4,40,,,percent of total billed charges,40% of total billed charges,39.15,90,,,percent of total billed charges,90% of total billed charges,33.06,76,,,percent of total billed charges,76% of total billed charges,17.4,40,,,percent of total billed charges,40% of total billed charges,36.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,34.8,80,,,percent of total billed charges,80% of total billed charges,16.88,38.8,,,percent of total billed charges,38.8% of total billed charges,36.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,41.33,
BD DEXA Axial Skeleton,41477080,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,586.1,468.88,,439.58,75,,,percent of total billed charges,75% of total billed charges,234.44,40,,,percent of total billed charges,40% of total billed charges,464.19,79.2,,,percent of total billed charges,79.2% of total billed charges,498.19,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,556.8,95,,,percent of total billed charges,95% of total billed charges,468.88,80,,,percent of total billed charges,80% of total billed charges,498.19,85,,,percent of total billed charges,85% of total billed charges,527.49,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,234.44,40,,,percent of total billed charges,40% of total billed charges,234.44,40,,,percent of total billed charges,40% of total billed charges,527.49,90,,,percent of total billed charges,90% of total billed charges,445.44,76,,,percent of total billed charges,76% of total billed charges,234.44,40,,,percent of total billed charges,40% of total billed charges,498.19,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,468.88,80,,,percent of total billed charges,80% of total billed charges,227.41,38.8,,,percent of total billed charges,38.8% of total billed charges,498.19,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,556.8,
CT Abdomen w/ + w/o Cont,41174170,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Abdomen w/ Cont,41174160,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1653.2,1322.56,TC,1239.9,75,,,percent of total billed charges,75% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1570.54,95,,,percent of total billed charges,95% of total billed charges,1322.56,80,,,percent of total billed charges,80% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,1487.88,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,661.28,40,,,percent of total billed charges,40% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,1487.88,90,,,percent of total billed charges,90% of total billed charges,1256.43,76,,,percent of total billed charges,76% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1322.56,80,,,percent of total billed charges,80% of total billed charges,641.44,38.8,,,percent of total billed charges,38.8% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1570.54,
CT Abdomen w/o Cont,41174150,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1378.9,1103.12,TC,1034.18,75,,,percent of total billed charges,75% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1309.96,95,,,percent of total billed charges,95% of total billed charges,1103.12,80,,,percent of total billed charges,80% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,551.56,40,,,percent of total billed charges,40% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,1047.96,76,,,percent of total billed charges,76% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1103.12,80,,,percent of total billed charges,80% of total billed charges,535.01,38.8,,,percent of total billed charges,38.8% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1309.96,
CT Head or Brain w/ + w/o Cont,41170470,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Head or Brain w/ Cont,41170460,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1855.5,1484.4,TC,1391.63,75,,,percent of total billed charges,75% of total billed charges,742.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1577.18,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1762.73,95,,,percent of total billed charges,95% of total billed charges,1484.4,80,,,percent of total billed charges,80% of total billed charges,1577.18,85,,,percent of total billed charges,85% of total billed charges,1669.95,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,742.2,40,,,percent of total billed charges,40% of total billed charges,742.2,40,,,percent of total billed charges,40% of total billed charges,1669.95,90,,,percent of total billed charges,90% of total billed charges,1410.18,76,,,percent of total billed charges,76% of total billed charges,742.2,40,,,percent of total billed charges,40% of total billed charges,1577.18,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1484.4,80,,,percent of total billed charges,80% of total billed charges,719.93,38.8,,,percent of total billed charges,38.8% of total billed charges,1577.18,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1762.73,
CT Head or Brain w/o Cont,41170450,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT LE w/ Cont Lt,60001065,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT LE w/ Cont Rt,60001066,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Orbit Sella etc. w/ Cont,41170481,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Orbit Sella etc. w/o Cont,41170480,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Pelvis w/ + w/o Cont,41172194,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,2232.4,1785.92,TC,1674.3,75,,,percent of total billed charges,75% of total billed charges,892.96,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1897.54,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,2120.78,95,,,percent of total billed charges,95% of total billed charges,1785.92,80,,,percent of total billed charges,80% of total billed charges,1897.54,85,,,percent of total billed charges,85% of total billed charges,2009.16,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,892.96,40,,,percent of total billed charges,40% of total billed charges,892.96,40,,,percent of total billed charges,40% of total billed charges,2009.16,90,,,percent of total billed charges,90% of total billed charges,1696.62,76,,,percent of total billed charges,76% of total billed charges,892.96,40,,,percent of total billed charges,40% of total billed charges,1897.54,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1785.92,80,,,percent of total billed charges,80% of total billed charges,866.17,38.8,,,percent of total billed charges,38.8% of total billed charges,1897.54,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,2120.78,
CT Pelvis w/ Cont,41172193,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1653.2,1322.56,TC,1239.9,75,,,percent of total billed charges,75% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1570.54,95,,,percent of total billed charges,95% of total billed charges,1322.56,80,,,percent of total billed charges,80% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,1487.88,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,661.28,40,,,percent of total billed charges,40% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,1487.88,90,,,percent of total billed charges,90% of total billed charges,1256.43,76,,,percent of total billed charges,76% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1322.56,80,,,percent of total billed charges,80% of total billed charges,641.44,38.8,,,percent of total billed charges,38.8% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1570.54,
CT Pelvis w/o Cont,41172192,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1378.9,1103.12,TC,1034.18,75,,,percent of total billed charges,75% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1309.96,95,,,percent of total billed charges,95% of total billed charges,1103.12,80,,,percent of total billed charges,80% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,551.56,40,,,percent of total billed charges,40% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,1047.96,76,,,percent of total billed charges,76% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1103.12,80,,,percent of total billed charges,80% of total billed charges,535.01,38.8,,,percent of total billed charges,38.8% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1309.96,
CT Neck Soft Tissue w/ + w/o Cont,41170492,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Neck Soft Tissue w/ Cont,41170491,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Neck Soft Tissue w/o Cont,41170490,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1378.9,1103.12,TC,1034.18,75,,,percent of total billed charges,75% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1309.96,95,,,percent of total billed charges,95% of total billed charges,1103.12,80,,,percent of total billed charges,80% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,551.56,40,,,percent of total billed charges,40% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,1047.96,76,,,percent of total billed charges,76% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1103.12,80,,,percent of total billed charges,80% of total billed charges,535.01,38.8,,,percent of total billed charges,38.8% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1309.96,
CT Spine Cervical w/o Cont,41172125,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1378.9,1103.12,TC,1034.18,75,,,percent of total billed charges,75% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1309.96,95,,,percent of total billed charges,95% of total billed charges,1103.12,80,,,percent of total billed charges,80% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,551.56,40,,,percent of total billed charges,40% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,1047.96,76,,,percent of total billed charges,76% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1103.12,80,,,percent of total billed charges,80% of total billed charges,535.01,38.8,,,percent of total billed charges,38.8% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1309.96,
CT Spine Lumbar w/o Cont,41172131,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1378.9,1103.12,TC,1034.18,75,,,percent of total billed charges,75% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1309.96,95,,,percent of total billed charges,95% of total billed charges,1103.12,80,,,percent of total billed charges,80% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,551.56,40,,,percent of total billed charges,40% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,1047.96,76,,,percent of total billed charges,76% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1103.12,80,,,percent of total billed charges,80% of total billed charges,535.01,38.8,,,percent of total billed charges,38.8% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1309.96,
CT Spine Thoracic w/o Cont,41172128,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1378.9,1103.12,TC,1034.18,75,,,percent of total billed charges,75% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1309.96,95,,,percent of total billed charges,95% of total billed charges,1103.12,80,,,percent of total billed charges,80% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,551.56,40,,,percent of total billed charges,40% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,1047.96,76,,,percent of total billed charges,76% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1103.12,80,,,percent of total billed charges,80% of total billed charges,535.01,38.8,,,percent of total billed charges,38.8% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1309.96,
MRA Head w/ Cont,41370545,CDM,615,RC,70545,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,499.88,200,,,fee schedule,200% of CMS fee schedule,368.43,2723.56,
MRI Brain w/ + w/o Cont,41370553,CDM,611,RC,70553,HCPCS,OUTPATIENT,,,3250.1,2600.08,TC,2437.58,75,,,percent of total billed charges,75% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3087.6,95,,,percent of total billed charges,95% of total billed charges,2600.08,80,,,percent of total billed charges,80% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1300.04,40,,,percent of total billed charges,40% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,2470.08,76,,,percent of total billed charges,76% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2600.08,80,,,percent of total billed charges,80% of total billed charges,1261.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,699.04,200,,,fee schedule,200% of CMS fee schedule,368.43,3087.6,
MRI Brain w/ Cont,41370552,CDM,611,RC,70553,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,699.04,200,,,fee schedule,200% of CMS fee schedule,368.43,2723.56,
MRI Brain w/o Cont,41370551,CDM,611,RC,70553,HCPCS,OUTPATIENT,,,2539.7,2031.76,TC,1904.78,75,,,percent of total billed charges,75% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2412.72,95,,,percent of total billed charges,95% of total billed charges,2031.76,80,,,percent of total billed charges,80% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,2285.73,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1015.88,40,,,percent of total billed charges,40% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,2285.73,90,,,percent of total billed charges,90% of total billed charges,1930.17,76,,,percent of total billed charges,76% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2031.76,80,,,percent of total billed charges,80% of total billed charges,985.4,38.8,,,percent of total billed charges,38.8% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,699.04,200,,,fee schedule,200% of CMS fee schedule,368.43,2412.72,
MRI Chest w/ + w/o Cont,41371552,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Face Neck Orbit w/ + w/o Cont,41370543,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Face Neck Orbit w/ Cont,41370542,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Femur w/o Cont Lt,41373718,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Femur w/o Cont Rt,41373718,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Pelvis w/ Cont,41372196,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Pelvis w/o Cont,41372195,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Spine Cervical w/ Cont,41372142,CDM,612,RC,72142,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,605.22,200,,,fee schedule,200% of CMS fee schedule,368.43,2723.56,
MRI Spine Cervical w/o Cont,41372141,CDM,612,RC,72142,HCPCS,OUTPATIENT,,,2539.7,2031.76,TC,1904.78,75,,,percent of total billed charges,75% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2412.72,95,,,percent of total billed charges,95% of total billed charges,2031.76,80,,,percent of total billed charges,80% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,2285.73,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1015.88,40,,,percent of total billed charges,40% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,2285.73,90,,,percent of total billed charges,90% of total billed charges,1930.17,76,,,percent of total billed charges,76% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2031.76,80,,,percent of total billed charges,80% of total billed charges,985.4,38.8,,,percent of total billed charges,38.8% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,605.22,200,,,fee schedule,200% of CMS fee schedule,368.43,2412.72,
MRI Spine Lumbar w/ Cont,41372149,CDM,612,RC,72142,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,605.22,200,,,fee schedule,200% of CMS fee schedule,368.43,2723.56,
MRI Spine Lumbar w/o Cont,41372148,CDM,612,RC,72142,HCPCS,OUTPATIENT,,,2539.7,2031.76,TC,1904.78,75,,,percent of total billed charges,75% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2412.72,95,,,percent of total billed charges,95% of total billed charges,2031.76,80,,,percent of total billed charges,80% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,2285.73,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1015.88,40,,,percent of total billed charges,40% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,2285.73,90,,,percent of total billed charges,90% of total billed charges,1930.17,76,,,percent of total billed charges,76% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2031.76,80,,,percent of total billed charges,80% of total billed charges,985.4,38.8,,,percent of total billed charges,38.8% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,605.22,200,,,fee schedule,200% of CMS fee schedule,368.43,2412.72,
MRI Spine Thoracic w/ Cont,41372147,CDM,612,RC,72142,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,605.22,200,,,fee schedule,200% of CMS fee schedule,368.43,2723.56,
MRI Spine Thoracic w/o Cont,41372146,CDM,612,RC,72142,HCPCS,OUTPATIENT,,,2539.7,2031.76,TC,1904.78,75,,,percent of total billed charges,75% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2412.72,95,,,percent of total billed charges,95% of total billed charges,2031.76,80,,,percent of total billed charges,80% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,2285.73,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1015.88,40,,,percent of total billed charges,40% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,2285.73,90,,,percent of total billed charges,90% of total billed charges,1930.17,76,,,percent of total billed charges,76% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2031.76,80,,,percent of total billed charges,80% of total billed charges,985.4,38.8,,,percent of total billed charges,38.8% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,605.22,200,,,fee schedule,200% of CMS fee schedule,368.43,2412.72,
NM Bone 3 Phase Study,41578315,CDM,340,RC,78315,HCPCS,OUTPATIENT,,,1245.5,996.4,TC,934.13,75,,,percent of total billed charges,75% of total billed charges,498.2,40,,,percent of total billed charges,40% of total billed charges,986.44,79.2,,,percent of total billed charges,79.2% of total billed charges,1058.68,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rates,1183.23,95,,,percent of total billed charges,95% of total billed charges,996.4,80,,,percent of total billed charges,80% of total billed charges,1058.68,85,,,percent of total billed charges,85% of total billed charges,1120.95,90,,,percent of total billed charges,90% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rates,505.7,100,,,fee schedule,100% of CO APG rates,388.68,100,,,fee schedule,100% of NM APC rate,498.2,40,,,percent of total billed charges,40% of total billed charges,498.2,40,,,percent of total billed charges,40% of total billed charges,1120.95,90,,,percent of total billed charges,90% of total billed charges,946.58,76,,,percent of total billed charges,76% of total billed charges,498.2,40,,,percent of total billed charges,40% of total billed charges,1058.68,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rate,996.4,80,,,percent of total billed charges,80% of total billed charges,483.25,38.8,,,percent of total billed charges,38.8% of total billed charges,1058.68,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of APG fee schedule,682.94,200,,,fee schedule,200% of CMS fee schedule,388.68,1183.23,
NM Hepa Duct System,41578226,CDM,340,RC,78315,HCPCS,OUTPATIENT,,,1233.7,986.96,TC,925.28,75,,,percent of total billed charges,75% of total billed charges,493.48,40,,,percent of total billed charges,40% of total billed charges,977.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1048.65,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rates,1172.02,95,,,percent of total billed charges,95% of total billed charges,986.96,80,,,percent of total billed charges,80% of total billed charges,1048.65,85,,,percent of total billed charges,85% of total billed charges,1110.33,90,,,percent of total billed charges,90% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rates,505.7,100,,,fee schedule,100% of CO APG rates,388.68,100,,,fee schedule,100% of NM APC rate,493.48,40,,,percent of total billed charges,40% of total billed charges,493.48,40,,,percent of total billed charges,40% of total billed charges,1110.33,90,,,percent of total billed charges,90% of total billed charges,937.61,76,,,percent of total billed charges,76% of total billed charges,493.48,40,,,percent of total billed charges,40% of total billed charges,1048.65,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rate,986.96,80,,,percent of total billed charges,80% of total billed charges,478.68,38.8,,,percent of total billed charges,38.8% of total billed charges,1048.65,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of APG fee schedule,682.94,200,,,fee schedule,200% of CMS fee schedule,388.68,1172.02,
US Abdomen Comp,41276700,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,642.9,514.32,TC,482.18,75,,,percent of total billed charges,75% of total billed charges,257.16,40,,,percent of total billed charges,40% of total billed charges,509.18,79.2,,,percent of total billed charges,79.2% of total billed charges,546.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,610.76,95,,,percent of total billed charges,95% of total billed charges,514.32,80,,,percent of total billed charges,80% of total billed charges,546.47,85,,,percent of total billed charges,85% of total billed charges,578.61,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,257.16,40,,,percent of total billed charges,40% of total billed charges,257.16,40,,,percent of total billed charges,40% of total billed charges,578.61,90,,,percent of total billed charges,90% of total billed charges,488.6,76,,,percent of total billed charges,76% of total billed charges,257.16,40,,,percent of total billed charges,40% of total billed charges,546.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,514.32,80,,,percent of total billed charges,80% of total billed charges,249.45,38.8,,,percent of total billed charges,38.8% of total billed charges,546.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,610.76,
US Abdomen Ltd,41276705,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,498.2,398.56,TC,373.65,75,,,percent of total billed charges,75% of total billed charges,199.28,40,,,percent of total billed charges,40% of total billed charges,394.57,79.2,,,percent of total billed charges,79.2% of total billed charges,423.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,473.29,95,,,percent of total billed charges,95% of total billed charges,398.56,80,,,percent of total billed charges,80% of total billed charges,423.47,85,,,percent of total billed charges,85% of total billed charges,448.38,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,199.28,40,,,percent of total billed charges,40% of total billed charges,199.28,40,,,percent of total billed charges,40% of total billed charges,448.38,90,,,percent of total billed charges,90% of total billed charges,378.63,76,,,percent of total billed charges,76% of total billed charges,199.28,40,,,percent of total billed charges,40% of total billed charges,423.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,398.56,80,,,percent of total billed charges,80% of total billed charges,193.3,38.8,,,percent of total billed charges,38.8% of total billed charges,423.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,473.29,
US Chest,41276604,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,405.5,324.4,,304.13,75,,,percent of total billed charges,75% of total billed charges,162.2,40,,,percent of total billed charges,40% of total billed charges,321.16,79.2,,,percent of total billed charges,79.2% of total billed charges,344.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,385.23,95,,,percent of total billed charges,95% of total billed charges,324.4,80,,,percent of total billed charges,80% of total billed charges,344.68,85,,,percent of total billed charges,85% of total billed charges,364.95,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,162.2,40,,,percent of total billed charges,40% of total billed charges,162.2,40,,,percent of total billed charges,40% of total billed charges,364.95,90,,,percent of total billed charges,90% of total billed charges,308.18,76,,,percent of total billed charges,76% of total billed charges,162.2,40,,,percent of total billed charges,40% of total billed charges,344.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,324.4,80,,,percent of total billed charges,80% of total billed charges,157.33,38.8,,,percent of total billed charges,38.8% of total billed charges,344.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,385.23,
US Hernia,41276705,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,498.2,398.56,TC,373.65,75,,,percent of total billed charges,75% of total billed charges,199.28,40,,,percent of total billed charges,40% of total billed charges,394.57,79.2,,,percent of total billed charges,79.2% of total billed charges,423.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,473.29,95,,,percent of total billed charges,95% of total billed charges,398.56,80,,,percent of total billed charges,80% of total billed charges,423.47,85,,,percent of total billed charges,85% of total billed charges,448.38,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,199.28,40,,,percent of total billed charges,40% of total billed charges,199.28,40,,,percent of total billed charges,40% of total billed charges,448.38,90,,,percent of total billed charges,90% of total billed charges,378.63,76,,,percent of total billed charges,76% of total billed charges,199.28,40,,,percent of total billed charges,40% of total billed charges,423.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,398.56,80,,,percent of total billed charges,80% of total billed charges,193.3,38.8,,,percent of total billed charges,38.8% of total billed charges,423.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,473.29,
US Head +Neck Soft Tissue,41276536,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,351,280.8,TC,263.25,75,,,percent of total billed charges,75% of total billed charges,140.4,40,,,percent of total billed charges,40% of total billed charges,277.99,79.2,,,percent of total billed charges,79.2% of total billed charges,298.35,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,333.45,95,,,percent of total billed charges,95% of total billed charges,280.8,80,,,percent of total billed charges,80% of total billed charges,298.35,85,,,percent of total billed charges,85% of total billed charges,315.9,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,140.4,40,,,percent of total billed charges,40% of total billed charges,140.4,40,,,percent of total billed charges,40% of total billed charges,315.9,90,,,percent of total billed charges,90% of total billed charges,266.76,76,,,percent of total billed charges,76% of total billed charges,140.4,40,,,percent of total billed charges,40% of total billed charges,298.35,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,280.8,80,,,percent of total billed charges,80% of total billed charges,136.19,38.8,,,percent of total billed charges,38.8% of total billed charges,298.35,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,333.45,
US LE Art Duplex Bil,41293925,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,875.8,700.64,TC,656.85,75,,,percent of total billed charges,75% of total billed charges,350.32,40,,,percent of total billed charges,40% of total billed charges,693.63,79.2,,,percent of total billed charges,79.2% of total billed charges,744.43,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,832.01,95,,,percent of total billed charges,95% of total billed charges,700.64,80,,,percent of total billed charges,80% of total billed charges,744.43,85,,,percent of total billed charges,85% of total billed charges,788.22,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,350.32,40,,,percent of total billed charges,40% of total billed charges,350.32,40,,,percent of total billed charges,40% of total billed charges,788.22,90,,,percent of total billed charges,90% of total billed charges,665.61,76,,,percent of total billed charges,76% of total billed charges,350.32,40,,,percent of total billed charges,40% of total billed charges,744.43,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,700.64,80,,,percent of total billed charges,80% of total billed charges,339.81,38.8,,,percent of total billed charges,38.8% of total billed charges,744.43,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,832.01,
US LE Art Duplex Lt,41293926,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,560.8,448.64,TC,420.6,75,,,percent of total billed charges,75% of total billed charges,224.32,40,,,percent of total billed charges,40% of total billed charges,444.15,79.2,,,percent of total billed charges,79.2% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,532.76,95,,,percent of total billed charges,95% of total billed charges,448.64,80,,,percent of total billed charges,80% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,504.72,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,224.32,40,,,percent of total billed charges,40% of total billed charges,224.32,40,,,percent of total billed charges,40% of total billed charges,504.72,90,,,percent of total billed charges,90% of total billed charges,426.21,76,,,percent of total billed charges,76% of total billed charges,224.32,40,,,percent of total billed charges,40% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,448.64,80,,,percent of total billed charges,80% of total billed charges,217.59,38.8,,,percent of total billed charges,38.8% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,217.59,532.76,
US LE Art Duplex Rt,41293926,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,560.8,448.64,TC,420.6,75,,,percent of total billed charges,75% of total billed charges,224.32,40,,,percent of total billed charges,40% of total billed charges,444.15,79.2,,,percent of total billed charges,79.2% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,532.76,95,,,percent of total billed charges,95% of total billed charges,448.64,80,,,percent of total billed charges,80% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,504.72,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,224.32,40,,,percent of total billed charges,40% of total billed charges,224.32,40,,,percent of total billed charges,40% of total billed charges,504.72,90,,,percent of total billed charges,90% of total billed charges,426.21,76,,,percent of total billed charges,76% of total billed charges,224.32,40,,,percent of total billed charges,40% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,448.64,80,,,percent of total billed charges,80% of total billed charges,217.59,38.8,,,percent of total billed charges,38.8% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,217.59,532.76,
US LE Veins Duplex Bil,41293970,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,903.8,723.04,TC,677.85,75,,,percent of total billed charges,75% of total billed charges,361.52,40,,,percent of total billed charges,40% of total billed charges,715.81,79.2,,,percent of total billed charges,79.2% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,858.61,95,,,percent of total billed charges,95% of total billed charges,723.04,80,,,percent of total billed charges,80% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,813.42,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,361.52,40,,,percent of total billed charges,40% of total billed charges,361.52,40,,,percent of total billed charges,40% of total billed charges,813.42,90,,,percent of total billed charges,90% of total billed charges,686.89,76,,,percent of total billed charges,76% of total billed charges,361.52,40,,,percent of total billed charges,40% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,723.04,80,,,percent of total billed charges,80% of total billed charges,350.67,38.8,,,percent of total billed charges,38.8% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,858.61,
US LE Veins Duplex Lt,41293971,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,573.5,458.8,TC,430.13,75,,,percent of total billed charges,75% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,454.21,79.2,,,percent of total billed charges,79.2% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,544.83,95,,,percent of total billed charges,95% of total billed charges,458.8,80,,,percent of total billed charges,80% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,229.4,40,,,percent of total billed charges,40% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,435.86,76,,,percent of total billed charges,76% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,458.8,80,,,percent of total billed charges,80% of total billed charges,222.52,38.8,,,percent of total billed charges,38.8% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,544.83,
US LE Veins Duplex Rt,41293971,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,573.5,458.8,TC,430.13,75,,,percent of total billed charges,75% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,454.21,79.2,,,percent of total billed charges,79.2% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,544.83,95,,,percent of total billed charges,95% of total billed charges,458.8,80,,,percent of total billed charges,80% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,229.4,40,,,percent of total billed charges,40% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,435.86,76,,,percent of total billed charges,76% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,458.8,80,,,percent of total billed charges,80% of total billed charges,222.52,38.8,,,percent of total billed charges,38.8% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,544.83,
US Pregnant < 14 Weeks Ea Addl Gest,41276810,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,458.7,366.96,,344.03,75,,,percent of total billed charges,75% of total billed charges,183.48,40,,,percent of total billed charges,40% of total billed charges,363.29,79.2,,,percent of total billed charges,79.2% of total billed charges,389.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,435.77,95,,,percent of total billed charges,95% of total billed charges,366.96,80,,,percent of total billed charges,80% of total billed charges,389.9,85,,,percent of total billed charges,85% of total billed charges,412.83,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,183.48,40,,,percent of total billed charges,40% of total billed charges,183.48,40,,,percent of total billed charges,40% of total billed charges,412.83,90,,,percent of total billed charges,90% of total billed charges,348.61,76,,,percent of total billed charges,76% of total billed charges,183.48,40,,,percent of total billed charges,40% of total billed charges,389.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,366.96,80,,,percent of total billed charges,80% of total billed charges,177.98,38.8,,,percent of total billed charges,38.8% of total billed charges,389.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,435.77,
US Pregnant Transvaginal,41276817,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,338.2,270.56,TC,253.65,75,,,percent of total billed charges,75% of total billed charges,135.28,40,,,percent of total billed charges,40% of total billed charges,267.85,79.2,,,percent of total billed charges,79.2% of total billed charges,287.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,321.29,95,,,percent of total billed charges,95% of total billed charges,270.56,80,,,percent of total billed charges,80% of total billed charges,287.47,85,,,percent of total billed charges,85% of total billed charges,304.38,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,135.28,40,,,percent of total billed charges,40% of total billed charges,135.28,40,,,percent of total billed charges,40% of total billed charges,304.38,90,,,percent of total billed charges,90% of total billed charges,257.03,76,,,percent of total billed charges,76% of total billed charges,135.28,40,,,percent of total billed charges,40% of total billed charges,287.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,270.56,80,,,percent of total billed charges,80% of total billed charges,131.22,38.8,,,percent of total billed charges,38.8% of total billed charges,287.47,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,321.29,
US Unlisted Procedure,41276999,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,382.3,305.84,TC,286.73,75,,,percent of total billed charges,75% of total billed charges,152.92,40,,,percent of total billed charges,40% of total billed charges,302.78,79.2,,,percent of total billed charges,79.2% of total billed charges,324.96,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,363.19,95,,,percent of total billed charges,95% of total billed charges,305.84,80,,,percent of total billed charges,80% of total billed charges,324.96,85,,,percent of total billed charges,85% of total billed charges,344.07,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,152.92,40,,,percent of total billed charges,40% of total billed charges,152.92,40,,,percent of total billed charges,40% of total billed charges,344.07,90,,,percent of total billed charges,90% of total billed charges,290.55,76,,,percent of total billed charges,76% of total billed charges,152.92,40,,,percent of total billed charges,40% of total billed charges,324.96,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,305.84,80,,,percent of total billed charges,80% of total billed charges,148.33,38.8,,,percent of total billed charges,38.8% of total billed charges,324.96,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,363.19,
US Scrotum +Contents,41276870,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,1290.6,1032.48,TC,967.95,75,,,percent of total billed charges,75% of total billed charges,516.24,40,,,percent of total billed charges,40% of total billed charges,1022.16,79.2,,,percent of total billed charges,79.2% of total billed charges,1097.01,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,1226.07,95,,,percent of total billed charges,95% of total billed charges,1032.48,80,,,percent of total billed charges,80% of total billed charges,1097.01,85,,,percent of total billed charges,85% of total billed charges,1161.54,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,516.24,40,,,percent of total billed charges,40% of total billed charges,516.24,40,,,percent of total billed charges,40% of total billed charges,1161.54,90,,,percent of total billed charges,90% of total billed charges,980.86,76,,,percent of total billed charges,76% of total billed charges,516.24,40,,,percent of total billed charges,40% of total billed charges,1097.01,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,1032.48,80,,,percent of total billed charges,80% of total billed charges,500.75,38.8,,,percent of total billed charges,38.8% of total billed charges,1097.01,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,1226.07,
US Transvaginal,41276830,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,581.6,465.28,TC,436.2,75,,,percent of total billed charges,75% of total billed charges,232.64,40,,,percent of total billed charges,40% of total billed charges,460.63,79.2,,,percent of total billed charges,79.2% of total billed charges,494.36,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,552.52,95,,,percent of total billed charges,95% of total billed charges,465.28,80,,,percent of total billed charges,80% of total billed charges,494.36,85,,,percent of total billed charges,85% of total billed charges,523.44,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,232.64,40,,,percent of total billed charges,40% of total billed charges,232.64,40,,,percent of total billed charges,40% of total billed charges,523.44,90,,,percent of total billed charges,90% of total billed charges,442.02,76,,,percent of total billed charges,76% of total billed charges,232.64,40,,,percent of total billed charges,40% of total billed charges,494.36,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,465.28,80,,,percent of total billed charges,80% of total billed charges,225.66,38.8,,,percent of total billed charges,38.8% of total billed charges,494.36,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,552.52,
US UE Art Duplex Bil,41293930,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,850.4,680.32,TC,637.8,75,,,percent of total billed charges,75% of total billed charges,340.16,40,,,percent of total billed charges,40% of total billed charges,673.52,79.2,,,percent of total billed charges,79.2% of total billed charges,722.84,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,807.88,95,,,percent of total billed charges,95% of total billed charges,680.32,80,,,percent of total billed charges,80% of total billed charges,722.84,85,,,percent of total billed charges,85% of total billed charges,765.36,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,340.16,40,,,percent of total billed charges,40% of total billed charges,340.16,40,,,percent of total billed charges,40% of total billed charges,765.36,90,,,percent of total billed charges,90% of total billed charges,646.3,76,,,percent of total billed charges,76% of total billed charges,340.16,40,,,percent of total billed charges,40% of total billed charges,722.84,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,680.32,80,,,percent of total billed charges,80% of total billed charges,329.96,38.8,,,percent of total billed charges,38.8% of total billed charges,722.84,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,807.88,
US UE Art Duplex Lt,41293931,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,538.7,430.96,TC,404.03,75,,,percent of total billed charges,75% of total billed charges,215.48,40,,,percent of total billed charges,40% of total billed charges,426.65,79.2,,,percent of total billed charges,79.2% of total billed charges,457.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,511.77,95,,,percent of total billed charges,95% of total billed charges,430.96,80,,,percent of total billed charges,80% of total billed charges,457.9,85,,,percent of total billed charges,85% of total billed charges,484.83,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,215.48,40,,,percent of total billed charges,40% of total billed charges,215.48,40,,,percent of total billed charges,40% of total billed charges,484.83,90,,,percent of total billed charges,90% of total billed charges,409.41,76,,,percent of total billed charges,76% of total billed charges,215.48,40,,,percent of total billed charges,40% of total billed charges,457.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,430.96,80,,,percent of total billed charges,80% of total billed charges,209.02,38.8,,,percent of total billed charges,38.8% of total billed charges,457.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,209.02,511.77,
US UE Art Duplex Rt,41293931,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,538.7,430.96,TC,404.03,75,,,percent of total billed charges,75% of total billed charges,215.48,40,,,percent of total billed charges,40% of total billed charges,426.65,79.2,,,percent of total billed charges,79.2% of total billed charges,457.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,511.77,95,,,percent of total billed charges,95% of total billed charges,430.96,80,,,percent of total billed charges,80% of total billed charges,457.9,85,,,percent of total billed charges,85% of total billed charges,484.83,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,215.48,40,,,percent of total billed charges,40% of total billed charges,215.48,40,,,percent of total billed charges,40% of total billed charges,484.83,90,,,percent of total billed charges,90% of total billed charges,409.41,76,,,percent of total billed charges,76% of total billed charges,215.48,40,,,percent of total billed charges,40% of total billed charges,457.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,430.96,80,,,percent of total billed charges,80% of total billed charges,209.02,38.8,,,percent of total billed charges,38.8% of total billed charges,457.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,209.02,511.77,
US UE Veins Duplex Bil,41293970,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,903.8,723.04,TC,677.85,75,,,percent of total billed charges,75% of total billed charges,361.52,40,,,percent of total billed charges,40% of total billed charges,715.81,79.2,,,percent of total billed charges,79.2% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,858.61,95,,,percent of total billed charges,95% of total billed charges,723.04,80,,,percent of total billed charges,80% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,813.42,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,361.52,40,,,percent of total billed charges,40% of total billed charges,361.52,40,,,percent of total billed charges,40% of total billed charges,813.42,90,,,percent of total billed charges,90% of total billed charges,686.89,76,,,percent of total billed charges,76% of total billed charges,361.52,40,,,percent of total billed charges,40% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,723.04,80,,,percent of total billed charges,80% of total billed charges,350.67,38.8,,,percent of total billed charges,38.8% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,858.61,
US UE Veins Duplex Lt,41293971,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,573.5,458.8,TC,430.13,75,,,percent of total billed charges,75% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,454.21,79.2,,,percent of total billed charges,79.2% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,544.83,95,,,percent of total billed charges,95% of total billed charges,458.8,80,,,percent of total billed charges,80% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,229.4,40,,,percent of total billed charges,40% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,435.86,76,,,percent of total billed charges,76% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,458.8,80,,,percent of total billed charges,80% of total billed charges,222.52,38.8,,,percent of total billed charges,38.8% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,544.83,
US UE Veins Duplex Rt,41293971,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,573.5,458.8,TC,430.13,75,,,percent of total billed charges,75% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,454.21,79.2,,,percent of total billed charges,79.2% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,544.83,95,,,percent of total billed charges,95% of total billed charges,458.8,80,,,percent of total billed charges,80% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,229.4,40,,,percent of total billed charges,40% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,435.86,76,,,percent of total billed charges,76% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,458.8,80,,,percent of total billed charges,80% of total billed charges,222.52,38.8,,,percent of total billed charges,38.8% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,544.83,
"RADIOLOGIC EXAMINATION, ABDOMEN, 1 VIEW",41074018,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
"RADIOLOGIC EXAMINATION, ABDOMEN, 2 VIEW",41074019,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,373.5,298.8,,280.13,75,,,percent of total billed charges,75% of total billed charges,149.4,40,,,percent of total billed charges,40% of total billed charges,295.81,79.2,,,percent of total billed charges,79.2% of total billed charges,317.48,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,354.83,95,,,percent of total billed charges,95% of total billed charges,298.8,80,,,percent of total billed charges,80% of total billed charges,317.48,85,,,percent of total billed charges,85% of total billed charges,336.15,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,149.4,40,,,percent of total billed charges,40% of total billed charges,149.4,40,,,percent of total billed charges,40% of total billed charges,336.15,90,,,percent of total billed charges,90% of total billed charges,283.86,76,,,percent of total billed charges,76% of total billed charges,149.4,40,,,percent of total billed charges,40% of total billed charges,317.48,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,298.8,80,,,percent of total billed charges,80% of total billed charges,144.92,38.8,,,percent of total billed charges,38.8% of total billed charges,317.48,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,354.83,
XR Ankle Comp Min 3 Views Lt,41073610,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Ankle Comp Min 3 Views Rt,41073610,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Heel Min 2 Views Lt,41073650,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Heel Min 2 Views Rt,41073650,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
"RADIOLOGIC EXAMINATION, CHEST, SINGLE VIEW",41071045,CDM,324,RC,71045,HCPCS,OUTPATIENT,,,270.1,216.08,,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,75.44,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,75.44,100,,,fee schedule,100% of CO APG rates,75.44,100,,,fee schedule,100% of CO APG rates,86.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,75.44,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,75.44,100,,,fee schedule,100% of APG fee schedule,54.6,200,,,fee schedule,200% of CMS fee schedule,54.6,256.6,
"RADIOLOGIC EXAM, CHES, 2 VIEWS",71071046,CDM,324,RC,71045,HCPCS,OUTPATIENT,,,303.8,243.04,TC,227.85,75,,,percent of total billed charges,75% of total billed charges,121.52,40,,,percent of total billed charges,40% of total billed charges,240.61,79.2,,,percent of total billed charges,79.2% of total billed charges,258.23,85,,,percent of total billed charges,85% of total billed charges,75.44,100,,,fee schedule,100% of CO APG rates,288.61,95,,,percent of total billed charges,95% of total billed charges,243.04,80,,,percent of total billed charges,80% of total billed charges,258.23,85,,,percent of total billed charges,85% of total billed charges,273.42,90,,,percent of total billed charges,90% of total billed charges,75.44,100,,,fee schedule,100% of CO APG rates,75.44,100,,,fee schedule,100% of CO APG rates,86.88,100,,,fee schedule,100% of NM APC rate,121.52,40,,,percent of total billed charges,40% of total billed charges,121.52,40,,,percent of total billed charges,40% of total billed charges,273.42,90,,,percent of total billed charges,90% of total billed charges,230.89,76,,,percent of total billed charges,76% of total billed charges,121.52,40,,,percent of total billed charges,40% of total billed charges,258.23,85,,,percent of total billed charges,85% of total billed charges,75.44,100,,,fee schedule,100% of CO APG rate,243.04,80,,,percent of total billed charges,80% of total billed charges,117.87,38.8,,,percent of total billed charges,38.8% of total billed charges,258.23,85,,,percent of total billed charges,85% of total billed charges,75.44,100,,,fee schedule,100% of APG fee schedule,54.6,200,,,fee schedule,200% of CMS fee schedule,54.6,288.61,
XR Clavicle Comp Lt,41073000,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Clavicle Comp Rt,41073000,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Elbow 2 Views Lt,41073070,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Elbow 2 Views Rt,41073070,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Facial Bones < 3 Views,41070140,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Facial Bones Comp Min 3 Views,41070150,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,347.6,278.08,TC,260.7,75,,,percent of total billed charges,75% of total billed charges,139.04,40,,,percent of total billed charges,40% of total billed charges,275.3,79.2,,,percent of total billed charges,79.2% of total billed charges,295.46,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,330.22,95,,,percent of total billed charges,95% of total billed charges,278.08,80,,,percent of total billed charges,80% of total billed charges,295.46,85,,,percent of total billed charges,85% of total billed charges,312.84,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,139.04,40,,,percent of total billed charges,40% of total billed charges,139.04,40,,,percent of total billed charges,40% of total billed charges,312.84,90,,,percent of total billed charges,90% of total billed charges,264.18,76,,,percent of total billed charges,76% of total billed charges,139.04,40,,,percent of total billed charges,40% of total billed charges,295.46,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,278.08,80,,,percent of total billed charges,80% of total billed charges,134.87,38.8,,,percent of total billed charges,38.8% of total billed charges,295.46,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,330.22,
"FLUOROSCOPY, Up to 1 Hour",41076000,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,171,136.8,,128.25,75,,,percent of total billed charges,75% of total billed charges,68.4,40,,,percent of total billed charges,40% of total billed charges,135.43,79.2,,,percent of total billed charges,79.2% of total billed charges,145.35,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,162.45,95,,,percent of total billed charges,95% of total billed charges,136.8,80,,,percent of total billed charges,80% of total billed charges,145.35,85,,,percent of total billed charges,85% of total billed charges,153.9,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,68.4,40,,,percent of total billed charges,40% of total billed charges,68.4,40,,,percent of total billed charges,40% of total billed charges,153.9,90,,,percent of total billed charges,90% of total billed charges,129.96,76,,,percent of total billed charges,76% of total billed charges,68.4,40,,,percent of total billed charges,40% of total billed charges,145.35,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,136.8,80,,,percent of total billed charges,80% of total billed charges,66.35,38.8,,,percent of total billed charges,38.8% of total billed charges,145.35,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,66.35,162.45,
XR Foot 2 Views Lt,41073620,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Foot 2 Views Rt,41073620,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Foot Comp Min 3 Views Lt,41073630,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Foot Comp Min 3 Views Rt,41073630,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Forearm 2 Views Lt,41073090,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Forearm 2 Views Rt,41073090,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Hand 2 Views Lt,41073120,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Hand 2 Views Rt,41073120,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Hand Min 3 Views Lt,41073130,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Hand Min 3 Views Rt,41073130,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Hip 1 View Lt,41073501,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Hip 1 View Rt,41073501,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Hip Comp Min 2 Views Lt,41073502,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Hip Comp Min 2 Views Rt,41073502,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Humerus Min 2 Views Lt,41073060,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Humerus Min 2 Views Rt,41073060,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,259.9,207.92,TC,194.93,75,,,percent of total billed charges,75% of total billed charges,103.96,40,,,percent of total billed charges,40% of total billed charges,205.84,79.2,,,percent of total billed charges,79.2% of total billed charges,220.92,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,246.91,95,,,percent of total billed charges,95% of total billed charges,207.92,80,,,percent of total billed charges,80% of total billed charges,220.92,85,,,percent of total billed charges,85% of total billed charges,233.91,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,103.96,40,,,percent of total billed charges,40% of total billed charges,103.96,40,,,percent of total billed charges,40% of total billed charges,233.91,90,,,percent of total billed charges,90% of total billed charges,197.52,76,,,percent of total billed charges,76% of total billed charges,103.96,40,,,percent of total billed charges,40% of total billed charges,220.92,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,207.92,80,,,percent of total billed charges,80% of total billed charges,100.84,38.8,,,percent of total billed charges,38.8% of total billed charges,220.92,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,246.91,
XR Knee 3 Views Lt,41073562,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,209.3,167.44,TC,156.98,75,,,percent of total billed charges,75% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,165.77,79.2,,,percent of total billed charges,79.2% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,198.84,95,,,percent of total billed charges,95% of total billed charges,167.44,80,,,percent of total billed charges,80% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,83.72,40,,,percent of total billed charges,40% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,159.07,76,,,percent of total billed charges,76% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,167.44,80,,,percent of total billed charges,80% of total billed charges,81.21,38.8,,,percent of total billed charges,38.8% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,198.84,
XR Knee 3 Views Rt,41073562,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,209.3,167.44,TC,156.98,75,,,percent of total billed charges,75% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,165.77,79.2,,,percent of total billed charges,79.2% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,198.84,95,,,percent of total billed charges,95% of total billed charges,167.44,80,,,percent of total billed charges,80% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,83.72,40,,,percent of total billed charges,40% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,159.07,76,,,percent of total billed charges,76% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,167.44,80,,,percent of total billed charges,80% of total billed charges,81.21,38.8,,,percent of total billed charges,38.8% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,198.84,
XR Knee 1 or 2 Views Lt,41073560,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,209.3,167.44,TC,156.98,75,,,percent of total billed charges,75% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,165.77,79.2,,,percent of total billed charges,79.2% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,198.84,95,,,percent of total billed charges,95% of total billed charges,167.44,80,,,percent of total billed charges,80% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,83.72,40,,,percent of total billed charges,40% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,159.07,76,,,percent of total billed charges,76% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,167.44,80,,,percent of total billed charges,80% of total billed charges,81.21,38.8,,,percent of total billed charges,38.8% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,198.84,
XR Knee 1 or 2 Views Rt,41073560,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,209.3,167.44,TC,156.98,75,,,percent of total billed charges,75% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,165.77,79.2,,,percent of total billed charges,79.2% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,198.84,95,,,percent of total billed charges,95% of total billed charges,167.44,80,,,percent of total billed charges,80% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,83.72,40,,,percent of total billed charges,40% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,159.07,76,,,percent of total billed charges,76% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,167.44,80,,,percent of total billed charges,80% of total billed charges,81.21,38.8,,,percent of total billed charges,38.8% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,198.84,
XR Mandible Comp Min 4 Views,41070110,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Nasal Bones Comp Min 3 Views,41070160,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Neck Soft Tissue,41070360,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR ORBITS COMPL MIN 4V,41070200,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,401.7,321.36,TC,301.28,75,,,percent of total billed charges,75% of total billed charges,160.68,40,,,percent of total billed charges,40% of total billed charges,318.15,79.2,,,percent of total billed charges,79.2% of total billed charges,341.45,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,381.62,95,,,percent of total billed charges,95% of total billed charges,321.36,80,,,percent of total billed charges,80% of total billed charges,341.45,85,,,percent of total billed charges,85% of total billed charges,361.53,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,160.68,40,,,percent of total billed charges,40% of total billed charges,160.68,40,,,percent of total billed charges,40% of total billed charges,361.53,90,,,percent of total billed charges,90% of total billed charges,305.29,76,,,percent of total billed charges,76% of total billed charges,160.68,40,,,percent of total billed charges,40% of total billed charges,341.45,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,321.36,80,,,percent of total billed charges,80% of total billed charges,155.86,38.8,,,percent of total billed charges,38.8% of total billed charges,341.45,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,381.62,
XR Ribs 2 Views Lt,41071100,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Ribs 2 Views Rt,41071100,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Ribs 3 Views Bil,41071110,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Sacrum +Coccyx Min 2 Views,41072220,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Scapula Comp Lt,41073010,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Scapula Comp Rt,41073010,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Shoulder 1 View Lt,41073020,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Shoulder 1 View Rt,41073020,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Sinuses Paranasal Comp Min 3 Views,41070220,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Skull < 4 Views,41070250,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Spine Cerv 2 or 3 Views,41072040,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,293.7,234.96,TC,220.28,75,,,percent of total billed charges,75% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,232.61,79.2,,,percent of total billed charges,79.2% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,279.02,95,,,percent of total billed charges,95% of total billed charges,234.96,80,,,percent of total billed charges,80% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,117.48,40,,,percent of total billed charges,40% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,223.21,76,,,percent of total billed charges,76% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,234.96,80,,,percent of total billed charges,80% of total billed charges,113.96,38.8,,,percent of total billed charges,38.8% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,279.02,
XR Spine Lumbosacral 2 or 3 Views,41072100,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,293.7,234.96,TC,220.28,75,,,percent of total billed charges,75% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,232.61,79.2,,,percent of total billed charges,79.2% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,279.02,95,,,percent of total billed charges,95% of total billed charges,234.96,80,,,percent of total billed charges,80% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,117.48,40,,,percent of total billed charges,40% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,223.21,76,,,percent of total billed charges,76% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,234.96,80,,,percent of total billed charges,80% of total billed charges,113.96,38.8,,,percent of total billed charges,38.8% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,279.02,
XR Spine Thoracic 2 Views,41072070,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Spine Thoracic 3 Views,41072072,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,293.7,234.96,TC,220.28,75,,,percent of total billed charges,75% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,232.61,79.2,,,percent of total billed charges,79.2% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,279.02,95,,,percent of total billed charges,95% of total billed charges,234.96,80,,,percent of total billed charges,80% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,117.48,40,,,percent of total billed charges,40% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,223.21,76,,,percent of total billed charges,76% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,234.96,80,,,percent of total billed charges,80% of total billed charges,113.96,38.8,,,percent of total billed charges,38.8% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,279.02,
XR Sternoclavicular Joint(s) Min 3 Views,41071130,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,293.7,234.96,TC,220.28,75,,,percent of total billed charges,75% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,232.61,79.2,,,percent of total billed charges,79.2% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,279.02,95,,,percent of total billed charges,95% of total billed charges,234.96,80,,,percent of total billed charges,80% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,117.48,40,,,percent of total billed charges,40% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,223.21,76,,,percent of total billed charges,76% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,234.96,80,,,percent of total billed charges,80% of total billed charges,113.96,38.8,,,percent of total billed charges,38.8% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,279.02,
XR Sternum Min 2 Views,41071120,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Wrist Comp Min 3 Views Rt,41073110,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Wrist Comp Min 3 Views Lt,41073110,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Wrist 2 Views Rt,41073100,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Wrist 2 Views Lt,41073100,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
NM Parathyroid,41578070,CDM,340,RC,78315,HCPCS,OUTPATIENT,,,1051,840.8,,788.25,75,,,percent of total billed charges,75% of total billed charges,420.4,40,,,percent of total billed charges,40% of total billed charges,832.39,79.2,,,percent of total billed charges,79.2% of total billed charges,893.35,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rates,998.45,95,,,percent of total billed charges,95% of total billed charges,840.8,80,,,percent of total billed charges,80% of total billed charges,893.35,85,,,percent of total billed charges,85% of total billed charges,945.9,90,,,percent of total billed charges,90% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rates,505.7,100,,,fee schedule,100% of CO APG rates,388.68,100,,,fee schedule,100% of NM APC rate,420.4,40,,,percent of total billed charges,40% of total billed charges,420.4,40,,,percent of total billed charges,40% of total billed charges,945.9,90,,,percent of total billed charges,90% of total billed charges,798.76,76,,,percent of total billed charges,76% of total billed charges,420.4,40,,,percent of total billed charges,40% of total billed charges,893.35,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rate,840.8,80,,,percent of total billed charges,80% of total billed charges,407.79,38.8,,,percent of total billed charges,38.8% of total billed charges,893.35,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of APG fee schedule,682.94,200,,,fee schedule,200% of CMS fee schedule,388.68,998.45,
NT Pro-BNP,40083880,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,250.7,200.56,,188.03,75,,,percent of total billed charges,75% of total billed charges,100.28,40,,,percent of total billed charges,40% of total billed charges,198.55,79.2,,,percent of total billed charges,79.2% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,238.17,95,,,percent of total billed charges,95% of total billed charges,200.56,80,,,percent of total billed charges,80% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,225.63,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,100.28,40,,,percent of total billed charges,40% of total billed charges,100.28,40,,,percent of total billed charges,40% of total billed charges,225.63,90,,,percent of total billed charges,90% of total billed charges,190.53,76,,,percent of total billed charges,76% of total billed charges,100.28,40,,,percent of total billed charges,40% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,200.56,80,,,percent of total billed charges,80% of total billed charges,97.27,38.8,,,percent of total billed charges,38.8% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,238.17,
RBC Count,40085041,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,35.2,28.16,,26.4,75,,,percent of total billed charges,75% of total billed charges,14.08,40,,,percent of total billed charges,40% of total billed charges,27.88,79.2,,,percent of total billed charges,79.2% of total billed charges,29.92,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,33.44,95,,,percent of total billed charges,95% of total billed charges,28.16,80,,,percent of total billed charges,80% of total billed charges,29.92,85,,,percent of total billed charges,85% of total billed charges,31.68,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,14.08,40,,,percent of total billed charges,40% of total billed charges,14.08,40,,,percent of total billed charges,40% of total billed charges,31.68,90,,,percent of total billed charges,90% of total billed charges,26.75,76,,,percent of total billed charges,76% of total billed charges,14.08,40,,,percent of total billed charges,40% of total billed charges,29.92,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,28.16,80,,,percent of total billed charges,80% of total billed charges,13.66,38.8,,,percent of total billed charges,38.8% of total billed charges,29.92,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,33.44,
C Diff Toxin A/B,40087493,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,264.2,211.36,,198.15,75,,,percent of total billed charges,75% of total billed charges,105.68,40,,,percent of total billed charges,40% of total billed charges,209.25,79.2,,,percent of total billed charges,79.2% of total billed charges,224.57,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,250.99,95,,,percent of total billed charges,95% of total billed charges,211.36,80,,,percent of total billed charges,80% of total billed charges,224.57,85,,,percent of total billed charges,85% of total billed charges,237.78,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,105.68,40,,,percent of total billed charges,40% of total billed charges,105.68,40,,,percent of total billed charges,40% of total billed charges,237.78,90,,,percent of total billed charges,90% of total billed charges,200.79,76,,,percent of total billed charges,76% of total billed charges,105.68,40,,,percent of total billed charges,40% of total billed charges,224.57,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,211.36,80,,,percent of total billed charges,80% of total billed charges,102.51,38.8,,,percent of total billed charges,38.8% of total billed charges,224.57,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,250.99,
History Check,40586901,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,43.7,34.96,,32.78,75,,,percent of total billed charges,75% of total billed charges,17.48,40,,,percent of total billed charges,40% of total billed charges,34.61,79.2,,,percent of total billed charges,79.2% of total billed charges,37.15,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,41.52,95,,,percent of total billed charges,95% of total billed charges,34.96,80,,,percent of total billed charges,80% of total billed charges,37.15,85,,,percent of total billed charges,85% of total billed charges,39.33,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,17.48,40,,,percent of total billed charges,40% of total billed charges,17.48,40,,,percent of total billed charges,40% of total billed charges,39.33,90,,,percent of total billed charges,90% of total billed charges,33.21,76,,,percent of total billed charges,76% of total billed charges,17.48,40,,,percent of total billed charges,40% of total billed charges,37.15,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,34.96,80,,,percent of total billed charges,80% of total billed charges,16.96,38.8,,,percent of total billed charges,38.8% of total billed charges,37.15,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,41.52,
RBC CP2D AS3 500 LR,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
FFP Thawed CP2D,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
RBC CP2D AS3 500 LR Irr,4050106,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,1397.2,1117.76,,1047.9,75,,,percent of total billed charges,75% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1106.58,79.2,,,percent of total billed charges,79.2% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,1327.34,95,,,percent of total billed charges,95% of total billed charges,1117.76,80,,,percent of total billed charges,80% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,1257.48,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,558.88,40,,,percent of total billed charges,40% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1257.48,90,,,percent of total billed charges,90% of total billed charges,1061.87,76,,,percent of total billed charges,76% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,1117.76,80,,,percent of total billed charges,80% of total billed charges,542.11,38.8,,,percent of total billed charges,38.8% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,1327.34,
RBC CPD AS1 500 LR,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph Plt ACDA LR,4050108,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,1527.7,1222.16,,1145.78,75,,,percent of total billed charges,75% of total billed charges,611.08,40,,,percent of total billed charges,40% of total billed charges,1209.94,79.2,,,percent of total billed charges,79.2% of total billed charges,1298.55,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,1451.32,95,,,percent of total billed charges,95% of total billed charges,1222.16,80,,,percent of total billed charges,80% of total billed charges,1298.55,85,,,percent of total billed charges,85% of total billed charges,1374.93,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,611.08,40,,,percent of total billed charges,40% of total billed charges,611.08,40,,,percent of total billed charges,40% of total billed charges,1374.93,90,,,percent of total billed charges,90% of total billed charges,1161.05,76,,,percent of total billed charges,76% of total billed charges,611.08,40,,,percent of total billed charges,40% of total billed charges,1298.55,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,1222.16,80,,,percent of total billed charges,80% of total billed charges,592.75,38.8,,,percent of total billed charges,38.8% of total billed charges,1298.55,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,1451.32,
Aph Plt ACDA LR 2,4050108,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,1527.7,1222.16,,1145.78,75,,,percent of total billed charges,75% of total billed charges,611.08,40,,,percent of total billed charges,40% of total billed charges,1209.94,79.2,,,percent of total billed charges,79.2% of total billed charges,1298.55,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,1451.32,95,,,percent of total billed charges,95% of total billed charges,1222.16,80,,,percent of total billed charges,80% of total billed charges,1298.55,85,,,percent of total billed charges,85% of total billed charges,1374.93,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,611.08,40,,,percent of total billed charges,40% of total billed charges,611.08,40,,,percent of total billed charges,40% of total billed charges,1374.93,90,,,percent of total billed charges,90% of total billed charges,1161.05,76,,,percent of total billed charges,76% of total billed charges,611.08,40,,,percent of total billed charges,40% of total billed charges,1298.55,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,1222.16,80,,,percent of total billed charges,80% of total billed charges,592.75,38.8,,,percent of total billed charges,38.8% of total billed charges,1298.55,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,1451.32,
Aph Plt ACDA LR Irr 1,4050107,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,1850.2,1480.16,,1387.65,75,,,percent of total billed charges,75% of total billed charges,740.08,40,,,percent of total billed charges,40% of total billed charges,1465.36,79.2,,,percent of total billed charges,79.2% of total billed charges,1572.67,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,1757.69,95,,,percent of total billed charges,95% of total billed charges,1480.16,80,,,percent of total billed charges,80% of total billed charges,1572.67,85,,,percent of total billed charges,85% of total billed charges,1665.18,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,740.08,40,,,percent of total billed charges,40% of total billed charges,740.08,40,,,percent of total billed charges,40% of total billed charges,1665.18,90,,,percent of total billed charges,90% of total billed charges,1406.15,76,,,percent of total billed charges,76% of total billed charges,740.08,40,,,percent of total billed charges,40% of total billed charges,1572.67,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,1480.16,80,,,percent of total billed charges,80% of total billed charges,717.88,38.8,,,percent of total billed charges,38.8% of total billed charges,1572.67,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,1757.69,
"Analgesics, non-opioid; 1 or 2",40080329,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,141.1,112.88,,105.83,75,,,percent of total billed charges,75% of total billed charges,56.44,40,,,percent of total billed charges,40% of total billed charges,111.75,79.2,,,percent of total billed charges,79.2% of total billed charges,119.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,134.05,95,,,percent of total billed charges,95% of total billed charges,112.88,80,,,percent of total billed charges,80% of total billed charges,119.94,85,,,percent of total billed charges,85% of total billed charges,126.99,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,56.44,40,,,percent of total billed charges,40% of total billed charges,56.44,40,,,percent of total billed charges,40% of total billed charges,126.99,90,,,percent of total billed charges,90% of total billed charges,107.24,76,,,percent of total billed charges,76% of total billed charges,56.44,40,,,percent of total billed charges,40% of total billed charges,119.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,112.88,80,,,percent of total billed charges,80% of total billed charges,54.75,38.8,,,percent of total billed charges,38.8% of total billed charges,119.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,134.05,
Free T4,40084439,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
Gentamycin Level Peak,40080170,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,131.8,105.44,,98.85,75,,,percent of total billed charges,75% of total billed charges,52.72,40,,,percent of total billed charges,40% of total billed charges,104.39,79.2,,,percent of total billed charges,79.2% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,125.21,95,,,percent of total billed charges,95% of total billed charges,105.44,80,,,percent of total billed charges,80% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,118.62,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,52.72,40,,,percent of total billed charges,40% of total billed charges,52.72,40,,,percent of total billed charges,40% of total billed charges,118.62,90,,,percent of total billed charges,90% of total billed charges,100.17,76,,,percent of total billed charges,76% of total billed charges,52.72,40,,,percent of total billed charges,40% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,105.44,80,,,percent of total billed charges,80% of total billed charges,51.14,38.8,,,percent of total billed charges,38.8% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,125.21,
Gentamycin Level Trough,40080170,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,131.8,105.44,,98.85,75,,,percent of total billed charges,75% of total billed charges,52.72,40,,,percent of total billed charges,40% of total billed charges,104.39,79.2,,,percent of total billed charges,79.2% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,125.21,95,,,percent of total billed charges,95% of total billed charges,105.44,80,,,percent of total billed charges,80% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,118.62,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,52.72,40,,,percent of total billed charges,40% of total billed charges,52.72,40,,,percent of total billed charges,40% of total billed charges,118.62,90,,,percent of total billed charges,90% of total billed charges,100.17,76,,,percent of total billed charges,76% of total billed charges,52.72,40,,,percent of total billed charges,40% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,105.44,80,,,percent of total billed charges,80% of total billed charges,51.14,38.8,,,percent of total billed charges,38.8% of total billed charges,112.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,125.21,
Phenytoin Level,40080185,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,126.5,101.2,,94.88,75,,,percent of total billed charges,75% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,100.19,79.2,,,percent of total billed charges,79.2% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,120.18,95,,,percent of total billed charges,95% of total billed charges,101.2,80,,,percent of total billed charges,80% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,113.85,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,50.6,40,,,percent of total billed charges,40% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,113.85,90,,,percent of total billed charges,90% of total billed charges,96.14,76,,,percent of total billed charges,76% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,101.2,80,,,percent of total billed charges,80% of total billed charges,49.08,38.8,,,percent of total billed charges,38.8% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,120.18,
ROOM/BED: Private,30000001,CDM,120,RC,,,INPATIENT,,,1386,1108.8,,1039.5,75,,,percent of total billed charges,75% of total billed charges,4772,100,,,per diem,pays based on per day rate,1386,79.2,,,percent of total billed charges,79.2% of total billed charges,1178.1,85,,,percent of total billed charges,85% of total billed charges,1386,100,,,fee schedule,100% of CO APG rates,1316.7,95,,,percent of total billed charges,95% of total billed charges,1108.8,80,,,percent of total billed charges,80% of total billed charges,1178.1,85,,,percent of total billed charges,85% of total billed charges,1247.4,90,,,percent of total billed charges,90% of total billed charges,1386,100,,,fee schedule,100% of CO APG rates,1386,100,,,fee schedule,100% of CO APG rates,1386,100,,,fee schedule,100% of NM fee schedule,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,1247.4,90,,,percent of total billed charges,90% of total billed charges,1053.36,76,,,percent of total billed charges,76% of total billed charges,4772,100,,,per diem,pays based on per day rate,1178.1,85,,,percent of total billed charges,85% of total billed charges,1386,100,,,fee schedule,100% of CO APG rate,1108.8,80,,,percent of total billed charges,80% of total billed charges,4628.84,100,,,per diem,pays based on per day rate,1386,85,,,percent of total billed charges,85% of total billed charges,1386,100,,,fee schedule,100% of APG fee schedule,4772,100,,,per diem,pays based on per day rate,1039.5,4772,
ROOM/BED: Swing,30000002,CDM,120,RC,,,INPATIENT,,,1264,1011.2,,948,75,,,percent of total billed charges,75% of total billed charges,4772,100,,,per diem,pays based on per day rate,1264,79.2,,,percent of total billed charges,79.2% of total billed charges,1074.4,85,,,percent of total billed charges,85% of total billed charges,1264,100,,,fee schedule,100% of CO APG rates,1200.8,95,,,percent of total billed charges,95% of total billed charges,1011.2,80,,,percent of total billed charges,80% of total billed charges,1074.4,85,,,percent of total billed charges,85% of total billed charges,1137.6,90,,,percent of total billed charges,90% of total billed charges,1264,100,,,fee schedule,100% of CO APG rates,1264,100,,,fee schedule,100% of CO APG rates,1264,100,,,fee schedule,100% of NM fee schedule,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,1137.6,90,,,percent of total billed charges,90% of total billed charges,960.64,76,,,percent of total billed charges,76% of total billed charges,4772,100,,,per diem,pays based on per day rate,1074.4,85,,,percent of total billed charges,85% of total billed charges,1264,100,,,fee schedule,100% of CO APG rate,1011.2,80,,,percent of total billed charges,80% of total billed charges,4628.84,100,,,per diem,pays based on per day rate,1264,85,,,percent of total billed charges,85% of total billed charges,1264,100,,,fee schedule,100% of APG fee schedule,4772,100,,,per diem,pays based on per day rate,948,4772,
25605 Closed Treatment Of Distal Radial Fracture w/ manipula,60000045,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4679,3743.2,,3509.25,75,,,percent of total billed charges,75% of total billed charges,1871.6,40,,,percent of total billed charges,40% of total billed charges,3705.77,79.2,,,percent of total billed charges,79.2% of total billed charges,3977.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4445.05,95,,,percent of total billed charges,95% of total billed charges,3743.2,80,,,percent of total billed charges,80% of total billed charges,3977.15,85,,,percent of total billed charges,85% of total billed charges,4211.1,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1871.6,40,,,percent of total billed charges,40% of total billed charges,1871.6,40,,,percent of total billed charges,40% of total billed charges,4211.1,90,,,percent of total billed charges,90% of total billed charges,3556.04,76,,,percent of total billed charges,76% of total billed charges,1871.6,40,,,percent of total billed charges,40% of total billed charges,3977.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3743.2,80,,,percent of total billed charges,80% of total billed charges,1815.45,38.8,,,percent of total billed charges,38.8% of total billed charges,3977.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4445.05,
"Closed tx of phalangeal shaft fx, proximal or midlle phalanx, finger or thumb: w",60000052,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,751.4,601.12,,563.55,75,,,percent of total billed charges,75% of total billed charges,300.56,40,,,percent of total billed charges,40% of total billed charges,595.11,79.2,,,percent of total billed charges,79.2% of total billed charges,638.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,713.83,95,,,percent of total billed charges,95% of total billed charges,601.12,80,,,percent of total billed charges,80% of total billed charges,638.69,85,,,percent of total billed charges,85% of total billed charges,676.26,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,300.56,40,,,percent of total billed charges,40% of total billed charges,300.56,40,,,percent of total billed charges,40% of total billed charges,676.26,90,,,percent of total billed charges,90% of total billed charges,571.06,76,,,percent of total billed charges,76% of total billed charges,300.56,40,,,percent of total billed charges,40% of total billed charges,638.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,601.12,80,,,percent of total billed charges,80% of total billed charges,291.54,38.8,,,percent of total billed charges,38.8% of total billed charges,638.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,713.83,
Colonoscopy,46000102,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1906,1524.8,,1429.5,75,,,percent of total billed charges,75% of total billed charges,762.4,40,,,percent of total billed charges,40% of total billed charges,1509.55,79.2,,,percent of total billed charges,79.2% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1810.7,95,,,percent of total billed charges,95% of total billed charges,1524.8,80,,,percent of total billed charges,80% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,1715.4,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,762.4,40,,,percent of total billed charges,40% of total billed charges,762.4,40,,,percent of total billed charges,40% of total billed charges,1715.4,90,,,percent of total billed charges,90% of total billed charges,1448.56,76,,,percent of total billed charges,76% of total billed charges,762.4,40,,,percent of total billed charges,40% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1524.8,80,,,percent of total billed charges,80% of total billed charges,739.53,38.8,,,percent of total billed charges,38.8% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1810.7,
Epidural Steroid Injection,60000387,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,2888,2310.4,,2166,75,,,percent of total billed charges,75% of total billed charges,1155.2,40,,,percent of total billed charges,40% of total billed charges,2287.3,79.2,,,percent of total billed charges,79.2% of total billed charges,2454.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2743.6,95,,,percent of total billed charges,95% of total billed charges,2310.4,80,,,percent of total billed charges,80% of total billed charges,2454.8,85,,,percent of total billed charges,85% of total billed charges,2599.2,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,1155.2,40,,,percent of total billed charges,40% of total billed charges,1155.2,40,,,percent of total billed charges,40% of total billed charges,2599.2,90,,,percent of total billed charges,90% of total billed charges,2194.88,76,,,percent of total billed charges,76% of total billed charges,1155.2,40,,,percent of total billed charges,40% of total billed charges,2454.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,2310.4,80,,,percent of total billed charges,80% of total billed charges,1120.54,38.8,,,percent of total billed charges,38.8% of total billed charges,2454.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,2743.6,
Esophagogastroduodenoscopy,4600100,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,2478,1982.4,,1858.5,75,,,percent of total billed charges,75% of total billed charges,991.2,40,,,percent of total billed charges,40% of total billed charges,1962.58,79.2,,,percent of total billed charges,79.2% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2354.1,95,,,percent of total billed charges,95% of total billed charges,1982.4,80,,,percent of total billed charges,80% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,2230.2,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,991.2,40,,,percent of total billed charges,40% of total billed charges,991.2,40,,,percent of total billed charges,40% of total billed charges,2230.2,90,,,percent of total billed charges,90% of total billed charges,1883.28,76,,,percent of total billed charges,76% of total billed charges,991.2,40,,,percent of total billed charges,40% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1982.4,80,,,percent of total billed charges,80% of total billed charges,961.46,38.8,,,percent of total billed charges,38.8% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,2354.1,
Fecal Leukocytes,40089055,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,65.8,52.64,,49.35,75,,,percent of total billed charges,75% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,52.11,79.2,,,percent of total billed charges,79.2% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,62.51,95,,,percent of total billed charges,95% of total billed charges,52.64,80,,,percent of total billed charges,80% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,26.32,40,,,percent of total billed charges,40% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,50.01,76,,,percent of total billed charges,76% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,52.64,80,,,percent of total billed charges,80% of total billed charges,25.53,38.8,,,percent of total billed charges,38.8% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,62.51,
Sodium Level Urine,40084300,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,70,56,,52.5,75,,,percent of total billed charges,75% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,55.44,79.2,,,percent of total billed charges,79.2% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,66.5,95,,,percent of total billed charges,95% of total billed charges,56,80,,,percent of total billed charges,80% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,63,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,28,40,,,percent of total billed charges,40% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,63,90,,,percent of total billed charges,90% of total billed charges,53.2,76,,,percent of total billed charges,76% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,56,80,,,percent of total billed charges,80% of total billed charges,27.16,38.8,,,percent of total billed charges,38.8% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,66.5,
Potassium Level Urine,40084133,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
ECHO 2D COMPLETE W/ CONTRAST,428C8929,CDM,483,RC,,,OUTPATIENT,,,2217.3,1773.84,TC,1662.98,75,,,percent of total billed charges,75% of total billed charges,886.92,40,,,percent of total billed charges,40% of total billed charges,1756.1,79.2,,,percent of total billed charges,79.2% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,2217.3,100,,,fee schedule,100% of CO APG rates,2106.44,95,,,percent of total billed charges,95% of total billed charges,1773.84,80,,,percent of total billed charges,80% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,1995.57,90,,,percent of total billed charges,90% of total billed charges,2217.3,100,,,fee schedule,100% of CO APG rates,2217.3,100,,,fee schedule,100% of CO APG rates,2217.3,100,,,fee schedule,100% of NM fee schedule,886.92,40,,,percent of total billed charges,40% of total billed charges,886.92,40,,,percent of total billed charges,40% of total billed charges,1995.57,90,,,percent of total billed charges,90% of total billed charges,1685.15,76,,,percent of total billed charges,76% of total billed charges,886.92,40,,,percent of total billed charges,40% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,2217.3,100,,,fee schedule,100% of CO APG rate,1773.84,80,,,percent of total billed charges,80% of total billed charges,860.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,2217.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,860.31,2217.3,
Cataract Extraction with Intraocular Lens Implantation,46000500,CDM,360,RC,43215,HCPCS,OUTPATIENT,,,2860,2288,,2145,75,,,percent of total billed charges,75% of total billed charges,1144,40,,,percent of total billed charges,40% of total billed charges,2265.12,79.2,,,percent of total billed charges,79.2% of total billed charges,2431,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rates,2717,95,,,percent of total billed charges,95% of total billed charges,2288,80,,,percent of total billed charges,80% of total billed charges,2431,85,,,percent of total billed charges,85% of total billed charges,2574,90,,,percent of total billed charges,90% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rates,1260.54,100,,,fee schedule,100% of CO APG rates,1741.59,100,,,fee schedule,100% of NM APC rate,1144,40,,,percent of total billed charges,40% of total billed charges,1144,40,,,percent of total billed charges,40% of total billed charges,2574,90,,,percent of total billed charges,90% of total billed charges,2173.6,76,,,percent of total billed charges,76% of total billed charges,1144,40,,,percent of total billed charges,40% of total billed charges,2431,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rate,2288,80,,,percent of total billed charges,80% of total billed charges,1109.68,38.8,,,percent of total billed charges,38.8% of total billed charges,2431,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of APG fee schedule,281.54,200,,,fee schedule,200% of CMS fee schedule,281.54,2717,
Ab ID Interp,40586870,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,288.5,230.8,,216.38,75,,,percent of total billed charges,75% of total billed charges,115.4,40,,,percent of total billed charges,40% of total billed charges,228.49,79.2,,,percent of total billed charges,79.2% of total billed charges,245.23,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,274.08,95,,,percent of total billed charges,95% of total billed charges,230.8,80,,,percent of total billed charges,80% of total billed charges,245.23,85,,,percent of total billed charges,85% of total billed charges,259.65,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,115.4,40,,,percent of total billed charges,40% of total billed charges,115.4,40,,,percent of total billed charges,40% of total billed charges,259.65,90,,,percent of total billed charges,90% of total billed charges,219.26,76,,,percent of total billed charges,76% of total billed charges,115.4,40,,,percent of total billed charges,40% of total billed charges,245.23,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,230.8,80,,,percent of total billed charges,80% of total billed charges,111.94,38.8,,,percent of total billed charges,38.8% of total billed charges,245.23,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,274.08,
BD DEXA Vert Fracture,41577086,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,217.1,173.68,,162.83,75,,,percent of total billed charges,75% of total billed charges,86.84,40,,,percent of total billed charges,40% of total billed charges,171.94,79.2,,,percent of total billed charges,79.2% of total billed charges,184.54,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,206.25,95,,,percent of total billed charges,95% of total billed charges,173.68,80,,,percent of total billed charges,80% of total billed charges,184.54,85,,,percent of total billed charges,85% of total billed charges,195.39,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,86.84,40,,,percent of total billed charges,40% of total billed charges,86.84,40,,,percent of total billed charges,40% of total billed charges,195.39,90,,,percent of total billed charges,90% of total billed charges,165,76,,,percent of total billed charges,76% of total billed charges,86.84,40,,,percent of total billed charges,40% of total billed charges,184.54,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,173.68,80,,,percent of total billed charges,80% of total billed charges,84.23,38.8,,,percent of total billed charges,38.8% of total billed charges,184.54,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,206.25,
CT Abdomen +Pelvis w/ + w/o Cont,41174178,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,2168,1734.4,,1626,75,,,percent of total billed charges,75% of total billed charges,867.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1842.8,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,2059.6,95,,,percent of total billed charges,95% of total billed charges,1734.4,80,,,percent of total billed charges,80% of total billed charges,1842.8,85,,,percent of total billed charges,85% of total billed charges,1951.2,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,867.2,40,,,percent of total billed charges,40% of total billed charges,867.2,40,,,percent of total billed charges,40% of total billed charges,1951.2,90,,,percent of total billed charges,90% of total billed charges,1647.68,76,,,percent of total billed charges,76% of total billed charges,867.2,40,,,percent of total billed charges,40% of total billed charges,1842.8,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1734.4,80,,,percent of total billed charges,80% of total billed charges,841.18,38.8,,,percent of total billed charges,38.8% of total billed charges,1842.8,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,2059.6,
CT Abdomen +Pelvis w/ Cont,41174177,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1653.2,1322.56,TC,1239.9,75,,,percent of total billed charges,75% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1570.54,95,,,percent of total billed charges,95% of total billed charges,1322.56,80,,,percent of total billed charges,80% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,1487.88,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,661.28,40,,,percent of total billed charges,40% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,1487.88,90,,,percent of total billed charges,90% of total billed charges,1256.43,76,,,percent of total billed charges,76% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1322.56,80,,,percent of total billed charges,80% of total billed charges,641.44,38.8,,,percent of total billed charges,38.8% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1570.54,
CT Abdomen +Pelvis w/o Cont,41174176,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1356.1,1084.88,,1017.08,75,,,percent of total billed charges,75% of total billed charges,542.44,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1152.69,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1288.3,95,,,percent of total billed charges,95% of total billed charges,1084.88,80,,,percent of total billed charges,80% of total billed charges,1152.69,85,,,percent of total billed charges,85% of total billed charges,1220.49,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,542.44,40,,,percent of total billed charges,40% of total billed charges,542.44,40,,,percent of total billed charges,40% of total billed charges,1220.49,90,,,percent of total billed charges,90% of total billed charges,1030.64,76,,,percent of total billed charges,76% of total billed charges,542.44,40,,,percent of total billed charges,40% of total billed charges,1152.69,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1084.88,80,,,percent of total billed charges,80% of total billed charges,526.17,38.8,,,percent of total billed charges,38.8% of total billed charges,1152.69,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1288.3,
CT Angio Neck w/ Cont,41070498,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,787.8,630.24,TC,590.85,75,,,percent of total billed charges,75% of total billed charges,315.12,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,669.63,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,748.41,95,,,percent of total billed charges,95% of total billed charges,630.24,80,,,percent of total billed charges,80% of total billed charges,669.63,85,,,percent of total billed charges,85% of total billed charges,709.02,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,315.12,40,,,percent of total billed charges,40% of total billed charges,315.12,40,,,percent of total billed charges,40% of total billed charges,709.02,90,,,percent of total billed charges,90% of total billed charges,598.73,76,,,percent of total billed charges,76% of total billed charges,315.12,40,,,percent of total billed charges,40% of total billed charges,669.63,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,630.24,80,,,percent of total billed charges,80% of total billed charges,305.67,38.8,,,percent of total billed charges,38.8% of total billed charges,669.63,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,748.41,
CT Abdomen +Pelvis w/ + w/o Cont,41100065,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1642.3,1313.84,TC,1231.73,75,,,percent of total billed charges,75% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1560.19,95,,,percent of total billed charges,95% of total billed charges,1313.84,80,,,percent of total billed charges,80% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,656.92,40,,,percent of total billed charges,40% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,1248.15,76,,,percent of total billed charges,76% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1313.84,80,,,percent of total billed charges,80% of total billed charges,637.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1560.19,
CT Abdomen +Pelvis w/ Cont,41100064,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1642.3,1313.84,TC,1231.73,75,,,percent of total billed charges,75% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1560.19,95,,,percent of total billed charges,95% of total billed charges,1313.84,80,,,percent of total billed charges,80% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,656.92,40,,,percent of total billed charges,40% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,1248.15,76,,,percent of total billed charges,76% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1313.84,80,,,percent of total billed charges,80% of total billed charges,637.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1560.19,
CT Abdomen +Pelvis w/o Cont,41100066,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,901.5,721.2,TC,676.13,75,,,percent of total billed charges,75% of total billed charges,360.6,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,766.28,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,856.43,95,,,percent of total billed charges,95% of total billed charges,721.2,80,,,percent of total billed charges,80% of total billed charges,766.28,85,,,percent of total billed charges,85% of total billed charges,811.35,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,360.6,40,,,percent of total billed charges,40% of total billed charges,360.6,40,,,percent of total billed charges,40% of total billed charges,811.35,90,,,percent of total billed charges,90% of total billed charges,685.14,76,,,percent of total billed charges,76% of total billed charges,360.6,40,,,percent of total billed charges,40% of total billed charges,766.28,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,721.2,80,,,percent of total billed charges,80% of total billed charges,349.78,38.8,,,percent of total billed charges,38.8% of total billed charges,766.28,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,856.43,
CT Chest w/o Cont,41171250,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1721,1376.8,TC,1290.75,75,,,percent of total billed charges,75% of total billed charges,688.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1462.85,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1634.95,95,,,percent of total billed charges,95% of total billed charges,1376.8,80,,,percent of total billed charges,80% of total billed charges,1462.85,85,,,percent of total billed charges,85% of total billed charges,1548.9,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,688.4,40,,,percent of total billed charges,40% of total billed charges,688.4,40,,,percent of total billed charges,40% of total billed charges,1548.9,90,,,percent of total billed charges,90% of total billed charges,1307.96,76,,,percent of total billed charges,76% of total billed charges,688.4,40,,,percent of total billed charges,40% of total billed charges,1462.85,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1376.8,80,,,percent of total billed charges,80% of total billed charges,667.75,38.8,,,percent of total billed charges,38.8% of total billed charges,1462.85,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1634.95,
CT Chest w/ + w/o Cont,41171270,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,2305.7,1844.56,TC,1729.28,75,,,percent of total billed charges,75% of total billed charges,922.28,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1959.85,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,2190.42,95,,,percent of total billed charges,95% of total billed charges,1844.56,80,,,percent of total billed charges,80% of total billed charges,1959.85,85,,,percent of total billed charges,85% of total billed charges,2075.13,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,922.28,40,,,percent of total billed charges,40% of total billed charges,922.28,40,,,percent of total billed charges,40% of total billed charges,2075.13,90,,,percent of total billed charges,90% of total billed charges,1752.33,76,,,percent of total billed charges,76% of total billed charges,922.28,40,,,percent of total billed charges,40% of total billed charges,1959.85,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1844.56,80,,,percent of total billed charges,80% of total billed charges,894.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1959.85,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,2190.42,
CT Chest +Abdomen w/ + w/o Cont,41100067,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,4236.5,3389.2,,3177.38,75,,,percent of total billed charges,75% of total billed charges,1694.6,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,3601.03,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,4024.68,95,,,percent of total billed charges,95% of total billed charges,3389.2,80,,,percent of total billed charges,80% of total billed charges,3601.03,85,,,percent of total billed charges,85% of total billed charges,3812.85,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,1694.6,40,,,percent of total billed charges,40% of total billed charges,1694.6,40,,,percent of total billed charges,40% of total billed charges,3812.85,90,,,percent of total billed charges,90% of total billed charges,3219.74,76,,,percent of total billed charges,76% of total billed charges,1694.6,40,,,percent of total billed charges,40% of total billed charges,3601.03,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,3389.2,80,,,percent of total billed charges,80% of total billed charges,1643.76,38.8,,,percent of total billed charges,38.8% of total billed charges,3601.03,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,4024.68,
CT Abdomen w/o Cont,41100069,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,3098.9,2479.12,TC,2324.18,75,,,percent of total billed charges,75% of total billed charges,1239.56,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,2634.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,2943.96,95,,,percent of total billed charges,95% of total billed charges,2479.12,80,,,percent of total billed charges,80% of total billed charges,2634.07,85,,,percent of total billed charges,85% of total billed charges,2789.01,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,1239.56,40,,,percent of total billed charges,40% of total billed charges,1239.56,40,,,percent of total billed charges,40% of total billed charges,2789.01,90,,,percent of total billed charges,90% of total billed charges,2355.16,76,,,percent of total billed charges,76% of total billed charges,1239.56,40,,,percent of total billed charges,40% of total billed charges,2634.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,2479.12,80,,,percent of total billed charges,80% of total billed charges,1202.37,38.8,,,percent of total billed charges,38.8% of total billed charges,2634.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,2943.96,
CT LE w/ Cont Bil,60001064,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,3009.3,2407.44,TC,2256.98,75,,,percent of total billed charges,75% of total billed charges,1203.72,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,2557.91,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,2858.84,95,,,percent of total billed charges,95% of total billed charges,2407.44,80,,,percent of total billed charges,80% of total billed charges,2557.91,85,,,percent of total billed charges,85% of total billed charges,2708.37,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,1203.72,40,,,percent of total billed charges,40% of total billed charges,1203.72,40,,,percent of total billed charges,40% of total billed charges,2708.37,90,,,percent of total billed charges,90% of total billed charges,2287.07,76,,,percent of total billed charges,76% of total billed charges,1203.72,40,,,percent of total billed charges,40% of total billed charges,2557.91,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,2407.44,80,,,percent of total billed charges,80% of total billed charges,1167.61,38.8,,,percent of total billed charges,38.8% of total billed charges,2557.91,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,2858.84,
CT Angio Chest PE w/ Cont,41171275,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,2834.5,2267.6,TC,2125.88,75,,,percent of total billed charges,75% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,2692.78,95,,,percent of total billed charges,95% of total billed charges,2267.6,80,,,percent of total billed charges,80% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,2551.05,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,1133.8,40,,,percent of total billed charges,40% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,2551.05,90,,,percent of total billed charges,90% of total billed charges,2154.22,76,,,percent of total billed charges,76% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,2267.6,80,,,percent of total billed charges,80% of total billed charges,1099.79,38.8,,,percent of total billed charges,38.8% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,2692.78,
CT Sinus or Facial w/ Cont,41170487,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Spine Cervical w/ + w/o Cont,41172127,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Spine Cervical w/ Cont,41172126,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1653.2,1322.56,TC,1239.9,75,,,percent of total billed charges,75% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1570.54,95,,,percent of total billed charges,95% of total billed charges,1322.56,80,,,percent of total billed charges,80% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,1487.88,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,661.28,40,,,percent of total billed charges,40% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,1487.88,90,,,percent of total billed charges,90% of total billed charges,1256.43,76,,,percent of total billed charges,76% of total billed charges,661.28,40,,,percent of total billed charges,40% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1322.56,80,,,percent of total billed charges,80% of total billed charges,641.44,38.8,,,percent of total billed charges,38.8% of total billed charges,1405.22,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1570.54,
CT Spine Lumbar w/ + w/o Cont,41172133,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Spine Lumbar w/ Cont,41172132,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Spine Thoracic w/ Cont,41172129,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,2006.2,1604.96,TC,1504.65,75,,,percent of total billed charges,75% of total billed charges,802.48,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1705.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1905.89,95,,,percent of total billed charges,95% of total billed charges,1604.96,80,,,percent of total billed charges,80% of total billed charges,1705.27,85,,,percent of total billed charges,85% of total billed charges,1805.58,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,802.48,40,,,percent of total billed charges,40% of total billed charges,802.48,40,,,percent of total billed charges,40% of total billed charges,1805.58,90,,,percent of total billed charges,90% of total billed charges,1524.71,76,,,percent of total billed charges,76% of total billed charges,802.48,40,,,percent of total billed charges,40% of total billed charges,1705.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1604.96,80,,,percent of total billed charges,80% of total billed charges,778.41,38.8,,,percent of total billed charges,38.8% of total billed charges,1705.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1905.89,
77054 MA Ductogram or Galactogram Mult Rt,41577054,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,92.7,74.16,TC,69.53,75,,,percent of total billed charges,75% of total billed charges,37.08,40,,,percent of total billed charges,40% of total billed charges,73.42,79.2,,,percent of total billed charges,79.2% of total billed charges,78.8,85,,,percent of total billed charges,85% of total billed charges,92.7,100,,,fee schedule,100% of CO APG rates,88.07,95,,,percent of total billed charges,95% of total billed charges,74.16,80,,,percent of total billed charges,80% of total billed charges,78.8,85,,,percent of total billed charges,85% of total billed charges,83.43,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,92.7,100,,,fee schedule,100% of NM APC rate,37.08,40,,,percent of total billed charges,40% of total billed charges,37.08,40,,,percent of total billed charges,40% of total billed charges,83.43,90,,,percent of total billed charges,90% of total billed charges,70.45,76,,,percent of total billed charges,76% of total billed charges,37.08,40,,,percent of total billed charges,40% of total billed charges,78.8,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,74.16,80,,,percent of total billed charges,80% of total billed charges,35.97,38.8,,,percent of total billed charges,38.8% of total billed charges,78.8,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,35.97,159.09,
MRA Chest w/ + w/o Cont,41371555,CDM,618,RC,71555,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,2866.9,100,,,fee schedule,100% of NM fee schedule,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,735.02,200,,,fee schedule,200% of CMS fee schedule,657.92,2866.9,
MRA Head w/ + w/o Cont,41370546,CDM,615,RC,70545,HCPCS,OUTPATIENT,,,3250.1,2600.08,TC,2437.58,75,,,percent of total billed charges,75% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2762.59,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,3087.6,95,,,percent of total billed charges,95% of total billed charges,2600.08,80,,,percent of total billed charges,80% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1300.04,40,,,percent of total billed charges,40% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,2470.08,76,,,percent of total billed charges,76% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2600.08,80,,,percent of total billed charges,80% of total billed charges,1261.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,499.88,200,,,fee schedule,200% of CMS fee schedule,368.43,3087.6,
MRA Head w/o Cont,41370544,CDM,615,RC,70545,HCPCS,OUTPATIENT,,,2539.7,2031.76,TC,1904.78,75,,,percent of total billed charges,75% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2158.75,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,2412.72,95,,,percent of total billed charges,95% of total billed charges,2031.76,80,,,percent of total billed charges,80% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,2285.73,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1015.88,40,,,percent of total billed charges,40% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,2285.73,90,,,percent of total billed charges,90% of total billed charges,1930.17,76,,,percent of total billed charges,76% of total billed charges,1015.88,40,,,percent of total billed charges,40% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2031.76,80,,,percent of total billed charges,80% of total billed charges,985.4,38.8,,,percent of total billed charges,38.8% of total billed charges,2158.75,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,499.88,200,,,fee schedule,200% of CMS fee schedule,368.43,2412.72,
MRA LE w/ + w/o Cont Lt,41373725,CDM,616,RC,73725,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,2866.9,100,,,fee schedule,100% of NM fee schedule,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,738.54,200,,,fee schedule,200% of CMS fee schedule,657.92,2866.9,
MRA LE w/ + w/o Cont Rt,41373725,CDM,616,RC,73725,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,2866.9,100,,,fee schedule,100% of NM fee schedule,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,738.54,200,,,fee schedule,200% of CMS fee schedule,657.92,2866.9,
MRA Neck w/ + w/o Cont,41370549,CDM,615,RC,70545,HCPCS,OUTPATIENT,,,3250.1,2600.08,TC,2437.58,75,,,percent of total billed charges,75% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2762.59,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,3087.6,95,,,percent of total billed charges,95% of total billed charges,2600.08,80,,,percent of total billed charges,80% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1300.04,40,,,percent of total billed charges,40% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,2470.08,76,,,percent of total billed charges,76% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2600.08,80,,,percent of total billed charges,80% of total billed charges,1261.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,499.88,200,,,fee schedule,200% of CMS fee schedule,368.43,3087.6,
MRA Neck w/ Cont,41370548,CDM,615,RC,70545,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,499.88,200,,,fee schedule,200% of CMS fee schedule,368.43,2723.56,
MRA Pelvis w/ + w/o Cont,41372198,CDM,618,RC,71555,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,2866.9,100,,,fee schedule,100% of NM fee schedule,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,735.02,200,,,fee schedule,200% of CMS fee schedule,657.92,2866.9,
MRI Abdomen w/ + w/o Cont,41374183,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Abdomen w/ Cont,41374182,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2723.56,
MRI Abdomen w/o Cont,41374181,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Bone Marrow Blood Supply,60000734,CDM,614,RC,77084,HCPCS,OUTPATIENT,,,823.7,658.96,,617.78,75,,,percent of total billed charges,75% of total billed charges,329.48,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,700.15,85,,,percent of total billed charges,85% of total billed charges,335.59,100,,,fee schedule,100% of CO APG rates,782.52,95,,,percent of total billed charges,95% of total billed charges,658.96,80,,,percent of total billed charges,80% of total billed charges,700.15,85,,,percent of total billed charges,85% of total billed charges,741.33,90,,,percent of total billed charges,90% of total billed charges,335.59,100,,,fee schedule,100% of CO APG rates,335.59,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,329.48,40,,,percent of total billed charges,40% of total billed charges,329.48,40,,,percent of total billed charges,40% of total billed charges,741.33,90,,,percent of total billed charges,90% of total billed charges,626.01,76,,,percent of total billed charges,76% of total billed charges,329.48,40,,,percent of total billed charges,40% of total billed charges,700.15,85,,,percent of total billed charges,85% of total billed charges,335.59,100,,,fee schedule,100% of CO APG rate,658.96,80,,,percent of total billed charges,80% of total billed charges,319.6,38.8,,,percent of total billed charges,38.8% of total billed charges,700.15,85,,,percent of total billed charges,85% of total billed charges,335.59,100,,,fee schedule,100% of APG fee schedule,322.81,200,,,fee schedule,200% of CMS fee schedule,233.52,782.52,
MRI Breast w/ + w/o Cont Bil,60000778,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2955,2364,,2216.25,75,,,percent of total billed charges,75% of total billed charges,1182,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2511.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2807.25,95,,,percent of total billed charges,95% of total billed charges,2364,80,,,percent of total billed charges,80% of total billed charges,2511.75,85,,,percent of total billed charges,85% of total billed charges,2659.5,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1182,40,,,percent of total billed charges,40% of total billed charges,1182,40,,,percent of total billed charges,40% of total billed charges,2659.5,90,,,percent of total billed charges,90% of total billed charges,2245.8,76,,,percent of total billed charges,76% of total billed charges,1182,40,,,percent of total billed charges,40% of total billed charges,2511.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2364,80,,,percent of total billed charges,80% of total billed charges,1146.54,38.8,,,percent of total billed charges,38.8% of total billed charges,2511.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2807.25,
MRI Breast w/ + w/o Cont Lt,60000777,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2955,2364,,2216.25,75,,,percent of total billed charges,75% of total billed charges,1182,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2511.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2807.25,95,,,percent of total billed charges,95% of total billed charges,2364,80,,,percent of total billed charges,80% of total billed charges,2511.75,85,,,percent of total billed charges,85% of total billed charges,2659.5,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1182,40,,,percent of total billed charges,40% of total billed charges,1182,40,,,percent of total billed charges,40% of total billed charges,2659.5,90,,,percent of total billed charges,90% of total billed charges,2245.8,76,,,percent of total billed charges,76% of total billed charges,1182,40,,,percent of total billed charges,40% of total billed charges,2511.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2364,80,,,percent of total billed charges,80% of total billed charges,1146.54,38.8,,,percent of total billed charges,38.8% of total billed charges,2511.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2807.25,
MRI Breast w/ + w/o Cont Rt,60000777,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2955,2364,,2216.25,75,,,percent of total billed charges,75% of total billed charges,1182,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2511.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2807.25,95,,,percent of total billed charges,95% of total billed charges,2364,80,,,percent of total billed charges,80% of total billed charges,2511.75,85,,,percent of total billed charges,85% of total billed charges,2659.5,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1182,40,,,percent of total billed charges,40% of total billed charges,1182,40,,,percent of total billed charges,40% of total billed charges,2659.5,90,,,percent of total billed charges,90% of total billed charges,2245.8,76,,,percent of total billed charges,76% of total billed charges,1182,40,,,percent of total billed charges,40% of total billed charges,2511.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2364,80,,,percent of total billed charges,80% of total billed charges,1146.54,38.8,,,percent of total billed charges,38.8% of total billed charges,2511.75,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2807.25,
MRI Chest w/ Cont,41371551,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Chest w/o Cont,41371550,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Face Neck Orbit w/o Cont,41370540,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Foot w/ + w/o Cont Lt,41373720,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Foot w/ + w/o Cont Rt,41373720,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Foot w/ Cont Lt,41373719,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Foot w/ Cont Rt,41373719,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Foot w/o Cont Lt,41373718,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Foot w/o Cont Rt,41373718,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Pelvis w/ + w/o Cont,41372197,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Spine Cervical w/ + w/o Cont,41372156,CDM,612,RC,72142,HCPCS,OUTPATIENT,,,3250.1,2600.08,TC,2437.58,75,,,percent of total billed charges,75% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3087.6,95,,,percent of total billed charges,95% of total billed charges,2600.08,80,,,percent of total billed charges,80% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1300.04,40,,,percent of total billed charges,40% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,2470.08,76,,,percent of total billed charges,76% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2600.08,80,,,percent of total billed charges,80% of total billed charges,1261.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,605.22,200,,,fee schedule,200% of CMS fee schedule,368.43,3087.6,
MRI Spine Lumbar w/ + w/o Cont,41372158,CDM,612,RC,72142,HCPCS,OUTPATIENT,,,3250.1,2600.08,TC,2437.58,75,,,percent of total billed charges,75% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3087.6,95,,,percent of total billed charges,95% of total billed charges,2600.08,80,,,percent of total billed charges,80% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1300.04,40,,,percent of total billed charges,40% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,2470.08,76,,,percent of total billed charges,76% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2600.08,80,,,percent of total billed charges,80% of total billed charges,1261.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,605.22,200,,,fee schedule,200% of CMS fee schedule,368.43,3087.6,
MRI Spine Thoracic w/ + w/o Cont,41372157,CDM,612,RC,72142,HCPCS,OUTPATIENT,,,3250.1,2600.08,TC,2437.58,75,,,percent of total billed charges,75% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3087.6,95,,,percent of total billed charges,95% of total billed charges,2600.08,80,,,percent of total billed charges,80% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1300.04,40,,,percent of total billed charges,40% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2925.09,90,,,percent of total billed charges,90% of total billed charges,2470.08,76,,,percent of total billed charges,76% of total billed charges,1300.04,40,,,percent of total billed charges,40% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2600.08,80,,,percent of total billed charges,80% of total billed charges,1261.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2762.59,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,605.22,200,,,fee schedule,200% of CMS fee schedule,368.43,3087.6,
MRI TMJ,41370336,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,1966.5,1573.2,TC,1474.88,75,,,percent of total billed charges,75% of total billed charges,786.6,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,1671.53,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,1868.18,95,,,percent of total billed charges,95% of total billed charges,1573.2,80,,,percent of total billed charges,80% of total billed charges,1671.53,85,,,percent of total billed charges,85% of total billed charges,1769.85,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,786.6,40,,,percent of total billed charges,40% of total billed charges,786.6,40,,,percent of total billed charges,40% of total billed charges,1769.85,90,,,percent of total billed charges,90% of total billed charges,1494.54,76,,,percent of total billed charges,76% of total billed charges,786.6,40,,,percent of total billed charges,40% of total billed charges,1671.53,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,1573.2,80,,,percent of total billed charges,80% of total billed charges,763,38.8,,,percent of total billed charges,38.8% of total billed charges,1671.53,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,1868.18,
MRI Wrist w/ + w/o Cont Lt,41373223,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Wrist w/ + w/o Cont Rt,41373223,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Wrist w/ Cont Lt,41373222,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Wrist w/ Cont Rt,41373222,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Wrist w/o Cont Lt,41373221,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Wrist w/o Cont Rt,41373221,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
38505 US Lymph Node Biopsy,41238505,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,309.1,247.28,,231.83,75,,,percent of total billed charges,75% of total billed charges,123.64,40,,,percent of total billed charges,40% of total billed charges,244.81,79.2,,,percent of total billed charges,79.2% of total billed charges,262.74,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,293.65,95,,,percent of total billed charges,95% of total billed charges,247.28,80,,,percent of total billed charges,80% of total billed charges,262.74,85,,,percent of total billed charges,85% of total billed charges,278.19,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,123.64,40,,,percent of total billed charges,40% of total billed charges,123.64,40,,,percent of total billed charges,40% of total billed charges,278.19,90,,,percent of total billed charges,90% of total billed charges,234.92,76,,,percent of total billed charges,76% of total billed charges,123.64,40,,,percent of total billed charges,40% of total billed charges,262.74,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,247.28,80,,,percent of total billed charges,80% of total billed charges,119.93,38.8,,,percent of total billed charges,38.8% of total billed charges,262.74,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,293.65,
US Axilla,41276882,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,693.6,554.88,TC,520.2,75,,,percent of total billed charges,75% of total billed charges,277.44,40,,,percent of total billed charges,40% of total billed charges,549.33,79.2,,,percent of total billed charges,79.2% of total billed charges,589.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,658.92,95,,,percent of total billed charges,95% of total billed charges,554.88,80,,,percent of total billed charges,80% of total billed charges,589.56,85,,,percent of total billed charges,85% of total billed charges,624.24,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,277.44,40,,,percent of total billed charges,40% of total billed charges,277.44,40,,,percent of total billed charges,40% of total billed charges,624.24,90,,,percent of total billed charges,90% of total billed charges,527.14,76,,,percent of total billed charges,76% of total billed charges,277.44,40,,,percent of total billed charges,40% of total billed charges,589.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,554.88,80,,,percent of total billed charges,80% of total billed charges,269.12,38.8,,,percent of total billed charges,38.8% of total billed charges,589.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,658.92,
US Pregnant Fol-Up,41276816,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,535.2,428.16,,401.4,75,,,percent of total billed charges,75% of total billed charges,214.08,40,,,percent of total billed charges,40% of total billed charges,423.88,79.2,,,percent of total billed charges,79.2% of total billed charges,454.92,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,508.44,95,,,percent of total billed charges,95% of total billed charges,428.16,80,,,percent of total billed charges,80% of total billed charges,454.92,85,,,percent of total billed charges,85% of total billed charges,481.68,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,214.08,40,,,percent of total billed charges,40% of total billed charges,214.08,40,,,percent of total billed charges,40% of total billed charges,481.68,90,,,percent of total billed charges,90% of total billed charges,406.75,76,,,percent of total billed charges,76% of total billed charges,214.08,40,,,percent of total billed charges,40% of total billed charges,454.92,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,428.16,80,,,percent of total billed charges,80% of total billed charges,207.66,38.8,,,percent of total billed charges,38.8% of total billed charges,454.92,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,508.44,
US Pregnant > 14 Weeks Ea Addl Gest,41276802,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,344.1,275.28,,258.08,75,,,percent of total billed charges,75% of total billed charges,137.64,40,,,percent of total billed charges,40% of total billed charges,272.53,79.2,,,percent of total billed charges,79.2% of total billed charges,292.49,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,326.9,95,,,percent of total billed charges,95% of total billed charges,275.28,80,,,percent of total billed charges,80% of total billed charges,292.49,85,,,percent of total billed charges,85% of total billed charges,309.69,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,137.64,40,,,percent of total billed charges,40% of total billed charges,137.64,40,,,percent of total billed charges,40% of total billed charges,309.69,90,,,percent of total billed charges,90% of total billed charges,261.52,76,,,percent of total billed charges,76% of total billed charges,137.64,40,,,percent of total billed charges,40% of total billed charges,292.49,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,275.28,80,,,percent of total billed charges,80% of total billed charges,133.51,38.8,,,percent of total billed charges,38.8% of total billed charges,292.49,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,326.9,
US Pelvic Non-OB Comp,41276856,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,581.6,465.28,TC,436.2,75,,,percent of total billed charges,75% of total billed charges,232.64,40,,,percent of total billed charges,40% of total billed charges,460.63,79.2,,,percent of total billed charges,79.2% of total billed charges,494.36,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,552.52,95,,,percent of total billed charges,95% of total billed charges,465.28,80,,,percent of total billed charges,80% of total billed charges,494.36,85,,,percent of total billed charges,85% of total billed charges,523.44,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,232.64,40,,,percent of total billed charges,40% of total billed charges,232.64,40,,,percent of total billed charges,40% of total billed charges,523.44,90,,,percent of total billed charges,90% of total billed charges,442.02,76,,,percent of total billed charges,76% of total billed charges,232.64,40,,,percent of total billed charges,40% of total billed charges,494.36,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,465.28,80,,,percent of total billed charges,80% of total billed charges,225.66,38.8,,,percent of total billed charges,38.8% of total billed charges,494.36,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,552.52,
US Pelvic Non-OB Ltd,41276857,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,394,315.2,TC,295.5,75,,,percent of total billed charges,75% of total billed charges,157.6,40,,,percent of total billed charges,40% of total billed charges,312.05,79.2,,,percent of total billed charges,79.2% of total billed charges,334.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,374.3,95,,,percent of total billed charges,95% of total billed charges,315.2,80,,,percent of total billed charges,80% of total billed charges,334.9,85,,,percent of total billed charges,85% of total billed charges,354.6,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,157.6,40,,,percent of total billed charges,40% of total billed charges,157.6,40,,,percent of total billed charges,40% of total billed charges,354.6,90,,,percent of total billed charges,90% of total billed charges,299.44,76,,,percent of total billed charges,76% of total billed charges,157.6,40,,,percent of total billed charges,40% of total billed charges,334.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,315.2,80,,,percent of total billed charges,80% of total billed charges,152.87,38.8,,,percent of total billed charges,38.8% of total billed charges,334.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,374.3,
US Pregnant Ltd,41276815,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,419.3,335.44,,314.48,75,,,percent of total billed charges,75% of total billed charges,167.72,40,,,percent of total billed charges,40% of total billed charges,332.09,79.2,,,percent of total billed charges,79.2% of total billed charges,356.41,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,398.34,95,,,percent of total billed charges,95% of total billed charges,335.44,80,,,percent of total billed charges,80% of total billed charges,356.41,85,,,percent of total billed charges,85% of total billed charges,377.37,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,167.72,40,,,percent of total billed charges,40% of total billed charges,167.72,40,,,percent of total billed charges,40% of total billed charges,377.37,90,,,percent of total billed charges,90% of total billed charges,318.67,76,,,percent of total billed charges,76% of total billed charges,167.72,40,,,percent of total billed charges,40% of total billed charges,356.41,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,335.44,80,,,percent of total billed charges,80% of total billed charges,162.69,38.8,,,percent of total billed charges,38.8% of total billed charges,356.41,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,398.34,
US Thyroid,41276536,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,550.3,440.24,TC,412.73,75,,,percent of total billed charges,75% of total billed charges,220.12,40,,,percent of total billed charges,40% of total billed charges,435.84,79.2,,,percent of total billed charges,79.2% of total billed charges,467.76,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,522.79,95,,,percent of total billed charges,95% of total billed charges,440.24,80,,,percent of total billed charges,80% of total billed charges,467.76,85,,,percent of total billed charges,85% of total billed charges,495.27,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,220.12,40,,,percent of total billed charges,40% of total billed charges,220.12,40,,,percent of total billed charges,40% of total billed charges,495.27,90,,,percent of total billed charges,90% of total billed charges,418.23,76,,,percent of total billed charges,76% of total billed charges,220.12,40,,,percent of total billed charges,40% of total billed charges,467.76,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,440.24,80,,,percent of total billed charges,80% of total billed charges,213.52,38.8,,,percent of total billed charges,38.8% of total billed charges,467.76,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,522.79,
XR Ankle 2 Views Lt,41073600,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Ankle 2 Views Rt,41073600,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Bone Age Studies,41077072,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,132.7,106.16,TC,99.53,75,,,percent of total billed charges,75% of total billed charges,53.08,40,,,percent of total billed charges,40% of total billed charges,105.1,79.2,,,percent of total billed charges,79.2% of total billed charges,112.8,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,126.07,95,,,percent of total billed charges,95% of total billed charges,106.16,80,,,percent of total billed charges,80% of total billed charges,112.8,85,,,percent of total billed charges,85% of total billed charges,119.43,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,53.08,40,,,percent of total billed charges,40% of total billed charges,53.08,40,,,percent of total billed charges,40% of total billed charges,119.43,90,,,percent of total billed charges,90% of total billed charges,100.85,76,,,percent of total billed charges,76% of total billed charges,53.08,40,,,percent of total billed charges,40% of total billed charges,112.8,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,106.16,80,,,percent of total billed charges,80% of total billed charges,51.49,38.8,,,percent of total billed charges,38.8% of total billed charges,112.8,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,51.49,126.07,
XR Knee Standing +1-2 Views Rt,41000303,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,209.3,167.44,TC,156.98,75,,,percent of total billed charges,75% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,165.77,79.2,,,percent of total billed charges,79.2% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,198.84,95,,,percent of total billed charges,95% of total billed charges,167.44,80,,,percent of total billed charges,80% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,83.72,40,,,percent of total billed charges,40% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,159.07,76,,,percent of total billed charges,76% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,167.44,80,,,percent of total billed charges,80% of total billed charges,81.21,38.8,,,percent of total billed charges,38.8% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,198.84,
XR Spine Cerv Comp w/ Flex +Ext,41072050,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,311.7,249.36,TC,233.78,75,,,percent of total billed charges,75% of total billed charges,124.68,40,,,percent of total billed charges,40% of total billed charges,246.87,79.2,,,percent of total billed charges,79.2% of total billed charges,264.95,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,296.12,95,,,percent of total billed charges,95% of total billed charges,249.36,80,,,percent of total billed charges,80% of total billed charges,264.95,85,,,percent of total billed charges,85% of total billed charges,280.53,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,124.68,40,,,percent of total billed charges,40% of total billed charges,124.68,40,,,percent of total billed charges,40% of total billed charges,280.53,90,,,percent of total billed charges,90% of total billed charges,236.89,76,,,percent of total billed charges,76% of total billed charges,124.68,40,,,percent of total billed charges,40% of total billed charges,264.95,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,249.36,80,,,percent of total billed charges,80% of total billed charges,120.94,38.8,,,percent of total billed charges,38.8% of total billed charges,264.95,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,296.12,
XR Bone Survey Infant,41077076,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,578.3,462.64,TC,433.73,75,,,percent of total billed charges,75% of total billed charges,231.32,40,,,percent of total billed charges,40% of total billed charges,458.01,79.2,,,percent of total billed charges,79.2% of total billed charges,491.56,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,549.39,95,,,percent of total billed charges,95% of total billed charges,462.64,80,,,percent of total billed charges,80% of total billed charges,491.56,85,,,percent of total billed charges,85% of total billed charges,520.47,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,231.32,40,,,percent of total billed charges,40% of total billed charges,231.32,40,,,percent of total billed charges,40% of total billed charges,520.47,90,,,percent of total billed charges,90% of total billed charges,439.51,76,,,percent of total billed charges,76% of total billed charges,231.32,40,,,percent of total billed charges,40% of total billed charges,491.56,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,462.64,80,,,percent of total billed charges,80% of total billed charges,224.38,38.8,,,percent of total billed charges,38.8% of total billed charges,491.56,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,549.39,
XR Spine Lumbosacral >3 Views w/Flex+Ext,41072120,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,466.9,373.52,TC,350.18,75,,,percent of total billed charges,75% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,369.78,79.2,,,percent of total billed charges,79.2% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,443.56,95,,,percent of total billed charges,95% of total billed charges,373.52,80,,,percent of total billed charges,80% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,186.76,40,,,percent of total billed charges,40% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,354.84,76,,,percent of total billed charges,76% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,373.52,80,,,percent of total billed charges,80% of total billed charges,181.16,38.8,,,percent of total billed charges,38.8% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,443.56,
XR Chest 2 Views w/ Apical Lordotic,60000634,CDM,324,RC,71045,HCPCS,OUTPATIENT,,,270.1,216.08,,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,75.44,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,75.44,100,,,fee schedule,100% of CO APG rates,75.44,100,,,fee schedule,100% of CO APG rates,86.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,75.44,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,75.44,100,,,fee schedule,100% of APG fee schedule,54.6,200,,,fee schedule,200% of CMS fee schedule,54.6,256.6,
XR Nose to Rectum FB 1 View Child,41076010,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Elbow Comp Min 3 Views Lt,41073080,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Elbow Comp Min 3 Views Rt,41073080,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Fingers Min 2 Views Lt,41073140,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Fingers Min 2 Views Rt,41073140,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Fluoro Guide Ndl Placement,60000498,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,694.2,555.36,,520.65,75,,,percent of total billed charges,75% of total billed charges,277.68,40,,,percent of total billed charges,40% of total billed charges,549.81,79.2,,,percent of total billed charges,79.2% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,659.49,95,,,percent of total billed charges,95% of total billed charges,555.36,80,,,percent of total billed charges,80% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,624.78,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,277.68,40,,,percent of total billed charges,40% of total billed charges,277.68,40,,,percent of total billed charges,40% of total billed charges,624.78,90,,,percent of total billed charges,90% of total billed charges,527.59,76,,,percent of total billed charges,76% of total billed charges,277.68,40,,,percent of total billed charges,40% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,555.36,80,,,percent of total billed charges,80% of total billed charges,269.35,38.8,,,percent of total billed charges,38.8% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,659.49,
XR Foot 2 Views Bil,41073620,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Hand 2 Views Bil,41073120,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Hip Min 2 Views Bil w/ Pelvis,41073522,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,466.9,373.52,TC,350.18,75,,,percent of total billed charges,75% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,369.78,79.2,,,percent of total billed charges,79.2% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,443.56,95,,,percent of total billed charges,95% of total billed charges,373.52,80,,,percent of total billed charges,80% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,186.76,40,,,percent of total billed charges,40% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,354.84,76,,,percent of total billed charges,76% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,373.52,80,,,percent of total billed charges,80% of total billed charges,181.16,38.8,,,percent of total billed charges,38.8% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,443.56,
XR Knee Comp Min 4 Views Lt,41073564,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,301.5,241.2,TC,226.13,75,,,percent of total billed charges,75% of total billed charges,120.6,40,,,percent of total billed charges,40% of total billed charges,238.79,79.2,,,percent of total billed charges,79.2% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,286.43,95,,,percent of total billed charges,95% of total billed charges,241.2,80,,,percent of total billed charges,80% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,271.35,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,120.6,40,,,percent of total billed charges,40% of total billed charges,120.6,40,,,percent of total billed charges,40% of total billed charges,271.35,90,,,percent of total billed charges,90% of total billed charges,229.14,76,,,percent of total billed charges,76% of total billed charges,120.6,40,,,percent of total billed charges,40% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,241.2,80,,,percent of total billed charges,80% of total billed charges,116.98,38.8,,,percent of total billed charges,38.8% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,286.43,
XR Knee Comp Min 4 Views Rt,41073564,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,301.5,241.2,TC,226.13,75,,,percent of total billed charges,75% of total billed charges,120.6,40,,,percent of total billed charges,40% of total billed charges,238.79,79.2,,,percent of total billed charges,79.2% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,286.43,95,,,percent of total billed charges,95% of total billed charges,241.2,80,,,percent of total billed charges,80% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,271.35,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,120.6,40,,,percent of total billed charges,40% of total billed charges,120.6,40,,,percent of total billed charges,40% of total billed charges,271.35,90,,,percent of total billed charges,90% of total billed charges,229.14,76,,,percent of total billed charges,76% of total billed charges,120.6,40,,,percent of total billed charges,40% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,241.2,80,,,percent of total billed charges,80% of total billed charges,116.98,38.8,,,percent of total billed charges,38.8% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,286.43,
XR Knee Standing AP Bil,41073565,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Ribs Min 3 Views Rt w/ AP Chest,41071101,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,317.2,253.76,TC,237.9,75,,,percent of total billed charges,75% of total billed charges,126.88,40,,,percent of total billed charges,40% of total billed charges,251.22,79.2,,,percent of total billed charges,79.2% of total billed charges,269.62,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,301.34,95,,,percent of total billed charges,95% of total billed charges,253.76,80,,,percent of total billed charges,80% of total billed charges,269.62,85,,,percent of total billed charges,85% of total billed charges,285.48,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,126.88,40,,,percent of total billed charges,40% of total billed charges,126.88,40,,,percent of total billed charges,40% of total billed charges,285.48,90,,,percent of total billed charges,90% of total billed charges,241.07,76,,,percent of total billed charges,76% of total billed charges,126.88,40,,,percent of total billed charges,40% of total billed charges,269.62,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,253.76,80,,,percent of total billed charges,80% of total billed charges,123.07,38.8,,,percent of total billed charges,38.8% of total billed charges,269.62,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,301.34,
XR Sinuses Paranasal < 3 Views,41070210,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Skull Comp Min 4 Views,41070260,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,448.9,359.12,TC,336.68,75,,,percent of total billed charges,75% of total billed charges,179.56,40,,,percent of total billed charges,40% of total billed charges,355.53,79.2,,,percent of total billed charges,79.2% of total billed charges,381.57,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,426.46,95,,,percent of total billed charges,95% of total billed charges,359.12,80,,,percent of total billed charges,80% of total billed charges,381.57,85,,,percent of total billed charges,85% of total billed charges,404.01,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,179.56,40,,,percent of total billed charges,40% of total billed charges,179.56,40,,,percent of total billed charges,40% of total billed charges,404.01,90,,,percent of total billed charges,90% of total billed charges,341.16,76,,,percent of total billed charges,76% of total billed charges,179.56,40,,,percent of total billed charges,40% of total billed charges,381.57,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,359.12,80,,,percent of total billed charges,80% of total billed charges,174.17,38.8,,,percent of total billed charges,38.8% of total billed charges,381.57,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,426.46,
XR Spine 1 View Cerv,41072020,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Spine Lumbosacral Comp w/ Bending,41072114,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,466.9,373.52,TC,350.18,75,,,percent of total billed charges,75% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,369.78,79.2,,,percent of total billed charges,79.2% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,443.56,95,,,percent of total billed charges,95% of total billed charges,373.52,80,,,percent of total billed charges,80% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,186.76,40,,,percent of total billed charges,40% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,354.84,76,,,percent of total billed charges,76% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,373.52,80,,,percent of total billed charges,80% of total billed charges,181.16,38.8,,,percent of total billed charges,38.8% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,443.56,
XR Spine Thoracolumbar 2 Views,41072080,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,293.7,234.96,TC,220.28,75,,,percent of total billed charges,75% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,232.61,79.2,,,percent of total billed charges,79.2% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,279.02,95,,,percent of total billed charges,95% of total billed charges,234.96,80,,,percent of total billed charges,80% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,117.48,40,,,percent of total billed charges,40% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,223.21,76,,,percent of total billed charges,76% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,234.96,80,,,percent of total billed charges,80% of total billed charges,113.96,38.8,,,percent of total billed charges,38.8% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,279.02,
XR TMJ Open +Closed Bil,41070330,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,209.3,167.44,TC,156.98,75,,,percent of total billed charges,75% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,165.77,79.2,,,percent of total billed charges,79.2% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,198.84,95,,,percent of total billed charges,95% of total billed charges,167.44,80,,,percent of total billed charges,80% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,83.72,40,,,percent of total billed charges,40% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,159.07,76,,,percent of total billed charges,76% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,167.44,80,,,percent of total billed charges,80% of total billed charges,81.21,38.8,,,percent of total billed charges,38.8% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,198.84,
Aph RBC CP2D AS3 LR,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph RBC ACDA AS3 LR,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph RBC ACDA AS3 LR 1,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph RBC ACDA AS3 LR Irr,4050106,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,1397.2,1117.76,,1047.9,75,,,percent of total billed charges,75% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1106.58,79.2,,,percent of total billed charges,79.2% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,1327.34,95,,,percent of total billed charges,95% of total billed charges,1117.76,80,,,percent of total billed charges,80% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,1257.48,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,558.88,40,,,percent of total billed charges,40% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1257.48,90,,,percent of total billed charges,90% of total billed charges,1061.87,76,,,percent of total billed charges,76% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,1117.76,80,,,percent of total billed charges,80% of total billed charges,542.11,38.8,,,percent of total billed charges,38.8% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,1327.34,
Aph RBC AS3 LR 1,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph RBC AS3 LR Irr,4050106,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,1397.2,1117.76,,1047.9,75,,,percent of total billed charges,75% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1106.58,79.2,,,percent of total billed charges,79.2% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,1327.34,95,,,percent of total billed charges,95% of total billed charges,1117.76,80,,,percent of total billed charges,80% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,1257.48,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,558.88,40,,,percent of total billed charges,40% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1257.48,90,,,percent of total billed charges,90% of total billed charges,1061.87,76,,,percent of total billed charges,76% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,1117.76,80,,,percent of total billed charges,80% of total billed charges,542.11,38.8,,,percent of total billed charges,38.8% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,1327.34,
Sigmoidoscopy,4600108,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1271,1016.8,,953.25,75,,,percent of total billed charges,75% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1006.63,79.2,,,percent of total billed charges,79.2% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1207.45,95,,,percent of total billed charges,95% of total billed charges,1016.8,80,,,percent of total billed charges,80% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,508.4,40,,,percent of total billed charges,40% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,965.96,76,,,percent of total billed charges,76% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1016.8,80,,,percent of total billed charges,80% of total billed charges,493.15,38.8,,,percent of total billed charges,38.8% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1207.45,
hCG Quantitative,40084702,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,193.4,154.72,,145.05,75,,,percent of total billed charges,75% of total billed charges,77.36,40,,,percent of total billed charges,40% of total billed charges,153.17,79.2,,,percent of total billed charges,79.2% of total billed charges,164.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,183.73,95,,,percent of total billed charges,95% of total billed charges,154.72,80,,,percent of total billed charges,80% of total billed charges,164.39,85,,,percent of total billed charges,85% of total billed charges,174.06,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,77.36,40,,,percent of total billed charges,40% of total billed charges,77.36,40,,,percent of total billed charges,40% of total billed charges,174.06,90,,,percent of total billed charges,90% of total billed charges,146.98,76,,,percent of total billed charges,76% of total billed charges,77.36,40,,,percent of total billed charges,40% of total billed charges,164.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,154.72,80,,,percent of total billed charges,80% of total billed charges,75.04,38.8,,,percent of total billed charges,38.8% of total billed charges,164.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,183.73,
PSA Screen,40000003,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,127.5,102,,95.63,75,,,percent of total billed charges,75% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,100.98,79.2,,,percent of total billed charges,79.2% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,121.13,95,,,percent of total billed charges,95% of total billed charges,102,80,,,percent of total billed charges,80% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,51,40,,,percent of total billed charges,40% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,96.9,76,,,percent of total billed charges,76% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,102,80,,,percent of total billed charges,80% of total billed charges,49.47,38.8,,,percent of total billed charges,38.8% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,121.13,
PSA Diagnostic,40084153,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,127.5,102,,95.63,75,,,percent of total billed charges,75% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,100.98,79.2,,,percent of total billed charges,79.2% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,121.13,95,,,percent of total billed charges,95% of total billed charges,102,80,,,percent of total billed charges,80% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,51,40,,,percent of total billed charges,40% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,96.9,76,,,percent of total billed charges,76% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,102,80,,,percent of total billed charges,80% of total billed charges,49.47,38.8,,,percent of total billed charges,38.8% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,121.13,
CBC w/ Auto Diff 3,40085025,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,103.2,82.56,,77.4,75,,,percent of total billed charges,75% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,81.73,79.2,,,percent of total billed charges,79.2% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,98.04,95,,,percent of total billed charges,95% of total billed charges,82.56,80,,,percent of total billed charges,80% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,41.28,40,,,percent of total billed charges,40% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,78.43,76,,,percent of total billed charges,76% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,82.56,80,,,percent of total billed charges,80% of total billed charges,40.04,38.8,,,percent of total billed charges,38.8% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,98.04,
Alcohol Level 1,40080320,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,117.8,94.24,,88.35,75,,,percent of total billed charges,75% of total billed charges,47.12,40,,,percent of total billed charges,40% of total billed charges,93.3,79.2,,,percent of total billed charges,79.2% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,111.91,95,,,percent of total billed charges,95% of total billed charges,94.24,80,,,percent of total billed charges,80% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,106.02,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,47.12,40,,,percent of total billed charges,40% of total billed charges,47.12,40,,,percent of total billed charges,40% of total billed charges,106.02,90,,,percent of total billed charges,90% of total billed charges,89.53,76,,,percent of total billed charges,76% of total billed charges,47.12,40,,,percent of total billed charges,40% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,94.24,80,,,percent of total billed charges,80% of total billed charges,45.71,38.8,,,percent of total billed charges,38.8% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,111.91,
CT Ankle w/ + w/o Cont Lt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Ankle w/ + w/o Cont Rt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Ankle w/ Cont Lt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Ankle w/ Cont Rt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Ankle w/o Cont Lt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Ankle w/o Cont Rt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Elbow w/o Cont Lt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Elbow w/o Cont Rt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Foot w/ + w/o Cont Lt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Foot w/ + w/o Cont Rt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Foot w/ Cont Lt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Foot w/ Cont Rt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Foot w/o Cont Lt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Foot w/o Cont Rt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Hip w/ + w/o Cont Lt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Hip w/ + w/o Cont Rt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Hip w/ Cont Lt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Hip w/ Cont Rt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Hip w/o Cont Lt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Hip w/o Cont Rt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Knee w/ + w/o Cont Lt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Knee w/ + w/o Cont Rt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Knee w/ Cont Lt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Knee w/ Cont Rt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Knee w/o Cont Lt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Knee w/o Cont Rt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Shoulder w/o Cont Lt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Shoulder w/o Cont Rt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Sinus or Facial w/ + w/o Cont,41170488,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1782.3,1425.84,TC,1336.73,75,,,percent of total billed charges,75% of total billed charges,712.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1514.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1693.19,95,,,percent of total billed charges,95% of total billed charges,1425.84,80,,,percent of total billed charges,80% of total billed charges,1514.96,85,,,percent of total billed charges,85% of total billed charges,1604.07,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,712.92,40,,,percent of total billed charges,40% of total billed charges,712.92,40,,,percent of total billed charges,40% of total billed charges,1604.07,90,,,percent of total billed charges,90% of total billed charges,1354.55,76,,,percent of total billed charges,76% of total billed charges,712.92,40,,,percent of total billed charges,40% of total billed charges,1514.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1425.84,80,,,percent of total billed charges,80% of total billed charges,691.53,38.8,,,percent of total billed charges,38.8% of total billed charges,1514.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1693.19,
CT Wrist w/o Cont Lt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Wrist w/o Cont Rt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
US Aorta Duplex IVC Iliac Comp,41276700,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,894.4,715.52,TC,670.8,75,,,percent of total billed charges,75% of total billed charges,357.76,40,,,percent of total billed charges,40% of total billed charges,708.36,79.2,,,percent of total billed charges,79.2% of total billed charges,760.24,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,849.68,95,,,percent of total billed charges,95% of total billed charges,715.52,80,,,percent of total billed charges,80% of total billed charges,760.24,85,,,percent of total billed charges,85% of total billed charges,804.96,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,357.76,40,,,percent of total billed charges,40% of total billed charges,357.76,40,,,percent of total billed charges,40% of total billed charges,804.96,90,,,percent of total billed charges,90% of total billed charges,679.74,76,,,percent of total billed charges,76% of total billed charges,357.76,40,,,percent of total billed charges,40% of total billed charges,760.24,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,715.52,80,,,percent of total billed charges,80% of total billed charges,347.03,38.8,,,percent of total billed charges,38.8% of total billed charges,760.24,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,849.68,
US Carotid Doppler Bil,41293880,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,662.7,530.16,,497.03,75,,,percent of total billed charges,75% of total billed charges,265.08,40,,,percent of total billed charges,40% of total billed charges,524.86,79.2,,,percent of total billed charges,79.2% of total billed charges,563.3,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,629.57,95,,,percent of total billed charges,95% of total billed charges,530.16,80,,,percent of total billed charges,80% of total billed charges,563.3,85,,,percent of total billed charges,85% of total billed charges,596.43,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,265.08,40,,,percent of total billed charges,40% of total billed charges,265.08,40,,,percent of total billed charges,40% of total billed charges,596.43,90,,,percent of total billed charges,90% of total billed charges,503.65,76,,,percent of total billed charges,76% of total billed charges,265.08,40,,,percent of total billed charges,40% of total billed charges,563.3,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,530.16,80,,,percent of total billed charges,80% of total billed charges,257.13,38.8,,,percent of total billed charges,38.8% of total billed charges,563.3,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,629.57,
US Fetal Biophys Profile w/o Non-Stress,41276819,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,431,344.8,TC,323.25,75,,,percent of total billed charges,75% of total billed charges,172.4,40,,,percent of total billed charges,40% of total billed charges,341.35,79.2,,,percent of total billed charges,79.2% of total billed charges,366.35,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,409.45,95,,,percent of total billed charges,95% of total billed charges,344.8,80,,,percent of total billed charges,80% of total billed charges,366.35,85,,,percent of total billed charges,85% of total billed charges,387.9,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,172.4,40,,,percent of total billed charges,40% of total billed charges,172.4,40,,,percent of total billed charges,40% of total billed charges,387.9,90,,,percent of total billed charges,90% of total billed charges,327.56,76,,,percent of total billed charges,76% of total billed charges,172.4,40,,,percent of total billed charges,40% of total billed charges,366.35,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,344.8,80,,,percent of total billed charges,80% of total billed charges,167.23,38.8,,,percent of total billed charges,38.8% of total billed charges,366.35,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,409.45,
XR Cholangiography Intraoperative,41074300,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,70.8,56.64,,53.1,75,,,percent of total billed charges,75% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,56.07,79.2,,,percent of total billed charges,79.2% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,70.8,100,,,fee schedule,100% of CO APG rates,67.26,95,,,percent of total billed charges,95% of total billed charges,56.64,80,,,percent of total billed charges,80% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,63.72,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,70.8,100,,,fee schedule,100% of NM APC rate,28.32,40,,,percent of total billed charges,40% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,63.72,90,,,percent of total billed charges,90% of total billed charges,53.81,76,,,percent of total billed charges,76% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,56.64,80,,,percent of total billed charges,80% of total billed charges,27.47,38.8,,,percent of total billed charges,38.8% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,27.47,104.58,
XR Pelvis Comp Min 3 Views,41072190,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR SI Joints Min 3 Views,41072202,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,301.5,241.2,TC,226.13,75,,,percent of total billed charges,75% of total billed charges,120.6,40,,,percent of total billed charges,40% of total billed charges,238.79,79.2,,,percent of total billed charges,79.2% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,286.43,95,,,percent of total billed charges,95% of total billed charges,241.2,80,,,percent of total billed charges,80% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,271.35,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,120.6,40,,,percent of total billed charges,40% of total billed charges,120.6,40,,,percent of total billed charges,40% of total billed charges,271.35,90,,,percent of total billed charges,90% of total billed charges,229.14,76,,,percent of total billed charges,76% of total billed charges,120.6,40,,,percent of total billed charges,40% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,241.2,80,,,percent of total billed charges,80% of total billed charges,116.98,38.8,,,percent of total billed charges,38.8% of total billed charges,256.28,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,286.43,
XR Spine 1 View Lumbar,41072020,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Spine 1 View Thoracic,41072020,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR TMJ Open +Closed Lt,41070328,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR TMJ Open +Closed Rt,41070328,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
CT Angio LE Bil,41173706,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1937.3,1549.84,TC,1452.98,75,,,percent of total billed charges,75% of total billed charges,774.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1646.71,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1840.44,95,,,percent of total billed charges,95% of total billed charges,1549.84,80,,,percent of total billed charges,80% of total billed charges,1646.71,85,,,percent of total billed charges,85% of total billed charges,1743.57,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,774.92,40,,,percent of total billed charges,40% of total billed charges,774.92,40,,,percent of total billed charges,40% of total billed charges,1743.57,90,,,percent of total billed charges,90% of total billed charges,1472.35,76,,,percent of total billed charges,76% of total billed charges,774.92,40,,,percent of total billed charges,40% of total billed charges,1646.71,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1549.84,80,,,percent of total billed charges,80% of total billed charges,751.67,38.8,,,percent of total billed charges,38.8% of total billed charges,1646.71,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1840.44,
Add'l 30 Min Increments CC > 74,31099292,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.4,580.32,,544.05,75,,,percent of total billed charges,75% of total billed charges,290.16,40,,,percent of total billed charges,40% of total billed charges,574.52,79.2,,,percent of total billed charges,79.2% of total billed charges,616.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.13,95,,,percent of total billed charges,95% of total billed charges,580.32,80,,,percent of total billed charges,80% of total billed charges,616.59,85,,,percent of total billed charges,85% of total billed charges,652.86,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.16,40,,,percent of total billed charges,40% of total billed charges,290.16,40,,,percent of total billed charges,40% of total billed charges,652.86,90,,,percent of total billed charges,90% of total billed charges,551.3,76,,,percent of total billed charges,76% of total billed charges,290.16,40,,,percent of total billed charges,40% of total billed charges,616.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.32,80,,,percent of total billed charges,80% of total billed charges,281.46,38.8,,,percent of total billed charges,38.8% of total billed charges,616.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.13,
Renal Panel 1,40080069,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,76.6,61.28,,57.45,75,,,percent of total billed charges,75% of total billed charges,30.64,40,,,percent of total billed charges,40% of total billed charges,60.67,79.2,,,percent of total billed charges,79.2% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,72.77,95,,,percent of total billed charges,95% of total billed charges,61.28,80,,,percent of total billed charges,80% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,68.94,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,30.64,40,,,percent of total billed charges,40% of total billed charges,30.64,40,,,percent of total billed charges,40% of total billed charges,68.94,90,,,percent of total billed charges,90% of total billed charges,58.22,76,,,percent of total billed charges,76% of total billed charges,30.64,40,,,percent of total billed charges,40% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,61.28,80,,,percent of total billed charges,80% of total billed charges,29.72,38.8,,,percent of total billed charges,38.8% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,72.77,
CEA LC,40002139,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,31.2,24.96,,23.4,75,,,percent of total billed charges,75% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,24.71,79.2,,,percent of total billed charges,79.2% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,29.64,95,,,percent of total billed charges,95% of total billed charges,24.96,80,,,percent of total billed charges,80% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.48,40,,,percent of total billed charges,40% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,23.71,76,,,percent of total billed charges,76% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,24.96,80,,,percent of total billed charges,80% of total billed charges,12.11,38.8,,,percent of total billed charges,38.8% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,29.64,
US Guide Ndl Placement,41276942,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,241,192.8,TC,180.75,75,,,percent of total billed charges,75% of total billed charges,96.4,40,,,percent of total billed charges,40% of total billed charges,190.87,79.2,,,percent of total billed charges,79.2% of total billed charges,204.85,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,228.95,95,,,percent of total billed charges,95% of total billed charges,192.8,80,,,percent of total billed charges,80% of total billed charges,204.85,85,,,percent of total billed charges,85% of total billed charges,216.9,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,96.4,40,,,percent of total billed charges,40% of total billed charges,96.4,40,,,percent of total billed charges,40% of total billed charges,216.9,90,,,percent of total billed charges,90% of total billed charges,183.16,76,,,percent of total billed charges,76% of total billed charges,96.4,40,,,percent of total billed charges,40% of total billed charges,204.85,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,192.8,80,,,percent of total billed charges,80% of total billed charges,93.51,38.8,,,percent of total billed charges,38.8% of total billed charges,204.85,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,93.51,246.44,
CT Angio Head w/ + w/o Cont,41170496,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,2834.5,2267.6,TC,2125.88,75,,,percent of total billed charges,75% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,2692.78,95,,,percent of total billed charges,95% of total billed charges,2267.6,80,,,percent of total billed charges,80% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,2551.05,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,1133.8,40,,,percent of total billed charges,40% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,2551.05,90,,,percent of total billed charges,90% of total billed charges,2154.22,76,,,percent of total billed charges,76% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,2267.6,80,,,percent of total billed charges,80% of total billed charges,1099.79,38.8,,,percent of total billed charges,38.8% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,2692.78,
US Soft Tissue Chest Wall,41076536,CDM,400,RC,76604,HCPCS,OUTPATIENT,,,232.9,186.32,TC,174.68,75,,,percent of total billed charges,75% of total billed charges,93.16,40,,,percent of total billed charges,40% of total billed charges,184.46,79.2,,,percent of total billed charges,79.2% of total billed charges,197.97,85,,,percent of total billed charges,85% of total billed charges,145.77,100,,,fee schedule,100% of CO APG rates,221.26,95,,,percent of total billed charges,95% of total billed charges,186.32,80,,,percent of total billed charges,80% of total billed charges,197.97,85,,,percent of total billed charges,85% of total billed charges,209.61,90,,,percent of total billed charges,90% of total billed charges,145.77,100,,,fee schedule,100% of CO APG rates,145.77,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,93.16,40,,,percent of total billed charges,40% of total billed charges,93.16,40,,,percent of total billed charges,40% of total billed charges,209.61,90,,,percent of total billed charges,90% of total billed charges,177,76,,,percent of total billed charges,76% of total billed charges,93.16,40,,,percent of total billed charges,40% of total billed charges,197.97,85,,,percent of total billed charges,85% of total billed charges,145.77,100,,,fee schedule,100% of CO APG rate,186.32,80,,,percent of total billed charges,80% of total billed charges,90.37,38.8,,,percent of total billed charges,38.8% of total billed charges,197.97,85,,,percent of total billed charges,85% of total billed charges,145.77,100,,,fee schedule,100% of APG fee schedule,118.32,200,,,fee schedule,200% of CMS fee schedule,90.37,221.26,
CT Angio LE Lt,41173706,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1937.3,1549.84,TC,1452.98,75,,,percent of total billed charges,75% of total billed charges,774.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1646.71,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1840.44,95,,,percent of total billed charges,95% of total billed charges,1549.84,80,,,percent of total billed charges,80% of total billed charges,1646.71,85,,,percent of total billed charges,85% of total billed charges,1743.57,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,774.92,40,,,percent of total billed charges,40% of total billed charges,774.92,40,,,percent of total billed charges,40% of total billed charges,1743.57,90,,,percent of total billed charges,90% of total billed charges,1472.35,76,,,percent of total billed charges,76% of total billed charges,774.92,40,,,percent of total billed charges,40% of total billed charges,1646.71,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1549.84,80,,,percent of total billed charges,80% of total billed charges,751.67,38.8,,,percent of total billed charges,38.8% of total billed charges,1646.71,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1840.44,
CT Angio LE Rt,41173706,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1937.3,1549.84,TC,1452.98,75,,,percent of total billed charges,75% of total billed charges,774.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1646.71,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1840.44,95,,,percent of total billed charges,95% of total billed charges,1549.84,80,,,percent of total billed charges,80% of total billed charges,1646.71,85,,,percent of total billed charges,85% of total billed charges,1743.57,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,774.92,40,,,percent of total billed charges,40% of total billed charges,774.92,40,,,percent of total billed charges,40% of total billed charges,1743.57,90,,,percent of total billed charges,90% of total billed charges,1472.35,76,,,percent of total billed charges,76% of total billed charges,774.92,40,,,percent of total billed charges,40% of total billed charges,1646.71,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1549.84,80,,,percent of total billed charges,80% of total billed charges,751.67,38.8,,,percent of total billed charges,38.8% of total billed charges,1646.71,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1840.44,
CT Chest w/ Cont,41171260,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1642.3,1313.84,TC,1231.73,75,,,percent of total billed charges,75% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1560.19,95,,,percent of total billed charges,95% of total billed charges,1313.84,80,,,percent of total billed charges,80% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,656.92,40,,,percent of total billed charges,40% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,1248.15,76,,,percent of total billed charges,76% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1313.84,80,,,percent of total billed charges,80% of total billed charges,637.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1560.19,
XR Toe(s) Min 2 Views Lt,41073660,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Toe(s) Min 2 Views Rt,41073660,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
US Bladder +Residual Post Voiding,41276857,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,394,315.2,TC,295.5,75,,,percent of total billed charges,75% of total billed charges,157.6,40,,,percent of total billed charges,40% of total billed charges,312.05,79.2,,,percent of total billed charges,79.2% of total billed charges,334.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,374.3,95,,,percent of total billed charges,95% of total billed charges,315.2,80,,,percent of total billed charges,80% of total billed charges,334.9,85,,,percent of total billed charges,85% of total billed charges,354.6,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,157.6,40,,,percent of total billed charges,40% of total billed charges,157.6,40,,,percent of total billed charges,40% of total billed charges,354.6,90,,,percent of total billed charges,90% of total billed charges,299.44,76,,,percent of total billed charges,76% of total billed charges,157.6,40,,,percent of total billed charges,40% of total billed charges,334.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,315.2,80,,,percent of total billed charges,80% of total billed charges,152.87,38.8,,,percent of total billed charges,38.8% of total billed charges,334.9,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,374.3,
US Abdomen Comp w/ Doppler,41200200,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,1815.5,1452.4,TC,1361.63,75,,,percent of total billed charges,75% of total billed charges,726.2,40,,,percent of total billed charges,40% of total billed charges,1437.88,79.2,,,percent of total billed charges,79.2% of total billed charges,1543.18,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,1724.73,95,,,percent of total billed charges,95% of total billed charges,1452.4,80,,,percent of total billed charges,80% of total billed charges,1543.18,85,,,percent of total billed charges,85% of total billed charges,1633.95,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,726.2,40,,,percent of total billed charges,40% of total billed charges,726.2,40,,,percent of total billed charges,40% of total billed charges,1633.95,90,,,percent of total billed charges,90% of total billed charges,1379.78,76,,,percent of total billed charges,76% of total billed charges,726.2,40,,,percent of total billed charges,40% of total billed charges,1543.18,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,1452.4,80,,,percent of total billed charges,80% of total billed charges,704.41,38.8,,,percent of total billed charges,38.8% of total billed charges,1543.18,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,1724.73,
US Doppler Middle Cerebral Art,41276821,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,303.5,242.8,,227.63,75,,,percent of total billed charges,75% of total billed charges,121.4,40,,,percent of total billed charges,40% of total billed charges,240.37,79.2,,,percent of total billed charges,79.2% of total billed charges,257.98,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,288.33,95,,,percent of total billed charges,95% of total billed charges,242.8,80,,,percent of total billed charges,80% of total billed charges,257.98,85,,,percent of total billed charges,85% of total billed charges,273.15,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,121.4,40,,,percent of total billed charges,40% of total billed charges,121.4,40,,,percent of total billed charges,40% of total billed charges,273.15,90,,,percent of total billed charges,90% of total billed charges,230.66,76,,,percent of total billed charges,76% of total billed charges,121.4,40,,,percent of total billed charges,40% of total billed charges,257.98,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,242.8,80,,,percent of total billed charges,80% of total billed charges,117.76,38.8,,,percent of total billed charges,38.8% of total billed charges,257.98,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,288.33,
US Pregnant < 14 Weeks 1st Gest,41276801,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,605.9,484.72,TC,454.43,75,,,percent of total billed charges,75% of total billed charges,242.36,40,,,percent of total billed charges,40% of total billed charges,479.87,79.2,,,percent of total billed charges,79.2% of total billed charges,515.02,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,575.61,95,,,percent of total billed charges,95% of total billed charges,484.72,80,,,percent of total billed charges,80% of total billed charges,515.02,85,,,percent of total billed charges,85% of total billed charges,545.31,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,242.36,40,,,percent of total billed charges,40% of total billed charges,242.36,40,,,percent of total billed charges,40% of total billed charges,545.31,90,,,percent of total billed charges,90% of total billed charges,460.48,76,,,percent of total billed charges,76% of total billed charges,242.36,40,,,percent of total billed charges,40% of total billed charges,515.02,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,484.72,80,,,percent of total billed charges,80% of total billed charges,235.09,38.8,,,percent of total billed charges,38.8% of total billed charges,515.02,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,575.61,
Iron Level,40083540,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,84.1,67.28,,63.08,75,,,percent of total billed charges,75% of total billed charges,33.64,40,,,percent of total billed charges,40% of total billed charges,66.61,79.2,,,percent of total billed charges,79.2% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,79.9,95,,,percent of total billed charges,95% of total billed charges,67.28,80,,,percent of total billed charges,80% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,75.69,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,33.64,40,,,percent of total billed charges,40% of total billed charges,33.64,40,,,percent of total billed charges,40% of total billed charges,75.69,90,,,percent of total billed charges,90% of total billed charges,63.92,76,,,percent of total billed charges,76% of total billed charges,33.64,40,,,percent of total billed charges,40% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,67.28,80,,,percent of total billed charges,80% of total billed charges,32.63,38.8,,,percent of total billed charges,38.8% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,79.9,
Urea Nitrogen 24 Hour Urine,40084540,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,37.1,29.68,,27.83,75,,,percent of total billed charges,75% of total billed charges,14.84,40,,,percent of total billed charges,40% of total billed charges,29.38,79.2,,,percent of total billed charges,79.2% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,35.25,95,,,percent of total billed charges,95% of total billed charges,29.68,80,,,percent of total billed charges,80% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,33.39,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,14.84,40,,,percent of total billed charges,40% of total billed charges,14.84,40,,,percent of total billed charges,40% of total billed charges,33.39,90,,,percent of total billed charges,90% of total billed charges,28.2,76,,,percent of total billed charges,76% of total billed charges,14.84,40,,,percent of total billed charges,40% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,29.68,80,,,percent of total billed charges,80% of total billed charges,14.39,38.8,,,percent of total billed charges,38.8% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,35.25,
Creatinine Level 24 Hour Urine,40082570,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,60.42,
Direct Coombs,40586880,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,40.4,32.32,,30.3,75,,,percent of total billed charges,75% of total billed charges,16.16,40,,,percent of total billed charges,40% of total billed charges,32,79.2,,,percent of total billed charges,79.2% of total billed charges,34.34,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,38.38,95,,,percent of total billed charges,95% of total billed charges,32.32,80,,,percent of total billed charges,80% of total billed charges,34.34,85,,,percent of total billed charges,85% of total billed charges,36.36,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,16.16,40,,,percent of total billed charges,40% of total billed charges,16.16,40,,,percent of total billed charges,40% of total billed charges,36.36,90,,,percent of total billed charges,90% of total billed charges,30.7,76,,,percent of total billed charges,76% of total billed charges,16.16,40,,,percent of total billed charges,40% of total billed charges,34.34,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,32.32,80,,,percent of total billed charges,80% of total billed charges,15.68,38.8,,,percent of total billed charges,38.8% of total billed charges,34.34,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,38.38,
.GTT-1 Hr,40082951,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
XR Spine Cerv Comp w/ Obl,41072052,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,455.6,364.48,TC,341.7,75,,,percent of total billed charges,75% of total billed charges,182.24,40,,,percent of total billed charges,40% of total billed charges,360.84,79.2,,,percent of total billed charges,79.2% of total billed charges,387.26,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,432.82,95,,,percent of total billed charges,95% of total billed charges,364.48,80,,,percent of total billed charges,80% of total billed charges,387.26,85,,,percent of total billed charges,85% of total billed charges,410.04,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,182.24,40,,,percent of total billed charges,40% of total billed charges,182.24,40,,,percent of total billed charges,40% of total billed charges,410.04,90,,,percent of total billed charges,90% of total billed charges,346.26,76,,,percent of total billed charges,76% of total billed charges,182.24,40,,,percent of total billed charges,40% of total billed charges,387.26,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,364.48,80,,,percent of total billed charges,80% of total billed charges,176.77,38.8,,,percent of total billed charges,38.8% of total billed charges,387.26,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,432.82,
MRI Ankle w/o Cont Lt,41373721,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Ankle w/o Cont Rt,41373721,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Elbow w/o Cont Lt,41373221,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Elbow w/o Cont Rt,41373221,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Femur w/ + w/o Cont Lt,41373720,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Femur w/ + w/o Cont Rt,41373720,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Forearm w/ + w/o Cont Lt,41373220,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Forearm w/ + w/o Cont Rt,41373220,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Knee w/o Cont Lt,41373721,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Knee w/o Cont Rt,41373721,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
US Echo 2D Comp,42800056,CDM,483,RC,,,OUTPATIENT,,,1691.6,1353.28,TC,1268.7,75,,,percent of total billed charges,75% of total billed charges,676.64,40,,,percent of total billed charges,40% of total billed charges,1339.75,79.2,,,percent of total billed charges,79.2% of total billed charges,1437.86,85,,,percent of total billed charges,85% of total billed charges,1691.6,100,,,fee schedule,100% of CO APG rates,1607.02,95,,,percent of total billed charges,95% of total billed charges,1353.28,80,,,percent of total billed charges,80% of total billed charges,1437.86,85,,,percent of total billed charges,85% of total billed charges,1522.44,90,,,percent of total billed charges,90% of total billed charges,1691.6,100,,,fee schedule,100% of CO APG rates,1691.6,100,,,fee schedule,100% of CO APG rates,1691.6,100,,,fee schedule,100% of NM fee schedule,676.64,40,,,percent of total billed charges,40% of total billed charges,676.64,40,,,percent of total billed charges,40% of total billed charges,1522.44,90,,,percent of total billed charges,90% of total billed charges,1285.62,76,,,percent of total billed charges,76% of total billed charges,676.64,40,,,percent of total billed charges,40% of total billed charges,1437.86,85,,,percent of total billed charges,85% of total billed charges,1691.6,100,,,fee schedule,100% of CO APG rate,1353.28,80,,,percent of total billed charges,80% of total billed charges,656.34,38.8,,,percent of total billed charges,38.8% of total billed charges,1437.86,85,,,percent of total billed charges,85% of total billed charges,1691.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,656.34,1691.6,
BD DEXA Body Composition,41077072,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,127.1,101.68,TC,95.33,75,,,percent of total billed charges,75% of total billed charges,50.84,40,,,percent of total billed charges,40% of total billed charges,100.66,79.2,,,percent of total billed charges,79.2% of total billed charges,108.04,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,120.75,95,,,percent of total billed charges,95% of total billed charges,101.68,80,,,percent of total billed charges,80% of total billed charges,108.04,85,,,percent of total billed charges,85% of total billed charges,114.39,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,50.84,40,,,percent of total billed charges,40% of total billed charges,50.84,40,,,percent of total billed charges,40% of total billed charges,114.39,90,,,percent of total billed charges,90% of total billed charges,96.6,76,,,percent of total billed charges,76% of total billed charges,50.84,40,,,percent of total billed charges,40% of total billed charges,108.04,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,101.68,80,,,percent of total billed charges,80% of total billed charges,49.31,38.8,,,percent of total billed charges,38.8% of total billed charges,108.04,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,49.31,120.75,
BD DEXA Appendicular Skeleton,41477081,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,231.7,185.36,TC,173.78,75,,,percent of total billed charges,75% of total billed charges,92.68,40,,,percent of total billed charges,40% of total billed charges,183.51,79.2,,,percent of total billed charges,79.2% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,220.12,95,,,percent of total billed charges,95% of total billed charges,185.36,80,,,percent of total billed charges,80% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,208.53,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,92.68,40,,,percent of total billed charges,40% of total billed charges,92.68,40,,,percent of total billed charges,40% of total billed charges,208.53,90,,,percent of total billed charges,90% of total billed charges,176.09,76,,,percent of total billed charges,76% of total billed charges,92.68,40,,,percent of total billed charges,40% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,185.36,80,,,percent of total billed charges,80% of total billed charges,89.9,38.8,,,percent of total billed charges,38.8% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,220.12,
CT Angio Abdomen Aorta +Iliofemoral,41175635,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,2834.5,2267.6,TC,2125.88,75,,,percent of total billed charges,75% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,2692.78,95,,,percent of total billed charges,95% of total billed charges,2267.6,80,,,percent of total billed charges,80% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,2551.05,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,1133.8,40,,,percent of total billed charges,40% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,2551.05,90,,,percent of total billed charges,90% of total billed charges,2154.22,76,,,percent of total billed charges,76% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,2267.6,80,,,percent of total billed charges,80% of total billed charges,1099.79,38.8,,,percent of total billed charges,38.8% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,2692.78,
CT Angio UE Lt,41173206,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,852.3,681.84,TC,639.23,75,,,percent of total billed charges,75% of total billed charges,340.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,724.46,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,809.69,95,,,percent of total billed charges,95% of total billed charges,681.84,80,,,percent of total billed charges,80% of total billed charges,724.46,85,,,percent of total billed charges,85% of total billed charges,767.07,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,340.92,40,,,percent of total billed charges,40% of total billed charges,340.92,40,,,percent of total billed charges,40% of total billed charges,767.07,90,,,percent of total billed charges,90% of total billed charges,647.75,76,,,percent of total billed charges,76% of total billed charges,340.92,40,,,percent of total billed charges,40% of total billed charges,724.46,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,681.84,80,,,percent of total billed charges,80% of total billed charges,330.69,38.8,,,percent of total billed charges,38.8% of total billed charges,724.46,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,809.69,
CT Angio UE Rt,41173206,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,852.3,681.84,TC,639.23,75,,,percent of total billed charges,75% of total billed charges,340.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,724.46,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,809.69,95,,,percent of total billed charges,95% of total billed charges,681.84,80,,,percent of total billed charges,80% of total billed charges,724.46,85,,,percent of total billed charges,85% of total billed charges,767.07,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,340.92,40,,,percent of total billed charges,40% of total billed charges,340.92,40,,,percent of total billed charges,40% of total billed charges,767.07,90,,,percent of total billed charges,90% of total billed charges,647.75,76,,,percent of total billed charges,76% of total billed charges,340.92,40,,,percent of total billed charges,40% of total billed charges,724.46,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,681.84,80,,,percent of total billed charges,80% of total billed charges,330.69,38.8,,,percent of total billed charges,38.8% of total billed charges,724.46,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,809.69,
CT Guide Ndl Placement,60000553,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,252.4,201.92,,189.3,75,,,percent of total billed charges,75% of total billed charges,100.96,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,214.54,85,,,percent of total billed charges,85% of total billed charges,252.4,100,,,fee schedule,100% of CO APG rates,239.78,95,,,percent of total billed charges,95% of total billed charges,201.92,80,,,percent of total billed charges,80% of total billed charges,214.54,85,,,percent of total billed charges,85% of total billed charges,227.16,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,100.96,40,,,percent of total billed charges,40% of total billed charges,100.96,40,,,percent of total billed charges,40% of total billed charges,227.16,90,,,percent of total billed charges,90% of total billed charges,191.82,76,,,percent of total billed charges,76% of total billed charges,100.96,40,,,percent of total billed charges,40% of total billed charges,214.54,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,201.92,80,,,percent of total billed charges,80% of total billed charges,97.93,38.8,,,percent of total billed charges,38.8% of total billed charges,214.54,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,97.93,514,
CT IAC w/ + w/o Cont,41170482,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1782.3,1425.84,TC,1336.73,75,,,percent of total billed charges,75% of total billed charges,712.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1514.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1693.19,95,,,percent of total billed charges,95% of total billed charges,1425.84,80,,,percent of total billed charges,80% of total billed charges,1514.96,85,,,percent of total billed charges,85% of total billed charges,1604.07,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,712.92,40,,,percent of total billed charges,40% of total billed charges,712.92,40,,,percent of total billed charges,40% of total billed charges,1604.07,90,,,percent of total billed charges,90% of total billed charges,1354.55,76,,,percent of total billed charges,76% of total billed charges,712.92,40,,,percent of total billed charges,40% of total billed charges,1514.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1425.84,80,,,percent of total billed charges,80% of total billed charges,691.53,38.8,,,percent of total billed charges,38.8% of total billed charges,1514.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1693.19,
CT Temporal Bones/IAC w/o Cont,41170480,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
77053 MA Ductogram or Galactogram Single Bil,41577053,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,158.7,126.96,TC,119.03,75,,,percent of total billed charges,75% of total billed charges,63.48,40,,,percent of total billed charges,40% of total billed charges,125.69,79.2,,,percent of total billed charges,79.2% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,158.7,100,,,fee schedule,100% of CO APG rates,150.77,95,,,percent of total billed charges,95% of total billed charges,126.96,80,,,percent of total billed charges,80% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,142.83,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,158.7,100,,,fee schedule,100% of NM APC rate,63.48,40,,,percent of total billed charges,40% of total billed charges,63.48,40,,,percent of total billed charges,40% of total billed charges,142.83,90,,,percent of total billed charges,90% of total billed charges,120.61,76,,,percent of total billed charges,76% of total billed charges,63.48,40,,,percent of total billed charges,40% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,126.96,80,,,percent of total billed charges,80% of total billed charges,61.58,38.8,,,percent of total billed charges,38.8% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,61.58,159.09,
77053 MA Ductogram or Galactogram Single Lt,41577053,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,158.7,126.96,TC,119.03,75,,,percent of total billed charges,75% of total billed charges,63.48,40,,,percent of total billed charges,40% of total billed charges,125.69,79.2,,,percent of total billed charges,79.2% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,158.7,100,,,fee schedule,100% of CO APG rates,150.77,95,,,percent of total billed charges,95% of total billed charges,126.96,80,,,percent of total billed charges,80% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,142.83,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,158.7,100,,,fee schedule,100% of NM APC rate,63.48,40,,,percent of total billed charges,40% of total billed charges,63.48,40,,,percent of total billed charges,40% of total billed charges,142.83,90,,,percent of total billed charges,90% of total billed charges,120.61,76,,,percent of total billed charges,76% of total billed charges,63.48,40,,,percent of total billed charges,40% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,126.96,80,,,percent of total billed charges,80% of total billed charges,61.58,38.8,,,percent of total billed charges,38.8% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,61.58,159.09,
MA Routine Screen Bil.,41400001,CDM,403,RC,77067,HCPCS,OUTPATIENT,,,395.1,316.08,TC,296.33,75,,,percent of total billed charges,75% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,312.92,79.2,,,percent of total billed charges,79.2% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,375.35,95,,,percent of total billed charges,95% of total billed charges,316.08,80,,,percent of total billed charges,80% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,66.74,100,,,fee schedule,100% of CO APG rates,127.61,100,,,fee schedule,100% of NM fee schedule,158.04,40,,,percent of total billed charges,40% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,300.28,76,,,percent of total billed charges,76% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rate,316.08,80,,,percent of total billed charges,80% of total billed charges,153.3,38.8,,,percent of total billed charges,38.8% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of APG fee schedule,270.8,200,,,fee schedule,200% of CMS fee schedule,66.74,375.35,
MA Routine Screen Lt.,41577067,CDM,403,RC,77067,HCPCS,OUTPATIENT,,,186.5,149.2,TC,139.88,75,,,percent of total billed charges,75% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,147.71,79.2,,,percent of total billed charges,79.2% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,177.18,95,,,percent of total billed charges,95% of total billed charges,149.2,80,,,percent of total billed charges,80% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,167.85,90,,,percent of total billed charges,90% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,66.74,100,,,fee schedule,100% of CO APG rates,127.61,100,,,fee schedule,100% of NM fee schedule,74.6,40,,,percent of total billed charges,40% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,167.85,90,,,percent of total billed charges,90% of total billed charges,141.74,76,,,percent of total billed charges,76% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rate,149.2,80,,,percent of total billed charges,80% of total billed charges,72.36,38.8,,,percent of total billed charges,38.8% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of APG fee schedule,270.8,200,,,fee schedule,200% of CMS fee schedule,66.74,270.8,
MA Routine Screen Rt.,41577067,CDM,403,RC,77067,HCPCS,OUTPATIENT,,,186.5,149.2,TC,139.88,75,,,percent of total billed charges,75% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,147.71,79.2,,,percent of total billed charges,79.2% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,177.18,95,,,percent of total billed charges,95% of total billed charges,149.2,80,,,percent of total billed charges,80% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,167.85,90,,,percent of total billed charges,90% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,66.74,100,,,fee schedule,100% of CO APG rates,127.61,100,,,fee schedule,100% of NM fee schedule,74.6,40,,,percent of total billed charges,40% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,167.85,90,,,percent of total billed charges,90% of total billed charges,141.74,76,,,percent of total billed charges,76% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rate,149.2,80,,,percent of total billed charges,80% of total billed charges,72.36,38.8,,,percent of total billed charges,38.8% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of APG fee schedule,270.8,200,,,fee schedule,200% of CMS fee schedule,66.74,270.8,
MRI Ankle w/ + w/o Cont Lt,41373723,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Ankle w/ + w/o Cont Rt,41373723,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Ankle w/ Cont Lt,41373722,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Ankle w/ Cont Rt,41373722,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Elbow w/ + w/o Cont Lt,41373223,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Elbow w/ + w/o Cont Rt,41373223,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Elbow w/ Cont Lt,41373222,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Elbow w/ Cont Rt,41373222,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Femur w/ Cont Lt,41373719,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Femur w/ Cont Rt,41373719,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Forearm w/ Cont Lt,41373219,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Forearm w/ Cont Rt,41373219,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Forearm w/o Cont Lt,41373218,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Forearm w/o Cont Rt,41373218,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRA Spine w/ + w/o Cont,41372159,CDM,618,RC,71555,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,2866.9,100,,,fee schedule,100% of NM fee schedule,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,735.02,200,,,fee schedule,200% of CMS fee schedule,657.92,2866.9,
MRI Knee w/ Cont Lt,41373722,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Knee w/ Cont Rt,41373722,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
US Abdomen/Pelvic/Scrotal Art/Vein Comp,41293975,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,595.5,476.4,,446.63,75,,,percent of total billed charges,75% of total billed charges,238.2,40,,,percent of total billed charges,40% of total billed charges,471.64,79.2,,,percent of total billed charges,79.2% of total billed charges,506.18,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,565.73,95,,,percent of total billed charges,95% of total billed charges,476.4,80,,,percent of total billed charges,80% of total billed charges,506.18,85,,,percent of total billed charges,85% of total billed charges,535.95,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,238.2,40,,,percent of total billed charges,40% of total billed charges,238.2,40,,,percent of total billed charges,40% of total billed charges,535.95,90,,,percent of total billed charges,90% of total billed charges,452.58,76,,,percent of total billed charges,76% of total billed charges,238.2,40,,,percent of total billed charges,40% of total billed charges,506.18,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,476.4,80,,,percent of total billed charges,80% of total billed charges,231.05,38.8,,,percent of total billed charges,38.8% of total billed charges,506.18,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,565.73,
US LE Art Doppler Single Level Lt,41293926,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,560.8,448.64,TC,420.6,75,,,percent of total billed charges,75% of total billed charges,224.32,40,,,percent of total billed charges,40% of total billed charges,444.15,79.2,,,percent of total billed charges,79.2% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,532.76,95,,,percent of total billed charges,95% of total billed charges,448.64,80,,,percent of total billed charges,80% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,504.72,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,224.32,40,,,percent of total billed charges,40% of total billed charges,224.32,40,,,percent of total billed charges,40% of total billed charges,504.72,90,,,percent of total billed charges,90% of total billed charges,426.21,76,,,percent of total billed charges,76% of total billed charges,224.32,40,,,percent of total billed charges,40% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,448.64,80,,,percent of total billed charges,80% of total billed charges,217.59,38.8,,,percent of total billed charges,38.8% of total billed charges,476.68,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,217.59,532.76,
XR Hip Arthrography LT,60000652,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Hip Arthrography Rt,41073525,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Spine Scoliosis Standing,41072082,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,466.9,373.52,TC,350.18,75,,,percent of total billed charges,75% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,369.78,79.2,,,percent of total billed charges,79.2% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,443.56,95,,,percent of total billed charges,95% of total billed charges,373.52,80,,,percent of total billed charges,80% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,186.76,40,,,percent of total billed charges,40% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,354.84,76,,,percent of total billed charges,76% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,373.52,80,,,percent of total billed charges,80% of total billed charges,181.16,38.8,,,percent of total billed charges,38.8% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,443.56,
XR Knee Standing +1-2 Views Lt,41000302,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,209.3,167.44,TC,156.98,75,,,percent of total billed charges,75% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,165.77,79.2,,,percent of total billed charges,79.2% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,198.84,95,,,percent of total billed charges,95% of total billed charges,167.44,80,,,percent of total billed charges,80% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,83.72,40,,,percent of total billed charges,40% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,188.37,90,,,percent of total billed charges,90% of total billed charges,159.07,76,,,percent of total billed charges,76% of total billed charges,83.72,40,,,percent of total billed charges,40% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,167.44,80,,,percent of total billed charges,80% of total billed charges,81.21,38.8,,,percent of total billed charges,38.8% of total billed charges,177.91,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,198.84,
CT Angio Abdomen w/ Cont,41174175,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,806.4,645.12,,604.8,75,,,percent of total billed charges,75% of total billed charges,322.56,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,685.44,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,766.08,95,,,percent of total billed charges,95% of total billed charges,645.12,80,,,percent of total billed charges,80% of total billed charges,685.44,85,,,percent of total billed charges,85% of total billed charges,725.76,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,322.56,40,,,percent of total billed charges,40% of total billed charges,322.56,40,,,percent of total billed charges,40% of total billed charges,725.76,90,,,percent of total billed charges,90% of total billed charges,612.86,76,,,percent of total billed charges,76% of total billed charges,322.56,40,,,percent of total billed charges,40% of total billed charges,685.44,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,645.12,80,,,percent of total billed charges,80% of total billed charges,312.88,38.8,,,percent of total billed charges,38.8% of total billed charges,685.44,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,766.08,
CT Angio Chest w/ Cont,41071275,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,798.7,638.96,TC,599.03,75,,,percent of total billed charges,75% of total billed charges,319.48,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,678.9,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,758.77,95,,,percent of total billed charges,95% of total billed charges,638.96,80,,,percent of total billed charges,80% of total billed charges,678.9,85,,,percent of total billed charges,85% of total billed charges,718.83,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,319.48,40,,,percent of total billed charges,40% of total billed charges,319.48,40,,,percent of total billed charges,40% of total billed charges,718.83,90,,,percent of total billed charges,90% of total billed charges,607.01,76,,,percent of total billed charges,76% of total billed charges,319.48,40,,,percent of total billed charges,40% of total billed charges,678.9,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,638.96,80,,,percent of total billed charges,80% of total billed charges,309.9,38.8,,,percent of total billed charges,38.8% of total billed charges,678.9,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,758.77,
ECHO 2D LTD W/ CONTRAST,428C8924,CDM,483,RC,,,OUTPATIENT,,,1439.6,1151.68,TC,1079.7,75,,,percent of total billed charges,75% of total billed charges,575.84,40,,,percent of total billed charges,40% of total billed charges,1140.16,79.2,,,percent of total billed charges,79.2% of total billed charges,1223.66,85,,,percent of total billed charges,85% of total billed charges,1439.6,100,,,fee schedule,100% of CO APG rates,1367.62,95,,,percent of total billed charges,95% of total billed charges,1151.68,80,,,percent of total billed charges,80% of total billed charges,1223.66,85,,,percent of total billed charges,85% of total billed charges,1295.64,90,,,percent of total billed charges,90% of total billed charges,1439.6,100,,,fee schedule,100% of CO APG rates,1439.6,100,,,fee schedule,100% of CO APG rates,1439.6,100,,,fee schedule,100% of NM fee schedule,575.84,40,,,percent of total billed charges,40% of total billed charges,575.84,40,,,percent of total billed charges,40% of total billed charges,1295.64,90,,,percent of total billed charges,90% of total billed charges,1094.1,76,,,percent of total billed charges,76% of total billed charges,575.84,40,,,percent of total billed charges,40% of total billed charges,1223.66,85,,,percent of total billed charges,85% of total billed charges,1439.6,100,,,fee schedule,100% of CO APG rate,1151.68,80,,,percent of total billed charges,80% of total billed charges,558.56,38.8,,,percent of total billed charges,38.8% of total billed charges,1223.66,85,,,percent of total billed charges,85% of total billed charges,1439.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,558.56,1439.6,
"96372  Therapeutic, prophylactic, or diagnostic injection, subcutaneous or intra",49196372,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,111.2,88.96,,83.4,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,88.07,79.2,,,percent of total billed charges,79.2% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,111.2,100,,,fee schedule,100% of CO APG rates,105.64,95,,,percent of total billed charges,95% of total billed charges,88.96,80,,,percent of total billed charges,80% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,100.08,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,111.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,100.08,90,,,percent of total billed charges,90% of total billed charges,84.51,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,94.52,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,88.96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,94.52,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,604.6,100,,,case rate,pays based on per visit rate,83.4,604.6,
90472  Each additional vaccine,49190472,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.8,50.67,
US Breast Bil.,41076641,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,287.3,229.84,TC,215.48,75,,,percent of total billed charges,75% of total billed charges,114.92,40,,,percent of total billed charges,40% of total billed charges,227.54,79.2,,,percent of total billed charges,79.2% of total billed charges,244.21,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,272.94,95,,,percent of total billed charges,95% of total billed charges,229.84,80,,,percent of total billed charges,80% of total billed charges,244.21,85,,,percent of total billed charges,85% of total billed charges,258.57,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.92,40,,,percent of total billed charges,40% of total billed charges,114.92,40,,,percent of total billed charges,40% of total billed charges,258.57,90,,,percent of total billed charges,90% of total billed charges,218.35,76,,,percent of total billed charges,76% of total billed charges,114.92,40,,,percent of total billed charges,40% of total billed charges,244.21,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,229.84,80,,,percent of total billed charges,80% of total billed charges,111.47,38.8,,,percent of total billed charges,38.8% of total billed charges,244.21,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,272.94,
US Breast Lt.,41576641,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,413.6,330.88,TC,310.2,75,,,percent of total billed charges,75% of total billed charges,165.44,40,,,percent of total billed charges,40% of total billed charges,327.57,79.2,,,percent of total billed charges,79.2% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,392.92,95,,,percent of total billed charges,95% of total billed charges,330.88,80,,,percent of total billed charges,80% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,372.24,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,165.44,40,,,percent of total billed charges,40% of total billed charges,165.44,40,,,percent of total billed charges,40% of total billed charges,372.24,90,,,percent of total billed charges,90% of total billed charges,314.34,76,,,percent of total billed charges,76% of total billed charges,165.44,40,,,percent of total billed charges,40% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,330.88,80,,,percent of total billed charges,80% of total billed charges,160.48,38.8,,,percent of total billed charges,38.8% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,392.92,
US Breast Rt.,41576641,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,413.6,330.88,TC,310.2,75,,,percent of total billed charges,75% of total billed charges,165.44,40,,,percent of total billed charges,40% of total billed charges,327.57,79.2,,,percent of total billed charges,79.2% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,392.92,95,,,percent of total billed charges,95% of total billed charges,330.88,80,,,percent of total billed charges,80% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,372.24,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,165.44,40,,,percent of total billed charges,40% of total billed charges,165.44,40,,,percent of total billed charges,40% of total billed charges,372.24,90,,,percent of total billed charges,90% of total billed charges,314.34,76,,,percent of total billed charges,76% of total billed charges,165.44,40,,,percent of total billed charges,40% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,330.88,80,,,percent of total billed charges,80% of total billed charges,160.48,38.8,,,percent of total billed charges,38.8% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,392.92,
XR Spine Lumbosacral Min 4 Views w/ Obl,41072110,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,466.9,373.52,TC,350.18,75,,,percent of total billed charges,75% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,369.78,79.2,,,percent of total billed charges,79.2% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,443.56,95,,,percent of total billed charges,95% of total billed charges,373.52,80,,,percent of total billed charges,80% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,186.76,40,,,percent of total billed charges,40% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,354.84,76,,,percent of total billed charges,76% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,373.52,80,,,percent of total billed charges,80% of total billed charges,181.16,38.8,,,percent of total billed charges,38.8% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,443.56,
MA Diag Bil.,41500004,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,477.3,381.84,TC,357.98,75,,,percent of total billed charges,75% of total billed charges,190.92,40,,,percent of total billed charges,40% of total billed charges,378.02,79.2,,,percent of total billed charges,79.2% of total billed charges,405.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,453.44,95,,,percent of total billed charges,95% of total billed charges,381.84,80,,,percent of total billed charges,80% of total billed charges,405.71,85,,,percent of total billed charges,85% of total billed charges,429.57,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,190.92,40,,,percent of total billed charges,40% of total billed charges,190.92,40,,,percent of total billed charges,40% of total billed charges,429.57,90,,,percent of total billed charges,90% of total billed charges,362.75,76,,,percent of total billed charges,76% of total billed charges,190.92,40,,,percent of total billed charges,40% of total billed charges,405.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,381.84,80,,,percent of total billed charges,80% of total billed charges,185.19,38.8,,,percent of total billed charges,38.8% of total billed charges,405.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,453.44,
MA Routine Screen Bil.,41400001,CDM,403,RC,77067,HCPCS,OUTPATIENT,,,395.1,316.08,TC,296.33,75,,,percent of total billed charges,75% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,312.92,79.2,,,percent of total billed charges,79.2% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,375.35,95,,,percent of total billed charges,95% of total billed charges,316.08,80,,,percent of total billed charges,80% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,66.74,100,,,fee schedule,100% of CO APG rates,127.61,100,,,fee schedule,100% of NM fee schedule,158.04,40,,,percent of total billed charges,40% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,300.28,76,,,percent of total billed charges,76% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rate,316.08,80,,,percent of total billed charges,80% of total billed charges,153.3,38.8,,,percent of total billed charges,38.8% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of APG fee schedule,270.8,200,,,fee schedule,200% of CMS fee schedule,66.74,375.35,
99291 - Critical Care,31099291,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,3177.2,2541.76,,2382.9,75,,,percent of total billed charges,75% of total billed charges,1270.88,40,,,percent of total billed charges,40% of total billed charges,2516.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2700.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,3018.34,95,,,percent of total billed charges,95% of total billed charges,2541.76,80,,,percent of total billed charges,80% of total billed charges,2700.62,85,,,percent of total billed charges,85% of total billed charges,2859.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1270.88,40,,,percent of total billed charges,40% of total billed charges,1270.88,40,,,percent of total billed charges,40% of total billed charges,2859.48,90,,,percent of total billed charges,90% of total billed charges,2414.67,76,,,percent of total billed charges,76% of total billed charges,1270.88,40,,,percent of total billed charges,40% of total billed charges,2700.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,2541.76,80,,,percent of total billed charges,80% of total billed charges,1232.75,38.8,,,percent of total billed charges,38.8% of total billed charges,2700.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,3018.34,
99285 - Level 5,31099285,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2048.8,1639.04,,1536.6,75,,,percent of total billed charges,75% of total billed charges,819.52,40,,,percent of total billed charges,40% of total billed charges,1622.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1741.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1946.36,95,,,percent of total billed charges,95% of total billed charges,1639.04,80,,,percent of total billed charges,80% of total billed charges,1741.48,85,,,percent of total billed charges,85% of total billed charges,1843.92,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,819.52,40,,,percent of total billed charges,40% of total billed charges,819.52,40,,,percent of total billed charges,40% of total billed charges,1843.92,90,,,percent of total billed charges,90% of total billed charges,1557.09,76,,,percent of total billed charges,76% of total billed charges,819.52,40,,,percent of total billed charges,40% of total billed charges,1741.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1639.04,80,,,percent of total billed charges,80% of total billed charges,794.93,38.8,,,percent of total billed charges,38.8% of total billed charges,1741.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1946.36,
99284 - Level 4,31099284,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1455,1164,,1091.25,75,,,percent of total billed charges,75% of total billed charges,582,40,,,percent of total billed charges,40% of total billed charges,1152.36,79.2,,,percent of total billed charges,79.2% of total billed charges,1236.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1382.25,95,,,percent of total billed charges,95% of total billed charges,1164,80,,,percent of total billed charges,80% of total billed charges,1236.75,85,,,percent of total billed charges,85% of total billed charges,1309.5,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,582,40,,,percent of total billed charges,40% of total billed charges,582,40,,,percent of total billed charges,40% of total billed charges,1309.5,90,,,percent of total billed charges,90% of total billed charges,1105.8,76,,,percent of total billed charges,76% of total billed charges,582,40,,,percent of total billed charges,40% of total billed charges,1236.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1164,80,,,percent of total billed charges,80% of total billed charges,564.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1236.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1382.25,
99283 - Level 3,31099283,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1003.6,802.88,,752.7,75,,,percent of total billed charges,75% of total billed charges,401.44,40,,,percent of total billed charges,40% of total billed charges,794.85,79.2,,,percent of total billed charges,79.2% of total billed charges,853.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,953.42,95,,,percent of total billed charges,95% of total billed charges,802.88,80,,,percent of total billed charges,80% of total billed charges,853.06,85,,,percent of total billed charges,85% of total billed charges,903.24,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,401.44,40,,,percent of total billed charges,40% of total billed charges,401.44,40,,,percent of total billed charges,40% of total billed charges,903.24,90,,,percent of total billed charges,90% of total billed charges,762.74,76,,,percent of total billed charges,76% of total billed charges,401.44,40,,,percent of total billed charges,40% of total billed charges,853.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,802.88,80,,,percent of total billed charges,80% of total billed charges,389.4,38.8,,,percent of total billed charges,38.8% of total billed charges,853.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,953.42,
99282 - Level 2,31099282,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,609.4,487.52,,457.05,75,,,percent of total billed charges,75% of total billed charges,243.76,40,,,percent of total billed charges,40% of total billed charges,482.64,79.2,,,percent of total billed charges,79.2% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,578.93,95,,,percent of total billed charges,95% of total billed charges,487.52,80,,,percent of total billed charges,80% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,548.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,243.76,40,,,percent of total billed charges,40% of total billed charges,243.76,40,,,percent of total billed charges,40% of total billed charges,548.46,90,,,percent of total billed charges,90% of total billed charges,463.14,76,,,percent of total billed charges,76% of total billed charges,243.76,40,,,percent of total billed charges,40% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,487.52,80,,,percent of total billed charges,80% of total billed charges,236.45,38.8,,,percent of total billed charges,38.8% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,578.93,
99281 - Level 1,31099281,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,412.9,330.32,,309.68,75,,,percent of total billed charges,75% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,327.02,79.2,,,percent of total billed charges,79.2% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,392.26,95,,,percent of total billed charges,95% of total billed charges,330.32,80,,,percent of total billed charges,80% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,371.61,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,165.16,40,,,percent of total billed charges,40% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,371.61,90,,,percent of total billed charges,90% of total billed charges,313.8,76,,,percent of total billed charges,76% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,330.32,80,,,percent of total billed charges,80% of total billed charges,160.21,38.8,,,percent of total billed charges,38.8% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,160.21,392.26,
Sigmoidoscopy,4600108,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1271,1016.8,,953.25,75,,,percent of total billed charges,75% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1006.63,79.2,,,percent of total billed charges,79.2% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1207.45,95,,,percent of total billed charges,95% of total billed charges,1016.8,80,,,percent of total billed charges,80% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,508.4,40,,,percent of total billed charges,40% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,965.96,76,,,percent of total billed charges,76% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1016.8,80,,,percent of total billed charges,80% of total billed charges,493.15,38.8,,,percent of total billed charges,38.8% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1207.45,
Sigmoidoscopy,4600108,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1271,1016.8,,953.25,75,,,percent of total billed charges,75% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1006.63,79.2,,,percent of total billed charges,79.2% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1207.45,95,,,percent of total billed charges,95% of total billed charges,1016.8,80,,,percent of total billed charges,80% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,508.4,40,,,percent of total billed charges,40% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,965.96,76,,,percent of total billed charges,76% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1016.8,80,,,percent of total billed charges,80% of total billed charges,493.15,38.8,,,percent of total billed charges,38.8% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1207.45,
24530 Closed Treatment Of Supracondylar Or Transcondylar Hum,60000038,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,767.5,614,,575.63,75,,,percent of total billed charges,75% of total billed charges,307,40,,,percent of total billed charges,40% of total billed charges,607.86,79.2,,,percent of total billed charges,79.2% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,729.13,95,,,percent of total billed charges,95% of total billed charges,614,80,,,percent of total billed charges,80% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,690.75,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,307,40,,,percent of total billed charges,40% of total billed charges,307,40,,,percent of total billed charges,40% of total billed charges,690.75,90,,,percent of total billed charges,90% of total billed charges,583.3,76,,,percent of total billed charges,76% of total billed charges,307,40,,,percent of total billed charges,40% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,614,80,,,percent of total billed charges,80% of total billed charges,297.79,38.8,,,percent of total billed charges,38.8% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,729.13,
MA Diag Rt.,41500002,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,373.1,298.48,TC,279.83,75,,,percent of total billed charges,75% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,295.5,79.2,,,percent of total billed charges,79.2% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,354.45,95,,,percent of total billed charges,95% of total billed charges,298.48,80,,,percent of total billed charges,80% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,335.79,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,149.24,40,,,percent of total billed charges,40% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,335.79,90,,,percent of total billed charges,90% of total billed charges,283.56,76,,,percent of total billed charges,76% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,298.48,80,,,percent of total billed charges,80% of total billed charges,144.76,38.8,,,percent of total billed charges,38.8% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,144.76,354.45,
Bill Venipuncture,40036415,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,5.04,33.06,
CT Abdomen w/ Cont,41100068,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1642.3,1313.84,TC,1231.73,75,,,percent of total billed charges,75% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1560.19,95,,,percent of total billed charges,95% of total billed charges,1313.84,80,,,percent of total billed charges,80% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,656.92,40,,,percent of total billed charges,40% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,1248.15,76,,,percent of total billed charges,76% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1313.84,80,,,percent of total billed charges,80% of total billed charges,637.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1560.19,
PKU Newborn,40084030,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,53,42.4,,39.75,75,,,percent of total billed charges,75% of total billed charges,21.2,40,,,percent of total billed charges,40% of total billed charges,41.98,79.2,,,percent of total billed charges,79.2% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,50.35,95,,,percent of total billed charges,95% of total billed charges,42.4,80,,,percent of total billed charges,80% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,47.7,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,21.2,40,,,percent of total billed charges,40% of total billed charges,21.2,40,,,percent of total billed charges,40% of total billed charges,47.7,90,,,percent of total billed charges,90% of total billed charges,40.28,76,,,percent of total billed charges,76% of total billed charges,21.2,40,,,percent of total billed charges,40% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,42.4,80,,,percent of total billed charges,80% of total billed charges,20.56,38.8,,,percent of total billed charges,38.8% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,50.35,
Thyroid Panel LC,40084479,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,30.1,24.08,,22.58,75,,,percent of total billed charges,75% of total billed charges,12.04,40,,,percent of total billed charges,40% of total billed charges,23.84,79.2,,,percent of total billed charges,79.2% of total billed charges,25.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,28.6,95,,,percent of total billed charges,95% of total billed charges,24.08,80,,,percent of total billed charges,80% of total billed charges,25.59,85,,,percent of total billed charges,85% of total billed charges,27.09,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.04,40,,,percent of total billed charges,40% of total billed charges,12.04,40,,,percent of total billed charges,40% of total billed charges,27.09,90,,,percent of total billed charges,90% of total billed charges,22.88,76,,,percent of total billed charges,76% of total billed charges,12.04,40,,,percent of total billed charges,40% of total billed charges,25.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,24.08,80,,,percent of total billed charges,80% of total billed charges,11.68,38.8,,,percent of total billed charges,38.8% of total billed charges,25.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,28.6,
Aph ARBC ACDA AS3 1 LR,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph ARBC ACDA AS3 LR,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph FFP ACDA Dv Thawed,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Yes- PT Unattended Electrical Therapy Charge,42597014,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,112.5,90,GP,84.38,75,,,percent of total billed charges,75% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,89.1,79.2,,,percent of total billed charges,79.2% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,106.88,95,,,percent of total billed charges,95% of total billed charges,90,80,,,percent of total billed charges,80% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,45,40,,,percent of total billed charges,40% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,85.5,76,,,percent of total billed charges,76% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,90,80,,,percent of total billed charges,80% of total billed charges,43.65,38.8,,,percent of total billed charges,38.8% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,106.88,
Yes- PT Paraffin Bath Charge,42597018,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,93.4,74.72,GP,70.05,75,,,percent of total billed charges,75% of total billed charges,37.36,40,,,percent of total billed charges,40% of total billed charges,73.97,79.2,,,percent of total billed charges,79.2% of total billed charges,79.39,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,88.73,95,,,percent of total billed charges,95% of total billed charges,74.72,80,,,percent of total billed charges,80% of total billed charges,79.39,85,,,percent of total billed charges,85% of total billed charges,84.06,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,37.36,40,,,percent of total billed charges,40% of total billed charges,37.36,40,,,percent of total billed charges,40% of total billed charges,84.06,90,,,percent of total billed charges,90% of total billed charges,70.98,76,,,percent of total billed charges,76% of total billed charges,37.36,40,,,percent of total billed charges,40% of total billed charges,79.39,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,74.72,80,,,percent of total billed charges,80% of total billed charges,36.24,38.8,,,percent of total billed charges,38.8% of total billed charges,79.39,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,88.73,
Yes- OT Paraffin Bath Charge,42597018,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,93.4,74.72,GP,70.05,75,,,percent of total billed charges,75% of total billed charges,37.36,40,,,percent of total billed charges,40% of total billed charges,73.97,79.2,,,percent of total billed charges,79.2% of total billed charges,79.39,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,88.73,95,,,percent of total billed charges,95% of total billed charges,74.72,80,,,percent of total billed charges,80% of total billed charges,79.39,85,,,percent of total billed charges,85% of total billed charges,84.06,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,37.36,40,,,percent of total billed charges,40% of total billed charges,37.36,40,,,percent of total billed charges,40% of total billed charges,84.06,90,,,percent of total billed charges,90% of total billed charges,70.98,76,,,percent of total billed charges,76% of total billed charges,37.36,40,,,percent of total billed charges,40% of total billed charges,79.39,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,74.72,80,,,percent of total billed charges,80% of total billed charges,36.24,38.8,,,percent of total billed charges,38.8% of total billed charges,79.39,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,88.73,
Evaluation of swallowing function,60000309,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,422.9,338.32,GN,317.18,75,,,percent of total billed charges,75% of total billed charges,169.16,40,,,percent of total billed charges,40% of total billed charges,334.94,79.2,,,percent of total billed charges,79.2% of total billed charges,359.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,401.76,95,,,percent of total billed charges,95% of total billed charges,338.32,80,,,percent of total billed charges,80% of total billed charges,359.47,85,,,percent of total billed charges,85% of total billed charges,380.61,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,169.16,40,,,percent of total billed charges,40% of total billed charges,169.16,40,,,percent of total billed charges,40% of total billed charges,380.61,90,,,percent of total billed charges,90% of total billed charges,321.4,76,,,percent of total billed charges,76% of total billed charges,169.16,40,,,percent of total billed charges,40% of total billed charges,359.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,338.32,80,,,percent of total billed charges,80% of total billed charges,164.09,38.8,,,percent of total billed charges,38.8% of total billed charges,359.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,401.76,
Treatment of Swallowing Dysfunction,42692526,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,715.4,572.32,GN,536.55,75,,,percent of total billed charges,75% of total billed charges,286.16,40,,,percent of total billed charges,40% of total billed charges,566.6,79.2,,,percent of total billed charges,79.2% of total billed charges,608.09,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,679.63,95,,,percent of total billed charges,95% of total billed charges,572.32,80,,,percent of total billed charges,80% of total billed charges,608.09,85,,,percent of total billed charges,85% of total billed charges,643.86,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,286.16,40,,,percent of total billed charges,40% of total billed charges,286.16,40,,,percent of total billed charges,40% of total billed charges,643.86,90,,,percent of total billed charges,90% of total billed charges,543.7,76,,,percent of total billed charges,76% of total billed charges,286.16,40,,,percent of total billed charges,40% of total billed charges,608.09,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,572.32,80,,,percent of total billed charges,80% of total billed charges,277.58,38.8,,,percent of total billed charges,38.8% of total billed charges,608.09,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,679.63,
Tx of Speech/Lang/Voice/Comm/Auditory Chg,42692507,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,539.2,431.36,GN,404.4,75,,,percent of total billed charges,75% of total billed charges,215.68,40,,,percent of total billed charges,40% of total billed charges,427.05,79.2,,,percent of total billed charges,79.2% of total billed charges,458.32,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,512.24,95,,,percent of total billed charges,95% of total billed charges,431.36,80,,,percent of total billed charges,80% of total billed charges,458.32,85,,,percent of total billed charges,85% of total billed charges,485.28,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,215.68,40,,,percent of total billed charges,40% of total billed charges,215.68,40,,,percent of total billed charges,40% of total billed charges,485.28,90,,,percent of total billed charges,90% of total billed charges,409.79,76,,,percent of total billed charges,76% of total billed charges,215.68,40,,,percent of total billed charges,40% of total billed charges,458.32,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,431.36,80,,,percent of total billed charges,80% of total billed charges,209.21,38.8,,,percent of total billed charges,38.8% of total billed charges,458.32,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,512.24,
ST Fluro Eval of Swallow Function,60000349,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,519.7,415.76,GN,389.78,75,,,percent of total billed charges,75% of total billed charges,207.88,40,,,percent of total billed charges,40% of total billed charges,411.6,79.2,,,percent of total billed charges,79.2% of total billed charges,441.75,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,493.72,95,,,percent of total billed charges,95% of total billed charges,415.76,80,,,percent of total billed charges,80% of total billed charges,441.75,85,,,percent of total billed charges,85% of total billed charges,467.73,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,207.88,40,,,percent of total billed charges,40% of total billed charges,207.88,40,,,percent of total billed charges,40% of total billed charges,467.73,90,,,percent of total billed charges,90% of total billed charges,394.97,76,,,percent of total billed charges,76% of total billed charges,207.88,40,,,percent of total billed charges,40% of total billed charges,441.75,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,415.76,80,,,percent of total billed charges,80% of total billed charges,201.64,38.8,,,percent of total billed charges,38.8% of total billed charges,441.75,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,493.72,
US Extremity Nonvascular Comp,41276881,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,603.6,482.88,TC,452.7,75,,,percent of total billed charges,75% of total billed charges,241.44,40,,,percent of total billed charges,40% of total billed charges,478.05,79.2,,,percent of total billed charges,79.2% of total billed charges,513.06,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,573.42,95,,,percent of total billed charges,95% of total billed charges,482.88,80,,,percent of total billed charges,80% of total billed charges,513.06,85,,,percent of total billed charges,85% of total billed charges,543.24,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,241.44,40,,,percent of total billed charges,40% of total billed charges,241.44,40,,,percent of total billed charges,40% of total billed charges,543.24,90,,,percent of total billed charges,90% of total billed charges,458.74,76,,,percent of total billed charges,76% of total billed charges,241.44,40,,,percent of total billed charges,40% of total billed charges,513.06,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,482.88,80,,,percent of total billed charges,80% of total billed charges,234.2,38.8,,,percent of total billed charges,38.8% of total billed charges,513.06,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,573.42,
Aquatic Charge,47297113,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,136.1,108.88,GO,102.08,75,,,percent of total billed charges,75% of total billed charges,54.44,40,,,percent of total billed charges,40% of total billed charges,107.79,79.2,,,percent of total billed charges,79.2% of total billed charges,115.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,129.3,95,,,percent of total billed charges,95% of total billed charges,108.88,80,,,percent of total billed charges,80% of total billed charges,115.69,85,,,percent of total billed charges,85% of total billed charges,122.49,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,54.44,40,,,percent of total billed charges,40% of total billed charges,54.44,40,,,percent of total billed charges,40% of total billed charges,122.49,90,,,percent of total billed charges,90% of total billed charges,103.44,76,,,percent of total billed charges,76% of total billed charges,54.44,40,,,percent of total billed charges,40% of total billed charges,115.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,108.88,80,,,percent of total billed charges,80% of total billed charges,52.81,38.8,,,percent of total billed charges,38.8% of total billed charges,115.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,129.3,
Wheelchair Charge,60000271,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,114.7,91.76,GO,86.03,75,,,percent of total billed charges,75% of total billed charges,45.88,40,,,percent of total billed charges,40% of total billed charges,90.84,79.2,,,percent of total billed charges,79.2% of total billed charges,97.5,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,108.97,95,,,percent of total billed charges,95% of total billed charges,91.76,80,,,percent of total billed charges,80% of total billed charges,97.5,85,,,percent of total billed charges,85% of total billed charges,103.23,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,45.88,40,,,percent of total billed charges,40% of total billed charges,45.88,40,,,percent of total billed charges,40% of total billed charges,103.23,90,,,percent of total billed charges,90% of total billed charges,87.17,76,,,percent of total billed charges,76% of total billed charges,45.88,40,,,percent of total billed charges,40% of total billed charges,97.5,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,91.76,80,,,percent of total billed charges,80% of total billed charges,44.5,38.8,,,percent of total billed charges,38.8% of total billed charges,97.5,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,108.97,
Prosthetic Charge,60000272,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,121.5,97.2,GO,91.13,75,,,percent of total billed charges,75% of total billed charges,48.6,40,,,percent of total billed charges,40% of total billed charges,96.23,79.2,,,percent of total billed charges,79.2% of total billed charges,103.28,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,115.43,95,,,percent of total billed charges,95% of total billed charges,97.2,80,,,percent of total billed charges,80% of total billed charges,103.28,85,,,percent of total billed charges,85% of total billed charges,109.35,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,48.6,40,,,percent of total billed charges,40% of total billed charges,48.6,40,,,percent of total billed charges,40% of total billed charges,109.35,90,,,percent of total billed charges,90% of total billed charges,92.34,76,,,percent of total billed charges,76% of total billed charges,48.6,40,,,percent of total billed charges,40% of total billed charges,103.28,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,97.2,80,,,percent of total billed charges,80% of total billed charges,47.14,38.8,,,percent of total billed charges,38.8% of total billed charges,103.28,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,115.43,
CT Angio Neck w/ + w/o Cont,41170498,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,2834.5,2267.6,TC,2125.88,75,,,percent of total billed charges,75% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,2692.78,95,,,percent of total billed charges,95% of total billed charges,2267.6,80,,,percent of total billed charges,80% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,2551.05,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,1133.8,40,,,percent of total billed charges,40% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,2551.05,90,,,percent of total billed charges,90% of total billed charges,2154.22,76,,,percent of total billed charges,76% of total billed charges,1133.8,40,,,percent of total billed charges,40% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,2267.6,80,,,percent of total billed charges,80% of total billed charges,1099.79,38.8,,,percent of total billed charges,38.8% of total billed charges,2409.33,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,2692.78,
CT Angio Abdomen +Pelvis w/ Cont,41174174,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1499.2,1199.36,,1124.4,75,,,percent of total billed charges,75% of total billed charges,599.68,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1274.32,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1424.24,95,,,percent of total billed charges,95% of total billed charges,1199.36,80,,,percent of total billed charges,80% of total billed charges,1274.32,85,,,percent of total billed charges,85% of total billed charges,1349.28,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,599.68,40,,,percent of total billed charges,40% of total billed charges,599.68,40,,,percent of total billed charges,40% of total billed charges,1349.28,90,,,percent of total billed charges,90% of total billed charges,1139.39,76,,,percent of total billed charges,76% of total billed charges,599.68,40,,,percent of total billed charges,40% of total billed charges,1274.32,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1199.36,80,,,percent of total billed charges,80% of total billed charges,581.69,38.8,,,percent of total billed charges,38.8% of total billed charges,1274.32,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1424.24,
MA Diag Lt.,41500002,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,373.1,298.48,TC,279.83,75,,,percent of total billed charges,75% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,295.5,79.2,,,percent of total billed charges,79.2% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,354.45,95,,,percent of total billed charges,95% of total billed charges,298.48,80,,,percent of total billed charges,80% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,335.79,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,149.24,40,,,percent of total billed charges,40% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,335.79,90,,,percent of total billed charges,90% of total billed charges,283.56,76,,,percent of total billed charges,76% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,298.48,80,,,percent of total billed charges,80% of total billed charges,144.76,38.8,,,percent of total billed charges,38.8% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,144.76,354.45,
76098 MA Breast Tissue Specimen.,41076098,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,1691.6,1353.28,TC,1268.7,75,,,percent of total billed charges,75% of total billed charges,676.64,40,,,percent of total billed charges,40% of total billed charges,1339.75,79.2,,,percent of total billed charges,79.2% of total billed charges,1437.86,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,1607.02,95,,,percent of total billed charges,95% of total billed charges,1353.28,80,,,percent of total billed charges,80% of total billed charges,1437.86,85,,,percent of total billed charges,85% of total billed charges,1522.44,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,676.64,40,,,percent of total billed charges,40% of total billed charges,676.64,40,,,percent of total billed charges,40% of total billed charges,1522.44,90,,,percent of total billed charges,90% of total billed charges,1285.62,76,,,percent of total billed charges,76% of total billed charges,676.64,40,,,percent of total billed charges,40% of total billed charges,1437.86,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,1353.28,80,,,percent of total billed charges,80% of total billed charges,656.34,38.8,,,percent of total billed charges,38.8% of total billed charges,1437.86,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,1607.02,
"Microalbumin, 24 Hour Urine.",40082043,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,136.9,109.52,,102.68,75,,,percent of total billed charges,75% of total billed charges,54.76,40,,,percent of total billed charges,40% of total billed charges,108.42,79.2,,,percent of total billed charges,79.2% of total billed charges,116.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,130.06,95,,,percent of total billed charges,95% of total billed charges,109.52,80,,,percent of total billed charges,80% of total billed charges,116.37,85,,,percent of total billed charges,85% of total billed charges,123.21,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,54.76,40,,,percent of total billed charges,40% of total billed charges,54.76,40,,,percent of total billed charges,40% of total billed charges,123.21,90,,,percent of total billed charges,90% of total billed charges,104.04,76,,,percent of total billed charges,76% of total billed charges,54.76,40,,,percent of total billed charges,40% of total billed charges,116.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,109.52,80,,,percent of total billed charges,80% of total billed charges,53.12,38.8,,,percent of total billed charges,38.8% of total billed charges,116.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,130.06,
ADL Training Charge,60000159,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,139.1,111.28,GP,104.33,75,,,percent of total billed charges,75% of total billed charges,55.64,40,,,percent of total billed charges,40% of total billed charges,110.17,79.2,,,percent of total billed charges,79.2% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,132.15,95,,,percent of total billed charges,95% of total billed charges,111.28,80,,,percent of total billed charges,80% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,125.19,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,55.64,40,,,percent of total billed charges,40% of total billed charges,55.64,40,,,percent of total billed charges,40% of total billed charges,125.19,90,,,percent of total billed charges,90% of total billed charges,105.72,76,,,percent of total billed charges,76% of total billed charges,55.64,40,,,percent of total billed charges,40% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,111.28,80,,,percent of total billed charges,80% of total billed charges,53.97,38.8,,,percent of total billed charges,38.8% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,132.15,
Sensory Stimulation Charge,60000353,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,117,93.6,GN,87.75,75,,,percent of total billed charges,75% of total billed charges,46.8,40,,,percent of total billed charges,40% of total billed charges,92.66,79.2,,,percent of total billed charges,79.2% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,111.15,95,,,percent of total billed charges,95% of total billed charges,93.6,80,,,percent of total billed charges,80% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,105.3,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,46.8,40,,,percent of total billed charges,40% of total billed charges,46.8,40,,,percent of total billed charges,40% of total billed charges,105.3,90,,,percent of total billed charges,90% of total billed charges,88.92,76,,,percent of total billed charges,76% of total billed charges,46.8,40,,,percent of total billed charges,40% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,93.6,80,,,percent of total billed charges,80% of total billed charges,45.4,38.8,,,percent of total billed charges,38.8% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,133.56,
"Analgesics, non-opioid; 1 or 2",40080329,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,103.9,83.12,,77.93,75,,,percent of total billed charges,75% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,82.29,79.2,,,percent of total billed charges,79.2% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,98.71,95,,,percent of total billed charges,95% of total billed charges,83.12,80,,,percent of total billed charges,80% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,41.56,40,,,percent of total billed charges,40% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,78.96,76,,,percent of total billed charges,76% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,83.12,80,,,percent of total billed charges,80% of total billed charges,40.31,38.8,,,percent of total billed charges,38.8% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,98.71,
"T4, Total",40084436,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,94.7,75.76,,71.03,75,,,percent of total billed charges,75% of total billed charges,37.88,40,,,percent of total billed charges,40% of total billed charges,75,79.2,,,percent of total billed charges,79.2% of total billed charges,80.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,89.97,95,,,percent of total billed charges,95% of total billed charges,75.76,80,,,percent of total billed charges,80% of total billed charges,80.5,85,,,percent of total billed charges,85% of total billed charges,85.23,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,37.88,40,,,percent of total billed charges,40% of total billed charges,37.88,40,,,percent of total billed charges,40% of total billed charges,85.23,90,,,percent of total billed charges,90% of total billed charges,71.97,76,,,percent of total billed charges,76% of total billed charges,37.88,40,,,percent of total billed charges,40% of total billed charges,80.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,75.76,80,,,percent of total billed charges,80% of total billed charges,36.74,38.8,,,percent of total billed charges,38.8% of total billed charges,80.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,89.97,
"Magnesium, Urine",40083735,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,80.66,
CT Elbow w/ + w/o Cont Lt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Elbow w/ + w/o Cont Rt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Elbow w/ Cont Lt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Elbow w/ Cont Rt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
US Echo 2D Rest +Stress,42893350,CDM,483,RC,,,OUTPATIENT,,,1625.4,1300.32,,1219.05,75,,,percent of total billed charges,75% of total billed charges,650.16,40,,,percent of total billed charges,40% of total billed charges,1287.32,79.2,,,percent of total billed charges,79.2% of total billed charges,1381.59,85,,,percent of total billed charges,85% of total billed charges,1625.4,100,,,fee schedule,100% of CO APG rates,1544.13,95,,,percent of total billed charges,95% of total billed charges,1300.32,80,,,percent of total billed charges,80% of total billed charges,1381.59,85,,,percent of total billed charges,85% of total billed charges,1462.86,90,,,percent of total billed charges,90% of total billed charges,1625.4,100,,,fee schedule,100% of CO APG rates,1625.4,100,,,fee schedule,100% of CO APG rates,1625.4,100,,,fee schedule,100% of NM fee schedule,650.16,40,,,percent of total billed charges,40% of total billed charges,650.16,40,,,percent of total billed charges,40% of total billed charges,1462.86,90,,,percent of total billed charges,90% of total billed charges,1235.3,76,,,percent of total billed charges,76% of total billed charges,650.16,40,,,percent of total billed charges,40% of total billed charges,1381.59,85,,,percent of total billed charges,85% of total billed charges,1625.4,100,,,fee schedule,100% of CO APG rate,1300.32,80,,,percent of total billed charges,80% of total billed charges,630.66,38.8,,,percent of total billed charges,38.8% of total billed charges,1381.59,85,,,percent of total billed charges,85% of total billed charges,1625.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,630.66,1625.4,
XR Shoulder Comp Min 2 Views Lt,41073030,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
XR Shoulder Comp Min 2 Views Rt,41073030,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,285.8,228.64,TC,214.35,75,,,percent of total billed charges,75% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,226.35,79.2,,,percent of total billed charges,79.2% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,271.51,95,,,percent of total billed charges,95% of total billed charges,228.64,80,,,percent of total billed charges,80% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,114.32,40,,,percent of total billed charges,40% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,257.22,90,,,percent of total billed charges,90% of total billed charges,217.21,76,,,percent of total billed charges,76% of total billed charges,114.32,40,,,percent of total billed charges,40% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,228.64,80,,,percent of total billed charges,80% of total billed charges,110.89,38.8,,,percent of total billed charges,38.8% of total billed charges,242.93,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,271.51,
T3 Uptake LC,40084479,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,20.8,16.64,,15.6,75,,,percent of total billed charges,75% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,16.47,79.2,,,percent of total billed charges,79.2% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,19.76,95,,,percent of total billed charges,95% of total billed charges,16.64,80,,,percent of total billed charges,80% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,8.32,40,,,percent of total billed charges,40% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,15.81,76,,,percent of total billed charges,76% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,16.64,80,,,percent of total billed charges,80% of total billed charges,8.07,38.8,,,percent of total billed charges,38.8% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,19.76,
"Thyroxine (T4) Free, Direct, LC",40084439,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,23.6,18.88,,17.7,75,,,percent of total billed charges,75% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,18.69,79.2,,,percent of total billed charges,79.2% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,22.42,95,,,percent of total billed charges,95% of total billed charges,18.88,80,,,percent of total billed charges,80% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,21.24,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.44,40,,,percent of total billed charges,40% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,21.24,90,,,percent of total billed charges,90% of total billed charges,17.94,76,,,percent of total billed charges,76% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,18.88,80,,,percent of total billed charges,80% of total billed charges,9.16,38.8,,,percent of total billed charges,38.8% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,22.42,
Triiodothyronine (T3) LC,40084480,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,31.2,24.96,,23.4,75,,,percent of total billed charges,75% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,24.71,79.2,,,percent of total billed charges,79.2% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,29.64,95,,,percent of total billed charges,95% of total billed charges,24.96,80,,,percent of total billed charges,80% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.48,40,,,percent of total billed charges,40% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,23.71,76,,,percent of total billed charges,76% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,24.96,80,,,percent of total billed charges,80% of total billed charges,12.11,38.8,,,percent of total billed charges,38.8% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,29.64,
"Triiodothyronine,Free LC",40084481,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,391.8,313.44,,293.85,75,,,percent of total billed charges,75% of total billed charges,156.72,40,,,percent of total billed charges,40% of total billed charges,310.31,79.2,,,percent of total billed charges,79.2% of total billed charges,333.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,372.21,95,,,percent of total billed charges,95% of total billed charges,313.44,80,,,percent of total billed charges,80% of total billed charges,333.03,85,,,percent of total billed charges,85% of total billed charges,352.62,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,156.72,40,,,percent of total billed charges,40% of total billed charges,156.72,40,,,percent of total billed charges,40% of total billed charges,352.62,90,,,percent of total billed charges,90% of total billed charges,297.77,76,,,percent of total billed charges,76% of total billed charges,156.72,40,,,percent of total billed charges,40% of total billed charges,333.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,313.44,80,,,percent of total billed charges,80% of total billed charges,152.02,38.8,,,percent of total billed charges,38.8% of total billed charges,333.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,372.21,
Testosterone LC,40084403,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,33.5,26.8,,25.13,75,,,percent of total billed charges,75% of total billed charges,13.4,40,,,percent of total billed charges,40% of total billed charges,26.53,79.2,,,percent of total billed charges,79.2% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,31.83,95,,,percent of total billed charges,95% of total billed charges,26.8,80,,,percent of total billed charges,80% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,30.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,13.4,40,,,percent of total billed charges,40% of total billed charges,13.4,40,,,percent of total billed charges,40% of total billed charges,30.15,90,,,percent of total billed charges,90% of total billed charges,25.46,76,,,percent of total billed charges,76% of total billed charges,13.4,40,,,percent of total billed charges,40% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,26.8,80,,,percent of total billed charges,80% of total billed charges,13,38.8,,,percent of total billed charges,38.8% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,31.83,
TSH LC,40084443,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,138.2,110.56,,103.65,75,,,percent of total billed charges,75% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,109.45,79.2,,,percent of total billed charges,79.2% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,131.29,95,,,percent of total billed charges,95% of total billed charges,110.56,80,,,percent of total billed charges,80% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,55.28,40,,,percent of total billed charges,40% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,105.03,76,,,percent of total billed charges,76% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,110.56,80,,,percent of total billed charges,80% of total billed charges,53.62,38.8,,,percent of total billed charges,38.8% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,131.29,
Vitamin B12 LC,40001503,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,26.6,21.28,,19.95,75,,,percent of total billed charges,75% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,21.07,79.2,,,percent of total billed charges,79.2% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,25.27,95,,,percent of total billed charges,95% of total billed charges,21.28,80,,,percent of total billed charges,80% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,23.94,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,10.64,40,,,percent of total billed charges,40% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,23.94,90,,,percent of total billed charges,90% of total billed charges,20.22,76,,,percent of total billed charges,76% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,21.28,80,,,percent of total billed charges,80% of total billed charges,10.32,38.8,,,percent of total billed charges,38.8% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,25.27,
Vit B12 and Folate LC,40082607,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,38,30.4,,28.5,75,,,percent of total billed charges,75% of total billed charges,15.2,40,,,percent of total billed charges,40% of total billed charges,30.1,79.2,,,percent of total billed charges,79.2% of total billed charges,32.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,36.1,95,,,percent of total billed charges,95% of total billed charges,30.4,80,,,percent of total billed charges,80% of total billed charges,32.3,85,,,percent of total billed charges,85% of total billed charges,34.2,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,15.2,40,,,percent of total billed charges,40% of total billed charges,15.2,40,,,percent of total billed charges,40% of total billed charges,34.2,90,,,percent of total billed charges,90% of total billed charges,28.88,76,,,percent of total billed charges,76% of total billed charges,15.2,40,,,percent of total billed charges,40% of total billed charges,32.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,30.4,80,,,percent of total billed charges,80% of total billed charges,14.74,38.8,,,percent of total billed charges,38.8% of total billed charges,32.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,36.1,
Copper Serum LC,40082525,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,41.14,
Zinc LC,40084630,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,116.9,93.52,,87.68,75,,,percent of total billed charges,75% of total billed charges,46.76,40,,,percent of total billed charges,40% of total billed charges,92.58,79.2,,,percent of total billed charges,79.2% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,111.06,95,,,percent of total billed charges,95% of total billed charges,93.52,80,,,percent of total billed charges,80% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,105.21,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,46.76,40,,,percent of total billed charges,40% of total billed charges,46.76,40,,,percent of total billed charges,40% of total billed charges,105.21,90,,,percent of total billed charges,90% of total billed charges,88.84,76,,,percent of total billed charges,76% of total billed charges,46.76,40,,,percent of total billed charges,40% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,93.52,80,,,percent of total billed charges,80% of total billed charges,45.36,38.8,,,percent of total billed charges,38.8% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,111.06,
Complement C3 LC,40086160,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,23.6,18.88,,17.7,75,,,percent of total billed charges,75% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,18.69,79.2,,,percent of total billed charges,79.2% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,22.42,95,,,percent of total billed charges,95% of total billed charges,18.88,80,,,percent of total billed charges,80% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,21.24,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,9.44,40,,,percent of total billed charges,40% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,21.24,90,,,percent of total billed charges,90% of total billed charges,17.94,76,,,percent of total billed charges,76% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,18.88,80,,,percent of total billed charges,80% of total billed charges,9.16,38.8,,,percent of total billed charges,38.8% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,22.42,
Complement C4 LC,40086160,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,22.1,17.68,,16.58,75,,,percent of total billed charges,75% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,17.5,79.2,,,percent of total billed charges,79.2% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,21,95,,,percent of total billed charges,95% of total billed charges,17.68,80,,,percent of total billed charges,80% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,19.89,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,8.84,40,,,percent of total billed charges,40% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,19.89,90,,,percent of total billed charges,90% of total billed charges,16.8,76,,,percent of total billed charges,76% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,17.68,80,,,percent of total billed charges,80% of total billed charges,8.57,38.8,,,percent of total billed charges,38.8% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,21,
Cancer Antigen (CA) 125 LC,40086304,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,31.2,24.96,,23.4,75,,,percent of total billed charges,75% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,24.71,79.2,,,percent of total billed charges,79.2% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,29.64,95,,,percent of total billed charges,95% of total billed charges,24.96,80,,,percent of total billed charges,80% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,12.48,40,,,percent of total billed charges,40% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,23.71,76,,,percent of total billed charges,76% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,24.96,80,,,percent of total billed charges,80% of total billed charges,12.11,38.8,,,percent of total billed charges,38.8% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,29.64,
FSH LC,40083001,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,156.2,124.96,,117.15,75,,,percent of total billed charges,75% of total billed charges,62.48,40,,,percent of total billed charges,40% of total billed charges,123.71,79.2,,,percent of total billed charges,79.2% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,148.39,95,,,percent of total billed charges,95% of total billed charges,124.96,80,,,percent of total billed charges,80% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,140.58,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,62.48,40,,,percent of total billed charges,40% of total billed charges,62.48,40,,,percent of total billed charges,40% of total billed charges,140.58,90,,,percent of total billed charges,90% of total billed charges,118.71,76,,,percent of total billed charges,76% of total billed charges,62.48,40,,,percent of total billed charges,40% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,124.96,80,,,percent of total billed charges,80% of total billed charges,60.61,38.8,,,percent of total billed charges,38.8% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,148.39,
Insulin LC,40083525,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,22.9,18.32,,17.18,75,,,percent of total billed charges,75% of total billed charges,9.16,40,,,percent of total billed charges,40% of total billed charges,18.14,79.2,,,percent of total billed charges,79.2% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,21.76,95,,,percent of total billed charges,95% of total billed charges,18.32,80,,,percent of total billed charges,80% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,20.61,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.16,40,,,percent of total billed charges,40% of total billed charges,9.16,40,,,percent of total billed charges,40% of total billed charges,20.61,90,,,percent of total billed charges,90% of total billed charges,17.4,76,,,percent of total billed charges,76% of total billed charges,9.16,40,,,percent of total billed charges,40% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,18.32,80,,,percent of total billed charges,80% of total billed charges,8.89,38.8,,,percent of total billed charges,38.8% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,21.76,
Prolactin LC,40004465,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,32.3,25.84,,24.23,75,,,percent of total billed charges,75% of total billed charges,12.92,40,,,percent of total billed charges,40% of total billed charges,25.58,79.2,,,percent of total billed charges,79.2% of total billed charges,27.46,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,30.69,95,,,percent of total billed charges,95% of total billed charges,25.84,80,,,percent of total billed charges,80% of total billed charges,27.46,85,,,percent of total billed charges,85% of total billed charges,29.07,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.92,40,,,percent of total billed charges,40% of total billed charges,12.92,40,,,percent of total billed charges,40% of total billed charges,29.07,90,,,percent of total billed charges,90% of total billed charges,24.55,76,,,percent of total billed charges,76% of total billed charges,12.92,40,,,percent of total billed charges,40% of total billed charges,27.46,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,25.84,80,,,percent of total billed charges,80% of total billed charges,12.53,38.8,,,percent of total billed charges,38.8% of total billed charges,27.46,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,30.69,
Estradiol LC,40004515,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,45.6,36.48,,34.2,75,,,percent of total billed charges,75% of total billed charges,18.24,40,,,percent of total billed charges,40% of total billed charges,36.12,79.2,,,percent of total billed charges,79.2% of total billed charges,38.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,43.32,95,,,percent of total billed charges,95% of total billed charges,36.48,80,,,percent of total billed charges,80% of total billed charges,38.76,85,,,percent of total billed charges,85% of total billed charges,41.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,18.24,40,,,percent of total billed charges,40% of total billed charges,18.24,40,,,percent of total billed charges,40% of total billed charges,41.04,90,,,percent of total billed charges,90% of total billed charges,34.66,76,,,percent of total billed charges,76% of total billed charges,18.24,40,,,percent of total billed charges,40% of total billed charges,38.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,36.48,80,,,percent of total billed charges,80% of total billed charges,17.69,38.8,,,percent of total billed charges,38.8% of total billed charges,38.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,43.32,
Rheumatoid Arthritis Factor LC,40086431,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,20.6,16.48,,15.45,75,,,percent of total billed charges,75% of total billed charges,8.24,40,,,percent of total billed charges,40% of total billed charges,16.32,79.2,,,percent of total billed charges,79.2% of total billed charges,17.51,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,19.57,95,,,percent of total billed charges,95% of total billed charges,16.48,80,,,percent of total billed charges,80% of total billed charges,17.51,85,,,percent of total billed charges,85% of total billed charges,18.54,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,8.24,40,,,percent of total billed charges,40% of total billed charges,8.24,40,,,percent of total billed charges,40% of total billed charges,18.54,90,,,percent of total billed charges,90% of total billed charges,15.66,76,,,percent of total billed charges,76% of total billed charges,8.24,40,,,percent of total billed charges,40% of total billed charges,17.51,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,16.48,80,,,percent of total billed charges,80% of total billed charges,7.99,38.8,,,percent of total billed charges,38.8% of total billed charges,17.51,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,19.57,
C-Reactive Protein LC,40086140,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,112.8,90.24,,84.6,75,,,percent of total billed charges,75% of total billed charges,45.12,40,,,percent of total billed charges,40% of total billed charges,89.34,79.2,,,percent of total billed charges,79.2% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,107.16,95,,,percent of total billed charges,95% of total billed charges,90.24,80,,,percent of total billed charges,80% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,101.52,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,45.12,40,,,percent of total billed charges,40% of total billed charges,45.12,40,,,percent of total billed charges,40% of total billed charges,101.52,90,,,percent of total billed charges,90% of total billed charges,85.73,76,,,percent of total billed charges,76% of total billed charges,45.12,40,,,percent of total billed charges,40% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,90.24,80,,,percent of total billed charges,80% of total billed charges,43.77,38.8,,,percent of total billed charges,38.8% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,107.16,
"C-Reactive Protein, Cardiac LC",40086141,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,119.2,95.36,,89.4,75,,,percent of total billed charges,75% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,94.41,79.2,,,percent of total billed charges,79.2% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,113.24,95,,,percent of total billed charges,95% of total billed charges,95.36,80,,,percent of total billed charges,80% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,107.28,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,47.68,40,,,percent of total billed charges,40% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,107.28,90,,,percent of total billed charges,90% of total billed charges,90.59,76,,,percent of total billed charges,76% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,95.36,80,,,percent of total billed charges,80% of total billed charges,46.25,38.8,,,percent of total billed charges,38.8% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,113.24,
Cyclosporine LC,40080158,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,47.1,37.68,,35.33,75,,,percent of total billed charges,75% of total billed charges,18.84,40,,,percent of total billed charges,40% of total billed charges,37.3,79.2,,,percent of total billed charges,79.2% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,44.75,95,,,percent of total billed charges,95% of total billed charges,37.68,80,,,percent of total billed charges,80% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,42.39,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,18.84,40,,,percent of total billed charges,40% of total billed charges,18.84,40,,,percent of total billed charges,40% of total billed charges,42.39,90,,,percent of total billed charges,90% of total billed charges,35.8,76,,,percent of total billed charges,76% of total billed charges,18.84,40,,,percent of total billed charges,40% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,37.68,80,,,percent of total billed charges,80% of total billed charges,18.27,38.8,,,percent of total billed charges,38.8% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,44.75,
Valproic Acid LC,40007260,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,31.2,24.96,,23.4,75,,,percent of total billed charges,75% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,24.71,79.2,,,percent of total billed charges,79.2% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,29.64,95,,,percent of total billed charges,95% of total billed charges,24.96,80,,,percent of total billed charges,80% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.48,40,,,percent of total billed charges,40% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,23.71,76,,,percent of total billed charges,76% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,24.96,80,,,percent of total billed charges,80% of total billed charges,12.11,38.8,,,percent of total billed charges,38.8% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,29.64,
Oxcarbazepine (Trileptal) LC,40080183,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,43,34.4,,32.25,75,,,percent of total billed charges,75% of total billed charges,17.2,40,,,percent of total billed charges,40% of total billed charges,34.06,79.2,,,percent of total billed charges,79.2% of total billed charges,36.55,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,40.85,95,,,percent of total billed charges,95% of total billed charges,34.4,80,,,percent of total billed charges,80% of total billed charges,36.55,85,,,percent of total billed charges,85% of total billed charges,38.7,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,17.2,40,,,percent of total billed charges,40% of total billed charges,17.2,40,,,percent of total billed charges,40% of total billed charges,38.7,90,,,percent of total billed charges,90% of total billed charges,32.68,76,,,percent of total billed charges,76% of total billed charges,17.2,40,,,percent of total billed charges,40% of total billed charges,36.55,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,34.4,80,,,percent of total billed charges,80% of total billed charges,16.68,38.8,,,percent of total billed charges,38.8% of total billed charges,36.55,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,40.85,
"Lead, Blood (Adult) LC",40083655,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,28.2,22.56,,21.15,75,,,percent of total billed charges,75% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,22.33,79.2,,,percent of total billed charges,79.2% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,26.79,95,,,percent of total billed charges,95% of total billed charges,22.56,80,,,percent of total billed charges,80% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,25.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,11.28,40,,,percent of total billed charges,40% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,25.38,90,,,percent of total billed charges,90% of total billed charges,21.43,76,,,percent of total billed charges,76% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,22.56,80,,,percent of total billed charges,80% of total billed charges,10.94,38.8,,,percent of total billed charges,38.8% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,26.79,
Lead (Pediatric) LC,40083655,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,24.9,19.92,,18.68,75,,,percent of total billed charges,75% of total billed charges,9.96,40,,,percent of total billed charges,40% of total billed charges,19.72,79.2,,,percent of total billed charges,79.2% of total billed charges,21.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,23.66,95,,,percent of total billed charges,95% of total billed charges,19.92,80,,,percent of total billed charges,80% of total billed charges,21.17,85,,,percent of total billed charges,85% of total billed charges,22.41,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.96,40,,,percent of total billed charges,40% of total billed charges,9.96,40,,,percent of total billed charges,40% of total billed charges,22.41,90,,,percent of total billed charges,90% of total billed charges,18.92,76,,,percent of total billed charges,76% of total billed charges,9.96,40,,,percent of total billed charges,40% of total billed charges,21.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,19.92,80,,,percent of total billed charges,80% of total billed charges,9.66,38.8,,,percent of total billed charges,38.8% of total billed charges,21.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,23.66,
C-Peptide LC,40084681,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,168.9,135.12,,126.68,75,,,percent of total billed charges,75% of total billed charges,67.56,40,,,percent of total billed charges,40% of total billed charges,133.77,79.2,,,percent of total billed charges,79.2% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,160.46,95,,,percent of total billed charges,95% of total billed charges,135.12,80,,,percent of total billed charges,80% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,152.01,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,67.56,40,,,percent of total billed charges,40% of total billed charges,67.56,40,,,percent of total billed charges,40% of total billed charges,152.01,90,,,percent of total billed charges,90% of total billed charges,128.36,76,,,percent of total billed charges,76% of total billed charges,67.56,40,,,percent of total billed charges,40% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,135.12,80,,,percent of total billed charges,80% of total billed charges,65.53,38.8,,,percent of total billed charges,38.8% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,160.46,
Prostate-Specific Ag LC,40084153,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,25.1,20.08,,18.83,75,,,percent of total billed charges,75% of total billed charges,10.04,40,,,percent of total billed charges,40% of total billed charges,19.88,79.2,,,percent of total billed charges,79.2% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,23.85,95,,,percent of total billed charges,95% of total billed charges,20.08,80,,,percent of total billed charges,80% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,22.59,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,10.04,40,,,percent of total billed charges,40% of total billed charges,10.04,40,,,percent of total billed charges,40% of total billed charges,22.59,90,,,percent of total billed charges,90% of total billed charges,19.08,76,,,percent of total billed charges,76% of total billed charges,10.04,40,,,percent of total billed charges,40% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,20.08,80,,,percent of total billed charges,80% of total billed charges,9.74,38.8,,,percent of total billed charges,38.8% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,23.85,
"Creatinine, Urine LC",40082570,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,8.8,7.04,,6.6,75,,,percent of total billed charges,75% of total billed charges,3.52,40,,,percent of total billed charges,40% of total billed charges,6.97,79.2,,,percent of total billed charges,79.2% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,8.36,95,,,percent of total billed charges,95% of total billed charges,7.04,80,,,percent of total billed charges,80% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,7.92,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,3.52,40,,,percent of total billed charges,40% of total billed charges,3.52,40,,,percent of total billed charges,40% of total billed charges,7.92,90,,,percent of total billed charges,90% of total billed charges,6.69,76,,,percent of total billed charges,76% of total billed charges,3.52,40,,,percent of total billed charges,40% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,7.04,80,,,percent of total billed charges,80% of total billed charges,3.41,38.8,,,percent of total billed charges,38.8% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,3.41,8.76,
Antibody; Borrelia burgdorferi (Lyme disease),40086618,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,166.8,133.44,,125.1,75,,,percent of total billed charges,75% of total billed charges,66.72,40,,,percent of total billed charges,40% of total billed charges,132.11,79.2,,,percent of total billed charges,79.2% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,158.46,95,,,percent of total billed charges,95% of total billed charges,133.44,80,,,percent of total billed charges,80% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,150.12,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,66.72,40,,,percent of total billed charges,40% of total billed charges,66.72,40,,,percent of total billed charges,40% of total billed charges,150.12,90,,,percent of total billed charges,90% of total billed charges,126.77,76,,,percent of total billed charges,76% of total billed charges,66.72,40,,,percent of total billed charges,40% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,133.44,80,,,percent of total billed charges,80% of total billed charges,64.72,38.8,,,percent of total billed charges,38.8% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,158.46,
"Vitamin D, 25-Hydroxy LC",40081950,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,69.1,55.28,,51.83,75,,,percent of total billed charges,75% of total billed charges,27.64,40,,,percent of total billed charges,40% of total billed charges,54.73,79.2,,,percent of total billed charges,79.2% of total billed charges,58.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,65.65,95,,,percent of total billed charges,95% of total billed charges,55.28,80,,,percent of total billed charges,80% of total billed charges,58.74,85,,,percent of total billed charges,85% of total billed charges,62.19,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,27.64,40,,,percent of total billed charges,40% of total billed charges,27.64,40,,,percent of total billed charges,40% of total billed charges,62.19,90,,,percent of total billed charges,90% of total billed charges,52.52,76,,,percent of total billed charges,76% of total billed charges,27.64,40,,,percent of total billed charges,40% of total billed charges,58.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,55.28,80,,,percent of total billed charges,80% of total billed charges,26.81,38.8,,,percent of total billed charges,38.8% of total billed charges,58.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,65.65,
Cortisol AM LC,40004051,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,26.6,21.28,,19.95,75,,,percent of total billed charges,75% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,21.07,79.2,,,percent of total billed charges,79.2% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,25.27,95,,,percent of total billed charges,95% of total billed charges,21.28,80,,,percent of total billed charges,80% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,23.94,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,10.64,40,,,percent of total billed charges,40% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,23.94,90,,,percent of total billed charges,90% of total billed charges,20.22,76,,,percent of total billed charges,76% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,21.28,80,,,percent of total billed charges,80% of total billed charges,10.32,38.8,,,percent of total billed charges,38.8% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,25.27,
HCV Antibody LC,40040659,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,26.6,21.28,,19.95,75,,,percent of total billed charges,75% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,21.07,79.2,,,percent of total billed charges,79.2% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,25.27,95,,,percent of total billed charges,95% of total billed charges,21.28,80,,,percent of total billed charges,80% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,23.94,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,10.64,40,,,percent of total billed charges,40% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,23.94,90,,,percent of total billed charges,90% of total billed charges,20.22,76,,,percent of total billed charges,76% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,21.28,80,,,percent of total billed charges,80% of total billed charges,10.32,38.8,,,percent of total billed charges,38.8% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,25.27,
"H. pylori IgG, Abs LC",40062289,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,37.2,29.76,,27.9,75,,,percent of total billed charges,75% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,29.46,79.2,,,percent of total billed charges,79.2% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,35.34,95,,,percent of total billed charges,95% of total billed charges,29.76,80,,,percent of total billed charges,80% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,33.48,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,14.88,40,,,percent of total billed charges,40% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,33.48,90,,,percent of total billed charges,90% of total billed charges,28.27,76,,,percent of total billed charges,76% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,29.76,80,,,percent of total billed charges,80% of total billed charges,14.43,38.8,,,percent of total billed charges,38.8% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,35.34,
"H pylori, IgM, IgG, IgA Ab LC",40086677,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,105.4,84.32,,79.05,75,,,percent of total billed charges,75% of total billed charges,42.16,40,,,percent of total billed charges,40% of total billed charges,83.48,79.2,,,percent of total billed charges,79.2% of total billed charges,89.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,100.13,95,,,percent of total billed charges,95% of total billed charges,84.32,80,,,percent of total billed charges,80% of total billed charges,89.59,85,,,percent of total billed charges,85% of total billed charges,94.86,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,42.16,40,,,percent of total billed charges,40% of total billed charges,42.16,40,,,percent of total billed charges,40% of total billed charges,94.86,90,,,percent of total billed charges,90% of total billed charges,80.1,76,,,percent of total billed charges,76% of total billed charges,42.16,40,,,percent of total billed charges,40% of total billed charges,89.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,84.32,80,,,percent of total billed charges,80% of total billed charges,40.9,38.8,,,percent of total billed charges,38.8% of total billed charges,89.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,100.13,
PSA Total+% Free LC,40084154,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,127.5,102,,95.63,75,,,percent of total billed charges,75% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,100.98,79.2,,,percent of total billed charges,79.2% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,121.13,95,,,percent of total billed charges,95% of total billed charges,102,80,,,percent of total billed charges,80% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,51,40,,,percent of total billed charges,40% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,96.9,76,,,percent of total billed charges,76% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,102,80,,,percent of total billed charges,80% of total billed charges,49.47,38.8,,,percent of total billed charges,38.8% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,121.13,
ANA Comprehensive Panel LC,40065902,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,894,715.2,,670.5,75,,,percent of total billed charges,75% of total billed charges,357.6,40,,,percent of total billed charges,40% of total billed charges,708.05,79.2,,,percent of total billed charges,79.2% of total billed charges,759.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,849.3,95,,,percent of total billed charges,95% of total billed charges,715.2,80,,,percent of total billed charges,80% of total billed charges,759.9,85,,,percent of total billed charges,85% of total billed charges,804.6,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,357.6,40,,,percent of total billed charges,40% of total billed charges,357.6,40,,,percent of total billed charges,40% of total billed charges,804.6,90,,,percent of total billed charges,90% of total billed charges,679.44,76,,,percent of total billed charges,76% of total billed charges,357.6,40,,,percent of total billed charges,40% of total billed charges,759.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,715.2,80,,,percent of total billed charges,80% of total billed charges,346.87,38.8,,,percent of total billed charges,38.8% of total billed charges,759.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,849.3,
"Rocky Mtn Spotted Fever, IgM LC",40086757,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,55.2,44.16,,41.4,75,,,percent of total billed charges,75% of total billed charges,22.08,40,,,percent of total billed charges,40% of total billed charges,43.72,79.2,,,percent of total billed charges,79.2% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,52.44,95,,,percent of total billed charges,95% of total billed charges,44.16,80,,,percent of total billed charges,80% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,22.08,40,,,percent of total billed charges,40% of total billed charges,22.08,40,,,percent of total billed charges,40% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,41.95,76,,,percent of total billed charges,76% of total billed charges,22.08,40,,,percent of total billed charges,40% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,44.16,80,,,percent of total billed charges,80% of total billed charges,21.42,38.8,,,percent of total billed charges,38.8% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,52.44,
"Rocky Mtn Spotted Fev, IgG, Qn LC",40086757,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,47.8,38.24,,35.85,75,,,percent of total billed charges,75% of total billed charges,19.12,40,,,percent of total billed charges,40% of total billed charges,37.86,79.2,,,percent of total billed charges,79.2% of total billed charges,40.63,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,45.41,95,,,percent of total billed charges,95% of total billed charges,38.24,80,,,percent of total billed charges,80% of total billed charges,40.63,85,,,percent of total billed charges,85% of total billed charges,43.02,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,19.12,40,,,percent of total billed charges,40% of total billed charges,19.12,40,,,percent of total billed charges,40% of total billed charges,43.02,90,,,percent of total billed charges,90% of total billed charges,36.33,76,,,percent of total billed charges,76% of total billed charges,19.12,40,,,percent of total billed charges,40% of total billed charges,40.63,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,38.24,80,,,percent of total billed charges,80% of total billed charges,18.55,38.8,,,percent of total billed charges,38.8% of total billed charges,40.63,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,45.41,
Antinuclear Antibodies Direct LC,40086038,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,35.7,28.56,,26.78,75,,,percent of total billed charges,75% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,28.27,79.2,,,percent of total billed charges,79.2% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,33.92,95,,,percent of total billed charges,95% of total billed charges,28.56,80,,,percent of total billed charges,80% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,14.28,40,,,percent of total billed charges,40% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,27.13,76,,,percent of total billed charges,76% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,28.56,80,,,percent of total billed charges,80% of total billed charges,13.85,38.8,,,percent of total billed charges,38.8% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,33.92,
"Antinuclear Antibodies, IFA LC",40086038,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,35.7,28.56,,26.78,75,,,percent of total billed charges,75% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,28.27,79.2,,,percent of total billed charges,79.2% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,33.92,95,,,percent of total billed charges,95% of total billed charges,28.56,80,,,percent of total billed charges,80% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,14.28,40,,,percent of total billed charges,40% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,27.13,76,,,percent of total billed charges,76% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,28.56,80,,,percent of total billed charges,80% of total billed charges,13.85,38.8,,,percent of total billed charges,38.8% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,33.92,
Ova + Parasite Exam LC,40087177,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,20.1,16.08,,15.08,75,,,percent of total billed charges,75% of total billed charges,8.04,40,,,percent of total billed charges,40% of total billed charges,15.92,79.2,,,percent of total billed charges,79.2% of total billed charges,17.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,19.1,95,,,percent of total billed charges,95% of total billed charges,16.08,80,,,percent of total billed charges,80% of total billed charges,17.09,85,,,percent of total billed charges,85% of total billed charges,18.09,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,8.04,40,,,percent of total billed charges,40% of total billed charges,8.04,40,,,percent of total billed charges,40% of total billed charges,18.09,90,,,percent of total billed charges,90% of total billed charges,15.28,76,,,percent of total billed charges,76% of total billed charges,8.04,40,,,percent of total billed charges,40% of total billed charges,17.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,16.08,80,,,percent of total billed charges,80% of total billed charges,7.8,38.8,,,percent of total billed charges,38.8% of total billed charges,17.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,7.8,33.1,
"Calcium, 24Hr Urine LC",40003269,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,9.1,7.28,,6.83,75,,,percent of total billed charges,75% of total billed charges,3.64,40,,,percent of total billed charges,40% of total billed charges,7.21,79.2,,,percent of total billed charges,79.2% of total billed charges,7.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,8.65,95,,,percent of total billed charges,95% of total billed charges,7.28,80,,,percent of total billed charges,80% of total billed charges,7.74,85,,,percent of total billed charges,85% of total billed charges,8.19,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,3.64,40,,,percent of total billed charges,40% of total billed charges,3.64,40,,,percent of total billed charges,40% of total billed charges,8.19,90,,,percent of total billed charges,90% of total billed charges,6.92,76,,,percent of total billed charges,76% of total billed charges,3.64,40,,,percent of total billed charges,40% of total billed charges,7.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,7.28,80,,,percent of total billed charges,80% of total billed charges,3.53,38.8,,,percent of total billed charges,38.8% of total billed charges,7.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,3.53,8.76,
"Protein Electro, 24-Hr Urine LC",40084156,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,29.8,23.84,,22.35,75,,,percent of total billed charges,75% of total billed charges,11.92,40,,,percent of total billed charges,40% of total billed charges,23.6,79.2,,,percent of total billed charges,79.2% of total billed charges,25.33,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,28.31,95,,,percent of total billed charges,95% of total billed charges,23.84,80,,,percent of total billed charges,80% of total billed charges,25.33,85,,,percent of total billed charges,85% of total billed charges,26.82,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,11.92,40,,,percent of total billed charges,40% of total billed charges,11.92,40,,,percent of total billed charges,40% of total billed charges,26.82,90,,,percent of total billed charges,90% of total billed charges,22.65,76,,,percent of total billed charges,76% of total billed charges,11.92,40,,,percent of total billed charges,40% of total billed charges,25.33,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,23.84,80,,,percent of total billed charges,80% of total billed charges,11.56,38.8,,,percent of total billed charges,38.8% of total billed charges,25.33,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,28.31,
"IFE+Protein Electro, 24-Hr Ur LC",40084156,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,80.5,64.4,,60.38,75,,,percent of total billed charges,75% of total billed charges,32.2,40,,,percent of total billed charges,40% of total billed charges,63.76,79.2,,,percent of total billed charges,79.2% of total billed charges,68.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,76.48,95,,,percent of total billed charges,95% of total billed charges,64.4,80,,,percent of total billed charges,80% of total billed charges,68.43,85,,,percent of total billed charges,85% of total billed charges,72.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,32.2,40,,,percent of total billed charges,40% of total billed charges,32.2,40,,,percent of total billed charges,40% of total billed charges,72.45,90,,,percent of total billed charges,90% of total billed charges,61.18,76,,,percent of total billed charges,76% of total billed charges,32.2,40,,,percent of total billed charges,40% of total billed charges,68.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,64.4,80,,,percent of total billed charges,80% of total billed charges,31.23,38.8,,,percent of total billed charges,38.8% of total billed charges,68.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,76.48,
"Albumin/Creat Ratio, Ur LC",40082043,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,76.4,61.12,,57.3,75,,,percent of total billed charges,75% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,60.51,79.2,,,percent of total billed charges,79.2% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,72.58,95,,,percent of total billed charges,95% of total billed charges,61.12,80,,,percent of total billed charges,80% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,30.56,40,,,percent of total billed charges,40% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,58.06,76,,,percent of total billed charges,76% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,61.12,80,,,percent of total billed charges,80% of total billed charges,29.64,38.8,,,percent of total billed charges,38.8% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,72.58,
HIV Ag/Ab with Reflex,60001055,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,86.7,69.36,,65.03,75,,,percent of total billed charges,75% of total billed charges,34.68,40,,,percent of total billed charges,40% of total billed charges,68.67,79.2,,,percent of total billed charges,79.2% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,82.37,95,,,percent of total billed charges,95% of total billed charges,69.36,80,,,percent of total billed charges,80% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,34.68,40,,,percent of total billed charges,40% of total billed charges,34.68,40,,,percent of total billed charges,40% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,65.89,76,,,percent of total billed charges,76% of total billed charges,34.68,40,,,percent of total billed charges,40% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,69.36,80,,,percent of total billed charges,80% of total billed charges,33.64,38.8,,,percent of total billed charges,38.8% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,82.37,
Comp. Metabolic Panel (14) LC,40022000,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,18.4,14.72,,13.8,75,,,percent of total billed charges,75% of total billed charges,7.36,40,,,percent of total billed charges,40% of total billed charges,14.57,79.2,,,percent of total billed charges,79.2% of total billed charges,15.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,17.48,95,,,percent of total billed charges,95% of total billed charges,14.72,80,,,percent of total billed charges,80% of total billed charges,15.64,85,,,percent of total billed charges,85% of total billed charges,16.56,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,7.36,40,,,percent of total billed charges,40% of total billed charges,7.36,40,,,percent of total billed charges,40% of total billed charges,16.56,90,,,percent of total billed charges,90% of total billed charges,13.98,76,,,percent of total billed charges,76% of total billed charges,7.36,40,,,percent of total billed charges,40% of total billed charges,15.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,14.72,80,,,percent of total billed charges,80% of total billed charges,7.14,38.8,,,percent of total billed charges,38.8% of total billed charges,15.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,7.14,33.06,
Hepatitis Panel (4) LC,40022744,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,384.5,307.6,,288.38,75,,,percent of total billed charges,75% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,304.52,79.2,,,percent of total billed charges,79.2% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,365.28,95,,,percent of total billed charges,95% of total billed charges,307.6,80,,,percent of total billed charges,80% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,346.05,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,153.8,40,,,percent of total billed charges,40% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,346.05,90,,,percent of total billed charges,90% of total billed charges,292.22,76,,,percent of total billed charges,76% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,307.6,80,,,percent of total billed charges,80% of total billed charges,149.19,38.8,,,percent of total billed charges,38.8% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,365.28,
"Lyme, Western Blot LC",40086617,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,172.1,137.68,,129.08,75,,,percent of total billed charges,75% of total billed charges,68.84,40,,,percent of total billed charges,40% of total billed charges,136.3,79.2,,,percent of total billed charges,79.2% of total billed charges,146.29,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,163.5,95,,,percent of total billed charges,95% of total billed charges,137.68,80,,,percent of total billed charges,80% of total billed charges,146.29,85,,,percent of total billed charges,85% of total billed charges,154.89,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,68.84,40,,,percent of total billed charges,40% of total billed charges,68.84,40,,,percent of total billed charges,40% of total billed charges,154.89,90,,,percent of total billed charges,90% of total billed charges,130.8,76,,,percent of total billed charges,76% of total billed charges,68.84,40,,,percent of total billed charges,40% of total billed charges,146.29,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,137.68,80,,,percent of total billed charges,80% of total billed charges,66.77,38.8,,,percent of total billed charges,38.8% of total billed charges,146.29,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,163.5,
Aldolase LC,40082085,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,20.8,16.64,,15.6,75,,,percent of total billed charges,75% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,16.47,79.2,,,percent of total billed charges,79.2% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,19.76,95,,,percent of total billed charges,95% of total billed charges,16.64,80,,,percent of total billed charges,80% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,8.32,40,,,percent of total billed charges,40% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,15.81,76,,,percent of total billed charges,76% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,16.64,80,,,percent of total billed charges,80% of total billed charges,8.07,38.8,,,percent of total billed charges,38.8% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,19.76,
"Calcium, Ionized LC",40004804,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,19.5,15.6,,14.63,75,,,percent of total billed charges,75% of total billed charges,7.8,40,,,percent of total billed charges,40% of total billed charges,15.44,79.2,,,percent of total billed charges,79.2% of total billed charges,16.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,18.53,95,,,percent of total billed charges,95% of total billed charges,15.6,80,,,percent of total billed charges,80% of total billed charges,16.58,85,,,percent of total billed charges,85% of total billed charges,17.55,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,7.8,40,,,percent of total billed charges,40% of total billed charges,7.8,40,,,percent of total billed charges,40% of total billed charges,17.55,90,,,percent of total billed charges,90% of total billed charges,14.82,76,,,percent of total billed charges,76% of total billed charges,7.8,40,,,percent of total billed charges,40% of total billed charges,16.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,15.6,80,,,percent of total billed charges,80% of total billed charges,7.57,38.8,,,percent of total billed charges,38.8% of total billed charges,16.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,18.53,
Immunoassay for analyte other than infectious agent antibody,40083516,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,118,94.4,,88.5,75,,,percent of total billed charges,75% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,93.46,79.2,,,percent of total billed charges,79.2% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,112.1,95,,,percent of total billed charges,95% of total billed charges,94.4,80,,,percent of total billed charges,80% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,47.2,40,,,percent of total billed charges,40% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,89.68,76,,,percent of total billed charges,76% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,94.4,80,,,percent of total billed charges,80% of total billed charges,45.78,38.8,,,percent of total billed charges,38.8% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,112.1,
Thyroid Peroxidase Ab LC,40086376,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,26,20.8,,19.5,75,,,percent of total billed charges,75% of total billed charges,10.4,40,,,percent of total billed charges,40% of total billed charges,20.59,79.2,,,percent of total billed charges,79.2% of total billed charges,22.1,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,24.7,95,,,percent of total billed charges,95% of total billed charges,20.8,80,,,percent of total billed charges,80% of total billed charges,22.1,85,,,percent of total billed charges,85% of total billed charges,23.4,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,10.4,40,,,percent of total billed charges,40% of total billed charges,10.4,40,,,percent of total billed charges,40% of total billed charges,23.4,90,,,percent of total billed charges,90% of total billed charges,19.76,76,,,percent of total billed charges,76% of total billed charges,10.4,40,,,percent of total billed charges,40% of total billed charges,22.1,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,20.8,80,,,percent of total billed charges,80% of total billed charges,10.09,38.8,,,percent of total billed charges,38.8% of total billed charges,22.1,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,24.7,
Beta Strep Gp A Culture LC,40087081,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,12.5,10,,9.38,75,,,percent of total billed charges,75% of total billed charges,5,40,,,percent of total billed charges,40% of total billed charges,9.9,79.2,,,percent of total billed charges,79.2% of total billed charges,10.63,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,11.88,95,,,percent of total billed charges,95% of total billed charges,10,80,,,percent of total billed charges,80% of total billed charges,10.63,85,,,percent of total billed charges,85% of total billed charges,11.25,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,5,40,,,percent of total billed charges,40% of total billed charges,5,40,,,percent of total billed charges,40% of total billed charges,11.25,90,,,percent of total billed charges,90% of total billed charges,9.5,76,,,percent of total billed charges,76% of total billed charges,5,40,,,percent of total billed charges,40% of total billed charges,10.63,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,10,80,,,percent of total billed charges,80% of total billed charges,4.85,38.8,,,percent of total billed charges,38.8% of total billed charges,10.63,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,4.85,33.1,
CCP Antibodies IgG/IgA LC,40086200,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,122.2,97.76,,91.65,75,,,percent of total billed charges,75% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,96.78,79.2,,,percent of total billed charges,79.2% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,116.09,95,,,percent of total billed charges,95% of total billed charges,97.76,80,,,percent of total billed charges,80% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,109.98,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,48.88,40,,,percent of total billed charges,40% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,109.98,90,,,percent of total billed charges,90% of total billed charges,92.87,76,,,percent of total billed charges,76% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,97.76,80,,,percent of total billed charges,80% of total billed charges,47.41,38.8,,,percent of total billed charges,38.8% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,116.09,
"Cardiolipin (phospholipid) antibody, each Ig class",40086147,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,134,107.2,,100.5,75,,,percent of total billed charges,75% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,106.13,79.2,,,percent of total billed charges,79.2% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,127.3,95,,,percent of total billed charges,95% of total billed charges,107.2,80,,,percent of total billed charges,80% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,53.6,40,,,percent of total billed charges,40% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,101.84,76,,,percent of total billed charges,76% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,107.2,80,,,percent of total billed charges,80% of total billed charges,51.99,38.8,,,percent of total billed charges,38.8% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,127.3,
"Sjogren's Ab, Anti-SS-A/-SS-B LC",40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,125.4,100.32,,94.05,75,,,percent of total billed charges,75% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,99.32,79.2,,,percent of total billed charges,79.2% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,119.13,95,,,percent of total billed charges,95% of total billed charges,100.32,80,,,percent of total billed charges,80% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.16,40,,,percent of total billed charges,40% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,95.3,76,,,percent of total billed charges,76% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,100.32,80,,,percent of total billed charges,80% of total billed charges,48.66,38.8,,,percent of total billed charges,38.8% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,119.13,
ANA w/Reflex LC,40086038,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,35.7,28.56,,26.78,75,,,percent of total billed charges,75% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,28.27,79.2,,,percent of total billed charges,79.2% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,33.92,95,,,percent of total billed charges,95% of total billed charges,28.56,80,,,percent of total billed charges,80% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,14.28,40,,,percent of total billed charges,40% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,27.13,76,,,percent of total billed charges,76% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,28.56,80,,,percent of total billed charges,80% of total billed charges,13.85,38.8,,,percent of total billed charges,38.8% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,33.92,
Chlamydia/GC Amplification LC,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,84.5,67.6,,63.38,75,,,percent of total billed charges,75% of total billed charges,33.8,40,,,percent of total billed charges,40% of total billed charges,66.92,79.2,,,percent of total billed charges,79.2% of total billed charges,71.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,80.28,95,,,percent of total billed charges,95% of total billed charges,67.6,80,,,percent of total billed charges,80% of total billed charges,71.83,85,,,percent of total billed charges,85% of total billed charges,76.05,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,33.8,40,,,percent of total billed charges,40% of total billed charges,33.8,40,,,percent of total billed charges,40% of total billed charges,76.05,90,,,percent of total billed charges,90% of total billed charges,64.22,76,,,percent of total billed charges,76% of total billed charges,33.8,40,,,percent of total billed charges,40% of total billed charges,71.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,67.6,80,,,percent of total billed charges,80% of total billed charges,32.79,38.8,,,percent of total billed charges,38.8% of total billed charges,71.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,80.28,
Antiscleroderma-70 Antibodies LC,40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,319.6,255.68,,239.7,75,,,percent of total billed charges,75% of total billed charges,127.84,40,,,percent of total billed charges,40% of total billed charges,253.12,79.2,,,percent of total billed charges,79.2% of total billed charges,271.66,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,303.62,95,,,percent of total billed charges,95% of total billed charges,255.68,80,,,percent of total billed charges,80% of total billed charges,271.66,85,,,percent of total billed charges,85% of total billed charges,287.64,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,127.84,40,,,percent of total billed charges,40% of total billed charges,127.84,40,,,percent of total billed charges,40% of total billed charges,287.64,90,,,percent of total billed charges,90% of total billed charges,242.9,76,,,percent of total billed charges,76% of total billed charges,127.84,40,,,percent of total billed charges,40% of total billed charges,271.66,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,255.68,80,,,percent of total billed charges,80% of total billed charges,124,38.8,,,percent of total billed charges,38.8% of total billed charges,271.66,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,303.62,
"Chlamydia trachomatis, NAA LC",40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,344.6,275.68,,258.45,75,,,percent of total billed charges,75% of total billed charges,137.84,40,,,percent of total billed charges,40% of total billed charges,272.92,79.2,,,percent of total billed charges,79.2% of total billed charges,292.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,327.37,95,,,percent of total billed charges,95% of total billed charges,275.68,80,,,percent of total billed charges,80% of total billed charges,292.91,85,,,percent of total billed charges,85% of total billed charges,310.14,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,137.84,40,,,percent of total billed charges,40% of total billed charges,137.84,40,,,percent of total billed charges,40% of total billed charges,310.14,90,,,percent of total billed charges,90% of total billed charges,261.9,76,,,percent of total billed charges,76% of total billed charges,137.84,40,,,percent of total billed charges,40% of total billed charges,292.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,275.68,80,,,percent of total billed charges,80% of total billed charges,133.7,38.8,,,percent of total billed charges,38.8% of total billed charges,292.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,327.37,
"Neisseria gonorrhoeae, NAA LC",40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,43.9,35.12,,32.93,75,,,percent of total billed charges,75% of total billed charges,17.56,40,,,percent of total billed charges,40% of total billed charges,34.77,79.2,,,percent of total billed charges,79.2% of total billed charges,37.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,41.71,95,,,percent of total billed charges,95% of total billed charges,35.12,80,,,percent of total billed charges,80% of total billed charges,37.32,85,,,percent of total billed charges,85% of total billed charges,39.51,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,17.56,40,,,percent of total billed charges,40% of total billed charges,17.56,40,,,percent of total billed charges,40% of total billed charges,39.51,90,,,percent of total billed charges,90% of total billed charges,33.36,76,,,percent of total billed charges,76% of total billed charges,17.56,40,,,percent of total billed charges,40% of total billed charges,37.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,35.12,80,,,percent of total billed charges,80% of total billed charges,17.03,38.8,,,percent of total billed charges,38.8% of total billed charges,37.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,41.71,
CT Femur w/ + w/o Cont Lt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Femur w/ + w/o Cont Rt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Femur w/ Cont Lt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Femur w/ Cont Rt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Femur w/o Cont Lt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Femur w/o Cont Rt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Forearm w/ + w/o Cont Lt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Forearm w/ + w/o Cont Rt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Forearm w/ Cont Lt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Forearm w/ Cont Rt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Forearm w/o Cont Lt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Forearm w/o Cont Rt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Hand w/ + w/o Cont Lt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Hand w/ + w/o Cont Rt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Hand w/ Cont Lt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Hand w/ Cont Rt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Hand w/o Cont Lt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Hand w/o Cont Rt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Humerus w/ + w/o Cont Lt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Humerus w/ + w/o Cont Rt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Humerus w/ Cont Lt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Humerus w/ Cont Rt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Humerus w/o Cont Lt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Humerus w/o Cont Rt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Shoulder w/ + w/o Cont Lt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Shoulder w/ + w/o Cont Rt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Shoulder w/ Cont Lt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Shoulder w/ Cont Rt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Tibia/Fibula w/ + w/o Cont Lt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Tibia/Fibula w/ + w/o Cont Rt,41173702,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1930.9,1544.72,TC,1448.18,75,,,percent of total billed charges,75% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1834.36,95,,,percent of total billed charges,95% of total billed charges,1544.72,80,,,percent of total billed charges,80% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,772.36,40,,,percent of total billed charges,40% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1737.81,90,,,percent of total billed charges,90% of total billed charges,1467.48,76,,,percent of total billed charges,76% of total billed charges,772.36,40,,,percent of total billed charges,40% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1544.72,80,,,percent of total billed charges,80% of total billed charges,749.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1641.27,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1834.36,
CT Tibia/Fibula w/ Cont Lt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Tibia/Fibula w/ Cont Rt,41173701,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Tibia/Fibula w/o Cont Lt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Tibia/Fibula w/o Cont Rt,41173700,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Wrist w/ + w/o Cont Lt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Wrist w/ + w/o Cont Rt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Wrist w/ Cont Lt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Wrist w/ Cont Rt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
MA Breast Ndl Loc Placement Lt.,41519281,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,408.5,326.8,LT,306.38,75,,,percent of total billed charges,75% of total billed charges,163.4,40,,,percent of total billed charges,40% of total billed charges,323.53,79.2,,,percent of total billed charges,79.2% of total billed charges,347.23,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,388.08,95,,,percent of total billed charges,95% of total billed charges,326.8,80,,,percent of total billed charges,80% of total billed charges,347.23,85,,,percent of total billed charges,85% of total billed charges,367.65,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,163.4,40,,,percent of total billed charges,40% of total billed charges,163.4,40,,,percent of total billed charges,40% of total billed charges,367.65,90,,,percent of total billed charges,90% of total billed charges,310.46,76,,,percent of total billed charges,76% of total billed charges,163.4,40,,,percent of total billed charges,40% of total billed charges,347.23,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,326.8,80,,,percent of total billed charges,80% of total billed charges,158.5,38.8,,,percent of total billed charges,38.8% of total billed charges,347.23,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,388.08,
"MA Breast needle Loc w/ clip placement; first lesion, mammog",41519281,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,408.5,326.8,LT,306.38,75,,,percent of total billed charges,75% of total billed charges,163.4,40,,,percent of total billed charges,40% of total billed charges,323.53,79.2,,,percent of total billed charges,79.2% of total billed charges,347.23,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,388.08,95,,,percent of total billed charges,95% of total billed charges,326.8,80,,,percent of total billed charges,80% of total billed charges,347.23,85,,,percent of total billed charges,85% of total billed charges,367.65,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,163.4,40,,,percent of total billed charges,40% of total billed charges,163.4,40,,,percent of total billed charges,40% of total billed charges,367.65,90,,,percent of total billed charges,90% of total billed charges,310.46,76,,,percent of total billed charges,76% of total billed charges,163.4,40,,,percent of total billed charges,40% of total billed charges,347.23,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,326.8,80,,,percent of total billed charges,80% of total billed charges,158.5,38.8,,,percent of total billed charges,38.8% of total billed charges,347.23,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,388.08,
Dilute Prothrombin Time(dPT) LC,40085705,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,208.4,166.72,,156.3,75,,,percent of total billed charges,75% of total billed charges,83.36,40,,,percent of total billed charges,40% of total billed charges,165.05,79.2,,,percent of total billed charges,79.2% of total billed charges,177.14,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,197.98,95,,,percent of total billed charges,95% of total billed charges,166.72,80,,,percent of total billed charges,80% of total billed charges,177.14,85,,,percent of total billed charges,85% of total billed charges,187.56,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,83.36,40,,,percent of total billed charges,40% of total billed charges,83.36,40,,,percent of total billed charges,40% of total billed charges,187.56,90,,,percent of total billed charges,90% of total billed charges,158.38,76,,,percent of total billed charges,76% of total billed charges,83.36,40,,,percent of total billed charges,40% of total billed charges,177.14,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,166.72,80,,,percent of total billed charges,80% of total billed charges,80.86,38.8,,,percent of total billed charges,38.8% of total billed charges,177.14,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,197.98,
Thrombin Time LC,40085670,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,77.4,61.92,,58.05,75,,,percent of total billed charges,75% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,61.3,79.2,,,percent of total billed charges,79.2% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,73.53,95,,,percent of total billed charges,95% of total billed charges,61.92,80,,,percent of total billed charges,80% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,69.66,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,30.96,40,,,percent of total billed charges,40% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,69.66,90,,,percent of total billed charges,90% of total billed charges,58.82,76,,,percent of total billed charges,76% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,61.92,80,,,percent of total billed charges,80% of total billed charges,30.03,38.8,,,percent of total billed charges,38.8% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,73.53,
PTT-LA LC,40085732,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,42.7,34.16,,32.03,75,,,percent of total billed charges,75% of total billed charges,17.08,40,,,percent of total billed charges,40% of total billed charges,33.82,79.2,,,percent of total billed charges,79.2% of total billed charges,36.3,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,40.57,95,,,percent of total billed charges,95% of total billed charges,34.16,80,,,percent of total billed charges,80% of total billed charges,36.3,85,,,percent of total billed charges,85% of total billed charges,38.43,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,17.08,40,,,percent of total billed charges,40% of total billed charges,17.08,40,,,percent of total billed charges,40% of total billed charges,38.43,90,,,percent of total billed charges,90% of total billed charges,32.45,76,,,percent of total billed charges,76% of total billed charges,17.08,40,,,percent of total billed charges,40% of total billed charges,36.3,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,34.16,80,,,percent of total billed charges,80% of total billed charges,16.57,38.8,,,percent of total billed charges,38.8% of total billed charges,36.3,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,40.57,
dRVVT LC,40085613,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,76.6,61.28,,57.45,75,,,percent of total billed charges,75% of total billed charges,30.64,40,,,percent of total billed charges,40% of total billed charges,60.67,79.2,,,percent of total billed charges,79.2% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,72.77,95,,,percent of total billed charges,95% of total billed charges,61.28,80,,,percent of total billed charges,80% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,68.94,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,30.64,40,,,percent of total billed charges,40% of total billed charges,30.64,40,,,percent of total billed charges,40% of total billed charges,68.94,90,,,percent of total billed charges,90% of total billed charges,58.22,76,,,percent of total billed charges,76% of total billed charges,30.64,40,,,percent of total billed charges,40% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,61.28,80,,,percent of total billed charges,80% of total billed charges,29.72,38.8,,,percent of total billed charges,38.8% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,72.77,
TSH LC,40084436,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,138.2,110.56,,103.65,75,,,percent of total billed charges,75% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,109.45,79.2,,,percent of total billed charges,79.2% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,131.29,95,,,percent of total billed charges,95% of total billed charges,110.56,80,,,percent of total billed charges,80% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,55.28,40,,,percent of total billed charges,40% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,105.03,76,,,percent of total billed charges,76% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,110.56,80,,,percent of total billed charges,80% of total billed charges,53.62,38.8,,,percent of total billed charges,38.8% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,131.29,
Thyroxine (T4) LC,40084436,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,20.8,16.64,,15.6,75,,,percent of total billed charges,75% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,16.47,79.2,,,percent of total billed charges,79.2% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,19.76,95,,,percent of total billed charges,95% of total billed charges,16.64,80,,,percent of total billed charges,80% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,8.32,40,,,percent of total billed charges,40% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,15.81,76,,,percent of total billed charges,76% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,16.64,80,,,percent of total billed charges,80% of total billed charges,8.07,38.8,,,percent of total billed charges,38.8% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,19.76,
T3 Uptake LC,40084479,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,20.8,16.64,,15.6,75,,,percent of total billed charges,75% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,16.47,79.2,,,percent of total billed charges,79.2% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,19.76,95,,,percent of total billed charges,95% of total billed charges,16.64,80,,,percent of total billed charges,80% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,8.32,40,,,percent of total billed charges,40% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,15.81,76,,,percent of total billed charges,76% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,16.64,80,,,percent of total billed charges,80% of total billed charges,8.07,38.8,,,percent of total billed charges,38.8% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,19.76,
Osmolality LC,40083930,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,27.2,21.76,,20.4,75,,,percent of total billed charges,75% of total billed charges,10.88,40,,,percent of total billed charges,40% of total billed charges,21.54,79.2,,,percent of total billed charges,79.2% of total billed charges,23.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,25.84,95,,,percent of total billed charges,95% of total billed charges,21.76,80,,,percent of total billed charges,80% of total billed charges,23.12,85,,,percent of total billed charges,85% of total billed charges,24.48,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,10.88,40,,,percent of total billed charges,40% of total billed charges,10.88,40,,,percent of total billed charges,40% of total billed charges,24.48,90,,,percent of total billed charges,90% of total billed charges,20.67,76,,,percent of total billed charges,76% of total billed charges,10.88,40,,,percent of total billed charges,40% of total billed charges,23.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,21.76,80,,,percent of total billed charges,80% of total billed charges,10.55,38.8,,,percent of total billed charges,38.8% of total billed charges,23.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,25.84,
Candida species LC,40087480,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,106.2,84.96,,79.65,75,,,percent of total billed charges,75% of total billed charges,42.48,40,,,percent of total billed charges,40% of total billed charges,84.11,79.2,,,percent of total billed charges,79.2% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,100.89,95,,,percent of total billed charges,95% of total billed charges,84.96,80,,,percent of total billed charges,80% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,95.58,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,42.48,40,,,percent of total billed charges,40% of total billed charges,42.48,40,,,percent of total billed charges,40% of total billed charges,95.58,90,,,percent of total billed charges,90% of total billed charges,80.71,76,,,percent of total billed charges,76% of total billed charges,42.48,40,,,percent of total billed charges,40% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,84.96,80,,,percent of total billed charges,80% of total billed charges,41.21,38.8,,,percent of total billed charges,38.8% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,100.89,
Gardnerella vaginalis LC,40087510,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,368.1,294.48,,276.08,75,,,percent of total billed charges,75% of total billed charges,147.24,40,,,percent of total billed charges,40% of total billed charges,291.54,79.2,,,percent of total billed charges,79.2% of total billed charges,312.89,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,349.7,95,,,percent of total billed charges,95% of total billed charges,294.48,80,,,percent of total billed charges,80% of total billed charges,312.89,85,,,percent of total billed charges,85% of total billed charges,331.29,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,147.24,40,,,percent of total billed charges,40% of total billed charges,147.24,40,,,percent of total billed charges,40% of total billed charges,331.29,90,,,percent of total billed charges,90% of total billed charges,279.76,76,,,percent of total billed charges,76% of total billed charges,147.24,40,,,percent of total billed charges,40% of total billed charges,312.89,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,294.48,80,,,percent of total billed charges,80% of total billed charges,142.82,38.8,,,percent of total billed charges,38.8% of total billed charges,312.89,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,349.7,
Trichomonas vaginalis LC,40087660,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,368.1,294.48,,276.08,75,,,percent of total billed charges,75% of total billed charges,147.24,40,,,percent of total billed charges,40% of total billed charges,291.54,79.2,,,percent of total billed charges,79.2% of total billed charges,312.89,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,349.7,95,,,percent of total billed charges,95% of total billed charges,294.48,80,,,percent of total billed charges,80% of total billed charges,312.89,85,,,percent of total billed charges,85% of total billed charges,331.29,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,147.24,40,,,percent of total billed charges,40% of total billed charges,147.24,40,,,percent of total billed charges,40% of total billed charges,331.29,90,,,percent of total billed charges,90% of total billed charges,279.76,76,,,percent of total billed charges,76% of total billed charges,147.24,40,,,percent of total billed charges,40% of total billed charges,312.89,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,294.48,80,,,percent of total billed charges,80% of total billed charges,142.82,38.8,,,percent of total billed charges,38.8% of total billed charges,312.89,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,349.7,
Anaerobic and Aerobic Culture LC,40087070,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,50,40,,37.5,75,,,percent of total billed charges,75% of total billed charges,20,40,,,percent of total billed charges,40% of total billed charges,39.6,79.2,,,percent of total billed charges,79.2% of total billed charges,42.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,47.5,95,,,percent of total billed charges,95% of total billed charges,40,80,,,percent of total billed charges,80% of total billed charges,42.5,85,,,percent of total billed charges,85% of total billed charges,45,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,20,40,,,percent of total billed charges,40% of total billed charges,20,40,,,percent of total billed charges,40% of total billed charges,45,90,,,percent of total billed charges,90% of total billed charges,38,76,,,percent of total billed charges,76% of total billed charges,20,40,,,percent of total billed charges,40% of total billed charges,42.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,40,80,,,percent of total billed charges,80% of total billed charges,19.4,38.8,,,percent of total billed charges,38.8% of total billed charges,42.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,47.5,
.Anaerobic Result LC,40087076,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,85.7,68.56,,64.28,75,,,percent of total billed charges,75% of total billed charges,34.28,40,,,percent of total billed charges,40% of total billed charges,67.87,79.2,,,percent of total billed charges,79.2% of total billed charges,72.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,81.42,95,,,percent of total billed charges,95% of total billed charges,68.56,80,,,percent of total billed charges,80% of total billed charges,72.85,85,,,percent of total billed charges,85% of total billed charges,77.13,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,34.28,40,,,percent of total billed charges,40% of total billed charges,34.28,40,,,percent of total billed charges,40% of total billed charges,77.13,90,,,percent of total billed charges,90% of total billed charges,65.13,76,,,percent of total billed charges,76% of total billed charges,34.28,40,,,percent of total billed charges,40% of total billed charges,72.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,68.56,80,,,percent of total billed charges,80% of total billed charges,33.25,38.8,,,percent of total billed charges,38.8% of total billed charges,72.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,81.42,
"Blood Culture, Routine LC",40087040,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,103.9,83.12,,77.93,75,,,percent of total billed charges,75% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,82.29,79.2,,,percent of total billed charges,79.2% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,98.71,95,,,percent of total billed charges,95% of total billed charges,83.12,80,,,percent of total billed charges,80% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,41.56,40,,,percent of total billed charges,40% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,78.96,76,,,percent of total billed charges,76% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,83.12,80,,,percent of total billed charges,80% of total billed charges,40.31,38.8,,,percent of total billed charges,38.8% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,98.71,
"Genital Culture, Routine LC",40087070,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,21.4,17.12,,16.05,75,,,percent of total billed charges,75% of total billed charges,8.56,40,,,percent of total billed charges,40% of total billed charges,16.95,79.2,,,percent of total billed charges,79.2% of total billed charges,18.19,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,20.33,95,,,percent of total billed charges,95% of total billed charges,17.12,80,,,percent of total billed charges,80% of total billed charges,18.19,85,,,percent of total billed charges,85% of total billed charges,19.26,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,8.56,40,,,percent of total billed charges,40% of total billed charges,8.56,40,,,percent of total billed charges,40% of total billed charges,19.26,90,,,percent of total billed charges,90% of total billed charges,16.26,76,,,percent of total billed charges,76% of total billed charges,8.56,40,,,percent of total billed charges,40% of total billed charges,18.19,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,17.12,80,,,percent of total billed charges,80% of total billed charges,8.3,38.8,,,percent of total billed charges,38.8% of total billed charges,18.19,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,8.3,33.1,
Upper Respiratory Culture LC,40087070,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,17.2,13.76,,12.9,75,,,percent of total billed charges,75% of total billed charges,6.88,40,,,percent of total billed charges,40% of total billed charges,13.62,79.2,,,percent of total billed charges,79.2% of total billed charges,14.62,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,16.34,95,,,percent of total billed charges,95% of total billed charges,13.76,80,,,percent of total billed charges,80% of total billed charges,14.62,85,,,percent of total billed charges,85% of total billed charges,15.48,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,6.88,40,,,percent of total billed charges,40% of total billed charges,6.88,40,,,percent of total billed charges,40% of total billed charges,15.48,90,,,percent of total billed charges,90% of total billed charges,13.07,76,,,percent of total billed charges,76% of total billed charges,6.88,40,,,percent of total billed charges,40% of total billed charges,14.62,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,13.76,80,,,percent of total billed charges,80% of total billed charges,6.67,38.8,,,percent of total billed charges,38.8% of total billed charges,14.62,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,6.67,33.1,
Urine Culture LC,40087086,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,12.1,9.68,,9.08,75,,,percent of total billed charges,75% of total billed charges,4.84,40,,,percent of total billed charges,40% of total billed charges,9.58,79.2,,,percent of total billed charges,79.2% of total billed charges,10.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,11.5,95,,,percent of total billed charges,95% of total billed charges,9.68,80,,,percent of total billed charges,80% of total billed charges,10.29,85,,,percent of total billed charges,85% of total billed charges,10.89,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,4.84,40,,,percent of total billed charges,40% of total billed charges,4.84,40,,,percent of total billed charges,40% of total billed charges,10.89,90,,,percent of total billed charges,90% of total billed charges,9.2,76,,,percent of total billed charges,76% of total billed charges,4.84,40,,,percent of total billed charges,40% of total billed charges,10.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,9.68,80,,,percent of total billed charges,80% of total billed charges,4.69,38.8,,,percent of total billed charges,38.8% of total billed charges,10.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,4.69,33.1,
.Lower Resp Cult Result LC,40094879,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,15.1,12.08,,11.33,75,,,percent of total billed charges,75% of total billed charges,6.04,40,,,percent of total billed charges,40% of total billed charges,11.96,79.2,,,percent of total billed charges,79.2% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,14.35,95,,,percent of total billed charges,95% of total billed charges,12.08,80,,,percent of total billed charges,80% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,13.59,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,6.04,40,,,percent of total billed charges,40% of total billed charges,6.04,40,,,percent of total billed charges,40% of total billed charges,13.59,90,,,percent of total billed charges,90% of total billed charges,11.48,76,,,percent of total billed charges,76% of total billed charges,6.04,40,,,percent of total billed charges,40% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,12.08,80,,,percent of total billed charges,80% of total billed charges,5.86,38.8,,,percent of total billed charges,38.8% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,5.86,33.06,
E coli Shiga Toxin EIA LC,40087045,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,28.6,22.88,,21.45,75,,,percent of total billed charges,75% of total billed charges,11.44,40,,,percent of total billed charges,40% of total billed charges,22.65,79.2,,,percent of total billed charges,79.2% of total billed charges,24.31,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,27.17,95,,,percent of total billed charges,95% of total billed charges,22.88,80,,,percent of total billed charges,80% of total billed charges,24.31,85,,,percent of total billed charges,85% of total billed charges,25.74,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,11.44,40,,,percent of total billed charges,40% of total billed charges,11.44,40,,,percent of total billed charges,40% of total billed charges,25.74,90,,,percent of total billed charges,90% of total billed charges,21.74,76,,,percent of total billed charges,76% of total billed charges,11.44,40,,,percent of total billed charges,40% of total billed charges,24.31,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,22.88,80,,,percent of total billed charges,80% of total billed charges,11.1,38.8,,,percent of total billed charges,38.8% of total billed charges,24.31,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,33.1,
Salmonella/Shigella Screen LC,40087427,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,60.6,48.48,,45.45,75,,,percent of total billed charges,75% of total billed charges,24.24,40,,,percent of total billed charges,40% of total billed charges,48,79.2,,,percent of total billed charges,79.2% of total billed charges,51.51,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,57.57,95,,,percent of total billed charges,95% of total billed charges,48.48,80,,,percent of total billed charges,80% of total billed charges,51.51,85,,,percent of total billed charges,85% of total billed charges,54.54,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,24.24,40,,,percent of total billed charges,40% of total billed charges,24.24,40,,,percent of total billed charges,40% of total billed charges,54.54,90,,,percent of total billed charges,90% of total billed charges,46.06,76,,,percent of total billed charges,76% of total billed charges,24.24,40,,,percent of total billed charges,40% of total billed charges,51.51,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,48.48,80,,,percent of total billed charges,80% of total billed charges,23.51,38.8,,,percent of total billed charges,38.8% of total billed charges,51.51,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,57.57,
Campylobacter Culture LC,40087046,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,12.1,9.68,,9.08,75,,,percent of total billed charges,75% of total billed charges,4.84,40,,,percent of total billed charges,40% of total billed charges,9.58,79.2,,,percent of total billed charges,79.2% of total billed charges,10.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,11.5,95,,,percent of total billed charges,95% of total billed charges,9.68,80,,,percent of total billed charges,80% of total billed charges,10.29,85,,,percent of total billed charges,85% of total billed charges,10.89,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,4.84,40,,,percent of total billed charges,40% of total billed charges,4.84,40,,,percent of total billed charges,40% of total billed charges,10.89,90,,,percent of total billed charges,90% of total billed charges,9.2,76,,,percent of total billed charges,76% of total billed charges,4.84,40,,,percent of total billed charges,40% of total billed charges,10.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,9.68,80,,,percent of total billed charges,80% of total billed charges,4.69,38.8,,,percent of total billed charges,38.8% of total billed charges,10.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,4.69,33.1,
"19083 US BREAST BX W/ CLIP PLACEMENT, LT; FIRST LESION",41219083,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,2698.1,2158.48,LT,2023.58,75,,,percent of total billed charges,75% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2136.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,2563.2,95,,,percent of total billed charges,95% of total billed charges,2158.48,80,,,percent of total billed charges,80% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,2428.29,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,1079.24,40,,,percent of total billed charges,40% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2428.29,90,,,percent of total billed charges,90% of total billed charges,2050.56,76,,,percent of total billed charges,76% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,2158.48,80,,,percent of total billed charges,80% of total billed charges,1046.86,38.8,,,percent of total billed charges,38.8% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,2563.2,
MRI Hand w/ + w/o Cont Lt,41373220,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Hand w/ + w/o Cont Rt,41373220,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Hand w/o Cont Lt,41373218,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Hand w/o Cont Rt,41373218,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Hip w/ + w/o Cont Lt,41373720,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Hip w/ + w/o Cont Rt,41373720,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Hip w/o Cont Lt,41373721,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Hip w/o Cont Rt,41373721,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Humerus w/ + w/o Cont Lt,41373220,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Humerus w/ + w/o Cont Rt,41373220,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Humerus w/o Cont Lt,41373218,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Humerus w/o Cont Rt,41373218,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Knee w/ + w/o Cont Lt,41373723,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Knee w/ + w/o Cont Rt,41373723,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Shoulder w/ + w/o Cont Lt,41373223,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Shoulder w/ + w/o Cont Rt,41373223,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Shoulder w/o Cont Lt,41373221,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Shoulder w/o Cont Rt,41373221,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Tibia/Fibula w/ + w/o Cont Lt,41373720,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Tibia/Fibula w/ + w/o Cont Rt,41373720,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Tibia/Fibula w/o Cont Lt,41373718,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Tibia/Fibula w/o Cont Rt,41373718,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
XR AC Joints w/ or w/o Weights Bil,41073050,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,293.7,234.96,TC,220.28,75,,,percent of total billed charges,75% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,232.61,79.2,,,percent of total billed charges,79.2% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,279.02,95,,,percent of total billed charges,95% of total billed charges,234.96,80,,,percent of total billed charges,80% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,117.48,40,,,percent of total billed charges,40% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,223.21,76,,,percent of total billed charges,76% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,234.96,80,,,percent of total billed charges,80% of total billed charges,113.96,38.8,,,percent of total billed charges,38.8% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,279.02,
XR Bone Survey Ltd Mets,41077072,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,127.1,101.68,TC,95.33,75,,,percent of total billed charges,75% of total billed charges,50.84,40,,,percent of total billed charges,40% of total billed charges,100.66,79.2,,,percent of total billed charges,79.2% of total billed charges,108.04,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,120.75,95,,,percent of total billed charges,95% of total billed charges,101.68,80,,,percent of total billed charges,80% of total billed charges,108.04,85,,,percent of total billed charges,85% of total billed charges,114.39,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,50.84,40,,,percent of total billed charges,40% of total billed charges,50.84,40,,,percent of total billed charges,40% of total billed charges,114.39,90,,,percent of total billed charges,90% of total billed charges,96.6,76,,,percent of total billed charges,76% of total billed charges,50.84,40,,,percent of total billed charges,40% of total billed charges,108.04,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,101.68,80,,,percent of total billed charges,80% of total billed charges,49.31,38.8,,,percent of total billed charges,38.8% of total billed charges,108.04,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,49.31,120.75,
XR Pelvis 1 View,41072170,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
Orthotic Mgmt and Training Charges,60000275,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,134.1,107.28,GO,100.58,75,,,percent of total billed charges,75% of total billed charges,53.64,40,,,percent of total billed charges,40% of total billed charges,106.21,79.2,,,percent of total billed charges,79.2% of total billed charges,113.99,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,127.4,95,,,percent of total billed charges,95% of total billed charges,107.28,80,,,percent of total billed charges,80% of total billed charges,113.99,85,,,percent of total billed charges,85% of total billed charges,120.69,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,53.64,40,,,percent of total billed charges,40% of total billed charges,53.64,40,,,percent of total billed charges,40% of total billed charges,120.69,90,,,percent of total billed charges,90% of total billed charges,101.92,76,,,percent of total billed charges,76% of total billed charges,53.64,40,,,percent of total billed charges,40% of total billed charges,113.99,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,107.28,80,,,percent of total billed charges,80% of total billed charges,52.03,38.8,,,percent of total billed charges,38.8% of total billed charges,113.99,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,127.4,
Pap IG (Image Guided) LC,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,40.1,32.08,,30.08,75,,,percent of total billed charges,75% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,31.76,79.2,,,percent of total billed charges,79.2% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,38.1,95,,,percent of total billed charges,95% of total billed charges,32.08,80,,,percent of total billed charges,80% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,16.04,40,,,percent of total billed charges,40% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,30.48,76,,,percent of total billed charges,76% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,32.08,80,,,percent of total billed charges,80% of total billed charges,15.56,38.8,,,percent of total billed charges,38.8% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,15.56,53.22,
"Pap IG, rfx HPV all pth LC",40096250,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,40.1,32.08,,30.08,75,,,percent of total billed charges,75% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,31.76,79.2,,,percent of total billed charges,79.2% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,38.1,95,,,percent of total billed charges,95% of total billed charges,32.08,80,,,percent of total billed charges,80% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,16.04,40,,,percent of total billed charges,40% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,30.48,76,,,percent of total billed charges,76% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,32.08,80,,,percent of total billed charges,80% of total billed charges,15.56,38.8,,,percent of total billed charges,38.8% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,15.56,53.22,
".HPV, high-risk  LC",40087624,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,83.3,66.64,,62.48,75,,,percent of total billed charges,75% of total billed charges,33.32,40,,,percent of total billed charges,40% of total billed charges,65.97,79.2,,,percent of total billed charges,79.2% of total billed charges,70.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,79.14,95,,,percent of total billed charges,95% of total billed charges,66.64,80,,,percent of total billed charges,80% of total billed charges,70.81,85,,,percent of total billed charges,85% of total billed charges,74.97,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,33.32,40,,,percent of total billed charges,40% of total billed charges,33.32,40,,,percent of total billed charges,40% of total billed charges,74.97,90,,,percent of total billed charges,90% of total billed charges,63.31,76,,,percent of total billed charges,76% of total billed charges,33.32,40,,,percent of total billed charges,40% of total billed charges,70.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,66.64,80,,,percent of total billed charges,80% of total billed charges,32.32,38.8,,,percent of total billed charges,38.8% of total billed charges,70.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,79.14,
"Pap IG, Ct-Ng TV rfx HPV all LC",40096596,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,127.9,102.32,,95.93,75,,,percent of total billed charges,75% of total billed charges,51.16,40,,,percent of total billed charges,40% of total billed charges,101.3,79.2,,,percent of total billed charges,79.2% of total billed charges,108.72,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,121.51,95,,,percent of total billed charges,95% of total billed charges,102.32,80,,,percent of total billed charges,80% of total billed charges,108.72,85,,,percent of total billed charges,85% of total billed charges,115.11,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,51.16,40,,,percent of total billed charges,40% of total billed charges,51.16,40,,,percent of total billed charges,40% of total billed charges,115.11,90,,,percent of total billed charges,90% of total billed charges,97.2,76,,,percent of total billed charges,76% of total billed charges,51.16,40,,,percent of total billed charges,40% of total billed charges,108.72,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,102.32,80,,,percent of total billed charges,80% of total billed charges,49.63,38.8,,,percent of total billed charges,38.8% of total billed charges,108.72,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,121.51,
CT,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
NG,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
CT,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
NG,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
Pap IG,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
HPV,40087624,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,151.24,
MRA UE w/ + w/o Cont Rt,41373225,CDM,618,RC,71555,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,2866.9,100,,,fee schedule,100% of NM fee schedule,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,735.02,200,,,fee schedule,200% of CMS fee schedule,657.92,2866.9,
XR Esophagus,41074220,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,544.5,435.6,TC,408.38,75,,,percent of total billed charges,75% of total billed charges,217.8,40,,,percent of total billed charges,40% of total billed charges,431.24,79.2,,,percent of total billed charges,79.2% of total billed charges,462.83,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,517.28,95,,,percent of total billed charges,95% of total billed charges,435.6,80,,,percent of total billed charges,80% of total billed charges,462.83,85,,,percent of total billed charges,85% of total billed charges,490.05,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,217.8,40,,,percent of total billed charges,40% of total billed charges,217.8,40,,,percent of total billed charges,40% of total billed charges,490.05,90,,,percent of total billed charges,90% of total billed charges,413.82,76,,,percent of total billed charges,76% of total billed charges,217.8,40,,,percent of total billed charges,40% of total billed charges,462.83,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,435.6,80,,,percent of total billed charges,80% of total billed charges,211.27,38.8,,,percent of total billed charges,38.8% of total billed charges,462.83,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,517.28,
REF Antibody ID,40586870,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,641.3,513.04,,480.98,75,,,percent of total billed charges,75% of total billed charges,256.52,40,,,percent of total billed charges,40% of total billed charges,507.91,79.2,,,percent of total billed charges,79.2% of total billed charges,545.11,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,609.24,95,,,percent of total billed charges,95% of total billed charges,513.04,80,,,percent of total billed charges,80% of total billed charges,545.11,85,,,percent of total billed charges,85% of total billed charges,577.17,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,256.52,40,,,percent of total billed charges,40% of total billed charges,256.52,40,,,percent of total billed charges,40% of total billed charges,577.17,90,,,percent of total billed charges,90% of total billed charges,487.39,76,,,percent of total billed charges,76% of total billed charges,256.52,40,,,percent of total billed charges,40% of total billed charges,545.11,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,513.04,80,,,percent of total billed charges,80% of total billed charges,248.82,38.8,,,percent of total billed charges,38.8% of total billed charges,545.11,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,609.24,
ABO/Rh,40586900,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,64.7,51.76,,48.53,75,,,percent of total billed charges,75% of total billed charges,25.88,40,,,percent of total billed charges,40% of total billed charges,51.24,79.2,,,percent of total billed charges,79.2% of total billed charges,55,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,61.47,95,,,percent of total billed charges,95% of total billed charges,51.76,80,,,percent of total billed charges,80% of total billed charges,55,85,,,percent of total billed charges,85% of total billed charges,58.23,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,25.88,40,,,percent of total billed charges,40% of total billed charges,25.88,40,,,percent of total billed charges,40% of total billed charges,58.23,90,,,percent of total billed charges,90% of total billed charges,49.17,76,,,percent of total billed charges,76% of total billed charges,25.88,40,,,percent of total billed charges,40% of total billed charges,55,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,51.76,80,,,percent of total billed charges,80% of total billed charges,25.1,38.8,,,percent of total billed charges,38.8% of total billed charges,55,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,61.47,
US Pregnant > 14 Weeks 1st Gest,41276805,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,684.7,547.76,TC,513.53,75,,,percent of total billed charges,75% of total billed charges,273.88,40,,,percent of total billed charges,40% of total billed charges,542.28,79.2,,,percent of total billed charges,79.2% of total billed charges,582,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,650.47,95,,,percent of total billed charges,95% of total billed charges,547.76,80,,,percent of total billed charges,80% of total billed charges,582,85,,,percent of total billed charges,85% of total billed charges,616.23,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,273.88,40,,,percent of total billed charges,40% of total billed charges,273.88,40,,,percent of total billed charges,40% of total billed charges,616.23,90,,,percent of total billed charges,90% of total billed charges,520.37,76,,,percent of total billed charges,76% of total billed charges,273.88,40,,,percent of total billed charges,40% of total billed charges,582,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,547.76,80,,,percent of total billed charges,80% of total billed charges,265.66,38.8,,,percent of total billed charges,38.8% of total billed charges,582,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,650.47,
US OB DETAILED SNGL FETUS,60000228,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,397.3,317.84,,297.98,75,,,percent of total billed charges,75% of total billed charges,158.92,40,,,percent of total billed charges,40% of total billed charges,314.66,79.2,,,percent of total billed charges,79.2% of total billed charges,337.71,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,377.44,95,,,percent of total billed charges,95% of total billed charges,317.84,80,,,percent of total billed charges,80% of total billed charges,337.71,85,,,percent of total billed charges,85% of total billed charges,357.57,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,158.92,40,,,percent of total billed charges,40% of total billed charges,158.92,40,,,percent of total billed charges,40% of total billed charges,357.57,90,,,percent of total billed charges,90% of total billed charges,301.95,76,,,percent of total billed charges,76% of total billed charges,158.92,40,,,percent of total billed charges,40% of total billed charges,337.71,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,317.84,80,,,percent of total billed charges,80% of total billed charges,154.15,38.8,,,percent of total billed charges,38.8% of total billed charges,337.71,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,377.44,
ABO/Rh Interp,40586900,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,66.7,53.36,,50.03,75,,,percent of total billed charges,75% of total billed charges,26.68,40,,,percent of total billed charges,40% of total billed charges,52.83,79.2,,,percent of total billed charges,79.2% of total billed charges,56.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,63.37,95,,,percent of total billed charges,95% of total billed charges,53.36,80,,,percent of total billed charges,80% of total billed charges,56.7,85,,,percent of total billed charges,85% of total billed charges,60.03,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,26.68,40,,,percent of total billed charges,40% of total billed charges,26.68,40,,,percent of total billed charges,40% of total billed charges,60.03,90,,,percent of total billed charges,90% of total billed charges,50.69,76,,,percent of total billed charges,76% of total billed charges,26.68,40,,,percent of total billed charges,40% of total billed charges,56.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,53.36,80,,,percent of total billed charges,80% of total billed charges,25.88,38.8,,,percent of total billed charges,38.8% of total billed charges,56.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,63.37,
Microalb/Creat Ratio,40082043,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,76.4,61.12,,57.3,75,,,percent of total billed charges,75% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,60.51,79.2,,,percent of total billed charges,79.2% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,72.58,95,,,percent of total billed charges,95% of total billed charges,61.12,80,,,percent of total billed charges,80% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,30.56,40,,,percent of total billed charges,40% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,58.06,76,,,percent of total billed charges,76% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,61.12,80,,,percent of total billed charges,80% of total billed charges,29.64,38.8,,,percent of total billed charges,38.8% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,72.58,
CT Angio Abdomen w/ + w/o Cont,41174175,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,806.4,645.12,,604.8,75,,,percent of total billed charges,75% of total billed charges,322.56,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,685.44,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,766.08,95,,,percent of total billed charges,95% of total billed charges,645.12,80,,,percent of total billed charges,80% of total billed charges,685.44,85,,,percent of total billed charges,85% of total billed charges,725.76,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,322.56,40,,,percent of total billed charges,40% of total billed charges,322.56,40,,,percent of total billed charges,40% of total billed charges,725.76,90,,,percent of total billed charges,90% of total billed charges,612.86,76,,,percent of total billed charges,76% of total billed charges,322.56,40,,,percent of total billed charges,40% of total billed charges,685.44,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,645.12,80,,,percent of total billed charges,80% of total billed charges,312.88,38.8,,,percent of total billed charges,38.8% of total billed charges,685.44,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,766.08,
MRI Breast w/o Cont Bil,60000776,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,1831.5,1465.2,,1373.63,75,,,percent of total billed charges,75% of total billed charges,732.6,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,1556.78,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,1739.93,95,,,percent of total billed charges,95% of total billed charges,1465.2,80,,,percent of total billed charges,80% of total billed charges,1556.78,85,,,percent of total billed charges,85% of total billed charges,1648.35,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,732.6,40,,,percent of total billed charges,40% of total billed charges,732.6,40,,,percent of total billed charges,40% of total billed charges,1648.35,90,,,percent of total billed charges,90% of total billed charges,1391.94,76,,,percent of total billed charges,76% of total billed charges,732.6,40,,,percent of total billed charges,40% of total billed charges,1556.78,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,1465.2,80,,,percent of total billed charges,80% of total billed charges,710.62,38.8,,,percent of total billed charges,38.8% of total billed charges,1556.78,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,1739.93,
MRI Breast w/o Cont Lt,60000775,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,1831.5,1465.2,,1373.63,75,,,percent of total billed charges,75% of total billed charges,732.6,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,1556.78,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,1739.93,95,,,percent of total billed charges,95% of total billed charges,1465.2,80,,,percent of total billed charges,80% of total billed charges,1556.78,85,,,percent of total billed charges,85% of total billed charges,1648.35,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,732.6,40,,,percent of total billed charges,40% of total billed charges,732.6,40,,,percent of total billed charges,40% of total billed charges,1648.35,90,,,percent of total billed charges,90% of total billed charges,1391.94,76,,,percent of total billed charges,76% of total billed charges,732.6,40,,,percent of total billed charges,40% of total billed charges,1556.78,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,1465.2,80,,,percent of total billed charges,80% of total billed charges,710.62,38.8,,,percent of total billed charges,38.8% of total billed charges,1556.78,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,1739.93,
MRI Breast w/o Cont Rt,60000775,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,1831.5,1465.2,,1373.63,75,,,percent of total billed charges,75% of total billed charges,732.6,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,1556.78,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,1739.93,95,,,percent of total billed charges,95% of total billed charges,1465.2,80,,,percent of total billed charges,80% of total billed charges,1556.78,85,,,percent of total billed charges,85% of total billed charges,1648.35,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,732.6,40,,,percent of total billed charges,40% of total billed charges,732.6,40,,,percent of total billed charges,40% of total billed charges,1648.35,90,,,percent of total billed charges,90% of total billed charges,1391.94,76,,,percent of total billed charges,76% of total billed charges,732.6,40,,,percent of total billed charges,40% of total billed charges,1556.78,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,1465.2,80,,,percent of total billed charges,80% of total billed charges,710.62,38.8,,,percent of total billed charges,38.8% of total billed charges,1556.78,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,1739.93,
"19083 US BREAST BX W/ CLIP PLACEMENT, RT; FIRST LESION",41219083,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,2698.1,2158.48,LT,2023.58,75,,,percent of total billed charges,75% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2136.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,2563.2,95,,,percent of total billed charges,95% of total billed charges,2158.48,80,,,percent of total billed charges,80% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,2428.29,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,1079.24,40,,,percent of total billed charges,40% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2428.29,90,,,percent of total billed charges,90% of total billed charges,2050.56,76,,,percent of total billed charges,76% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,2158.48,80,,,percent of total billed charges,80% of total billed charges,1046.86,38.8,,,percent of total billed charges,38.8% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,2563.2,
XR Eye FB Lt,41070030,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,293.7,234.96,TC,220.28,75,,,percent of total billed charges,75% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,232.61,79.2,,,percent of total billed charges,79.2% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,279.02,95,,,percent of total billed charges,95% of total billed charges,234.96,80,,,percent of total billed charges,80% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,117.48,40,,,percent of total billed charges,40% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,223.21,76,,,percent of total billed charges,76% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,234.96,80,,,percent of total billed charges,80% of total billed charges,113.96,38.8,,,percent of total billed charges,38.8% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,279.02,
XR Eye FB Rt,41070030,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,293.7,234.96,TC,220.28,75,,,percent of total billed charges,75% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,232.61,79.2,,,percent of total billed charges,79.2% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,279.02,95,,,percent of total billed charges,95% of total billed charges,234.96,80,,,percent of total billed charges,80% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,117.48,40,,,percent of total billed charges,40% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,264.33,90,,,percent of total billed charges,90% of total billed charges,223.21,76,,,percent of total billed charges,76% of total billed charges,117.48,40,,,percent of total billed charges,40% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,234.96,80,,,percent of total billed charges,80% of total billed charges,113.96,38.8,,,percent of total billed charges,38.8% of total billed charges,249.65,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,279.02,
38221 - BONE MARROW BIOPS NDL CHARGE,46038221,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,5508.9,4407.12,,4131.68,75,,,percent of total billed charges,75% of total billed charges,2203.56,40,,,percent of total billed charges,40% of total billed charges,4363.05,79.2,,,percent of total billed charges,79.2% of total billed charges,4682.57,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,5233.46,95,,,percent of total billed charges,95% of total billed charges,4407.12,80,,,percent of total billed charges,80% of total billed charges,4682.57,85,,,percent of total billed charges,85% of total billed charges,4958.01,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,2203.56,40,,,percent of total billed charges,40% of total billed charges,2203.56,40,,,percent of total billed charges,40% of total billed charges,4958.01,90,,,percent of total billed charges,90% of total billed charges,4186.76,76,,,percent of total billed charges,76% of total billed charges,2203.56,40,,,percent of total billed charges,40% of total billed charges,4682.57,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,4407.12,80,,,percent of total billed charges,80% of total billed charges,2137.45,38.8,,,percent of total billed charges,38.8% of total billed charges,4682.57,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,5233.46,
Computer XM Interp,40586923,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,95,76,,71.25,75,,,percent of total billed charges,75% of total billed charges,38,40,,,percent of total billed charges,40% of total billed charges,75.24,79.2,,,percent of total billed charges,79.2% of total billed charges,80.75,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,90.25,95,,,percent of total billed charges,95% of total billed charges,76,80,,,percent of total billed charges,80% of total billed charges,80.75,85,,,percent of total billed charges,85% of total billed charges,85.5,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,38,40,,,percent of total billed charges,40% of total billed charges,38,40,,,percent of total billed charges,40% of total billed charges,85.5,90,,,percent of total billed charges,90% of total billed charges,72.2,76,,,percent of total billed charges,76% of total billed charges,38,40,,,percent of total billed charges,40% of total billed charges,80.75,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,76,80,,,percent of total billed charges,80% of total billed charges,36.86,38.8,,,percent of total billed charges,38.8% of total billed charges,80.75,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,90.25,
ELECTRONIC CROSSMATCH,40586923,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,371.5,297.2,,278.63,75,,,percent of total billed charges,75% of total billed charges,148.6,40,,,percent of total billed charges,40% of total billed charges,294.23,79.2,,,percent of total billed charges,79.2% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,352.93,95,,,percent of total billed charges,95% of total billed charges,297.2,80,,,percent of total billed charges,80% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,334.35,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,148.6,40,,,percent of total billed charges,40% of total billed charges,148.6,40,,,percent of total billed charges,40% of total billed charges,334.35,90,,,percent of total billed charges,90% of total billed charges,282.34,76,,,percent of total billed charges,76% of total billed charges,148.6,40,,,percent of total billed charges,40% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,297.2,80,,,percent of total billed charges,80% of total billed charges,144.14,38.8,,,percent of total billed charges,38.8% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,352.93,
Pinworm Prep,40087172,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,55.2,44.16,,41.4,75,,,percent of total billed charges,75% of total billed charges,22.08,40,,,percent of total billed charges,40% of total billed charges,43.72,79.2,,,percent of total billed charges,79.2% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,52.44,95,,,percent of total billed charges,95% of total billed charges,44.16,80,,,percent of total billed charges,80% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,22.08,40,,,percent of total billed charges,40% of total billed charges,22.08,40,,,percent of total billed charges,40% of total billed charges,49.68,90,,,percent of total billed charges,90% of total billed charges,41.95,76,,,percent of total billed charges,76% of total billed charges,22.08,40,,,percent of total billed charges,40% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,44.16,80,,,percent of total billed charges,80% of total billed charges,21.42,38.8,,,percent of total billed charges,38.8% of total billed charges,46.92,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,52.44,
Closed treatment of phalangeal shaft fracture  with manipulation  w/wo skin or s,60000053,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,801.6,641.28,,601.2,75,,,percent of total billed charges,75% of total billed charges,320.64,40,,,percent of total billed charges,40% of total billed charges,634.87,79.2,,,percent of total billed charges,79.2% of total billed charges,681.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,761.52,95,,,percent of total billed charges,95% of total billed charges,641.28,80,,,percent of total billed charges,80% of total billed charges,681.36,85,,,percent of total billed charges,85% of total billed charges,721.44,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,320.64,40,,,percent of total billed charges,40% of total billed charges,320.64,40,,,percent of total billed charges,40% of total billed charges,721.44,90,,,percent of total billed charges,90% of total billed charges,609.22,76,,,percent of total billed charges,76% of total billed charges,320.64,40,,,percent of total billed charges,40% of total billed charges,681.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,641.28,80,,,percent of total billed charges,80% of total billed charges,311.02,38.8,,,percent of total billed charges,38.8% of total billed charges,681.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,761.52,
MRI Hand w/ Cont Lt,41373219,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Hand w/ Cont Rt,41373219,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Hip w/ Cont Lt,41373719,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Hip w/ Cont Rt,41373719,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Humerus w/ Cont Lt,41373219,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Humerus w/ Cont Rt,41373219,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Shoulder w/ Cont Lt,41373222,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Shoulder w/ Cont Rt,41373222,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Tibia/Fibula w/ Cont Lt,41373719,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Tibia/Fibula w/ Cont Rt,41373719,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
US Extremity Nonvascular Ltd Lt,41276882,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,308.2,246.56,TC,231.15,75,,,percent of total billed charges,75% of total billed charges,123.28,40,,,percent of total billed charges,40% of total billed charges,244.09,79.2,,,percent of total billed charges,79.2% of total billed charges,261.97,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,292.79,95,,,percent of total billed charges,95% of total billed charges,246.56,80,,,percent of total billed charges,80% of total billed charges,261.97,85,,,percent of total billed charges,85% of total billed charges,277.38,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,123.28,40,,,percent of total billed charges,40% of total billed charges,123.28,40,,,percent of total billed charges,40% of total billed charges,277.38,90,,,percent of total billed charges,90% of total billed charges,234.23,76,,,percent of total billed charges,76% of total billed charges,123.28,40,,,percent of total billed charges,40% of total billed charges,261.97,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,246.56,80,,,percent of total billed charges,80% of total billed charges,119.58,38.8,,,percent of total billed charges,38.8% of total billed charges,261.97,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,292.79,
US Extremity Nonvascular Ltd Rt,41276882,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,308.2,246.56,TC,231.15,75,,,percent of total billed charges,75% of total billed charges,123.28,40,,,percent of total billed charges,40% of total billed charges,244.09,79.2,,,percent of total billed charges,79.2% of total billed charges,261.97,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,292.79,95,,,percent of total billed charges,95% of total billed charges,246.56,80,,,percent of total billed charges,80% of total billed charges,261.97,85,,,percent of total billed charges,85% of total billed charges,277.38,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,123.28,40,,,percent of total billed charges,40% of total billed charges,123.28,40,,,percent of total billed charges,40% of total billed charges,277.38,90,,,percent of total billed charges,90% of total billed charges,234.23,76,,,percent of total billed charges,76% of total billed charges,123.28,40,,,percent of total billed charges,40% of total billed charges,261.97,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,246.56,80,,,percent of total billed charges,80% of total billed charges,119.58,38.8,,,percent of total billed charges,38.8% of total billed charges,261.97,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,292.79,
XR Hip Arthrography Bil,60000653,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,540.1,432.08,TC,405.08,75,,,percent of total billed charges,75% of total billed charges,216.04,40,,,percent of total billed charges,40% of total billed charges,427.76,79.2,,,percent of total billed charges,79.2% of total billed charges,459.09,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,513.1,95,,,percent of total billed charges,95% of total billed charges,432.08,80,,,percent of total billed charges,80% of total billed charges,459.09,85,,,percent of total billed charges,85% of total billed charges,486.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,216.04,40,,,percent of total billed charges,40% of total billed charges,216.04,40,,,percent of total billed charges,40% of total billed charges,486.09,90,,,percent of total billed charges,90% of total billed charges,410.48,76,,,percent of total billed charges,76% of total billed charges,216.04,40,,,percent of total billed charges,40% of total billed charges,459.09,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,432.08,80,,,percent of total billed charges,80% of total billed charges,209.56,38.8,,,percent of total billed charges,38.8% of total billed charges,459.09,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,513.1,
XR Ribs Min 4 Views Bil w/ PA Chest,41071111,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,455.6,364.48,TC,341.7,75,,,percent of total billed charges,75% of total billed charges,182.24,40,,,percent of total billed charges,40% of total billed charges,360.84,79.2,,,percent of total billed charges,79.2% of total billed charges,387.26,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,432.82,95,,,percent of total billed charges,95% of total billed charges,364.48,80,,,percent of total billed charges,80% of total billed charges,387.26,85,,,percent of total billed charges,85% of total billed charges,410.04,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,182.24,40,,,percent of total billed charges,40% of total billed charges,182.24,40,,,percent of total billed charges,40% of total billed charges,410.04,90,,,percent of total billed charges,90% of total billed charges,346.26,76,,,percent of total billed charges,76% of total billed charges,182.24,40,,,percent of total billed charges,40% of total billed charges,387.26,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,364.48,80,,,percent of total billed charges,80% of total billed charges,176.77,38.8,,,percent of total billed charges,38.8% of total billed charges,387.26,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,432.82,
"69210 Removal Impacted Cerumen Requiring Instrumentation, Un",49169210,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,205.9,164.72,,154.43,75,,,percent of total billed charges,75% of total billed charges,82.36,40,,,percent of total billed charges,40% of total billed charges,163.07,79.2,,,percent of total billed charges,79.2% of total billed charges,175.02,85,,,percent of total billed charges,85% of total billed charges,205.9,100,,,fee schedule,100% of CO APG rates,195.61,95,,,percent of total billed charges,95% of total billed charges,164.72,80,,,percent of total billed charges,80% of total billed charges,175.02,85,,,percent of total billed charges,85% of total billed charges,185.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,82.36,40,,,percent of total billed charges,40% of total billed charges,82.36,40,,,percent of total billed charges,40% of total billed charges,185.31,90,,,percent of total billed charges,90% of total billed charges,156.48,76,,,percent of total billed charges,76% of total billed charges,82.36,40,,,percent of total billed charges,40% of total billed charges,175.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,164.72,80,,,percent of total billed charges,80% of total billed charges,79.89,38.8,,,percent of total billed charges,38.8% of total billed charges,175.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,79.89,217.66,
ELECTRONIC CROSSMATCH,40586923,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,371.5,297.2,,278.63,75,,,percent of total billed charges,75% of total billed charges,148.6,40,,,percent of total billed charges,40% of total billed charges,294.23,79.2,,,percent of total billed charges,79.2% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,352.93,95,,,percent of total billed charges,95% of total billed charges,297.2,80,,,percent of total billed charges,80% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,334.35,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,148.6,40,,,percent of total billed charges,40% of total billed charges,148.6,40,,,percent of total billed charges,40% of total billed charges,334.35,90,,,percent of total billed charges,90% of total billed charges,282.34,76,,,percent of total billed charges,76% of total billed charges,148.6,40,,,percent of total billed charges,40% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,297.2,80,,,percent of total billed charges,80% of total billed charges,144.14,38.8,,,percent of total billed charges,38.8% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,352.93,
US Abdomen Transplant w/ Doppler,41293975,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,953.5,762.8,,715.13,75,,,percent of total billed charges,75% of total billed charges,381.4,40,,,percent of total billed charges,40% of total billed charges,755.17,79.2,,,percent of total billed charges,79.2% of total billed charges,810.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,905.83,95,,,percent of total billed charges,95% of total billed charges,762.8,80,,,percent of total billed charges,80% of total billed charges,810.48,85,,,percent of total billed charges,85% of total billed charges,858.15,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,381.4,40,,,percent of total billed charges,40% of total billed charges,381.4,40,,,percent of total billed charges,40% of total billed charges,858.15,90,,,percent of total billed charges,90% of total billed charges,724.66,76,,,percent of total billed charges,76% of total billed charges,381.4,40,,,percent of total billed charges,40% of total billed charges,810.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,762.8,80,,,percent of total billed charges,80% of total billed charges,369.96,38.8,,,percent of total billed charges,38.8% of total billed charges,810.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,905.83,
US Aorta Duplex Comp,41293978,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,894.4,715.52,TC,670.8,75,,,percent of total billed charges,75% of total billed charges,357.76,40,,,percent of total billed charges,40% of total billed charges,708.36,79.2,,,percent of total billed charges,79.2% of total billed charges,760.24,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,849.68,95,,,percent of total billed charges,95% of total billed charges,715.52,80,,,percent of total billed charges,80% of total billed charges,760.24,85,,,percent of total billed charges,85% of total billed charges,804.96,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,357.76,40,,,percent of total billed charges,40% of total billed charges,357.76,40,,,percent of total billed charges,40% of total billed charges,804.96,90,,,percent of total billed charges,90% of total billed charges,679.74,76,,,percent of total billed charges,76% of total billed charges,357.76,40,,,percent of total billed charges,40% of total billed charges,760.24,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,715.52,80,,,percent of total billed charges,80% of total billed charges,347.03,38.8,,,percent of total billed charges,38.8% of total billed charges,760.24,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,849.68,
US Echo 2D Ltd,428P93308,CDM,483,RC,,,OUTPATIENT,,,807.6,646.08,TC,605.7,75,,,percent of total billed charges,75% of total billed charges,323.04,40,,,percent of total billed charges,40% of total billed charges,639.62,79.2,,,percent of total billed charges,79.2% of total billed charges,686.46,85,,,percent of total billed charges,85% of total billed charges,807.6,100,,,fee schedule,100% of CO APG rates,767.22,95,,,percent of total billed charges,95% of total billed charges,646.08,80,,,percent of total billed charges,80% of total billed charges,686.46,85,,,percent of total billed charges,85% of total billed charges,726.84,90,,,percent of total billed charges,90% of total billed charges,807.6,100,,,fee schedule,100% of CO APG rates,807.6,100,,,fee schedule,100% of CO APG rates,807.6,100,,,fee schedule,100% of NM fee schedule,323.04,40,,,percent of total billed charges,40% of total billed charges,323.04,40,,,percent of total billed charges,40% of total billed charges,726.84,90,,,percent of total billed charges,90% of total billed charges,613.78,76,,,percent of total billed charges,76% of total billed charges,323.04,40,,,percent of total billed charges,40% of total billed charges,686.46,85,,,percent of total billed charges,85% of total billed charges,807.6,100,,,fee schedule,100% of CO APG rate,646.08,80,,,percent of total billed charges,80% of total billed charges,313.35,38.8,,,percent of total billed charges,38.8% of total billed charges,686.46,85,,,percent of total billed charges,85% of total billed charges,807.6,100,,,fee schedule,100% of APG fee schedule,1615.2,200,,,percent of total billed charges,200% of total billed charges,313.35,1615.2,
RT Pulse Oximetry; Exercise Charge,60000320,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,354.3,283.44,,265.73,75,,,percent of total billed charges,75% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,280.61,79.2,,,percent of total billed charges,79.2% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,336.59,95,,,percent of total billed charges,95% of total billed charges,283.44,80,,,percent of total billed charges,80% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,141.72,40,,,percent of total billed charges,40% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,269.27,76,,,percent of total billed charges,76% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,283.44,80,,,percent of total billed charges,80% of total billed charges,137.47,38.8,,,percent of total billed charges,38.8% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,336.59,
RT Airway Suction Charge,42231720,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,236.3,189.04,,177.23,75,,,percent of total billed charges,75% of total billed charges,94.52,40,,,percent of total billed charges,40% of total billed charges,187.15,79.2,,,percent of total billed charges,79.2% of total billed charges,200.86,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,224.49,95,,,percent of total billed charges,95% of total billed charges,189.04,80,,,percent of total billed charges,80% of total billed charges,200.86,85,,,percent of total billed charges,85% of total billed charges,212.67,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,94.52,40,,,percent of total billed charges,40% of total billed charges,94.52,40,,,percent of total billed charges,40% of total billed charges,212.67,90,,,percent of total billed charges,90% of total billed charges,179.59,76,,,percent of total billed charges,76% of total billed charges,94.52,40,,,percent of total billed charges,40% of total billed charges,200.86,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,189.04,80,,,percent of total billed charges,80% of total billed charges,91.68,38.8,,,percent of total billed charges,38.8% of total billed charges,200.86,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,224.49,
RT Oximetry - Continuous Charge,42294762,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,382.4,305.92,,286.8,75,,,percent of total billed charges,75% of total billed charges,152.96,40,,,percent of total billed charges,40% of total billed charges,302.86,79.2,,,percent of total billed charges,79.2% of total billed charges,325.04,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,363.28,95,,,percent of total billed charges,95% of total billed charges,305.92,80,,,percent of total billed charges,80% of total billed charges,325.04,85,,,percent of total billed charges,85% of total billed charges,344.16,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,152.96,40,,,percent of total billed charges,40% of total billed charges,152.96,40,,,percent of total billed charges,40% of total billed charges,344.16,90,,,percent of total billed charges,90% of total billed charges,290.62,76,,,percent of total billed charges,76% of total billed charges,152.96,40,,,percent of total billed charges,40% of total billed charges,325.04,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,305.92,80,,,percent of total billed charges,80% of total billed charges,148.37,38.8,,,percent of total billed charges,38.8% of total billed charges,325.04,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,363.28,
RT Overnight Oximetry Charge,42294762,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,382.4,305.92,,286.8,75,,,percent of total billed charges,75% of total billed charges,152.96,40,,,percent of total billed charges,40% of total billed charges,302.86,79.2,,,percent of total billed charges,79.2% of total billed charges,325.04,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,363.28,95,,,percent of total billed charges,95% of total billed charges,305.92,80,,,percent of total billed charges,80% of total billed charges,325.04,85,,,percent of total billed charges,85% of total billed charges,344.16,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,152.96,40,,,percent of total billed charges,40% of total billed charges,152.96,40,,,percent of total billed charges,40% of total billed charges,344.16,90,,,percent of total billed charges,90% of total billed charges,290.62,76,,,percent of total billed charges,76% of total billed charges,152.96,40,,,percent of total billed charges,40% of total billed charges,325.04,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,305.92,80,,,percent of total billed charges,80% of total billed charges,148.37,38.8,,,percent of total billed charges,38.8% of total billed charges,325.04,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,363.28,
RT Oxygen Per Day Charge,42200001,CDM,271,RC,,,OUTPATIENT,,,367.6,294.08,,275.7,75,,,percent of total billed charges,75% of total billed charges,147.04,40,,,percent of total billed charges,40% of total billed charges,291.14,79.2,,,percent of total billed charges,79.2% of total billed charges,312.46,85,,,percent of total billed charges,85% of total billed charges,367.6,100,,,fee schedule,100% of CO APG rates,349.22,95,,,percent of total billed charges,95% of total billed charges,294.08,80,,,percent of total billed charges,80% of total billed charges,312.46,85,,,percent of total billed charges,85% of total billed charges,330.84,90,,,percent of total billed charges,90% of total billed charges,367.6,100,,,fee schedule,100% of CO APG rates,367.6,100,,,fee schedule,100% of CO APG rates,367.6,100,,,fee schedule,100% of NM fee schedule,147.04,40,,,percent of total billed charges,40% of total billed charges,147.04,40,,,percent of total billed charges,40% of total billed charges,330.84,90,,,percent of total billed charges,90% of total billed charges,279.38,76,,,percent of total billed charges,76% of total billed charges,147.04,40,,,percent of total billed charges,40% of total billed charges,312.46,85,,,percent of total billed charges,85% of total billed charges,367.6,100,,,fee schedule,100% of CO APG rate,294.08,80,,,percent of total billed charges,80% of total billed charges,142.63,38.8,,,percent of total billed charges,38.8% of total billed charges,312.46,85,,,percent of total billed charges,85% of total billed charges,367.6,100,,,fee schedule,100% of APG fee schedule,735.2,200,,,percent of total billed charges,200% of total billed charges,142.63,735.2,
RT Pre  Post BD Spiro Charge,42294060,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,358.8,287.04,,269.1,75,,,percent of total billed charges,75% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,284.17,79.2,,,percent of total billed charges,79.2% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,340.86,95,,,percent of total billed charges,95% of total billed charges,287.04,80,,,percent of total billed charges,80% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,143.52,40,,,percent of total billed charges,40% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,272.69,76,,,percent of total billed charges,76% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,287.04,80,,,percent of total billed charges,80% of total billed charges,139.21,38.8,,,percent of total billed charges,38.8% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,340.86,
Sputum Induction - RT Charge,42294640,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
BiPAP/CPAP Initial,42294660,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,583.9,467.12,,437.93,75,,,percent of total billed charges,75% of total billed charges,233.56,40,,,percent of total billed charges,40% of total billed charges,462.45,79.2,,,percent of total billed charges,79.2% of total billed charges,496.32,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,554.71,95,,,percent of total billed charges,95% of total billed charges,467.12,80,,,percent of total billed charges,80% of total billed charges,496.32,85,,,percent of total billed charges,85% of total billed charges,525.51,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,233.56,40,,,percent of total billed charges,40% of total billed charges,233.56,40,,,percent of total billed charges,40% of total billed charges,525.51,90,,,percent of total billed charges,90% of total billed charges,443.76,76,,,percent of total billed charges,76% of total billed charges,233.56,40,,,percent of total billed charges,40% of total billed charges,496.32,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,467.12,80,,,percent of total billed charges,80% of total billed charges,226.55,38.8,,,percent of total billed charges,38.8% of total billed charges,496.32,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,554.71,
BiPAP/CPAP Subsequent,42294660,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,583.9,467.12,,437.93,75,,,percent of total billed charges,75% of total billed charges,233.56,40,,,percent of total billed charges,40% of total billed charges,462.45,79.2,,,percent of total billed charges,79.2% of total billed charges,496.32,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,554.71,95,,,percent of total billed charges,95% of total billed charges,467.12,80,,,percent of total billed charges,80% of total billed charges,496.32,85,,,percent of total billed charges,85% of total billed charges,525.51,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,233.56,40,,,percent of total billed charges,40% of total billed charges,233.56,40,,,percent of total billed charges,40% of total billed charges,525.51,90,,,percent of total billed charges,90% of total billed charges,443.76,76,,,percent of total billed charges,76% of total billed charges,233.56,40,,,percent of total billed charges,40% of total billed charges,496.32,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,467.12,80,,,percent of total billed charges,80% of total billed charges,226.55,38.8,,,percent of total billed charges,38.8% of total billed charges,496.32,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,554.71,
CPT Initial  RT Charge,42294667,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,354.3,283.44,,265.73,75,,,percent of total billed charges,75% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,280.61,79.2,,,percent of total billed charges,79.2% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,336.59,95,,,percent of total billed charges,95% of total billed charges,283.44,80,,,percent of total billed charges,80% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,141.72,40,,,percent of total billed charges,40% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,269.27,76,,,percent of total billed charges,76% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,283.44,80,,,percent of total billed charges,80% of total billed charges,137.47,38.8,,,percent of total billed charges,38.8% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,336.59,
CPT Subsequent,42294668,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,354.3,283.44,,265.73,75,,,percent of total billed charges,75% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,280.61,79.2,,,percent of total billed charges,79.2% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,336.59,95,,,percent of total billed charges,95% of total billed charges,283.44,80,,,percent of total billed charges,80% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,141.72,40,,,percent of total billed charges,40% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,269.27,76,,,percent of total billed charges,76% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,283.44,80,,,percent of total billed charges,80% of total billed charges,137.47,38.8,,,percent of total billed charges,38.8% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,336.59,
Flutter Therapy Initial,60000312,CDM,412,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
Flutter Therapy Subsequent,60000311,CDM,412,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,76,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
Meter Dose Inhaler (MDI) Initial,42294640,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
Meter Dose Inhaler (MDI) Subsequent,42294645,CDM,412,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,76,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
Mini-Neb Initial,42294640,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
Mini-Neb Subsequent,42294645,CDM,412,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,76,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
RT Postural Drainage - Initial Charge,42294667,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,354.3,283.44,,265.73,75,,,percent of total billed charges,75% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,280.61,79.2,,,percent of total billed charges,79.2% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,336.59,95,,,percent of total billed charges,95% of total billed charges,283.44,80,,,percent of total billed charges,80% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,141.72,40,,,percent of total billed charges,40% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,269.27,76,,,percent of total billed charges,76% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,283.44,80,,,percent of total billed charges,80% of total billed charges,137.47,38.8,,,percent of total billed charges,38.8% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,336.59,
RT Postural Drainage - Subsequent Charge,42294668,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,354.3,283.44,,265.73,75,,,percent of total billed charges,75% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,280.61,79.2,,,percent of total billed charges,79.2% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,336.59,95,,,percent of total billed charges,95% of total billed charges,283.44,80,,,percent of total billed charges,80% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,141.72,40,,,percent of total billed charges,40% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,269.27,76,,,percent of total billed charges,76% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,283.44,80,,,percent of total billed charges,80% of total billed charges,137.47,38.8,,,percent of total billed charges,38.8% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,336.59,
Ventilator Services Initial,42294002,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,951.6,761.28,,713.7,75,,,percent of total billed charges,75% of total billed charges,380.64,40,,,percent of total billed charges,40% of total billed charges,753.67,79.2,,,percent of total billed charges,79.2% of total billed charges,808.86,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,904.02,95,,,percent of total billed charges,95% of total billed charges,761.28,80,,,percent of total billed charges,80% of total billed charges,808.86,85,,,percent of total billed charges,85% of total billed charges,856.44,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,380.64,40,,,percent of total billed charges,40% of total billed charges,380.64,40,,,percent of total billed charges,40% of total billed charges,856.44,90,,,percent of total billed charges,90% of total billed charges,723.22,76,,,percent of total billed charges,76% of total billed charges,380.64,40,,,percent of total billed charges,40% of total billed charges,808.86,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,761.28,80,,,percent of total billed charges,80% of total billed charges,369.22,38.8,,,percent of total billed charges,38.8% of total billed charges,808.86,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,904.02,
RT Ventilator Services - Subsequent Charge,42294003,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,951.6,761.28,,713.7,75,,,percent of total billed charges,75% of total billed charges,380.64,40,,,percent of total billed charges,40% of total billed charges,753.67,79.2,,,percent of total billed charges,79.2% of total billed charges,808.86,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,904.02,95,,,percent of total billed charges,95% of total billed charges,761.28,80,,,percent of total billed charges,80% of total billed charges,808.86,85,,,percent of total billed charges,85% of total billed charges,856.44,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,380.64,40,,,percent of total billed charges,40% of total billed charges,380.64,40,,,percent of total billed charges,40% of total billed charges,856.44,90,,,percent of total billed charges,90% of total billed charges,723.22,76,,,percent of total billed charges,76% of total billed charges,380.64,40,,,percent of total billed charges,40% of total billed charges,808.86,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,761.28,80,,,percent of total billed charges,80% of total billed charges,369.22,38.8,,,percent of total billed charges,38.8% of total billed charges,808.86,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,904.02,
"11982 Removal, Non-Biodegradable Drug Delivery Implant",49111982,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,534.6,427.68,,400.95,75,,,percent of total billed charges,75% of total billed charges,213.84,40,,,percent of total billed charges,40% of total billed charges,423.4,79.2,,,percent of total billed charges,79.2% of total billed charges,454.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,507.87,95,,,percent of total billed charges,95% of total billed charges,427.68,80,,,percent of total billed charges,80% of total billed charges,454.41,85,,,percent of total billed charges,85% of total billed charges,481.14,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,213.84,40,,,percent of total billed charges,40% of total billed charges,213.84,40,,,percent of total billed charges,40% of total billed charges,481.14,90,,,percent of total billed charges,90% of total billed charges,406.3,76,,,percent of total billed charges,76% of total billed charges,213.84,40,,,percent of total billed charges,40% of total billed charges,454.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,427.68,80,,,percent of total billed charges,80% of total billed charges,207.42,38.8,,,percent of total billed charges,38.8% of total billed charges,454.41,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,507.87,
Drainage Abscess Palate Uvula,60000085,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,484.6,387.68,,363.45,75,,,percent of total billed charges,75% of total billed charges,193.84,40,,,percent of total billed charges,40% of total billed charges,383.8,79.2,,,percent of total billed charges,79.2% of total billed charges,411.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,460.37,95,,,percent of total billed charges,95% of total billed charges,387.68,80,,,percent of total billed charges,80% of total billed charges,411.91,85,,,percent of total billed charges,85% of total billed charges,436.14,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,193.84,40,,,percent of total billed charges,40% of total billed charges,193.84,40,,,percent of total billed charges,40% of total billed charges,436.14,90,,,percent of total billed charges,90% of total billed charges,368.3,76,,,percent of total billed charges,76% of total billed charges,193.84,40,,,percent of total billed charges,40% of total billed charges,411.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,387.68,80,,,percent of total billed charges,80% of total billed charges,188.02,38.8,,,percent of total billed charges,38.8% of total billed charges,411.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,460.37,
Injection Plantar Common Digital Nerve,49164455,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,940.2,752.16,,705.15,75,,,percent of total billed charges,75% of total billed charges,376.08,40,,,percent of total billed charges,40% of total billed charges,744.64,79.2,,,percent of total billed charges,79.2% of total billed charges,799.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,893.19,95,,,percent of total billed charges,95% of total billed charges,752.16,80,,,percent of total billed charges,80% of total billed charges,799.17,85,,,percent of total billed charges,85% of total billed charges,846.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,376.08,40,,,percent of total billed charges,40% of total billed charges,376.08,40,,,percent of total billed charges,40% of total billed charges,846.18,90,,,percent of total billed charges,90% of total billed charges,714.55,76,,,percent of total billed charges,76% of total billed charges,376.08,40,,,percent of total billed charges,40% of total billed charges,799.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,752.16,80,,,percent of total billed charges,80% of total billed charges,364.8,38.8,,,percent of total billed charges,38.8% of total billed charges,799.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,893.19,
Folate (Folic Acid) LC,40002014,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,24.4,19.52,,18.3,75,,,percent of total billed charges,75% of total billed charges,9.76,40,,,percent of total billed charges,40% of total billed charges,19.32,79.2,,,percent of total billed charges,79.2% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,23.18,95,,,percent of total billed charges,95% of total billed charges,19.52,80,,,percent of total billed charges,80% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,21.96,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.76,40,,,percent of total billed charges,40% of total billed charges,9.76,40,,,percent of total billed charges,40% of total billed charges,21.96,90,,,percent of total billed charges,90% of total billed charges,18.54,76,,,percent of total billed charges,76% of total billed charges,9.76,40,,,percent of total billed charges,40% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,19.52,80,,,percent of total billed charges,80% of total billed charges,9.47,38.8,,,percent of total billed charges,38.8% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,23.18,
"Allergen Profile, Basic Food LC",40086003,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,79.7,63.76,,59.78,75,,,percent of total billed charges,75% of total billed charges,31.88,40,,,percent of total billed charges,40% of total billed charges,63.12,79.2,,,percent of total billed charges,79.2% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,75.72,95,,,percent of total billed charges,95% of total billed charges,63.76,80,,,percent of total billed charges,80% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,71.73,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,31.88,40,,,percent of total billed charges,40% of total billed charges,31.88,40,,,percent of total billed charges,40% of total billed charges,71.73,90,,,percent of total billed charges,90% of total billed charges,60.57,76,,,percent of total billed charges,76% of total billed charges,31.88,40,,,percent of total billed charges,40% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,63.76,80,,,percent of total billed charges,80% of total billed charges,30.92,38.8,,,percent of total billed charges,38.8% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,75.72,
Tacrolimus (FK506) LC,40080197,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,42.5,34,,31.88,75,,,percent of total billed charges,75% of total billed charges,17,40,,,percent of total billed charges,40% of total billed charges,33.66,79.2,,,percent of total billed charges,79.2% of total billed charges,36.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,40.38,95,,,percent of total billed charges,95% of total billed charges,34,80,,,percent of total billed charges,80% of total billed charges,36.13,85,,,percent of total billed charges,85% of total billed charges,38.25,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,17,40,,,percent of total billed charges,40% of total billed charges,17,40,,,percent of total billed charges,40% of total billed charges,38.25,90,,,percent of total billed charges,90% of total billed charges,32.3,76,,,percent of total billed charges,76% of total billed charges,17,40,,,percent of total billed charges,40% of total billed charges,36.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,34,80,,,percent of total billed charges,80% of total billed charges,16.49,38.8,,,percent of total billed charges,38.8% of total billed charges,36.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,40.38,
AFP Tetra LC,40082677,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,55.4,44.32,,41.55,75,,,percent of total billed charges,75% of total billed charges,22.16,40,,,percent of total billed charges,40% of total billed charges,43.88,79.2,,,percent of total billed charges,79.2% of total billed charges,47.09,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,52.63,95,,,percent of total billed charges,95% of total billed charges,44.32,80,,,percent of total billed charges,80% of total billed charges,47.09,85,,,percent of total billed charges,85% of total billed charges,49.86,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,22.16,40,,,percent of total billed charges,40% of total billed charges,22.16,40,,,percent of total billed charges,40% of total billed charges,49.86,90,,,percent of total billed charges,90% of total billed charges,42.1,76,,,percent of total billed charges,76% of total billed charges,22.16,40,,,percent of total billed charges,40% of total billed charges,47.09,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,44.32,80,,,percent of total billed charges,80% of total billed charges,21.5,38.8,,,percent of total billed charges,38.8% of total billed charges,47.09,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,52.63,
Renin Activity LC,40084244,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,52,41.6,,39,75,,,percent of total billed charges,75% of total billed charges,20.8,40,,,percent of total billed charges,40% of total billed charges,41.18,79.2,,,percent of total billed charges,79.2% of total billed charges,44.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,49.4,95,,,percent of total billed charges,95% of total billed charges,41.6,80,,,percent of total billed charges,80% of total billed charges,44.2,85,,,percent of total billed charges,85% of total billed charges,46.8,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,20.8,40,,,percent of total billed charges,40% of total billed charges,20.8,40,,,percent of total billed charges,40% of total billed charges,46.8,90,,,percent of total billed charges,90% of total billed charges,39.52,76,,,percent of total billed charges,76% of total billed charges,20.8,40,,,percent of total billed charges,40% of total billed charges,44.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,41.6,80,,,percent of total billed charges,80% of total billed charges,20.18,38.8,,,percent of total billed charges,38.8% of total billed charges,44.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,49.4,
Antimyeloperoxidase (MPO) Abs LC,40063840,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,164.7,131.76,,123.53,75,,,percent of total billed charges,75% of total billed charges,65.88,40,,,percent of total billed charges,40% of total billed charges,130.44,79.2,,,percent of total billed charges,79.2% of total billed charges,140,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,156.47,95,,,percent of total billed charges,95% of total billed charges,131.76,80,,,percent of total billed charges,80% of total billed charges,140,85,,,percent of total billed charges,85% of total billed charges,148.23,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,65.88,40,,,percent of total billed charges,40% of total billed charges,65.88,40,,,percent of total billed charges,40% of total billed charges,148.23,90,,,percent of total billed charges,90% of total billed charges,125.17,76,,,percent of total billed charges,76% of total billed charges,65.88,40,,,percent of total billed charges,40% of total billed charges,140,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,131.76,80,,,percent of total billed charges,80% of total billed charges,63.9,38.8,,,percent of total billed charges,38.8% of total billed charges,140,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,156.47,
Antiscleroderma-70 Abs LC,40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,125.4,100.32,,94.05,75,,,percent of total billed charges,75% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,99.32,79.2,,,percent of total billed charges,79.2% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,119.13,95,,,percent of total billed charges,95% of total billed charges,100.32,80,,,percent of total billed charges,80% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.16,40,,,percent of total billed charges,40% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,95.3,76,,,percent of total billed charges,76% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,100.32,80,,,percent of total billed charges,80% of total billed charges,48.66,38.8,,,percent of total billed charges,38.8% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,119.13,
Calcitriol LC,40082652,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,61.5,49.2,,46.13,75,,,percent of total billed charges,75% of total billed charges,24.6,40,,,percent of total billed charges,40% of total billed charges,48.71,79.2,,,percent of total billed charges,79.2% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,58.43,95,,,percent of total billed charges,95% of total billed charges,49.2,80,,,percent of total billed charges,80% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,55.35,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.6,40,,,percent of total billed charges,40% of total billed charges,24.6,40,,,percent of total billed charges,40% of total billed charges,55.35,90,,,percent of total billed charges,90% of total billed charges,46.74,76,,,percent of total billed charges,76% of total billed charges,24.6,40,,,percent of total billed charges,40% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,49.2,80,,,percent of total billed charges,80% of total billed charges,23.86,38.8,,,percent of total billed charges,38.8% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,58.43,
Fungus (Mycology) Culture LC,40087101,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,23.1,18.48,,17.33,75,,,percent of total billed charges,75% of total billed charges,9.24,40,,,percent of total billed charges,40% of total billed charges,18.3,79.2,,,percent of total billed charges,79.2% of total billed charges,19.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,21.95,95,,,percent of total billed charges,95% of total billed charges,18.48,80,,,percent of total billed charges,80% of total billed charges,19.64,85,,,percent of total billed charges,85% of total billed charges,20.79,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,9.24,40,,,percent of total billed charges,40% of total billed charges,9.24,40,,,percent of total billed charges,40% of total billed charges,20.79,90,,,percent of total billed charges,90% of total billed charges,17.56,76,,,percent of total billed charges,76% of total billed charges,9.24,40,,,percent of total billed charges,40% of total billed charges,19.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,18.48,80,,,percent of total billed charges,80% of total billed charges,8.96,38.8,,,percent of total billed charges,38.8% of total billed charges,19.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,8.96,33.1,
Homocysteine LC,40083090,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,49.2,39.36,,36.9,75,,,percent of total billed charges,75% of total billed charges,19.68,40,,,percent of total billed charges,40% of total billed charges,38.97,79.2,,,percent of total billed charges,79.2% of total billed charges,41.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,46.74,95,,,percent of total billed charges,95% of total billed charges,39.36,80,,,percent of total billed charges,80% of total billed charges,41.82,85,,,percent of total billed charges,85% of total billed charges,44.28,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,19.68,40,,,percent of total billed charges,40% of total billed charges,19.68,40,,,percent of total billed charges,40% of total billed charges,44.28,90,,,percent of total billed charges,90% of total billed charges,37.39,76,,,percent of total billed charges,76% of total billed charges,19.68,40,,,percent of total billed charges,40% of total billed charges,41.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,39.36,80,,,percent of total billed charges,80% of total billed charges,19.09,38.8,,,percent of total billed charges,38.8% of total billed charges,41.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,46.74,
Lamotrigine (Lamictal) LC,40080175,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,51.7,41.36,,38.78,75,,,percent of total billed charges,75% of total billed charges,20.68,40,,,percent of total billed charges,40% of total billed charges,40.95,79.2,,,percent of total billed charges,79.2% of total billed charges,43.95,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,49.12,95,,,percent of total billed charges,95% of total billed charges,41.36,80,,,percent of total billed charges,80% of total billed charges,43.95,85,,,percent of total billed charges,85% of total billed charges,46.53,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,20.68,40,,,percent of total billed charges,40% of total billed charges,20.68,40,,,percent of total billed charges,40% of total billed charges,46.53,90,,,percent of total billed charges,90% of total billed charges,39.29,76,,,percent of total billed charges,76% of total billed charges,20.68,40,,,percent of total billed charges,40% of total billed charges,43.95,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,41.36,80,,,percent of total billed charges,80% of total billed charges,20.06,38.8,,,percent of total billed charges,38.8% of total billed charges,43.95,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,49.12,
"Osmolality, Urine LC",40083935,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,14.6,11.68,,10.95,75,,,percent of total billed charges,75% of total billed charges,5.84,40,,,percent of total billed charges,40% of total billed charges,11.56,79.2,,,percent of total billed charges,79.2% of total billed charges,12.41,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,13.87,95,,,percent of total billed charges,95% of total billed charges,11.68,80,,,percent of total billed charges,80% of total billed charges,12.41,85,,,percent of total billed charges,85% of total billed charges,13.14,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,5.84,40,,,percent of total billed charges,40% of total billed charges,5.84,40,,,percent of total billed charges,40% of total billed charges,13.14,90,,,percent of total billed charges,90% of total billed charges,11.1,76,,,percent of total billed charges,76% of total billed charges,5.84,40,,,percent of total billed charges,40% of total billed charges,12.41,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,11.68,80,,,percent of total billed charges,80% of total billed charges,5.66,38.8,,,percent of total billed charges,38.8% of total billed charges,12.41,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,13.87,
"Rotavirus Ag, EIA LC",40087425,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,30.2,24.16,,22.65,75,,,percent of total billed charges,75% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,23.92,79.2,,,percent of total billed charges,79.2% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,28.69,95,,,percent of total billed charges,95% of total billed charges,24.16,80,,,percent of total billed charges,80% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,27.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,12.08,40,,,percent of total billed charges,40% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,27.18,90,,,percent of total billed charges,90% of total billed charges,22.95,76,,,percent of total billed charges,76% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,24.16,80,,,percent of total billed charges,80% of total billed charges,11.72,38.8,,,percent of total billed charges,38.8% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,33.1,
"Sodium, Urine LC",40084300,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,4.9,3.92,,3.68,75,,,percent of total billed charges,75% of total billed charges,1.96,40,,,percent of total billed charges,40% of total billed charges,3.88,79.2,,,percent of total billed charges,79.2% of total billed charges,4.17,85,,,percent of total billed charges,85% of total billed charges,4.9,100,,,fee schedule,100% of CO APG rates,4.66,95,,,percent of total billed charges,95% of total billed charges,3.92,80,,,percent of total billed charges,80% of total billed charges,4.17,85,,,percent of total billed charges,85% of total billed charges,4.41,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,1.96,40,,,percent of total billed charges,40% of total billed charges,1.96,40,,,percent of total billed charges,40% of total billed charges,4.41,90,,,percent of total billed charges,90% of total billed charges,3.72,76,,,percent of total billed charges,76% of total billed charges,1.96,40,,,percent of total billed charges,40% of total billed charges,4.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,3.92,80,,,percent of total billed charges,80% of total billed charges,1.9,38.8,,,percent of total billed charges,38.8% of total billed charges,4.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,1.9,8.76,
"Testosterone, Free, Direct LC",40084402,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,58.5,46.8,,43.88,75,,,percent of total billed charges,75% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,46.33,79.2,,,percent of total billed charges,79.2% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,55.58,95,,,percent of total billed charges,95% of total billed charges,46.8,80,,,percent of total billed charges,80% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,23.4,40,,,percent of total billed charges,40% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,44.46,76,,,percent of total billed charges,76% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,46.8,80,,,percent of total billed charges,80% of total billed charges,22.7,38.8,,,percent of total billed charges,38.8% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,55.58,
"Varicella-Zoster V Ab, IgG LC",40096206,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,31.2,24.96,,23.4,75,,,percent of total billed charges,75% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,24.71,79.2,,,percent of total billed charges,79.2% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,29.64,95,,,percent of total billed charges,95% of total billed charges,24.96,80,,,percent of total billed charges,80% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,12.48,40,,,percent of total billed charges,40% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,23.71,76,,,percent of total billed charges,76% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,24.96,80,,,percent of total billed charges,80% of total billed charges,12.11,38.8,,,percent of total billed charges,38.8% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,29.64,
"AFP, Serum, Tumor Marker LC",40002253,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,138.2,110.56,,103.65,75,,,percent of total billed charges,75% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,109.45,79.2,,,percent of total billed charges,79.2% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,131.29,95,,,percent of total billed charges,95% of total billed charges,110.56,80,,,percent of total billed charges,80% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,55.28,40,,,percent of total billed charges,40% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,105.03,76,,,percent of total billed charges,76% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,110.56,80,,,percent of total billed charges,80% of total billed charges,53.62,38.8,,,percent of total billed charges,38.8% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,131.29,
Alk Phos Isoenzyme LC,40084080,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,33,26.4,,24.75,75,,,percent of total billed charges,75% of total billed charges,13.2,40,,,percent of total billed charges,40% of total billed charges,26.14,79.2,,,percent of total billed charges,79.2% of total billed charges,28.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,31.35,95,,,percent of total billed charges,95% of total billed charges,26.4,80,,,percent of total billed charges,80% of total billed charges,28.05,85,,,percent of total billed charges,85% of total billed charges,29.7,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,13.2,40,,,percent of total billed charges,40% of total billed charges,13.2,40,,,percent of total billed charges,40% of total billed charges,29.7,90,,,percent of total billed charges,90% of total billed charges,25.08,76,,,percent of total billed charges,76% of total billed charges,13.2,40,,,percent of total billed charges,40% of total billed charges,28.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,26.4,80,,,percent of total billed charges,80% of total billed charges,12.8,38.8,,,percent of total billed charges,38.8% of total billed charges,28.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,31.35,
Alpha-1-Antitrypsin LC,40082103,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,29.2,23.36,,21.9,75,,,percent of total billed charges,75% of total billed charges,11.68,40,,,percent of total billed charges,40% of total billed charges,23.13,79.2,,,percent of total billed charges,79.2% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,27.74,95,,,percent of total billed charges,95% of total billed charges,23.36,80,,,percent of total billed charges,80% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,26.28,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,11.68,40,,,percent of total billed charges,40% of total billed charges,11.68,40,,,percent of total billed charges,40% of total billed charges,26.28,90,,,percent of total billed charges,90% of total billed charges,22.19,76,,,percent of total billed charges,76% of total billed charges,11.68,40,,,percent of total billed charges,40% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,23.36,80,,,percent of total billed charges,80% of total billed charges,11.33,38.8,,,percent of total billed charges,38.8% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,27.74,
Angiotensin-Converting Enzyme LC,40082164,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,24.7,19.76,,18.53,75,,,percent of total billed charges,75% of total billed charges,9.88,40,,,percent of total billed charges,40% of total billed charges,19.56,79.2,,,percent of total billed charges,79.2% of total billed charges,21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,23.47,95,,,percent of total billed charges,95% of total billed charges,19.76,80,,,percent of total billed charges,80% of total billed charges,21,85,,,percent of total billed charges,85% of total billed charges,22.23,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.88,40,,,percent of total billed charges,40% of total billed charges,9.88,40,,,percent of total billed charges,40% of total billed charges,22.23,90,,,percent of total billed charges,90% of total billed charges,18.77,76,,,percent of total billed charges,76% of total billed charges,9.88,40,,,percent of total billed charges,40% of total billed charges,21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,19.76,80,,,percent of total billed charges,80% of total billed charges,9.58,38.8,,,percent of total billed charges,38.8% of total billed charges,21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,23.47,
"Cardiolipin (phospholipid) antibody, each Ig class",40086147,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,134,107.2,,100.5,75,,,percent of total billed charges,75% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,106.13,79.2,,,percent of total billed charges,79.2% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,127.3,95,,,percent of total billed charges,95% of total billed charges,107.2,80,,,percent of total billed charges,80% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,53.6,40,,,percent of total billed charges,40% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,101.84,76,,,percent of total billed charges,76% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,107.2,80,,,percent of total billed charges,80% of total billed charges,51.99,38.8,,,percent of total billed charges,38.8% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,127.3,
"Cardiolipin (phospholipid) antibody, each Ig class",40086147,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,134,107.2,,100.5,75,,,percent of total billed charges,75% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,106.13,79.2,,,percent of total billed charges,79.2% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,127.3,95,,,percent of total billed charges,95% of total billed charges,107.2,80,,,percent of total billed charges,80% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,53.6,40,,,percent of total billed charges,40% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,101.84,76,,,percent of total billed charges,76% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,107.2,80,,,percent of total billed charges,80% of total billed charges,51.99,38.8,,,percent of total billed charges,38.8% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,127.3,
Antiextractable Nuclear Ag LC,40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,125.4,100.32,,94.05,75,,,percent of total billed charges,75% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,99.32,79.2,,,percent of total billed charges,79.2% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,119.13,95,,,percent of total billed charges,95% of total billed charges,100.32,80,,,percent of total billed charges,80% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.16,40,,,percent of total billed charges,40% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,95.3,76,,,percent of total billed charges,76% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,100.32,80,,,percent of total billed charges,80% of total billed charges,48.66,38.8,,,percent of total billed charges,38.8% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,119.13,
Antistreptolysin O Ab LC,40086060,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,70.3,56.24,,52.73,75,,,percent of total billed charges,75% of total billed charges,28.12,40,,,percent of total billed charges,40% of total billed charges,55.68,79.2,,,percent of total billed charges,79.2% of total billed charges,59.76,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,66.79,95,,,percent of total billed charges,95% of total billed charges,56.24,80,,,percent of total billed charges,80% of total billed charges,59.76,85,,,percent of total billed charges,85% of total billed charges,63.27,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,28.12,40,,,percent of total billed charges,40% of total billed charges,28.12,40,,,percent of total billed charges,40% of total billed charges,63.27,90,,,percent of total billed charges,90% of total billed charges,53.43,76,,,percent of total billed charges,76% of total billed charges,28.12,40,,,percent of total billed charges,40% of total billed charges,59.76,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,56.24,80,,,percent of total billed charges,80% of total billed charges,27.28,38.8,,,percent of total billed charges,38.8% of total billed charges,59.76,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,66.79,
Ceruloplasmin LC,40082390,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,27.3,21.84,,20.48,75,,,percent of total billed charges,75% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,21.62,79.2,,,percent of total billed charges,79.2% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,25.94,95,,,percent of total billed charges,95% of total billed charges,21.84,80,,,percent of total billed charges,80% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,24.57,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,10.92,40,,,percent of total billed charges,40% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,24.57,90,,,percent of total billed charges,90% of total billed charges,20.75,76,,,percent of total billed charges,76% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,21.84,80,,,percent of total billed charges,80% of total billed charges,10.59,38.8,,,percent of total billed charges,38.8% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,25.94,
"Complement, Total (CH50) LC",40086162,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,22.1,17.68,,16.58,75,,,percent of total billed charges,75% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,17.5,79.2,,,percent of total billed charges,79.2% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,21,95,,,percent of total billed charges,95% of total billed charges,17.68,80,,,percent of total billed charges,80% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,19.89,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,8.84,40,,,percent of total billed charges,40% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,19.89,90,,,percent of total billed charges,90% of total billed charges,16.8,76,,,percent of total billed charges,76% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,17.68,80,,,percent of total billed charges,80% of total billed charges,8.57,38.8,,,percent of total billed charges,38.8% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,21,
Cortisol LC,40082533,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,26.6,21.28,,19.95,75,,,percent of total billed charges,75% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,21.07,79.2,,,percent of total billed charges,79.2% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,25.27,95,,,percent of total billed charges,95% of total billed charges,21.28,80,,,percent of total billed charges,80% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,23.94,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,10.64,40,,,percent of total billed charges,40% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,23.94,90,,,percent of total billed charges,90% of total billed charges,20.22,76,,,percent of total billed charges,76% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,21.28,80,,,percent of total billed charges,80% of total billed charges,10.32,38.8,,,percent of total billed charges,38.8% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,25.27,
"Cortisol, Urine Free LC",40082530,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,31.6,25.28,,23.7,75,,,percent of total billed charges,75% of total billed charges,12.64,40,,,percent of total billed charges,40% of total billed charges,25.03,79.2,,,percent of total billed charges,79.2% of total billed charges,26.86,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,30.02,95,,,percent of total billed charges,95% of total billed charges,25.28,80,,,percent of total billed charges,80% of total billed charges,26.86,85,,,percent of total billed charges,85% of total billed charges,28.44,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.64,40,,,percent of total billed charges,40% of total billed charges,12.64,40,,,percent of total billed charges,40% of total billed charges,28.44,90,,,percent of total billed charges,90% of total billed charges,24.02,76,,,percent of total billed charges,76% of total billed charges,12.64,40,,,percent of total billed charges,40% of total billed charges,26.86,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,25.28,80,,,percent of total billed charges,80% of total billed charges,12.26,38.8,,,percent of total billed charges,38.8% of total billed charges,26.86,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,30.02,
DHEA Serum LC,40082626,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,288.4,230.72,,216.3,75,,,percent of total billed charges,75% of total billed charges,115.36,40,,,percent of total billed charges,40% of total billed charges,228.41,79.2,,,percent of total billed charges,79.2% of total billed charges,245.14,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,273.98,95,,,percent of total billed charges,95% of total billed charges,230.72,80,,,percent of total billed charges,80% of total billed charges,245.14,85,,,percent of total billed charges,85% of total billed charges,259.56,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,115.36,40,,,percent of total billed charges,40% of total billed charges,115.36,40,,,percent of total billed charges,40% of total billed charges,259.56,90,,,percent of total billed charges,90% of total billed charges,219.18,76,,,percent of total billed charges,76% of total billed charges,115.36,40,,,percent of total billed charges,40% of total billed charges,245.14,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,230.72,80,,,percent of total billed charges,80% of total billed charges,111.9,38.8,,,percent of total billed charges,38.8% of total billed charges,245.14,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,273.98,
DHEA-Sulfate LC,40082627,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,38.8,31.04,,29.1,75,,,percent of total billed charges,75% of total billed charges,15.52,40,,,percent of total billed charges,40% of total billed charges,30.73,79.2,,,percent of total billed charges,79.2% of total billed charges,32.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,36.86,95,,,percent of total billed charges,95% of total billed charges,31.04,80,,,percent of total billed charges,80% of total billed charges,32.98,85,,,percent of total billed charges,85% of total billed charges,34.92,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,15.52,40,,,percent of total billed charges,40% of total billed charges,15.52,40,,,percent of total billed charges,40% of total billed charges,34.92,90,,,percent of total billed charges,90% of total billed charges,29.49,76,,,percent of total billed charges,76% of total billed charges,15.52,40,,,percent of total billed charges,40% of total billed charges,32.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,31.04,80,,,percent of total billed charges,80% of total billed charges,15.05,38.8,,,percent of total billed charges,38.8% of total billed charges,32.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,36.86,
Erythropoietin (EPO) LC,40082668,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,31.2,24.96,,23.4,75,,,percent of total billed charges,75% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,24.71,79.2,,,percent of total billed charges,79.2% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,29.64,95,,,percent of total billed charges,95% of total billed charges,24.96,80,,,percent of total billed charges,80% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.48,40,,,percent of total billed charges,40% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,23.71,76,,,percent of total billed charges,76% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,24.96,80,,,percent of total billed charges,80% of total billed charges,12.11,38.8,,,percent of total billed charges,38.8% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,29.64,
"Estrogens, Total LC",40082672,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,41.14,
Hematocrit LC,40085014,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,18.2,14.56,,13.65,75,,,percent of total billed charges,75% of total billed charges,7.28,40,,,percent of total billed charges,40% of total billed charges,14.41,79.2,,,percent of total billed charges,79.2% of total billed charges,15.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,17.29,95,,,percent of total billed charges,95% of total billed charges,14.56,80,,,percent of total billed charges,80% of total billed charges,15.47,85,,,percent of total billed charges,85% of total billed charges,16.38,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,7.28,40,,,percent of total billed charges,40% of total billed charges,7.28,40,,,percent of total billed charges,40% of total billed charges,16.38,90,,,percent of total billed charges,90% of total billed charges,13.83,76,,,percent of total billed charges,76% of total billed charges,7.28,40,,,percent of total billed charges,40% of total billed charges,15.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,14.56,80,,,percent of total billed charges,80% of total billed charges,7.06,38.8,,,percent of total billed charges,38.8% of total billed charges,15.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,17.29,
"Folate, RBC LC",40082747,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,34.4,27.52,,25.8,75,,,percent of total billed charges,75% of total billed charges,13.76,40,,,percent of total billed charges,40% of total billed charges,27.24,79.2,,,percent of total billed charges,79.2% of total billed charges,29.24,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,32.68,95,,,percent of total billed charges,95% of total billed charges,27.52,80,,,percent of total billed charges,80% of total billed charges,29.24,85,,,percent of total billed charges,85% of total billed charges,30.96,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,13.76,40,,,percent of total billed charges,40% of total billed charges,13.76,40,,,percent of total billed charges,40% of total billed charges,30.96,90,,,percent of total billed charges,90% of total billed charges,26.14,76,,,percent of total billed charges,76% of total billed charges,13.76,40,,,percent of total billed charges,40% of total billed charges,29.24,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,27.52,80,,,percent of total billed charges,80% of total billed charges,13.35,38.8,,,percent of total billed charges,38.8% of total billed charges,29.24,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,32.68,
HSV Culture and Typing LC,40008250,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,58.5,46.8,,43.88,75,,,percent of total billed charges,75% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,46.33,79.2,,,percent of total billed charges,79.2% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,55.58,95,,,percent of total billed charges,95% of total billed charges,46.8,80,,,percent of total billed charges,80% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,23.4,40,,,percent of total billed charges,40% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,44.46,76,,,percent of total billed charges,76% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,46.8,80,,,percent of total billed charges,80% of total billed charges,22.7,38.8,,,percent of total billed charges,38.8% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,55.58,
"HSV Type 2-Specific Ab, IgG LC",40086696,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,151.24,
"Immunoglobulin E, Total LC",40082785,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,26,20.8,,19.5,75,,,percent of total billed charges,75% of total billed charges,10.4,40,,,percent of total billed charges,40% of total billed charges,20.59,79.2,,,percent of total billed charges,79.2% of total billed charges,22.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,24.7,95,,,percent of total billed charges,95% of total billed charges,20.8,80,,,percent of total billed charges,80% of total billed charges,22.1,85,,,percent of total billed charges,85% of total billed charges,23.4,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,10.4,40,,,percent of total billed charges,40% of total billed charges,10.4,40,,,percent of total billed charges,40% of total billed charges,23.4,90,,,percent of total billed charges,90% of total billed charges,19.76,76,,,percent of total billed charges,76% of total billed charges,10.4,40,,,percent of total billed charges,40% of total billed charges,22.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,20.8,80,,,percent of total billed charges,80% of total billed charges,10.09,38.8,,,percent of total billed charges,38.8% of total billed charges,22.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,24.7,
"Immunoglobulin M, Qn, LC",40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,22.8,18.24,,17.1,75,,,percent of total billed charges,75% of total billed charges,9.12,40,,,percent of total billed charges,40% of total billed charges,18.06,79.2,,,percent of total billed charges,79.2% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,21.66,95,,,percent of total billed charges,95% of total billed charges,18.24,80,,,percent of total billed charges,80% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,20.52,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.12,40,,,percent of total billed charges,40% of total billed charges,9.12,40,,,percent of total billed charges,40% of total billed charges,20.52,90,,,percent of total billed charges,90% of total billed charges,17.33,76,,,percent of total billed charges,76% of total billed charges,9.12,40,,,percent of total billed charges,40% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,18.24,80,,,percent of total billed charges,80% of total billed charges,8.85,38.8,,,percent of total billed charges,38.8% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,21.66,
LDL Cholesterol (Direct) LC,40083721,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,10.6,8.48,,7.95,75,,,percent of total billed charges,75% of total billed charges,4.24,40,,,percent of total billed charges,40% of total billed charges,8.4,79.2,,,percent of total billed charges,79.2% of total billed charges,9.01,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,10.07,95,,,percent of total billed charges,95% of total billed charges,8.48,80,,,percent of total billed charges,80% of total billed charges,9.01,85,,,percent of total billed charges,85% of total billed charges,9.54,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,4.24,40,,,percent of total billed charges,40% of total billed charges,4.24,40,,,percent of total billed charges,40% of total billed charges,9.54,90,,,percent of total billed charges,90% of total billed charges,8.06,76,,,percent of total billed charges,76% of total billed charges,4.24,40,,,percent of total billed charges,40% of total billed charges,9.01,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,8.48,80,,,percent of total billed charges,80% of total billed charges,4.11,38.8,,,percent of total billed charges,38.8% of total billed charges,9.01,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.11,10.07,
Levetiracetam (Keppra) LC,40080177,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,66,52.8,,49.5,75,,,percent of total billed charges,75% of total billed charges,26.4,40,,,percent of total billed charges,40% of total billed charges,52.27,79.2,,,percent of total billed charges,79.2% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,62.7,95,,,percent of total billed charges,95% of total billed charges,52.8,80,,,percent of total billed charges,80% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,59.4,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,26.4,40,,,percent of total billed charges,40% of total billed charges,26.4,40,,,percent of total billed charges,40% of total billed charges,59.4,90,,,percent of total billed charges,90% of total billed charges,50.16,76,,,percent of total billed charges,76% of total billed charges,26.4,40,,,percent of total billed charges,40% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,52.8,80,,,percent of total billed charges,80% of total billed charges,25.61,38.8,,,percent of total billed charges,38.8% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,62.7,
Lupus Anticoagulant Reflex LC,40085613,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,88.8,71.04,,66.6,75,,,percent of total billed charges,75% of total billed charges,35.52,40,,,percent of total billed charges,40% of total billed charges,70.33,79.2,,,percent of total billed charges,79.2% of total billed charges,75.48,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,84.36,95,,,percent of total billed charges,95% of total billed charges,71.04,80,,,percent of total billed charges,80% of total billed charges,75.48,85,,,percent of total billed charges,85% of total billed charges,79.92,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,35.52,40,,,percent of total billed charges,40% of total billed charges,35.52,40,,,percent of total billed charges,40% of total billed charges,79.92,90,,,percent of total billed charges,90% of total billed charges,67.49,76,,,percent of total billed charges,76% of total billed charges,35.52,40,,,percent of total billed charges,40% of total billed charges,75.48,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,71.04,80,,,percent of total billed charges,80% of total billed charges,34.45,38.8,,,percent of total billed charges,38.8% of total billed charges,75.48,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,84.36,
Antibody; Borrelia burgdorferi (Lyme disease),40086618,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,166.8,133.44,,125.1,75,,,percent of total billed charges,75% of total billed charges,66.72,40,,,percent of total billed charges,40% of total billed charges,132.11,79.2,,,percent of total billed charges,79.2% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,158.46,95,,,percent of total billed charges,95% of total billed charges,133.44,80,,,percent of total billed charges,80% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,150.12,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,66.72,40,,,percent of total billed charges,40% of total billed charges,66.72,40,,,percent of total billed charges,40% of total billed charges,150.12,90,,,percent of total billed charges,90% of total billed charges,126.77,76,,,percent of total billed charges,76% of total billed charges,66.72,40,,,percent of total billed charges,40% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,133.44,80,,,percent of total billed charges,80% of total billed charges,64.72,38.8,,,percent of total billed charges,38.8% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,158.46,
"Metanephrines, Frac, 24-Hr U LC",40083835,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,42.9,34.32,,32.18,75,,,percent of total billed charges,75% of total billed charges,17.16,40,,,percent of total billed charges,40% of total billed charges,33.98,79.2,,,percent of total billed charges,79.2% of total billed charges,36.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,40.76,95,,,percent of total billed charges,95% of total billed charges,34.32,80,,,percent of total billed charges,80% of total billed charges,36.47,85,,,percent of total billed charges,85% of total billed charges,38.61,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,17.16,40,,,percent of total billed charges,40% of total billed charges,17.16,40,,,percent of total billed charges,40% of total billed charges,38.61,90,,,percent of total billed charges,90% of total billed charges,32.6,76,,,percent of total billed charges,76% of total billed charges,17.16,40,,,percent of total billed charges,40% of total billed charges,36.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,34.32,80,,,percent of total billed charges,80% of total billed charges,16.65,38.8,,,percent of total billed charges,38.8% of total billed charges,36.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,40.76,
Progesterone LC,40004317,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,31.2,24.96,,23.4,75,,,percent of total billed charges,75% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,24.71,79.2,,,percent of total billed charges,79.2% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,29.64,95,,,percent of total billed charges,95% of total billed charges,24.96,80,,,percent of total billed charges,80% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.48,40,,,percent of total billed charges,40% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,23.71,76,,,percent of total billed charges,76% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,24.96,80,,,percent of total billed charges,80% of total billed charges,12.11,38.8,,,percent of total billed charges,38.8% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,29.64,
Protein S-Antigen LC,40085305,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,97.8,78.24,,73.35,75,,,percent of total billed charges,75% of total billed charges,39.12,40,,,percent of total billed charges,40% of total billed charges,77.46,79.2,,,percent of total billed charges,79.2% of total billed charges,83.13,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,92.91,95,,,percent of total billed charges,95% of total billed charges,78.24,80,,,percent of total billed charges,80% of total billed charges,83.13,85,,,percent of total billed charges,85% of total billed charges,88.02,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,39.12,40,,,percent of total billed charges,40% of total billed charges,39.12,40,,,percent of total billed charges,40% of total billed charges,88.02,90,,,percent of total billed charges,90% of total billed charges,74.33,76,,,percent of total billed charges,76% of total billed charges,39.12,40,,,percent of total billed charges,40% of total billed charges,83.13,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,78.24,80,,,percent of total billed charges,80% of total billed charges,37.95,38.8,,,percent of total billed charges,38.8% of total billed charges,83.13,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,92.91,
Reticulocyte Count LC,40005280,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,20.2,16.16,,15.15,75,,,percent of total billed charges,75% of total billed charges,8.08,40,,,percent of total billed charges,40% of total billed charges,16,79.2,,,percent of total billed charges,79.2% of total billed charges,17.17,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,19.19,95,,,percent of total billed charges,95% of total billed charges,16.16,80,,,percent of total billed charges,80% of total billed charges,17.17,85,,,percent of total billed charges,85% of total billed charges,18.18,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,8.08,40,,,percent of total billed charges,40% of total billed charges,8.08,40,,,percent of total billed charges,40% of total billed charges,18.18,90,,,percent of total billed charges,90% of total billed charges,15.35,76,,,percent of total billed charges,76% of total billed charges,8.08,40,,,percent of total billed charges,40% of total billed charges,17.17,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,16.16,80,,,percent of total billed charges,80% of total billed charges,7.84,38.8,,,percent of total billed charges,38.8% of total billed charges,17.17,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,19.19,
"Testosterone,Free and Total LC",40084402,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,78.9,63.12,,59.18,75,,,percent of total billed charges,75% of total billed charges,31.56,40,,,percent of total billed charges,40% of total billed charges,62.49,79.2,,,percent of total billed charges,79.2% of total billed charges,67.07,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,74.96,95,,,percent of total billed charges,95% of total billed charges,63.12,80,,,percent of total billed charges,80% of total billed charges,67.07,85,,,percent of total billed charges,85% of total billed charges,71.01,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,31.56,40,,,percent of total billed charges,40% of total billed charges,31.56,40,,,percent of total billed charges,40% of total billed charges,71.01,90,,,percent of total billed charges,90% of total billed charges,59.96,76,,,percent of total billed charges,76% of total billed charges,31.56,40,,,percent of total billed charges,40% of total billed charges,67.07,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,63.12,80,,,percent of total billed charges,80% of total billed charges,30.61,38.8,,,percent of total billed charges,38.8% of total billed charges,67.07,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,74.96,
Transferrin LC,40084466,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,29.2,23.36,,21.9,75,,,percent of total billed charges,75% of total billed charges,11.68,40,,,percent of total billed charges,40% of total billed charges,23.13,79.2,,,percent of total billed charges,79.2% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,27.74,95,,,percent of total billed charges,95% of total billed charges,23.36,80,,,percent of total billed charges,80% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,26.28,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,11.68,40,,,percent of total billed charges,40% of total billed charges,11.68,40,,,percent of total billed charges,40% of total billed charges,26.28,90,,,percent of total billed charges,90% of total billed charges,22.19,76,,,percent of total billed charges,76% of total billed charges,11.68,40,,,percent of total billed charges,40% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,23.36,80,,,percent of total billed charges,80% of total billed charges,11.33,38.8,,,percent of total billed charges,38.8% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,27.74,
"Vanillylmandelic Acid, 24-Hr U LC",40084585,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,19.5,15.6,,14.63,75,,,percent of total billed charges,75% of total billed charges,7.8,40,,,percent of total billed charges,40% of total billed charges,15.44,79.2,,,percent of total billed charges,79.2% of total billed charges,16.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,18.53,95,,,percent of total billed charges,95% of total billed charges,15.6,80,,,percent of total billed charges,80% of total billed charges,16.58,85,,,percent of total billed charges,85% of total billed charges,17.55,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,7.8,40,,,percent of total billed charges,40% of total billed charges,7.8,40,,,percent of total billed charges,40% of total billed charges,17.55,90,,,percent of total billed charges,90% of total billed charges,14.82,76,,,percent of total billed charges,76% of total billed charges,7.8,40,,,percent of total billed charges,40% of total billed charges,16.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,15.6,80,,,percent of total billed charges,80% of total billed charges,7.57,38.8,,,percent of total billed charges,38.8% of total billed charges,16.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,18.53,
VAP Cholesterol Profile LC,40083704,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,10.6,8.48,,7.95,75,,,percent of total billed charges,75% of total billed charges,4.24,40,,,percent of total billed charges,40% of total billed charges,8.4,79.2,,,percent of total billed charges,79.2% of total billed charges,9.01,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,10.07,95,,,percent of total billed charges,95% of total billed charges,8.48,80,,,percent of total billed charges,80% of total billed charges,9.01,85,,,percent of total billed charges,85% of total billed charges,9.54,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,4.24,40,,,percent of total billed charges,40% of total billed charges,4.24,40,,,percent of total billed charges,40% of total billed charges,9.54,90,,,percent of total billed charges,90% of total billed charges,8.06,76,,,percent of total billed charges,76% of total billed charges,4.24,40,,,percent of total billed charges,40% of total billed charges,9.01,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,8.48,80,,,percent of total billed charges,80% of total billed charges,4.11,38.8,,,percent of total billed charges,38.8% of total billed charges,9.01,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.11,10.07,
Vitamin B6 LC,60000615,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,77.6,62.08,,58.2,75,,,percent of total billed charges,75% of total billed charges,31.04,40,,,percent of total billed charges,40% of total billed charges,61.46,79.2,,,percent of total billed charges,79.2% of total billed charges,65.96,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,73.72,95,,,percent of total billed charges,95% of total billed charges,62.08,80,,,percent of total billed charges,80% of total billed charges,65.96,85,,,percent of total billed charges,85% of total billed charges,69.84,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,31.04,40,,,percent of total billed charges,40% of total billed charges,31.04,40,,,percent of total billed charges,40% of total billed charges,69.84,90,,,percent of total billed charges,90% of total billed charges,58.98,76,,,percent of total billed charges,76% of total billed charges,31.04,40,,,percent of total billed charges,40% of total billed charges,65.96,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,62.08,80,,,percent of total billed charges,80% of total billed charges,30.11,38.8,,,percent of total billed charges,38.8% of total billed charges,65.96,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,73.72,
"Porphyrins, Qn, 24 Hr Urine LC",40084120,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,24.2,19.36,,18.15,75,,,percent of total billed charges,75% of total billed charges,9.68,40,,,percent of total billed charges,40% of total billed charges,19.17,79.2,,,percent of total billed charges,79.2% of total billed charges,20.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,22.99,95,,,percent of total billed charges,95% of total billed charges,19.36,80,,,percent of total billed charges,80% of total billed charges,20.57,85,,,percent of total billed charges,85% of total billed charges,21.78,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.68,40,,,percent of total billed charges,40% of total billed charges,9.68,40,,,percent of total billed charges,40% of total billed charges,21.78,90,,,percent of total billed charges,90% of total billed charges,18.39,76,,,percent of total billed charges,76% of total billed charges,9.68,40,,,percent of total billed charges,40% of total billed charges,20.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,19.36,80,,,percent of total billed charges,80% of total billed charges,9.39,38.8,,,percent of total billed charges,38.8% of total billed charges,20.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,22.99,
Aldosterone LCMS LC,40082088,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,31.4,25.12,,23.55,75,,,percent of total billed charges,75% of total billed charges,12.56,40,,,percent of total billed charges,40% of total billed charges,24.87,79.2,,,percent of total billed charges,79.2% of total billed charges,26.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,29.83,95,,,percent of total billed charges,95% of total billed charges,25.12,80,,,percent of total billed charges,80% of total billed charges,26.69,85,,,percent of total billed charges,85% of total billed charges,28.26,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.56,40,,,percent of total billed charges,40% of total billed charges,12.56,40,,,percent of total billed charges,40% of total billed charges,28.26,90,,,percent of total billed charges,90% of total billed charges,23.86,76,,,percent of total billed charges,76% of total billed charges,12.56,40,,,percent of total billed charges,40% of total billed charges,26.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,25.12,80,,,percent of total billed charges,80% of total billed charges,12.18,38.8,,,percent of total billed charges,38.8% of total billed charges,26.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,29.83,
CMV PCR Quant. LC,40087497,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,445.7,356.56,,334.28,75,,,percent of total billed charges,75% of total billed charges,178.28,40,,,percent of total billed charges,40% of total billed charges,352.99,79.2,,,percent of total billed charges,79.2% of total billed charges,378.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,423.42,95,,,percent of total billed charges,95% of total billed charges,356.56,80,,,percent of total billed charges,80% of total billed charges,378.85,85,,,percent of total billed charges,85% of total billed charges,401.13,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,178.28,40,,,percent of total billed charges,40% of total billed charges,178.28,40,,,percent of total billed charges,40% of total billed charges,401.13,90,,,percent of total billed charges,90% of total billed charges,338.73,76,,,percent of total billed charges,76% of total billed charges,178.28,40,,,percent of total billed charges,40% of total billed charges,378.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,356.56,80,,,percent of total billed charges,80% of total billed charges,172.93,38.8,,,percent of total billed charges,38.8% of total billed charges,378.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,423.42,
"Immunoglobulin G, Qn, LC",40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,22.8,18.24,,17.1,75,,,percent of total billed charges,75% of total billed charges,9.12,40,,,percent of total billed charges,40% of total billed charges,18.06,79.2,,,percent of total billed charges,79.2% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,21.66,95,,,percent of total billed charges,95% of total billed charges,18.24,80,,,percent of total billed charges,80% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,20.52,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.12,40,,,percent of total billed charges,40% of total billed charges,9.12,40,,,percent of total billed charges,40% of total billed charges,20.52,90,,,percent of total billed charges,90% of total billed charges,17.33,76,,,percent of total billed charges,76% of total billed charges,9.12,40,,,percent of total billed charges,40% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,18.24,80,,,percent of total billed charges,80% of total billed charges,8.85,38.8,,,percent of total billed charges,38.8% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,21.66,
BK Quant PCR LC,40087799,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,550,440,,412.5,75,,,percent of total billed charges,75% of total billed charges,220,40,,,percent of total billed charges,40% of total billed charges,435.6,79.2,,,percent of total billed charges,79.2% of total billed charges,467.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,522.5,95,,,percent of total billed charges,95% of total billed charges,440,80,,,percent of total billed charges,80% of total billed charges,467.5,85,,,percent of total billed charges,85% of total billed charges,495,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,220,40,,,percent of total billed charges,40% of total billed charges,220,40,,,percent of total billed charges,40% of total billed charges,495,90,,,percent of total billed charges,90% of total billed charges,418,76,,,percent of total billed charges,76% of total billed charges,220,40,,,percent of total billed charges,40% of total billed charges,467.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,440,80,,,percent of total billed charges,80% of total billed charges,213.4,38.8,,,percent of total billed charges,38.8% of total billed charges,467.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,522.5,
"Citric Acid, Urine LC",40082507,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,36.5,29.2,,27.38,75,,,percent of total billed charges,75% of total billed charges,14.6,40,,,percent of total billed charges,40% of total billed charges,28.91,79.2,,,percent of total billed charges,79.2% of total billed charges,31.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,34.68,95,,,percent of total billed charges,95% of total billed charges,29.2,80,,,percent of total billed charges,80% of total billed charges,31.03,85,,,percent of total billed charges,85% of total billed charges,32.85,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,14.6,40,,,percent of total billed charges,40% of total billed charges,14.6,40,,,percent of total billed charges,40% of total billed charges,32.85,90,,,percent of total billed charges,90% of total billed charges,27.74,76,,,percent of total billed charges,76% of total billed charges,14.6,40,,,percent of total billed charges,40% of total billed charges,31.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,29.2,80,,,percent of total billed charges,80% of total billed charges,14.16,38.8,,,percent of total billed charges,38.8% of total billed charges,31.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,34.68,
"Oxalate, 24-Hr Urine LC",40083945,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,20.6,16.48,,15.45,75,,,percent of total billed charges,75% of total billed charges,8.24,40,,,percent of total billed charges,40% of total billed charges,16.32,79.2,,,percent of total billed charges,79.2% of total billed charges,17.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,19.57,95,,,percent of total billed charges,95% of total billed charges,16.48,80,,,percent of total billed charges,80% of total billed charges,17.51,85,,,percent of total billed charges,85% of total billed charges,18.54,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,8.24,40,,,percent of total billed charges,40% of total billed charges,8.24,40,,,percent of total billed charges,40% of total billed charges,18.54,90,,,percent of total billed charges,90% of total billed charges,15.66,76,,,percent of total billed charges,76% of total billed charges,8.24,40,,,percent of total billed charges,40% of total billed charges,17.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,16.48,80,,,percent of total billed charges,80% of total billed charges,7.99,38.8,,,percent of total billed charges,38.8% of total billed charges,17.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,19.57,
Methylmalonic Acid LC,40083921,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,81.2,64.96,,60.9,75,,,percent of total billed charges,75% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,64.31,79.2,,,percent of total billed charges,79.2% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,77.14,95,,,percent of total billed charges,95% of total billed charges,64.96,80,,,percent of total billed charges,80% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,32.48,40,,,percent of total billed charges,40% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,61.71,76,,,percent of total billed charges,76% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,64.96,80,,,percent of total billed charges,80% of total billed charges,31.51,38.8,,,percent of total billed charges,38.8% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,77.14,
Chromogranin A LC,40086316,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,103.9,83.12,,77.93,75,,,percent of total billed charges,75% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,82.29,79.2,,,percent of total billed charges,79.2% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,98.71,95,,,percent of total billed charges,95% of total billed charges,83.12,80,,,percent of total billed charges,80% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,41.56,40,,,percent of total billed charges,40% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,78.96,76,,,percent of total billed charges,76% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,83.12,80,,,percent of total billed charges,80% of total billed charges,40.31,38.8,,,percent of total billed charges,38.8% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,98.71,
"Calculi, Urinary LC",40082360,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,30.2,24.16,,22.65,75,,,percent of total billed charges,75% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,23.92,79.2,,,percent of total billed charges,79.2% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,28.69,95,,,percent of total billed charges,95% of total billed charges,24.16,80,,,percent of total billed charges,80% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,27.18,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.08,40,,,percent of total billed charges,40% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,27.18,90,,,percent of total billed charges,90% of total billed charges,22.95,76,,,percent of total billed charges,76% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,24.16,80,,,percent of total billed charges,80% of total billed charges,11.72,38.8,,,percent of total billed charges,38.8% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,28.69,
Luteinizing Hormone(LH) LC,40004283,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,30.1,24.08,,22.58,75,,,percent of total billed charges,75% of total billed charges,12.04,40,,,percent of total billed charges,40% of total billed charges,23.84,79.2,,,percent of total billed charges,79.2% of total billed charges,25.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,28.6,95,,,percent of total billed charges,95% of total billed charges,24.08,80,,,percent of total billed charges,80% of total billed charges,25.59,85,,,percent of total billed charges,85% of total billed charges,27.09,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.04,40,,,percent of total billed charges,40% of total billed charges,12.04,40,,,percent of total billed charges,40% of total billed charges,27.09,90,,,percent of total billed charges,90% of total billed charges,22.88,76,,,percent of total billed charges,76% of total billed charges,12.04,40,,,percent of total billed charges,40% of total billed charges,25.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,24.08,80,,,percent of total billed charges,80% of total billed charges,11.68,38.8,,,percent of total billed charges,38.8% of total billed charges,25.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,28.6,
"Viral Culture, General LC",40087252,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,60.8,48.64,,45.6,75,,,percent of total billed charges,75% of total billed charges,24.32,40,,,percent of total billed charges,40% of total billed charges,48.15,79.2,,,percent of total billed charges,79.2% of total billed charges,51.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,57.76,95,,,percent of total billed charges,95% of total billed charges,48.64,80,,,percent of total billed charges,80% of total billed charges,51.68,85,,,percent of total billed charges,85% of total billed charges,54.72,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,24.32,40,,,percent of total billed charges,40% of total billed charges,24.32,40,,,percent of total billed charges,40% of total billed charges,54.72,90,,,percent of total billed charges,90% of total billed charges,46.21,76,,,percent of total billed charges,76% of total billed charges,24.32,40,,,percent of total billed charges,40% of total billed charges,51.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,48.64,80,,,percent of total billed charges,80% of total billed charges,23.59,38.8,,,percent of total billed charges,38.8% of total billed charges,51.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,57.76,
"H. pylori Stool Ag, EIA LC",40087338,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,25.7,20.56,,19.28,75,,,percent of total billed charges,75% of total billed charges,10.28,40,,,percent of total billed charges,40% of total billed charges,20.35,79.2,,,percent of total billed charges,79.2% of total billed charges,21.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,24.42,95,,,percent of total billed charges,95% of total billed charges,20.56,80,,,percent of total billed charges,80% of total billed charges,21.85,85,,,percent of total billed charges,85% of total billed charges,23.13,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,10.28,40,,,percent of total billed charges,40% of total billed charges,10.28,40,,,percent of total billed charges,40% of total billed charges,23.13,90,,,percent of total billed charges,90% of total billed charges,19.53,76,,,percent of total billed charges,76% of total billed charges,10.28,40,,,percent of total billed charges,40% of total billed charges,21.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,20.56,80,,,percent of total billed charges,80% of total billed charges,9.97,38.8,,,percent of total billed charges,38.8% of total billed charges,21.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,33.1,
Protein C-Functional LC,40085303,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,58.5,46.8,,43.88,75,,,percent of total billed charges,75% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,46.33,79.2,,,percent of total billed charges,79.2% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,55.58,95,,,percent of total billed charges,95% of total billed charges,46.8,80,,,percent of total billed charges,80% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,23.4,40,,,percent of total billed charges,40% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,44.46,76,,,percent of total billed charges,76% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,46.8,80,,,percent of total billed charges,80% of total billed charges,22.7,38.8,,,percent of total billed charges,38.8% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,55.58,
Vitamin A LC,40084590,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,30.8,24.64,,23.1,75,,,percent of total billed charges,75% of total billed charges,12.32,40,,,percent of total billed charges,40% of total billed charges,24.39,79.2,,,percent of total billed charges,79.2% of total billed charges,26.18,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,29.26,95,,,percent of total billed charges,95% of total billed charges,24.64,80,,,percent of total billed charges,80% of total billed charges,26.18,85,,,percent of total billed charges,85% of total billed charges,27.72,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.32,40,,,percent of total billed charges,40% of total billed charges,12.32,40,,,percent of total billed charges,40% of total billed charges,27.72,90,,,percent of total billed charges,90% of total billed charges,23.41,76,,,percent of total billed charges,76% of total billed charges,12.32,40,,,percent of total billed charges,40% of total billed charges,26.18,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,24.64,80,,,percent of total billed charges,80% of total billed charges,11.95,38.8,,,percent of total billed charges,38.8% of total billed charges,26.18,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,29.26,
Vitamin E,40084446,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,126.5,101.2,,94.88,75,,,percent of total billed charges,75% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,100.19,79.2,,,percent of total billed charges,79.2% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,120.18,95,,,percent of total billed charges,95% of total billed charges,101.2,80,,,percent of total billed charges,80% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,113.85,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,50.6,40,,,percent of total billed charges,40% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,113.85,90,,,percent of total billed charges,90% of total billed charges,96.14,76,,,percent of total billed charges,76% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,101.2,80,,,percent of total billed charges,80% of total billed charges,49.08,38.8,,,percent of total billed charges,38.8% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,120.18,
82784 Celiac Disease Ab Screen w/Rfx LC,40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,50,40,,37.5,75,,,percent of total billed charges,75% of total billed charges,20,40,,,percent of total billed charges,40% of total billed charges,39.6,79.2,,,percent of total billed charges,79.2% of total billed charges,42.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,47.5,95,,,percent of total billed charges,95% of total billed charges,40,80,,,percent of total billed charges,80% of total billed charges,42.5,85,,,percent of total billed charges,85% of total billed charges,45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,20,40,,,percent of total billed charges,40% of total billed charges,20,40,,,percent of total billed charges,40% of total billed charges,45,90,,,percent of total billed charges,90% of total billed charges,38,76,,,percent of total billed charges,76% of total billed charges,20,40,,,percent of total billed charges,40% of total billed charges,42.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,40,80,,,percent of total billed charges,80% of total billed charges,19.4,38.8,,,percent of total billed charges,38.8% of total billed charges,42.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,47.5,
"Catecholamines, Free,24 Hr U LC",40082384,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,63.84,
Bartonella Antibody Panel LC,40086611,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,75.2,60.16,,56.4,75,,,percent of total billed charges,75% of total billed charges,30.08,40,,,percent of total billed charges,40% of total billed charges,59.56,79.2,,,percent of total billed charges,79.2% of total billed charges,63.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,71.44,95,,,percent of total billed charges,95% of total billed charges,60.16,80,,,percent of total billed charges,80% of total billed charges,63.92,85,,,percent of total billed charges,85% of total billed charges,67.68,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,30.08,40,,,percent of total billed charges,40% of total billed charges,30.08,40,,,percent of total billed charges,40% of total billed charges,67.68,90,,,percent of total billed charges,90% of total billed charges,57.15,76,,,percent of total billed charges,76% of total billed charges,30.08,40,,,percent of total billed charges,40% of total billed charges,63.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,60.16,80,,,percent of total billed charges,80% of total billed charges,29.18,38.8,,,percent of total billed charges,38.8% of total billed charges,63.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,71.44,
Sirolimus (Rapamune) LC,40080195,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,61.5,49.2,,46.13,75,,,percent of total billed charges,75% of total billed charges,24.6,40,,,percent of total billed charges,40% of total billed charges,48.71,79.2,,,percent of total billed charges,79.2% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,58.43,95,,,percent of total billed charges,95% of total billed charges,49.2,80,,,percent of total billed charges,80% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,55.35,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.6,40,,,percent of total billed charges,40% of total billed charges,24.6,40,,,percent of total billed charges,40% of total billed charges,55.35,90,,,percent of total billed charges,90% of total billed charges,46.74,76,,,percent of total billed charges,76% of total billed charges,24.6,40,,,percent of total billed charges,40% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,49.2,80,,,percent of total billed charges,80% of total billed charges,23.86,38.8,,,percent of total billed charges,38.8% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,58.43,
"Nicotine and Metabolite, Quant LC",40080323,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,50.8,40.64,,38.1,75,,,percent of total billed charges,75% of total billed charges,20.32,40,,,percent of total billed charges,40% of total billed charges,40.23,79.2,,,percent of total billed charges,79.2% of total billed charges,43.18,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,48.26,95,,,percent of total billed charges,95% of total billed charges,40.64,80,,,percent of total billed charges,80% of total billed charges,43.18,85,,,percent of total billed charges,85% of total billed charges,45.72,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,20.32,40,,,percent of total billed charges,40% of total billed charges,20.32,40,,,percent of total billed charges,40% of total billed charges,45.72,90,,,percent of total billed charges,90% of total billed charges,38.61,76,,,percent of total billed charges,76% of total billed charges,20.32,40,,,percent of total billed charges,40% of total billed charges,43.18,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,40.64,80,,,percent of total billed charges,80% of total billed charges,19.71,38.8,,,percent of total billed charges,38.8% of total billed charges,43.18,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,48.26,
Hgb Solubility LC,40085660,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,97.9,78.32,,73.43,75,,,percent of total billed charges,75% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,77.54,79.2,,,percent of total billed charges,79.2% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,93.01,95,,,percent of total billed charges,95% of total billed charges,78.32,80,,,percent of total billed charges,80% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,39.16,40,,,percent of total billed charges,40% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,74.4,76,,,percent of total billed charges,76% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,78.32,80,,,percent of total billed charges,80% of total billed charges,37.99,38.8,,,percent of total billed charges,38.8% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,93.01,
"Phosphorus, 24 Hr Urine LC",40084105,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,4.9,3.92,,3.68,75,,,percent of total billed charges,75% of total billed charges,1.96,40,,,percent of total billed charges,40% of total billed charges,3.88,79.2,,,percent of total billed charges,79.2% of total billed charges,4.17,85,,,percent of total billed charges,85% of total billed charges,4.9,100,,,fee schedule,100% of CO APG rates,4.66,95,,,percent of total billed charges,95% of total billed charges,3.92,80,,,percent of total billed charges,80% of total billed charges,4.17,85,,,percent of total billed charges,85% of total billed charges,4.41,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,1.96,40,,,percent of total billed charges,40% of total billed charges,1.96,40,,,percent of total billed charges,40% of total billed charges,4.41,90,,,percent of total billed charges,90% of total billed charges,3.72,76,,,percent of total billed charges,76% of total billed charges,1.96,40,,,percent of total billed charges,40% of total billed charges,4.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,3.92,80,,,percent of total billed charges,80% of total billed charges,1.9,38.8,,,percent of total billed charges,38.8% of total billed charges,4.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,1.9,8.76,
Protein C Antigen LC,40085302,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,38.8,31.04,,29.1,75,,,percent of total billed charges,75% of total billed charges,15.52,40,,,percent of total billed charges,40% of total billed charges,30.73,79.2,,,percent of total billed charges,79.2% of total billed charges,32.98,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,36.86,95,,,percent of total billed charges,95% of total billed charges,31.04,80,,,percent of total billed charges,80% of total billed charges,32.98,85,,,percent of total billed charges,85% of total billed charges,34.92,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,15.52,40,,,percent of total billed charges,40% of total billed charges,15.52,40,,,percent of total billed charges,40% of total billed charges,34.92,90,,,percent of total billed charges,90% of total billed charges,29.49,76,,,percent of total billed charges,76% of total billed charges,15.52,40,,,percent of total billed charges,40% of total billed charges,32.98,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,31.04,80,,,percent of total billed charges,80% of total billed charges,15.05,38.8,,,percent of total billed charges,38.8% of total billed charges,32.98,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,36.86,
"Rubella Abs, IgG LC",40006197,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,24.4,19.52,,18.3,75,,,percent of total billed charges,75% of total billed charges,9.76,40,,,percent of total billed charges,40% of total billed charges,19.32,79.2,,,percent of total billed charges,79.2% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,23.18,95,,,percent of total billed charges,95% of total billed charges,19.52,80,,,percent of total billed charges,80% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,21.96,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,9.76,40,,,percent of total billed charges,40% of total billed charges,9.76,40,,,percent of total billed charges,40% of total billed charges,21.96,90,,,percent of total billed charges,90% of total billed charges,18.54,76,,,percent of total billed charges,76% of total billed charges,9.76,40,,,percent of total billed charges,40% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,19.52,80,,,percent of total billed charges,80% of total billed charges,9.47,38.8,,,percent of total billed charges,38.8% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,23.18,
"Beta 2 Glycoprotein I antibody, each",40086146,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,116.9,93.52,,87.68,75,,,percent of total billed charges,75% of total billed charges,46.76,40,,,percent of total billed charges,40% of total billed charges,92.58,79.2,,,percent of total billed charges,79.2% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,111.06,95,,,percent of total billed charges,95% of total billed charges,93.52,80,,,percent of total billed charges,80% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,105.21,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,46.76,40,,,percent of total billed charges,40% of total billed charges,46.76,40,,,percent of total billed charges,40% of total billed charges,105.21,90,,,percent of total billed charges,90% of total billed charges,88.84,76,,,percent of total billed charges,76% of total billed charges,46.76,40,,,percent of total billed charges,40% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,93.52,80,,,percent of total billed charges,80% of total billed charges,45.36,38.8,,,percent of total billed charges,38.8% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,111.06,
"LD, Body Fluid LC",40100156,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,17.9,14.32,,13.43,75,,,percent of total billed charges,75% of total billed charges,7.16,40,,,percent of total billed charges,40% of total billed charges,14.18,79.2,,,percent of total billed charges,79.2% of total billed charges,15.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,17.01,95,,,percent of total billed charges,95% of total billed charges,14.32,80,,,percent of total billed charges,80% of total billed charges,15.22,85,,,percent of total billed charges,85% of total billed charges,16.11,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,7.16,40,,,percent of total billed charges,40% of total billed charges,7.16,40,,,percent of total billed charges,40% of total billed charges,16.11,90,,,percent of total billed charges,90% of total billed charges,13.6,76,,,percent of total billed charges,76% of total billed charges,7.16,40,,,percent of total billed charges,40% of total billed charges,15.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,14.32,80,,,percent of total billed charges,80% of total billed charges,6.95,38.8,,,percent of total billed charges,38.8% of total billed charges,15.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,17.01,
"5-HIAA, 24 Hr Urine LC",40083497,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,16.3,13.04,,12.23,75,,,percent of total billed charges,75% of total billed charges,6.52,40,,,percent of total billed charges,40% of total billed charges,12.91,79.2,,,percent of total billed charges,79.2% of total billed charges,13.86,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,15.49,95,,,percent of total billed charges,95% of total billed charges,13.04,80,,,percent of total billed charges,80% of total billed charges,13.86,85,,,percent of total billed charges,85% of total billed charges,14.67,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,6.52,40,,,percent of total billed charges,40% of total billed charges,6.52,40,,,percent of total billed charges,40% of total billed charges,14.67,90,,,percent of total billed charges,90% of total billed charges,12.39,76,,,percent of total billed charges,76% of total billed charges,6.52,40,,,percent of total billed charges,40% of total billed charges,13.86,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,13.04,80,,,percent of total billed charges,80% of total billed charges,6.32,38.8,,,percent of total billed charges,38.8% of total billed charges,13.86,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,15.49,
"Allergen Profile, Food-Basic LC",40086003,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,79.7,63.76,,59.78,75,,,percent of total billed charges,75% of total billed charges,31.88,40,,,percent of total billed charges,40% of total billed charges,63.12,79.2,,,percent of total billed charges,79.2% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,75.72,95,,,percent of total billed charges,95% of total billed charges,63.76,80,,,percent of total billed charges,80% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,71.73,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,31.88,40,,,percent of total billed charges,40% of total billed charges,31.88,40,,,percent of total billed charges,40% of total billed charges,71.73,90,,,percent of total billed charges,90% of total billed charges,60.57,76,,,percent of total billed charges,76% of total billed charges,31.88,40,,,percent of total billed charges,40% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,63.76,80,,,percent of total billed charges,80% of total billed charges,30.92,38.8,,,percent of total billed charges,38.8% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,75.72,
C1 Esterase Inhibitor LC,40086161,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,49,39.2,,36.75,75,,,percent of total billed charges,75% of total billed charges,19.6,40,,,percent of total billed charges,40% of total billed charges,38.81,79.2,,,percent of total billed charges,79.2% of total billed charges,41.65,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,46.55,95,,,percent of total billed charges,95% of total billed charges,39.2,80,,,percent of total billed charges,80% of total billed charges,41.65,85,,,percent of total billed charges,85% of total billed charges,44.1,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,19.6,40,,,percent of total billed charges,40% of total billed charges,19.6,40,,,percent of total billed charges,40% of total billed charges,44.1,90,,,percent of total billed charges,90% of total billed charges,37.24,76,,,percent of total billed charges,76% of total billed charges,19.6,40,,,percent of total billed charges,40% of total billed charges,41.65,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,39.2,80,,,percent of total billed charges,80% of total billed charges,19.01,38.8,,,percent of total billed charges,38.8% of total billed charges,41.65,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,46.55,
CMV PCR Qual. LC,40087496,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,371.5,297.2,,278.63,75,,,percent of total billed charges,75% of total billed charges,148.6,40,,,percent of total billed charges,40% of total billed charges,294.23,79.2,,,percent of total billed charges,79.2% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,352.93,95,,,percent of total billed charges,95% of total billed charges,297.2,80,,,percent of total billed charges,80% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,334.35,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,148.6,40,,,percent of total billed charges,40% of total billed charges,148.6,40,,,percent of total billed charges,40% of total billed charges,334.35,90,,,percent of total billed charges,90% of total billed charges,282.34,76,,,percent of total billed charges,76% of total billed charges,148.6,40,,,percent of total billed charges,40% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,297.2,80,,,percent of total billed charges,80% of total billed charges,144.14,38.8,,,percent of total billed charges,38.8% of total billed charges,315.78,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,352.93,
"Fecal Fat, Qualitative LC",40082705,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,27.3,21.84,,20.48,75,,,percent of total billed charges,75% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,21.62,79.2,,,percent of total billed charges,79.2% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,25.94,95,,,percent of total billed charges,95% of total billed charges,21.84,80,,,percent of total billed charges,80% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,24.57,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,10.92,40,,,percent of total billed charges,40% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,24.57,90,,,percent of total billed charges,90% of total billed charges,20.75,76,,,percent of total billed charges,76% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,21.84,80,,,percent of total billed charges,80% of total billed charges,10.59,38.8,,,percent of total billed charges,38.8% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,25.94,
Hepatitis B Core Ab LC,40086704,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,23.6,18.88,,17.7,75,,,percent of total billed charges,75% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,18.69,79.2,,,percent of total billed charges,79.2% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,22.42,95,,,percent of total billed charges,95% of total billed charges,18.88,80,,,percent of total billed charges,80% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,21.24,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,9.44,40,,,percent of total billed charges,40% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,21.24,90,,,percent of total billed charges,90% of total billed charges,17.94,76,,,percent of total billed charges,76% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,18.88,80,,,percent of total billed charges,80% of total billed charges,9.16,38.8,,,percent of total billed charges,38.8% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,22.42,
HSV 1/2 PCR LC,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,64.4,51.52,,48.3,75,,,percent of total billed charges,75% of total billed charges,25.76,40,,,percent of total billed charges,40% of total billed charges,51,79.2,,,percent of total billed charges,79.2% of total billed charges,54.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,61.18,95,,,percent of total billed charges,95% of total billed charges,51.52,80,,,percent of total billed charges,80% of total billed charges,54.74,85,,,percent of total billed charges,85% of total billed charges,57.96,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,25.76,40,,,percent of total billed charges,40% of total billed charges,25.76,40,,,percent of total billed charges,40% of total billed charges,57.96,90,,,percent of total billed charges,90% of total billed charges,48.94,76,,,percent of total billed charges,76% of total billed charges,25.76,40,,,percent of total billed charges,40% of total billed charges,54.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,51.52,80,,,percent of total billed charges,80% of total billed charges,24.99,38.8,,,percent of total billed charges,38.8% of total billed charges,54.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,61.18,
"HSV, IgM I/II Combination LC",40086694,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,40.1,32.08,,30.08,75,,,percent of total billed charges,75% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,31.76,79.2,,,percent of total billed charges,79.2% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,38.1,95,,,percent of total billed charges,95% of total billed charges,32.08,80,,,percent of total billed charges,80% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,16.04,40,,,percent of total billed charges,40% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,30.48,76,,,percent of total billed charges,76% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,32.08,80,,,percent of total billed charges,80% of total billed charges,15.56,38.8,,,percent of total billed charges,38.8% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,38.1,
"Immunoglobulins A/E/G/M,  LC",40082785,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,57.1,45.68,,42.83,75,,,percent of total billed charges,75% of total billed charges,22.84,40,,,percent of total billed charges,40% of total billed charges,45.22,79.2,,,percent of total billed charges,79.2% of total billed charges,48.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,54.25,95,,,percent of total billed charges,95% of total billed charges,45.68,80,,,percent of total billed charges,80% of total billed charges,48.54,85,,,percent of total billed charges,85% of total billed charges,51.39,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,22.84,40,,,percent of total billed charges,40% of total billed charges,22.84,40,,,percent of total billed charges,40% of total billed charges,51.39,90,,,percent of total billed charges,90% of total billed charges,43.4,76,,,percent of total billed charges,76% of total billed charges,22.84,40,,,percent of total billed charges,40% of total billed charges,48.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,45.68,80,,,percent of total billed charges,80% of total billed charges,22.15,38.8,,,percent of total billed charges,38.8% of total billed charges,48.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,54.25,
"Immunoglobulins A/G/M, Qn LC",40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,42.2,33.76,,31.65,75,,,percent of total billed charges,75% of total billed charges,16.88,40,,,percent of total billed charges,40% of total billed charges,33.42,79.2,,,percent of total billed charges,79.2% of total billed charges,35.87,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,40.09,95,,,percent of total billed charges,95% of total billed charges,33.76,80,,,percent of total billed charges,80% of total billed charges,35.87,85,,,percent of total billed charges,85% of total billed charges,37.98,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,16.88,40,,,percent of total billed charges,40% of total billed charges,16.88,40,,,percent of total billed charges,40% of total billed charges,37.98,90,,,percent of total billed charges,90% of total billed charges,32.07,76,,,percent of total billed charges,76% of total billed charges,16.88,40,,,percent of total billed charges,40% of total billed charges,35.87,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,33.76,80,,,percent of total billed charges,80% of total billed charges,16.37,38.8,,,percent of total billed charges,38.8% of total billed charges,35.87,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,40.09,
MTHFR LC,40081291,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,139.1,111.28,,104.33,75,,,percent of total billed charges,75% of total billed charges,55.64,40,,,percent of total billed charges,40% of total billed charges,110.17,79.2,,,percent of total billed charges,79.2% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,132.15,95,,,percent of total billed charges,95% of total billed charges,111.28,80,,,percent of total billed charges,80% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,125.19,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,55.64,40,,,percent of total billed charges,40% of total billed charges,55.64,40,,,percent of total billed charges,40% of total billed charges,125.19,90,,,percent of total billed charges,90% of total billed charges,105.72,76,,,percent of total billed charges,76% of total billed charges,55.64,40,,,percent of total billed charges,40% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,111.28,80,,,percent of total billed charges,80% of total billed charges,53.97,38.8,,,percent of total billed charges,38.8% of total billed charges,118.24,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,132.15,
"Protein Electro, Random Urine LC",40084156,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,24.6,19.68,,18.45,75,,,percent of total billed charges,75% of total billed charges,9.84,40,,,percent of total billed charges,40% of total billed charges,19.48,79.2,,,percent of total billed charges,79.2% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,23.37,95,,,percent of total billed charges,95% of total billed charges,19.68,80,,,percent of total billed charges,80% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.84,40,,,percent of total billed charges,40% of total billed charges,9.84,40,,,percent of total billed charges,40% of total billed charges,22.14,90,,,percent of total billed charges,90% of total billed charges,18.7,76,,,percent of total billed charges,76% of total billed charges,9.84,40,,,percent of total billed charges,40% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,19.68,80,,,percent of total billed charges,80% of total billed charges,9.54,38.8,,,percent of total billed charges,38.8% of total billed charges,20.91,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,23.37,
"Clotting inhibitors or anticoagulants; protein S, total",40085305,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,152,121.6,,114,75,,,percent of total billed charges,75% of total billed charges,60.8,40,,,percent of total billed charges,40% of total billed charges,120.38,79.2,,,percent of total billed charges,79.2% of total billed charges,129.2,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,144.4,95,,,percent of total billed charges,95% of total billed charges,121.6,80,,,percent of total billed charges,80% of total billed charges,129.2,85,,,percent of total billed charges,85% of total billed charges,136.8,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,60.8,40,,,percent of total billed charges,40% of total billed charges,60.8,40,,,percent of total billed charges,40% of total billed charges,136.8,90,,,percent of total billed charges,90% of total billed charges,115.52,76,,,percent of total billed charges,76% of total billed charges,60.8,40,,,percent of total billed charges,40% of total billed charges,129.2,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,121.6,80,,,percent of total billed charges,80% of total billed charges,58.98,38.8,,,percent of total billed charges,38.8% of total billed charges,129.2,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,144.4,
"Clotting inhibitors or anticoagulants; protein S, free",40085306,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,177.4,141.92,,133.05,75,,,percent of total billed charges,75% of total billed charges,70.96,40,,,percent of total billed charges,40% of total billed charges,140.5,79.2,,,percent of total billed charges,79.2% of total billed charges,150.79,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,168.53,95,,,percent of total billed charges,95% of total billed charges,141.92,80,,,percent of total billed charges,80% of total billed charges,150.79,85,,,percent of total billed charges,85% of total billed charges,159.66,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,70.96,40,,,percent of total billed charges,40% of total billed charges,70.96,40,,,percent of total billed charges,40% of total billed charges,159.66,90,,,percent of total billed charges,90% of total billed charges,134.82,76,,,percent of total billed charges,76% of total billed charges,70.96,40,,,percent of total billed charges,40% of total billed charges,150.79,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,141.92,80,,,percent of total billed charges,80% of total billed charges,68.83,38.8,,,percent of total billed charges,38.8% of total billed charges,150.79,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,168.53,
"Protein, Urine LC",40084156,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,6.4,5.12,,4.8,75,,,percent of total billed charges,75% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.07,79.2,,,percent of total billed charges,79.2% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,6.4,100,,,fee schedule,100% of CO APG rates,6.08,95,,,percent of total billed charges,95% of total billed charges,5.12,80,,,percent of total billed charges,80% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,2.56,40,,,percent of total billed charges,40% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.76,90,,,percent of total billed charges,90% of total billed charges,4.86,76,,,percent of total billed charges,76% of total billed charges,2.56,40,,,percent of total billed charges,40% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,5.12,80,,,percent of total billed charges,80% of total billed charges,2.48,38.8,,,percent of total billed charges,38.8% of total billed charges,5.44,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,2.48,8.76,
QuantiFERON TB Gold LC,40086480,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,184.9,147.92,,138.68,75,,,percent of total billed charges,75% of total billed charges,73.96,40,,,percent of total billed charges,40% of total billed charges,146.44,79.2,,,percent of total billed charges,79.2% of total billed charges,157.17,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,175.66,95,,,percent of total billed charges,95% of total billed charges,147.92,80,,,percent of total billed charges,80% of total billed charges,157.17,85,,,percent of total billed charges,85% of total billed charges,166.41,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,73.96,40,,,percent of total billed charges,40% of total billed charges,73.96,40,,,percent of total billed charges,40% of total billed charges,166.41,90,,,percent of total billed charges,90% of total billed charges,140.52,76,,,percent of total billed charges,76% of total billed charges,73.96,40,,,percent of total billed charges,40% of total billed charges,157.17,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,147.92,80,,,percent of total billed charges,80% of total billed charges,71.74,38.8,,,percent of total billed charges,38.8% of total billed charges,157.17,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,175.66,
Reverse T3 LC,40084482,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,46.8,37.44,,35.1,75,,,percent of total billed charges,75% of total billed charges,18.72,40,,,percent of total billed charges,40% of total billed charges,37.07,79.2,,,percent of total billed charges,79.2% of total billed charges,39.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,44.46,95,,,percent of total billed charges,95% of total billed charges,37.44,80,,,percent of total billed charges,80% of total billed charges,39.78,85,,,percent of total billed charges,85% of total billed charges,42.12,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,18.72,40,,,percent of total billed charges,40% of total billed charges,18.72,40,,,percent of total billed charges,40% of total billed charges,42.12,90,,,percent of total billed charges,90% of total billed charges,35.57,76,,,percent of total billed charges,76% of total billed charges,18.72,40,,,percent of total billed charges,40% of total billed charges,39.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,37.44,80,,,percent of total billed charges,80% of total billed charges,18.16,38.8,,,percent of total billed charges,38.8% of total billed charges,39.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,44.46,
Thyroid Abs LC,40086376,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,39.2,31.36,,29.4,75,,,percent of total billed charges,75% of total billed charges,15.68,40,,,percent of total billed charges,40% of total billed charges,31.05,79.2,,,percent of total billed charges,79.2% of total billed charges,33.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,37.24,95,,,percent of total billed charges,95% of total billed charges,31.36,80,,,percent of total billed charges,80% of total billed charges,33.32,85,,,percent of total billed charges,85% of total billed charges,35.28,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,15.68,40,,,percent of total billed charges,40% of total billed charges,15.68,40,,,percent of total billed charges,40% of total billed charges,35.28,90,,,percent of total billed charges,90% of total billed charges,29.79,76,,,percent of total billed charges,76% of total billed charges,15.68,40,,,percent of total billed charges,40% of total billed charges,33.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,31.36,80,,,percent of total billed charges,80% of total billed charges,15.21,38.8,,,percent of total billed charges,38.8% of total billed charges,33.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,37.24,
Thyrotropin Receptor Ab LC,40083520,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,142.9,114.32,,107.18,75,,,percent of total billed charges,75% of total billed charges,57.16,40,,,percent of total billed charges,40% of total billed charges,113.18,79.2,,,percent of total billed charges,79.2% of total billed charges,121.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,135.76,95,,,percent of total billed charges,95% of total billed charges,114.32,80,,,percent of total billed charges,80% of total billed charges,121.47,85,,,percent of total billed charges,85% of total billed charges,128.61,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,57.16,40,,,percent of total billed charges,40% of total billed charges,57.16,40,,,percent of total billed charges,40% of total billed charges,128.61,90,,,percent of total billed charges,90% of total billed charges,108.6,76,,,percent of total billed charges,76% of total billed charges,57.16,40,,,percent of total billed charges,40% of total billed charges,121.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,114.32,80,,,percent of total billed charges,80% of total billed charges,55.45,38.8,,,percent of total billed charges,38.8% of total billed charges,121.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,135.76,
Immunoassay for analyte other than infectious agent antibody,40083516,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,118,94.4,,88.5,75,,,percent of total billed charges,75% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,93.46,79.2,,,percent of total billed charges,79.2% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,112.1,95,,,percent of total billed charges,95% of total billed charges,94.4,80,,,percent of total billed charges,80% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,47.2,40,,,percent of total billed charges,40% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,89.68,76,,,percent of total billed charges,76% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,94.4,80,,,percent of total billed charges,80% of total billed charges,45.78,38.8,,,percent of total billed charges,38.8% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,112.1,
ELEC STIM OTHER THAN WOUND,60000303,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,112.5,90,GO,84.38,75,,,percent of total billed charges,75% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,89.1,79.2,,,percent of total billed charges,79.2% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,106.88,95,,,percent of total billed charges,95% of total billed charges,90,80,,,percent of total billed charges,80% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,45,40,,,percent of total billed charges,40% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,101.25,90,,,percent of total billed charges,90% of total billed charges,85.5,76,,,percent of total billed charges,76% of total billed charges,45,40,,,percent of total billed charges,40% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,90,80,,,percent of total billed charges,80% of total billed charges,43.65,38.8,,,percent of total billed charges,38.8% of total billed charges,95.63,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,106.88,
"RT CO2 Monitor, Single Charge",42294770,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,52.8,42.24,,39.6,75,,,percent of total billed charges,75% of total billed charges,21.12,40,,,percent of total billed charges,40% of total billed charges,41.82,79.2,,,percent of total billed charges,79.2% of total billed charges,44.88,85,,,percent of total billed charges,85% of total billed charges,52.8,100,,,fee schedule,100% of CO APG rates,50.16,95,,,percent of total billed charges,95% of total billed charges,42.24,80,,,percent of total billed charges,80% of total billed charges,44.88,85,,,percent of total billed charges,85% of total billed charges,47.52,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,52.8,100,,,fee schedule,100% of NM APC rate,21.12,40,,,percent of total billed charges,40% of total billed charges,21.12,40,,,percent of total billed charges,40% of total billed charges,47.52,90,,,percent of total billed charges,90% of total billed charges,40.13,76,,,percent of total billed charges,76% of total billed charges,21.12,40,,,percent of total billed charges,40% of total billed charges,44.88,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,42.24,80,,,percent of total billed charges,80% of total billed charges,20.49,38.8,,,percent of total billed charges,38.8% of total billed charges,44.88,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,20.49,69.18,
Evaluation for prescription for speech-generating augmentati,60000352,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,211.4,169.12,GN,158.55,75,,,percent of total billed charges,75% of total billed charges,84.56,40,,,percent of total billed charges,40% of total billed charges,167.43,79.2,,,percent of total billed charges,79.2% of total billed charges,179.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,200.83,95,,,percent of total billed charges,95% of total billed charges,169.12,80,,,percent of total billed charges,80% of total billed charges,179.69,85,,,percent of total billed charges,85% of total billed charges,190.26,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,84.56,40,,,percent of total billed charges,40% of total billed charges,84.56,40,,,percent of total billed charges,40% of total billed charges,190.26,90,,,percent of total billed charges,90% of total billed charges,160.66,76,,,percent of total billed charges,76% of total billed charges,84.56,40,,,percent of total billed charges,40% of total billed charges,179.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,169.12,80,,,percent of total billed charges,80% of total billed charges,82.02,38.8,,,percent of total billed charges,38.8% of total billed charges,179.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,200.83,
Meter Dose Inhaler (MDI) Instruction,42294664,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,135,108,,101.25,75,,,percent of total billed charges,75% of total billed charges,54,40,,,percent of total billed charges,40% of total billed charges,106.92,79.2,,,percent of total billed charges,79.2% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,128.25,95,,,percent of total billed charges,95% of total billed charges,108,80,,,percent of total billed charges,80% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,121.5,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,135,100,,,fee schedule,100% of NM APC rate,54,40,,,percent of total billed charges,40% of total billed charges,54,40,,,percent of total billed charges,40% of total billed charges,121.5,90,,,percent of total billed charges,90% of total billed charges,102.6,76,,,percent of total billed charges,76% of total billed charges,54,40,,,percent of total billed charges,40% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,108,80,,,percent of total billed charges,80% of total billed charges,52.38,38.8,,,percent of total billed charges,38.8% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,135,
RT Sputum Induction Subsequent Charge,42294645,CDM,412,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,76,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
ST Standard Cognitive Eval,60000350,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,367.9,294.32,GN,275.93,75,,,percent of total billed charges,75% of total billed charges,147.16,40,,,percent of total billed charges,40% of total billed charges,291.38,79.2,,,percent of total billed charges,79.2% of total billed charges,312.72,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,349.51,95,,,percent of total billed charges,95% of total billed charges,294.32,80,,,percent of total billed charges,80% of total billed charges,312.72,85,,,percent of total billed charges,85% of total billed charges,331.11,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,147.16,40,,,percent of total billed charges,40% of total billed charges,147.16,40,,,percent of total billed charges,40% of total billed charges,331.11,90,,,percent of total billed charges,90% of total billed charges,279.6,76,,,percent of total billed charges,76% of total billed charges,147.16,40,,,percent of total billed charges,40% of total billed charges,312.72,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,294.32,80,,,percent of total billed charges,80% of total billed charges,142.75,38.8,,,percent of total billed charges,38.8% of total billed charges,312.72,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,349.51,
Evaluation for prescription for speech-generating augmentati,60000351,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,475.8,380.64,GN,356.85,75,,,percent of total billed charges,75% of total billed charges,190.32,40,,,percent of total billed charges,40% of total billed charges,376.83,79.2,,,percent of total billed charges,79.2% of total billed charges,404.43,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,452.01,95,,,percent of total billed charges,95% of total billed charges,380.64,80,,,percent of total billed charges,80% of total billed charges,404.43,85,,,percent of total billed charges,85% of total billed charges,428.22,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,190.32,40,,,percent of total billed charges,40% of total billed charges,190.32,40,,,percent of total billed charges,40% of total billed charges,428.22,90,,,percent of total billed charges,90% of total billed charges,361.61,76,,,percent of total billed charges,76% of total billed charges,190.32,40,,,percent of total billed charges,40% of total billed charges,404.43,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,380.64,80,,,percent of total billed charges,80% of total billed charges,184.61,38.8,,,percent of total billed charges,38.8% of total billed charges,404.43,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,452.01,
PT Manual Therapy Charge Units,42597140,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,111.4,89.12,GP,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,105.83,
PT Manual Therapy Charge Units,42597140,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,111.4,89.12,GP,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,105.83,
PT Manual Therapy Charge Units,42597140,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,111.4,89.12,GP,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,105.83,
CT Sinus or Facial w/o Cont,41170486,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,1378.9,1103.12,TC,1034.18,75,,,percent of total billed charges,75% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1309.96,95,,,percent of total billed charges,95% of total billed charges,1103.12,80,,,percent of total billed charges,80% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,551.56,40,,,percent of total billed charges,40% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1241.01,90,,,percent of total billed charges,90% of total billed charges,1047.96,76,,,percent of total billed charges,76% of total billed charges,551.56,40,,,percent of total billed charges,40% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1103.12,80,,,percent of total billed charges,80% of total billed charges,535.01,38.8,,,percent of total billed charges,38.8% of total billed charges,1172.07,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,1309.96,
"RADIOLOGIC EXAMINATION, ABDOMEN 3 OR MORE VIEWS",41074021,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,466.9,373.52,TC,350.18,75,,,percent of total billed charges,75% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,369.78,79.2,,,percent of total billed charges,79.2% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,443.56,95,,,percent of total billed charges,95% of total billed charges,373.52,80,,,percent of total billed charges,80% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,186.76,40,,,percent of total billed charges,40% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,354.84,76,,,percent of total billed charges,76% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,373.52,80,,,percent of total billed charges,80% of total billed charges,181.16,38.8,,,percent of total billed charges,38.8% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,443.56,
XR Femur 2 Views Lt,41073552,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Femur 2 Views Rt,41073552,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR LE Infant Min 2 Views Lt,41073592,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR LE Infant Min 2 Views Rt,41073592,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Ribs Min 3 Views Lt w/ AP Chest,41071101,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,317.2,253.76,TC,237.9,75,,,percent of total billed charges,75% of total billed charges,126.88,40,,,percent of total billed charges,40% of total billed charges,251.22,79.2,,,percent of total billed charges,79.2% of total billed charges,269.62,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,301.34,95,,,percent of total billed charges,95% of total billed charges,253.76,80,,,percent of total billed charges,80% of total billed charges,269.62,85,,,percent of total billed charges,85% of total billed charges,285.48,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,126.88,40,,,percent of total billed charges,40% of total billed charges,126.88,40,,,percent of total billed charges,40% of total billed charges,285.48,90,,,percent of total billed charges,90% of total billed charges,241.07,76,,,percent of total billed charges,76% of total billed charges,126.88,40,,,percent of total billed charges,40% of total billed charges,269.62,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,253.76,80,,,percent of total billed charges,80% of total billed charges,123.07,38.8,,,percent of total billed charges,38.8% of total billed charges,269.62,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,301.34,
XR Tibia +Fibula 2 Views Lt,41073590,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR Tibia +Fibula 2 Views Rt,41073590,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR UE Infant Min 2 Views Lt,41073092,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
XR UE Infant Min 2 Views Rt,41073092,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,270.1,216.08,TC,202.58,75,,,percent of total billed charges,75% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,213.92,79.2,,,percent of total billed charges,79.2% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,256.6,95,,,percent of total billed charges,95% of total billed charges,216.08,80,,,percent of total billed charges,80% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,108.04,40,,,percent of total billed charges,40% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,243.09,90,,,percent of total billed charges,90% of total billed charges,205.28,76,,,percent of total billed charges,76% of total billed charges,108.04,40,,,percent of total billed charges,40% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,216.08,80,,,percent of total billed charges,80% of total billed charges,104.8,38.8,,,percent of total billed charges,38.8% of total billed charges,229.59,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,256.6,
Ferritin Level,40082728,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,119.2,95.36,,89.4,75,,,percent of total billed charges,75% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,94.41,79.2,,,percent of total billed charges,79.2% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,113.24,95,,,percent of total billed charges,95% of total billed charges,95.36,80,,,percent of total billed charges,80% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,107.28,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,47.68,40,,,percent of total billed charges,40% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,107.28,90,,,percent of total billed charges,90% of total billed charges,90.59,76,,,percent of total billed charges,76% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,95.36,80,,,percent of total billed charges,80% of total billed charges,46.25,38.8,,,percent of total billed charges,38.8% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,113.24,
"POX, Single Determination Charge",42294760,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,175.2,140.16,,131.4,75,,,percent of total billed charges,75% of total billed charges,70.08,40,,,percent of total billed charges,40% of total billed charges,138.76,79.2,,,percent of total billed charges,79.2% of total billed charges,148.92,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,166.44,95,,,percent of total billed charges,95% of total billed charges,140.16,80,,,percent of total billed charges,80% of total billed charges,148.92,85,,,percent of total billed charges,85% of total billed charges,157.68,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,70.08,40,,,percent of total billed charges,40% of total billed charges,70.08,40,,,percent of total billed charges,40% of total billed charges,157.68,90,,,percent of total billed charges,90% of total billed charges,133.15,76,,,percent of total billed charges,76% of total billed charges,70.08,40,,,percent of total billed charges,40% of total billed charges,148.92,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,140.16,80,,,percent of total billed charges,80% of total billed charges,67.98,38.8,,,percent of total billed charges,38.8% of total billed charges,148.92,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,67.98,166.44,
"POX, Multiple Determination Charge",42294761,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,192.5,154,,144.38,75,,,percent of total billed charges,75% of total billed charges,77,40,,,percent of total billed charges,40% of total billed charges,152.46,79.2,,,percent of total billed charges,79.2% of total billed charges,163.63,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,182.88,95,,,percent of total billed charges,95% of total billed charges,154,80,,,percent of total billed charges,80% of total billed charges,163.63,85,,,percent of total billed charges,85% of total billed charges,173.25,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,77,40,,,percent of total billed charges,40% of total billed charges,77,40,,,percent of total billed charges,40% of total billed charges,173.25,90,,,percent of total billed charges,90% of total billed charges,146.3,76,,,percent of total billed charges,76% of total billed charges,77,40,,,percent of total billed charges,40% of total billed charges,163.63,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,154,80,,,percent of total billed charges,80% of total billed charges,74.69,38.8,,,percent of total billed charges,38.8% of total billed charges,163.63,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,182.88,
WORK HARDENING/CONDITIONING 1ST 2 HR,60000304,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,449.9,359.92,GO,337.43,75,,,percent of total billed charges,75% of total billed charges,179.96,40,,,percent of total billed charges,40% of total billed charges,356.32,79.2,,,percent of total billed charges,79.2% of total billed charges,382.42,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,427.41,95,,,percent of total billed charges,95% of total billed charges,359.92,80,,,percent of total billed charges,80% of total billed charges,382.42,85,,,percent of total billed charges,85% of total billed charges,404.91,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,179.96,40,,,percent of total billed charges,40% of total billed charges,179.96,40,,,percent of total billed charges,40% of total billed charges,404.91,90,,,percent of total billed charges,90% of total billed charges,341.92,76,,,percent of total billed charges,76% of total billed charges,179.96,40,,,percent of total billed charges,40% of total billed charges,382.42,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,359.92,80,,,percent of total billed charges,80% of total billed charges,174.56,38.8,,,percent of total billed charges,38.8% of total billed charges,382.42,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,427.41,
"Cryoglobulin, Ql, Rflx LC",40082595,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,21,16.8,,15.75,75,,,percent of total billed charges,75% of total billed charges,8.4,40,,,percent of total billed charges,40% of total billed charges,16.63,79.2,,,percent of total billed charges,79.2% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,19.95,95,,,percent of total billed charges,95% of total billed charges,16.8,80,,,percent of total billed charges,80% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,18.9,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,8.4,40,,,percent of total billed charges,40% of total billed charges,8.4,40,,,percent of total billed charges,40% of total billed charges,18.9,90,,,percent of total billed charges,90% of total billed charges,15.96,76,,,percent of total billed charges,76% of total billed charges,8.4,40,,,percent of total billed charges,40% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,16.8,80,,,percent of total billed charges,80% of total billed charges,8.15,38.8,,,percent of total billed charges,38.8% of total billed charges,17.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,19.95,
Haptoglobin LC,40083010,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,24.8,19.84,,18.6,75,,,percent of total billed charges,75% of total billed charges,9.92,40,,,percent of total billed charges,40% of total billed charges,19.64,79.2,,,percent of total billed charges,79.2% of total billed charges,21.08,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,23.56,95,,,percent of total billed charges,95% of total billed charges,19.84,80,,,percent of total billed charges,80% of total billed charges,21.08,85,,,percent of total billed charges,85% of total billed charges,22.32,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.92,40,,,percent of total billed charges,40% of total billed charges,9.92,40,,,percent of total billed charges,40% of total billed charges,22.32,90,,,percent of total billed charges,90% of total billed charges,18.85,76,,,percent of total billed charges,76% of total billed charges,9.92,40,,,percent of total billed charges,40% of total billed charges,21.08,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,19.84,80,,,percent of total billed charges,80% of total billed charges,9.62,38.8,,,percent of total billed charges,38.8% of total billed charges,21.08,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,23.56,
CA 19-9 LC,40086301,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,34.6,27.68,,25.95,75,,,percent of total billed charges,75% of total billed charges,13.84,40,,,percent of total billed charges,40% of total billed charges,27.4,79.2,,,percent of total billed charges,79.2% of total billed charges,29.41,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,32.87,95,,,percent of total billed charges,95% of total billed charges,27.68,80,,,percent of total billed charges,80% of total billed charges,29.41,85,,,percent of total billed charges,85% of total billed charges,31.14,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,13.84,40,,,percent of total billed charges,40% of total billed charges,13.84,40,,,percent of total billed charges,40% of total billed charges,31.14,90,,,percent of total billed charges,90% of total billed charges,26.3,76,,,percent of total billed charges,76% of total billed charges,13.84,40,,,percent of total billed charges,40% of total billed charges,29.41,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,27.68,80,,,percent of total billed charges,80% of total billed charges,13.42,38.8,,,percent of total billed charges,38.8% of total billed charges,29.41,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,32.87,
Anoscopy,60000357,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1258.4,1006.72,,943.8,75,,,percent of total billed charges,75% of total billed charges,503.36,40,,,percent of total billed charges,40% of total billed charges,996.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1069.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1195.48,95,,,percent of total billed charges,95% of total billed charges,1006.72,80,,,percent of total billed charges,80% of total billed charges,1069.64,85,,,percent of total billed charges,85% of total billed charges,1132.56,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,503.36,40,,,percent of total billed charges,40% of total billed charges,503.36,40,,,percent of total billed charges,40% of total billed charges,1132.56,90,,,percent of total billed charges,90% of total billed charges,956.38,76,,,percent of total billed charges,76% of total billed charges,503.36,40,,,percent of total billed charges,40% of total billed charges,1069.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1006.72,80,,,percent of total billed charges,80% of total billed charges,488.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1069.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1195.48,
"Ferritin, Serum LC",40004598,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,23.2,18.56,,17.4,75,,,percent of total billed charges,75% of total billed charges,9.28,40,,,percent of total billed charges,40% of total billed charges,18.37,79.2,,,percent of total billed charges,79.2% of total billed charges,19.72,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,22.04,95,,,percent of total billed charges,95% of total billed charges,18.56,80,,,percent of total billed charges,80% of total billed charges,19.72,85,,,percent of total billed charges,85% of total billed charges,20.88,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.28,40,,,percent of total billed charges,40% of total billed charges,9.28,40,,,percent of total billed charges,40% of total billed charges,20.88,90,,,percent of total billed charges,90% of total billed charges,17.63,76,,,percent of total billed charges,76% of total billed charges,9.28,40,,,percent of total billed charges,40% of total billed charges,19.72,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,18.56,80,,,percent of total billed charges,80% of total billed charges,9,38.8,,,percent of total billed charges,38.8% of total billed charges,19.72,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,22.04,
RPR LC,40086592,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,19.1,15.28,,14.33,75,,,percent of total billed charges,75% of total billed charges,7.64,40,,,percent of total billed charges,40% of total billed charges,15.13,79.2,,,percent of total billed charges,79.2% of total billed charges,16.24,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,18.15,95,,,percent of total billed charges,95% of total billed charges,15.28,80,,,percent of total billed charges,80% of total billed charges,16.24,85,,,percent of total billed charges,85% of total billed charges,17.19,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,7.64,40,,,percent of total billed charges,40% of total billed charges,7.64,40,,,percent of total billed charges,40% of total billed charges,17.19,90,,,percent of total billed charges,90% of total billed charges,14.52,76,,,percent of total billed charges,76% of total billed charges,7.64,40,,,percent of total billed charges,40% of total billed charges,16.24,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,15.28,80,,,percent of total billed charges,80% of total billed charges,7.41,38.8,,,percent of total billed charges,38.8% of total billed charges,16.24,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,18.15,
Immunofixation LC,40086334,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,57.3,45.84,,42.98,75,,,percent of total billed charges,75% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,45.38,79.2,,,percent of total billed charges,79.2% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,54.44,95,,,percent of total billed charges,95% of total billed charges,45.84,80,,,percent of total billed charges,80% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,51.57,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,22.92,40,,,percent of total billed charges,40% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,51.57,90,,,percent of total billed charges,90% of total billed charges,43.55,76,,,percent of total billed charges,76% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,45.84,80,,,percent of total billed charges,80% of total billed charges,22.23,38.8,,,percent of total billed charges,38.8% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,54.44,
"Carbamazepine(Tegretol), S LC",40007419,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,34.2,27.36,,25.65,75,,,percent of total billed charges,75% of total billed charges,13.68,40,,,percent of total billed charges,40% of total billed charges,27.09,79.2,,,percent of total billed charges,79.2% of total billed charges,29.07,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,32.49,95,,,percent of total billed charges,95% of total billed charges,27.36,80,,,percent of total billed charges,80% of total billed charges,29.07,85,,,percent of total billed charges,85% of total billed charges,30.78,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,13.68,40,,,percent of total billed charges,40% of total billed charges,13.68,40,,,percent of total billed charges,40% of total billed charges,30.78,90,,,percent of total billed charges,90% of total billed charges,25.99,76,,,percent of total billed charges,76% of total billed charges,13.68,40,,,percent of total billed charges,40% of total billed charges,29.07,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,27.36,80,,,percent of total billed charges,80% of total billed charges,13.27,38.8,,,percent of total billed charges,38.8% of total billed charges,29.07,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,32.49,
"Parvovirus B19, Human, IgG/IgM LC",40086747,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,119.1,95.28,,89.33,75,,,percent of total billed charges,75% of total billed charges,47.64,40,,,percent of total billed charges,40% of total billed charges,94.33,79.2,,,percent of total billed charges,79.2% of total billed charges,101.24,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,113.15,95,,,percent of total billed charges,95% of total billed charges,95.28,80,,,percent of total billed charges,80% of total billed charges,101.24,85,,,percent of total billed charges,85% of total billed charges,107.19,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,47.64,40,,,percent of total billed charges,40% of total billed charges,47.64,40,,,percent of total billed charges,40% of total billed charges,107.19,90,,,percent of total billed charges,90% of total billed charges,90.52,76,,,percent of total billed charges,76% of total billed charges,47.64,40,,,percent of total billed charges,40% of total billed charges,101.24,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,95.28,80,,,percent of total billed charges,80% of total billed charges,46.21,38.8,,,percent of total billed charges,38.8% of total billed charges,101.24,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,113.15,
"Body Fluid Culture, Sterile LC",40087070,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,140,112,,105,75,,,percent of total billed charges,75% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,110.88,79.2,,,percent of total billed charges,79.2% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,133,95,,,percent of total billed charges,95% of total billed charges,112,80,,,percent of total billed charges,80% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,126,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,56,40,,,percent of total billed charges,40% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,126,90,,,percent of total billed charges,90% of total billed charges,106.4,76,,,percent of total billed charges,76% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,112,80,,,percent of total billed charges,80% of total billed charges,54.32,38.8,,,percent of total billed charges,38.8% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,133,
ANCA Panel LC,40083520,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,85.1,68.08,,63.83,75,,,percent of total billed charges,75% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,67.4,79.2,,,percent of total billed charges,79.2% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,80.85,95,,,percent of total billed charges,95% of total billed charges,68.08,80,,,percent of total billed charges,80% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,34.04,40,,,percent of total billed charges,40% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,64.68,76,,,percent of total billed charges,76% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,68.08,80,,,percent of total billed charges,80% of total billed charges,33.02,38.8,,,percent of total billed charges,38.8% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,80.85,
"Copper, Serum LC",40082525,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,41.14,
Leukocyte Alkaline Phos Score LC,40085540,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,28.2,22.56,,21.15,75,,,percent of total billed charges,75% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,22.33,79.2,,,percent of total billed charges,79.2% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,26.79,95,,,percent of total billed charges,95% of total billed charges,22.56,80,,,percent of total billed charges,80% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,25.38,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,11.28,40,,,percent of total billed charges,40% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,25.38,90,,,percent of total billed charges,90% of total billed charges,21.43,76,,,percent of total billed charges,76% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,22.56,80,,,percent of total billed charges,80% of total billed charges,10.94,38.8,,,percent of total billed charges,38.8% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,26.79,
Amylase LC,60001004,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,19.8,15.84,,14.85,75,,,percent of total billed charges,75% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,15.68,79.2,,,percent of total billed charges,79.2% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,18.81,95,,,percent of total billed charges,95% of total billed charges,15.84,80,,,percent of total billed charges,80% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,17.82,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,7.92,40,,,percent of total billed charges,40% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,17.82,90,,,percent of total billed charges,90% of total billed charges,15.05,76,,,percent of total billed charges,76% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,15.84,80,,,percent of total billed charges,80% of total billed charges,7.68,38.8,,,percent of total billed charges,38.8% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,7.68,33.06,
T pallidum Ab (FTA-Ab) LC,40086780,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,50.5,40.4,,37.88,75,,,percent of total billed charges,75% of total billed charges,20.2,40,,,percent of total billed charges,40% of total billed charges,40,79.2,,,percent of total billed charges,79.2% of total billed charges,42.93,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,47.98,95,,,percent of total billed charges,95% of total billed charges,40.4,80,,,percent of total billed charges,80% of total billed charges,42.93,85,,,percent of total billed charges,85% of total billed charges,45.45,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,20.2,40,,,percent of total billed charges,40% of total billed charges,20.2,40,,,percent of total billed charges,40% of total billed charges,45.45,90,,,percent of total billed charges,90% of total billed charges,38.38,76,,,percent of total billed charges,76% of total billed charges,20.2,40,,,percent of total billed charges,40% of total billed charges,42.93,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,40.4,80,,,percent of total billed charges,80% of total billed charges,19.59,38.8,,,percent of total billed charges,38.8% of total billed charges,42.93,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,47.98,
CA 27.29 LC,40086300,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,26.8,21.44,,20.1,75,,,percent of total billed charges,75% of total billed charges,10.72,40,,,percent of total billed charges,40% of total billed charges,21.23,79.2,,,percent of total billed charges,79.2% of total billed charges,22.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,25.46,95,,,percent of total billed charges,95% of total billed charges,21.44,80,,,percent of total billed charges,80% of total billed charges,22.78,85,,,percent of total billed charges,85% of total billed charges,24.12,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,10.72,40,,,percent of total billed charges,40% of total billed charges,10.72,40,,,percent of total billed charges,40% of total billed charges,24.12,90,,,percent of total billed charges,90% of total billed charges,20.37,76,,,percent of total billed charges,76% of total billed charges,10.72,40,,,percent of total billed charges,40% of total billed charges,22.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,21.44,80,,,percent of total billed charges,80% of total billed charges,10.4,38.8,,,percent of total billed charges,38.8% of total billed charges,22.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,25.46,
Sex Hormone Binding Globulin LC,40084270,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,58.5,46.8,,43.88,75,,,percent of total billed charges,75% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,46.33,79.2,,,percent of total billed charges,79.2% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,55.58,95,,,percent of total billed charges,95% of total billed charges,46.8,80,,,percent of total billed charges,80% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,23.4,40,,,percent of total billed charges,40% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,44.46,76,,,percent of total billed charges,76% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,46.8,80,,,percent of total billed charges,80% of total billed charges,22.7,38.8,,,percent of total billed charges,38.8% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,55.58,
EKG/ECG 12 Lead,31093000,CDM,730,RC,93005,HCPCS,OUTPATIENT,,,200.3,160.24,,150.23,75,,,percent of total billed charges,75% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,158.64,79.2,,,percent of total billed charges,79.2% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,190.29,95,,,percent of total billed charges,95% of total billed charges,160.24,80,,,percent of total billed charges,80% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,180.27,90,,,percent of total billed charges,90% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,34.77,100,,,fee schedule,100% of CO APG rates,57.48,100,,,fee schedule,100% of NM APC rate,80.12,40,,,percent of total billed charges,40% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,180.27,90,,,percent of total billed charges,90% of total billed charges,152.23,76,,,percent of total billed charges,76% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rate,160.24,80,,,percent of total billed charges,80% of total billed charges,77.72,38.8,,,percent of total billed charges,38.8% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of APG fee schedule,13.34,200,,,fee schedule,200% of CMS fee schedule,13.34,190.29,
RT Arterial Puncture Charge,60000315,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,340.9,272.72,,255.68,75,,,percent of total billed charges,75% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,269.99,79.2,,,percent of total billed charges,79.2% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,323.86,95,,,percent of total billed charges,95% of total billed charges,272.72,80,,,percent of total billed charges,80% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,306.81,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,136.36,40,,,percent of total billed charges,40% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,306.81,90,,,percent of total billed charges,90% of total billed charges,259.08,76,,,percent of total billed charges,76% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,272.72,80,,,percent of total billed charges,80% of total billed charges,132.27,38.8,,,percent of total billed charges,38.8% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,323.86,
77053 MA Ductogram or Galactogram Single Rt,41577053,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,158.7,126.96,TC,119.03,75,,,percent of total billed charges,75% of total billed charges,63.48,40,,,percent of total billed charges,40% of total billed charges,125.69,79.2,,,percent of total billed charges,79.2% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,158.7,100,,,fee schedule,100% of CO APG rates,150.77,95,,,percent of total billed charges,95% of total billed charges,126.96,80,,,percent of total billed charges,80% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,142.83,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,158.7,100,,,fee schedule,100% of NM APC rate,63.48,40,,,percent of total billed charges,40% of total billed charges,63.48,40,,,percent of total billed charges,40% of total billed charges,142.83,90,,,percent of total billed charges,90% of total billed charges,120.61,76,,,percent of total billed charges,76% of total billed charges,63.48,40,,,percent of total billed charges,40% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,126.96,80,,,percent of total billed charges,80% of total billed charges,61.58,38.8,,,percent of total billed charges,38.8% of total billed charges,134.9,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,61.58,159.09,
"19083 US BREAST BX W/ CLIP PLACEMENT, Bil; FIRST LESION",41219083,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,2698.1,2158.48,LT,2023.58,75,,,percent of total billed charges,75% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2136.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,2563.2,95,,,percent of total billed charges,95% of total billed charges,2158.48,80,,,percent of total billed charges,80% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,2428.29,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,1079.24,40,,,percent of total billed charges,40% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2428.29,90,,,percent of total billed charges,90% of total billed charges,2050.56,76,,,percent of total billed charges,76% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,2158.48,80,,,percent of total billed charges,80% of total billed charges,1046.86,38.8,,,percent of total billed charges,38.8% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,2563.2,
"Susceptibility, Aer + Anaerob LC",40087186,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,20.5,16.4,,15.38,75,,,percent of total billed charges,75% of total billed charges,8.2,40,,,percent of total billed charges,40% of total billed charges,16.24,79.2,,,percent of total billed charges,79.2% of total billed charges,17.43,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,19.48,95,,,percent of total billed charges,95% of total billed charges,16.4,80,,,percent of total billed charges,80% of total billed charges,17.43,85,,,percent of total billed charges,85% of total billed charges,18.45,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,8.2,40,,,percent of total billed charges,40% of total billed charges,8.2,40,,,percent of total billed charges,40% of total billed charges,18.45,90,,,percent of total billed charges,90% of total billed charges,15.58,76,,,percent of total billed charges,76% of total billed charges,8.2,40,,,percent of total billed charges,40% of total billed charges,17.43,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,16.4,80,,,percent of total billed charges,80% of total billed charges,7.95,38.8,,,percent of total billed charges,38.8% of total billed charges,17.43,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,7.95,33.1,
"Rubella Antibody, IgM LC",40086762,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,33.5,26.8,,25.13,75,,,percent of total billed charges,75% of total billed charges,13.4,40,,,percent of total billed charges,40% of total billed charges,26.53,79.2,,,percent of total billed charges,79.2% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,31.83,95,,,percent of total billed charges,95% of total billed charges,26.8,80,,,percent of total billed charges,80% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,30.15,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,13.4,40,,,percent of total billed charges,40% of total billed charges,13.4,40,,,percent of total billed charges,40% of total billed charges,30.15,90,,,percent of total billed charges,90% of total billed charges,25.46,76,,,percent of total billed charges,76% of total billed charges,13.4,40,,,percent of total billed charges,40% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,26.8,80,,,percent of total billed charges,80% of total billed charges,13,38.8,,,percent of total billed charges,38.8% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,31.83,
Bill Rh(D) Type,40586901,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,115.8,92.64,,86.85,75,,,percent of total billed charges,75% of total billed charges,46.32,40,,,percent of total billed charges,40% of total billed charges,91.71,79.2,,,percent of total billed charges,79.2% of total billed charges,98.43,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,110.01,95,,,percent of total billed charges,95% of total billed charges,92.64,80,,,percent of total billed charges,80% of total billed charges,98.43,85,,,percent of total billed charges,85% of total billed charges,104.22,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,46.32,40,,,percent of total billed charges,40% of total billed charges,46.32,40,,,percent of total billed charges,40% of total billed charges,104.22,90,,,percent of total billed charges,90% of total billed charges,88.01,76,,,percent of total billed charges,76% of total billed charges,46.32,40,,,percent of total billed charges,40% of total billed charges,98.43,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,92.64,80,,,percent of total billed charges,80% of total billed charges,44.93,38.8,,,percent of total billed charges,38.8% of total billed charges,98.43,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,110.01,
Bill DAT,40586880,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,52.4,41.92,,39.3,75,,,percent of total billed charges,75% of total billed charges,20.96,40,,,percent of total billed charges,40% of total billed charges,41.5,79.2,,,percent of total billed charges,79.2% of total billed charges,44.54,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,49.78,95,,,percent of total billed charges,95% of total billed charges,41.92,80,,,percent of total billed charges,80% of total billed charges,44.54,85,,,percent of total billed charges,85% of total billed charges,47.16,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,20.96,40,,,percent of total billed charges,40% of total billed charges,20.96,40,,,percent of total billed charges,40% of total billed charges,47.16,90,,,percent of total billed charges,90% of total billed charges,39.82,76,,,percent of total billed charges,76% of total billed charges,20.96,40,,,percent of total billed charges,40% of total billed charges,44.54,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,41.92,80,,,percent of total billed charges,80% of total billed charges,20.33,38.8,,,percent of total billed charges,38.8% of total billed charges,44.54,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,49.78,
Urinalysis Dipstick,40081003,CDM,307,RC,81002,HCPCS,OUTPATIENT,,,40.3,32.24,,30.23,75,,,percent of total billed charges,75% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,31.92,79.2,,,percent of total billed charges,79.2% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,38.29,95,,,percent of total billed charges,95% of total billed charges,32.24,80,,,percent of total billed charges,80% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,3.61,100,,,fee schedule,100% of CO APG rates,3.27,100,,,fee schedule,100% of NM fee schedule,16.12,40,,,percent of total billed charges,40% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,30.63,76,,,percent of total billed charges,76% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rate,32.24,80,,,percent of total billed charges,80% of total billed charges,15.64,38.8,,,percent of total billed charges,38.8% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of APG fee schedule,6.96,200,,,fee schedule,200% of CMS fee schedule,3.27,38.29,
TB Test POC,49186580,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,21.2,16.96,,15.9,75,,,percent of total billed charges,75% of total billed charges,8.48,40,,,percent of total billed charges,40% of total billed charges,16.79,79.2,,,percent of total billed charges,79.2% of total billed charges,18.02,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,20.14,95,,,percent of total billed charges,95% of total billed charges,16.96,80,,,percent of total billed charges,80% of total billed charges,18.02,85,,,percent of total billed charges,85% of total billed charges,19.08,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,8.48,40,,,percent of total billed charges,40% of total billed charges,8.48,40,,,percent of total billed charges,40% of total billed charges,19.08,90,,,percent of total billed charges,90% of total billed charges,16.11,76,,,percent of total billed charges,76% of total billed charges,8.48,40,,,percent of total billed charges,40% of total billed charges,18.02,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,16.96,80,,,percent of total billed charges,80% of total billed charges,8.23,38.8,,,percent of total billed charges,38.8% of total billed charges,18.02,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,8.23,33.06,
US Doppler Fetal Umbilical Art,41276820,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,127.4,101.92,,95.55,75,,,percent of total billed charges,75% of total billed charges,50.96,40,,,percent of total billed charges,40% of total billed charges,100.9,79.2,,,percent of total billed charges,79.2% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,127.4,100,,,fee schedule,100% of CO APG rates,121.03,95,,,percent of total billed charges,95% of total billed charges,101.92,80,,,percent of total billed charges,80% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,114.66,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,50.96,40,,,percent of total billed charges,40% of total billed charges,50.96,40,,,percent of total billed charges,40% of total billed charges,114.66,90,,,percent of total billed charges,90% of total billed charges,96.82,76,,,percent of total billed charges,76% of total billed charges,50.96,40,,,percent of total billed charges,40% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,101.92,80,,,percent of total billed charges,80% of total billed charges,49.43,38.8,,,percent of total billed charges,38.8% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,49.43,246.44,
Gait Training Charges,60000277,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,104.6,83.68,GO,78.45,75,,,percent of total billed charges,75% of total billed charges,41.84,40,,,percent of total billed charges,40% of total billed charges,82.84,79.2,,,percent of total billed charges,79.2% of total billed charges,88.91,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,99.37,95,,,percent of total billed charges,95% of total billed charges,83.68,80,,,percent of total billed charges,80% of total billed charges,88.91,85,,,percent of total billed charges,85% of total billed charges,94.14,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,41.84,40,,,percent of total billed charges,40% of total billed charges,41.84,40,,,percent of total billed charges,40% of total billed charges,94.14,90,,,percent of total billed charges,90% of total billed charges,79.5,76,,,percent of total billed charges,76% of total billed charges,41.84,40,,,percent of total billed charges,40% of total billed charges,88.91,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,83.68,80,,,percent of total billed charges,80% of total billed charges,40.58,38.8,,,percent of total billed charges,38.8% of total billed charges,88.91,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,99.37,
WBC w/ Auto Diff,40085004,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,62.9,50.32,,47.18,75,,,percent of total billed charges,75% of total billed charges,25.16,40,,,percent of total billed charges,40% of total billed charges,49.82,79.2,,,percent of total billed charges,79.2% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,59.76,95,,,percent of total billed charges,95% of total billed charges,50.32,80,,,percent of total billed charges,80% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,56.61,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,25.16,40,,,percent of total billed charges,40% of total billed charges,25.16,40,,,percent of total billed charges,40% of total billed charges,56.61,90,,,percent of total billed charges,90% of total billed charges,47.8,76,,,percent of total billed charges,76% of total billed charges,25.16,40,,,percent of total billed charges,40% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,50.32,80,,,percent of total billed charges,80% of total billed charges,24.41,38.8,,,percent of total billed charges,38.8% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,59.76,
White Blood Cell,40085004,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,62.9,50.32,,47.18,75,,,percent of total billed charges,75% of total billed charges,25.16,40,,,percent of total billed charges,40% of total billed charges,49.82,79.2,,,percent of total billed charges,79.2% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,59.76,95,,,percent of total billed charges,95% of total billed charges,50.32,80,,,percent of total billed charges,80% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,56.61,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,25.16,40,,,percent of total billed charges,40% of total billed charges,25.16,40,,,percent of total billed charges,40% of total billed charges,56.61,90,,,percent of total billed charges,90% of total billed charges,47.8,76,,,percent of total billed charges,76% of total billed charges,25.16,40,,,percent of total billed charges,40% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,50.32,80,,,percent of total billed charges,80% of total billed charges,24.41,38.8,,,percent of total billed charges,38.8% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,59.76,
Auto Baso Pct,40085048,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,53.3,42.64,,39.98,75,,,percent of total billed charges,75% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,42.21,79.2,,,percent of total billed charges,79.2% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,50.64,95,,,percent of total billed charges,95% of total billed charges,42.64,80,,,percent of total billed charges,80% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,47.97,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,21.32,40,,,percent of total billed charges,40% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,47.97,90,,,percent of total billed charges,90% of total billed charges,40.51,76,,,percent of total billed charges,76% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,42.64,80,,,percent of total billed charges,80% of total billed charges,20.68,38.8,,,percent of total billed charges,38.8% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,50.64,
Clozapine LC,40080159,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.6,58.88,,55.2,75,,,percent of total billed charges,75% of total billed charges,29.44,40,,,percent of total billed charges,40% of total billed charges,58.29,79.2,,,percent of total billed charges,79.2% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.92,95,,,percent of total billed charges,95% of total billed charges,58.88,80,,,percent of total billed charges,80% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,66.24,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.44,40,,,percent of total billed charges,40% of total billed charges,29.44,40,,,percent of total billed charges,40% of total billed charges,66.24,90,,,percent of total billed charges,90% of total billed charges,55.94,76,,,percent of total billed charges,76% of total billed charges,29.44,40,,,percent of total billed charges,40% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.88,80,,,percent of total billed charges,80% of total billed charges,28.56,38.8,,,percent of total billed charges,38.8% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.92,
DEBRIDEMENT OPEN WOUND 20 SQ CM/<,60000302,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,570.3,456.24,GP,427.73,75,,,percent of total billed charges,75% of total billed charges,228.12,40,,,percent of total billed charges,40% of total billed charges,451.68,79.2,,,percent of total billed charges,79.2% of total billed charges,484.76,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,541.79,95,,,percent of total billed charges,95% of total billed charges,456.24,80,,,percent of total billed charges,80% of total billed charges,484.76,85,,,percent of total billed charges,85% of total billed charges,513.27,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,228.12,40,,,percent of total billed charges,40% of total billed charges,228.12,40,,,percent of total billed charges,40% of total billed charges,513.27,90,,,percent of total billed charges,90% of total billed charges,433.43,76,,,percent of total billed charges,76% of total billed charges,228.12,40,,,percent of total billed charges,40% of total billed charges,484.76,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,456.24,80,,,percent of total billed charges,80% of total billed charges,221.28,38.8,,,percent of total billed charges,38.8% of total billed charges,484.76,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,541.79,
Intrinsic Factors LC,40086340,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,45.4,36.32,,34.05,75,,,percent of total billed charges,75% of total billed charges,18.16,40,,,percent of total billed charges,40% of total billed charges,35.96,79.2,,,percent of total billed charges,79.2% of total billed charges,38.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,43.13,95,,,percent of total billed charges,95% of total billed charges,36.32,80,,,percent of total billed charges,80% of total billed charges,38.59,85,,,percent of total billed charges,85% of total billed charges,40.86,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,18.16,40,,,percent of total billed charges,40% of total billed charges,18.16,40,,,percent of total billed charges,40% of total billed charges,40.86,90,,,percent of total billed charges,90% of total billed charges,34.5,76,,,percent of total billed charges,76% of total billed charges,18.16,40,,,percent of total billed charges,40% of total billed charges,38.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,36.32,80,,,percent of total billed charges,80% of total billed charges,17.62,38.8,,,percent of total billed charges,38.8% of total billed charges,38.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,43.13,
ROM Each Extremity/Trunk Charges,60000278,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,73.7,58.96,GO,55.28,75,,,percent of total billed charges,75% of total billed charges,29.48,40,,,percent of total billed charges,40% of total billed charges,58.37,79.2,,,percent of total billed charges,79.2% of total billed charges,62.65,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,70.02,95,,,percent of total billed charges,95% of total billed charges,58.96,80,,,percent of total billed charges,80% of total billed charges,62.65,85,,,percent of total billed charges,85% of total billed charges,66.33,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,29.48,40,,,percent of total billed charges,40% of total billed charges,29.48,40,,,percent of total billed charges,40% of total billed charges,66.33,90,,,percent of total billed charges,90% of total billed charges,56.01,76,,,percent of total billed charges,76% of total billed charges,29.48,40,,,percent of total billed charges,40% of total billed charges,62.65,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,58.96,80,,,percent of total billed charges,80% of total billed charges,28.6,38.8,,,percent of total billed charges,38.8% of total billed charges,62.65,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,70.02,
ROM Hand Charges,60000279,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,96.7,77.36,GO,72.53,75,,,percent of total billed charges,75% of total billed charges,38.68,40,,,percent of total billed charges,40% of total billed charges,76.59,79.2,,,percent of total billed charges,79.2% of total billed charges,82.2,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,91.87,95,,,percent of total billed charges,95% of total billed charges,77.36,80,,,percent of total billed charges,80% of total billed charges,82.2,85,,,percent of total billed charges,85% of total billed charges,87.03,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,38.68,40,,,percent of total billed charges,40% of total billed charges,38.68,40,,,percent of total billed charges,40% of total billed charges,87.03,90,,,percent of total billed charges,90% of total billed charges,73.49,76,,,percent of total billed charges,76% of total billed charges,38.68,40,,,percent of total billed charges,40% of total billed charges,82.2,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,77.36,80,,,percent of total billed charges,80% of total billed charges,37.52,38.8,,,percent of total billed charges,38.8% of total billed charges,82.2,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,91.87,
Manual Traction Charge,47297140,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,111.4,89.12,GO,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,105.83,
Hepatic Panel 1,40080076,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,180.7,144.56,,135.53,75,,,percent of total billed charges,75% of total billed charges,72.28,40,,,percent of total billed charges,40% of total billed charges,143.11,79.2,,,percent of total billed charges,79.2% of total billed charges,153.6,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,171.67,95,,,percent of total billed charges,95% of total billed charges,144.56,80,,,percent of total billed charges,80% of total billed charges,153.6,85,,,percent of total billed charges,85% of total billed charges,162.63,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,72.28,40,,,percent of total billed charges,40% of total billed charges,72.28,40,,,percent of total billed charges,40% of total billed charges,162.63,90,,,percent of total billed charges,90% of total billed charges,137.33,76,,,percent of total billed charges,76% of total billed charges,72.28,40,,,percent of total billed charges,40% of total billed charges,153.6,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,144.56,80,,,percent of total billed charges,80% of total billed charges,70.11,38.8,,,percent of total billed charges,38.8% of total billed charges,153.6,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,171.67,
Vancomycin Trough,40080202,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
Vancomycin Peak,40080202,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
TELEHEALTH  FACILITY FEE,49100061,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,31.4,25.12,,23.55,75,,,percent of total billed charges,75% of total billed charges,12.56,40,,,percent of total billed charges,40% of total billed charges,24.87,79.2,,,percent of total billed charges,79.2% of total billed charges,26.69,85,,,percent of total billed charges,85% of total billed charges,31.4,100,,,fee schedule,100% of CO APG rates,29.83,95,,,percent of total billed charges,95% of total billed charges,25.12,80,,,percent of total billed charges,80% of total billed charges,26.69,85,,,percent of total billed charges,85% of total billed charges,28.26,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,31.4,100,,,fee schedule,100% of NM APC rate,12.56,40,,,percent of total billed charges,40% of total billed charges,12.56,40,,,percent of total billed charges,40% of total billed charges,28.26,90,,,percent of total billed charges,90% of total billed charges,23.86,76,,,percent of total billed charges,76% of total billed charges,12.56,40,,,percent of total billed charges,40% of total billed charges,26.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,25.12,80,,,percent of total billed charges,80% of total billed charges,12.18,38.8,,,percent of total billed charges,38.8% of total billed charges,26.69,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,62.8,200,,,fee schedule,200% of CMS fee schedule,12.18,215.49,
Yes- PT Vasopneumatic Device Charge,42597016,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,70.8,56.64,GP,53.1,75,,,percent of total billed charges,75% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,56.07,79.2,,,percent of total billed charges,79.2% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,67.26,95,,,percent of total billed charges,95% of total billed charges,56.64,80,,,percent of total billed charges,80% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,63.72,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,28.32,40,,,percent of total billed charges,40% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,63.72,90,,,percent of total billed charges,90% of total billed charges,53.81,76,,,percent of total billed charges,76% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,56.64,80,,,percent of total billed charges,80% of total billed charges,27.47,38.8,,,percent of total billed charges,38.8% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,67.26,
RT Continuous Neb Initial Charge,42294644,CDM,412,RC,94640,HCPCS,OUTPATIENT,,,369,295.2,,276.75,75,,,percent of total billed charges,75% of total billed charges,147.6,40,,,percent of total billed charges,40% of total billed charges,292.25,79.2,,,percent of total billed charges,79.2% of total billed charges,313.65,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,350.55,95,,,percent of total billed charges,95% of total billed charges,295.2,80,,,percent of total billed charges,80% of total billed charges,313.65,85,,,percent of total billed charges,85% of total billed charges,332.1,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,147.6,40,,,percent of total billed charges,40% of total billed charges,147.6,40,,,percent of total billed charges,40% of total billed charges,332.1,90,,,percent of total billed charges,90% of total billed charges,280.44,76,,,percent of total billed charges,76% of total billed charges,147.6,40,,,percent of total billed charges,40% of total billed charges,313.65,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,295.2,80,,,percent of total billed charges,80% of total billed charges,143.17,38.8,,,percent of total billed charges,38.8% of total billed charges,313.65,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,350.55,
RT Continuous Neb Subsequent Charge,42294645,CDM,412,RC,94640,HCPCS,OUTPATIENT,,,99,79.2,76,74.25,75,,,percent of total billed charges,75% of total billed charges,39.6,40,,,percent of total billed charges,40% of total billed charges,78.41,79.2,,,percent of total billed charges,79.2% of total billed charges,84.15,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,94.05,95,,,percent of total billed charges,95% of total billed charges,79.2,80,,,percent of total billed charges,80% of total billed charges,84.15,85,,,percent of total billed charges,85% of total billed charges,89.1,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,99,100,,,fee schedule,100% of NM APC rate,39.6,40,,,percent of total billed charges,40% of total billed charges,39.6,40,,,percent of total billed charges,40% of total billed charges,89.1,90,,,percent of total billed charges,90% of total billed charges,75.24,76,,,percent of total billed charges,76% of total billed charges,39.6,40,,,percent of total billed charges,40% of total billed charges,84.15,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,79.2,80,,,percent of total billed charges,80% of total billed charges,38.41,38.8,,,percent of total billed charges,38.8% of total billed charges,84.15,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,99,
RT Spirometry with Graphic Record Charge,42294010,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,283.5,226.8,,212.63,75,,,percent of total billed charges,75% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,224.53,79.2,,,percent of total billed charges,79.2% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,269.33,95,,,percent of total billed charges,95% of total billed charges,226.8,80,,,percent of total billed charges,80% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,255.15,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,113.4,40,,,percent of total billed charges,40% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,255.15,90,,,percent of total billed charges,90% of total billed charges,215.46,76,,,percent of total billed charges,76% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,226.8,80,,,percent of total billed charges,80% of total billed charges,110,38.8,,,percent of total billed charges,38.8% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,269.33,
94642 Aerosol inhalation of pentamidine for pneumocystis car,60000473,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,646.8,517.44,,485.1,75,,,percent of total billed charges,75% of total billed charges,258.72,40,,,percent of total billed charges,40% of total billed charges,512.27,79.2,,,percent of total billed charges,79.2% of total billed charges,549.78,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,614.46,95,,,percent of total billed charges,95% of total billed charges,517.44,80,,,percent of total billed charges,80% of total billed charges,549.78,85,,,percent of total billed charges,85% of total billed charges,582.12,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,258.72,40,,,percent of total billed charges,40% of total billed charges,258.72,40,,,percent of total billed charges,40% of total billed charges,582.12,90,,,percent of total billed charges,90% of total billed charges,491.57,76,,,percent of total billed charges,76% of total billed charges,258.72,40,,,percent of total billed charges,40% of total billed charges,549.78,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,517.44,80,,,percent of total billed charges,80% of total billed charges,250.96,38.8,,,percent of total billed charges,38.8% of total billed charges,549.78,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,614.46,
Bill Blood Administration,40536430,CDM,391,RC,36430,HCPCS,OUTPATIENT,,,1292.9,1034.32,,969.68,75,,,percent of total billed charges,75% of total billed charges,517.16,40,,,percent of total billed charges,40% of total billed charges,1023.98,79.2,,,percent of total billed charges,79.2% of total billed charges,1098.97,85,,,percent of total billed charges,85% of total billed charges,606.63,100,,,fee schedule,100% of CO APG rates,1228.26,95,,,percent of total billed charges,95% of total billed charges,1034.32,80,,,percent of total billed charges,80% of total billed charges,1098.97,85,,,percent of total billed charges,85% of total billed charges,1163.61,90,,,percent of total billed charges,90% of total billed charges,606.63,100,,,fee schedule,100% of CO APG rates,606.63,100,,,fee schedule,100% of CO APG rates,407.75,100,,,fee schedule,100% of NM APC rate,517.16,40,,,percent of total billed charges,40% of total billed charges,517.16,40,,,percent of total billed charges,40% of total billed charges,1163.61,90,,,percent of total billed charges,90% of total billed charges,982.6,76,,,percent of total billed charges,76% of total billed charges,517.16,40,,,percent of total billed charges,40% of total billed charges,1098.97,85,,,percent of total billed charges,85% of total billed charges,606.63,100,,,fee schedule,100% of CO APG rate,1034.32,80,,,percent of total billed charges,80% of total billed charges,501.65,38.8,,,percent of total billed charges,38.8% of total billed charges,1098.97,85,,,percent of total billed charges,85% of total billed charges,606.63,100,,,fee schedule,100% of APG fee schedule,82.9,200,,,fee schedule,200% of CMS fee schedule,82.9,1228.26,
Removal of central venous catheter for infusion,30036589,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,642.7,514.16,,482.03,75,,,percent of total billed charges,75% of total billed charges,257.08,40,,,percent of total billed charges,40% of total billed charges,509.02,79.2,,,percent of total billed charges,79.2% of total billed charges,546.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,610.57,95,,,percent of total billed charges,95% of total billed charges,514.16,80,,,percent of total billed charges,80% of total billed charges,546.3,85,,,percent of total billed charges,85% of total billed charges,578.43,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,257.08,40,,,percent of total billed charges,40% of total billed charges,257.08,40,,,percent of total billed charges,40% of total billed charges,578.43,90,,,percent of total billed charges,90% of total billed charges,488.45,76,,,percent of total billed charges,76% of total billed charges,257.08,40,,,percent of total billed charges,40% of total billed charges,546.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,514.16,80,,,percent of total billed charges,80% of total billed charges,249.37,38.8,,,percent of total billed charges,38.8% of total billed charges,546.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,610.57,
Eval for Use/Fitting of Voice Prosthetic Dvc,80377307,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,462.3,369.84,GN,346.73,75,,,percent of total billed charges,75% of total billed charges,184.92,40,,,percent of total billed charges,40% of total billed charges,366.14,79.2,,,percent of total billed charges,79.2% of total billed charges,392.96,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,439.19,95,,,percent of total billed charges,95% of total billed charges,369.84,80,,,percent of total billed charges,80% of total billed charges,392.96,85,,,percent of total billed charges,85% of total billed charges,416.07,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,184.92,40,,,percent of total billed charges,40% of total billed charges,184.92,40,,,percent of total billed charges,40% of total billed charges,416.07,90,,,percent of total billed charges,90% of total billed charges,351.35,76,,,percent of total billed charges,76% of total billed charges,184.92,40,,,percent of total billed charges,40% of total billed charges,392.96,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,369.84,80,,,percent of total billed charges,80% of total billed charges,179.37,38.8,,,percent of total billed charges,38.8% of total billed charges,392.96,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,439.19,
G0009 ADMIN PNEUMOCOCCAL VACCINE CHARGE,30090670,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,147.1,117.68,,110.33,75,,,percent of total billed charges,75% of total billed charges,58.84,40,,,percent of total billed charges,40% of total billed charges,116.5,79.2,,,percent of total billed charges,79.2% of total billed charges,125.04,85,,,percent of total billed charges,85% of total billed charges,147.1,100,,,fee schedule,100% of CO APG rates,139.75,95,,,percent of total billed charges,95% of total billed charges,117.68,80,,,percent of total billed charges,80% of total billed charges,125.04,85,,,percent of total billed charges,85% of total billed charges,132.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,147.1,100,,,fee schedule,100% of NM APC rate,58.84,40,,,percent of total billed charges,40% of total billed charges,58.84,40,,,percent of total billed charges,40% of total billed charges,132.39,90,,,percent of total billed charges,90% of total billed charges,111.8,76,,,percent of total billed charges,76% of total billed charges,58.84,40,,,percent of total billed charges,40% of total billed charges,125.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,117.68,80,,,percent of total billed charges,80% of total billed charges,57.07,38.8,,,percent of total billed charges,38.8% of total billed charges,125.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,57.07,217.66,
G0008 ADMIN FLU VACCINE CHARGE,30090656,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,147.1,117.68,,110.33,75,,,percent of total billed charges,75% of total billed charges,58.84,40,,,percent of total billed charges,40% of total billed charges,116.5,79.2,,,percent of total billed charges,79.2% of total billed charges,125.04,85,,,percent of total billed charges,85% of total billed charges,147.1,100,,,fee schedule,100% of CO APG rates,139.75,95,,,percent of total billed charges,95% of total billed charges,117.68,80,,,percent of total billed charges,80% of total billed charges,125.04,85,,,percent of total billed charges,85% of total billed charges,132.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,147.1,100,,,fee schedule,100% of NM APC rate,58.84,40,,,percent of total billed charges,40% of total billed charges,58.84,40,,,percent of total billed charges,40% of total billed charges,132.39,90,,,percent of total billed charges,90% of total billed charges,111.8,76,,,percent of total billed charges,76% of total billed charges,58.84,40,,,percent of total billed charges,40% of total billed charges,125.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,117.68,80,,,percent of total billed charges,80% of total billed charges,57.07,38.8,,,percent of total billed charges,38.8% of total billed charges,125.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,57.07,217.66,
96375 IV PUSH EA ADDITIONAL CHARGE,30996375,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,115.3,92.24,,86.48,75,,,percent of total billed charges,75% of total billed charges,46.12,40,,,percent of total billed charges,40% of total billed charges,91.32,79.2,,,percent of total billed charges,79.2% of total billed charges,98.01,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,109.54,95,,,percent of total billed charges,95% of total billed charges,92.24,80,,,percent of total billed charges,80% of total billed charges,98.01,85,,,percent of total billed charges,85% of total billed charges,103.77,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,115.3,100,,,fee schedule,100% of NM APC rate,46.12,40,,,percent of total billed charges,40% of total billed charges,46.12,40,,,percent of total billed charges,40% of total billed charges,103.77,90,,,percent of total billed charges,90% of total billed charges,87.63,76,,,percent of total billed charges,76% of total billed charges,46.12,40,,,percent of total billed charges,40% of total billed charges,98.01,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,92.24,80,,,percent of total billed charges,80% of total billed charges,44.74,38.8,,,percent of total billed charges,38.8% of total billed charges,98.01,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,44.74,115.3,
96366 IV INFUSION ADD HR CHARGE,42196366,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,88.5,70.8,,66.38,75,,,percent of total billed charges,75% of total billed charges,35.4,40,,,percent of total billed charges,40% of total billed charges,70.09,79.2,,,percent of total billed charges,79.2% of total billed charges,75.23,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,84.08,95,,,percent of total billed charges,95% of total billed charges,70.8,80,,,percent of total billed charges,80% of total billed charges,75.23,85,,,percent of total billed charges,85% of total billed charges,79.65,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,88.5,100,,,fee schedule,100% of NM APC rate,35.4,40,,,percent of total billed charges,40% of total billed charges,35.4,40,,,percent of total billed charges,40% of total billed charges,79.65,90,,,percent of total billed charges,90% of total billed charges,67.26,76,,,percent of total billed charges,76% of total billed charges,35.4,40,,,percent of total billed charges,40% of total billed charges,75.23,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,70.8,80,,,percent of total billed charges,80% of total billed charges,34.34,38.8,,,percent of total billed charges,38.8% of total billed charges,75.23,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,34.34,88.5,
Aspartate Aminotransferase,40084450,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Vasectomy,4605525,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,748.8,599.04,,561.6,75,,,percent of total billed charges,75% of total billed charges,299.52,40,,,percent of total billed charges,40% of total billed charges,593.05,79.2,,,percent of total billed charges,79.2% of total billed charges,636.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,711.36,95,,,percent of total billed charges,95% of total billed charges,599.04,80,,,percent of total billed charges,80% of total billed charges,636.48,85,,,percent of total billed charges,85% of total billed charges,673.92,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,299.52,40,,,percent of total billed charges,40% of total billed charges,299.52,40,,,percent of total billed charges,40% of total billed charges,673.92,90,,,percent of total billed charges,90% of total billed charges,569.09,76,,,percent of total billed charges,76% of total billed charges,299.52,40,,,percent of total billed charges,40% of total billed charges,636.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,599.04,80,,,percent of total billed charges,80% of total billed charges,290.53,38.8,,,percent of total billed charges,38.8% of total billed charges,636.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,711.36,
Cataract Extraction with Intraocular Lens Implantation,46000500,CDM,360,RC,43215,HCPCS,OUTPATIENT,,,2498.5,1998.8,,1873.88,75,,,percent of total billed charges,75% of total billed charges,999.4,40,,,percent of total billed charges,40% of total billed charges,1978.81,79.2,,,percent of total billed charges,79.2% of total billed charges,2123.73,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rates,2373.58,95,,,percent of total billed charges,95% of total billed charges,1998.8,80,,,percent of total billed charges,80% of total billed charges,2123.73,85,,,percent of total billed charges,85% of total billed charges,2248.65,90,,,percent of total billed charges,90% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rates,1260.54,100,,,fee schedule,100% of CO APG rates,1741.59,100,,,fee schedule,100% of NM APC rate,999.4,40,,,percent of total billed charges,40% of total billed charges,999.4,40,,,percent of total billed charges,40% of total billed charges,2248.65,90,,,percent of total billed charges,90% of total billed charges,1898.86,76,,,percent of total billed charges,76% of total billed charges,999.4,40,,,percent of total billed charges,40% of total billed charges,2123.73,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rate,1998.8,80,,,percent of total billed charges,80% of total billed charges,969.42,38.8,,,percent of total billed charges,38.8% of total billed charges,2123.73,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of APG fee schedule,281.54,200,,,fee schedule,200% of CMS fee schedule,281.54,2373.58,
Colonoscopy,46000102,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1271,1016.8,,953.25,75,,,percent of total billed charges,75% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1006.63,79.2,,,percent of total billed charges,79.2% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1207.45,95,,,percent of total billed charges,95% of total billed charges,1016.8,80,,,percent of total billed charges,80% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,508.4,40,,,percent of total billed charges,40% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,965.96,76,,,percent of total billed charges,76% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1016.8,80,,,percent of total billed charges,80% of total billed charges,493.15,38.8,,,percent of total billed charges,38.8% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1207.45,
Esophagogastroduodenoscopy,4600100,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,2478,1982.4,,1858.5,75,,,percent of total billed charges,75% of total billed charges,991.2,40,,,percent of total billed charges,40% of total billed charges,1962.58,79.2,,,percent of total billed charges,79.2% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2354.1,95,,,percent of total billed charges,95% of total billed charges,1982.4,80,,,percent of total billed charges,80% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,2230.2,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,991.2,40,,,percent of total billed charges,40% of total billed charges,991.2,40,,,percent of total billed charges,40% of total billed charges,2230.2,90,,,percent of total billed charges,90% of total billed charges,1883.28,76,,,percent of total billed charges,76% of total billed charges,991.2,40,,,percent of total billed charges,40% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1982.4,80,,,percent of total billed charges,80% of total billed charges,961.46,38.8,,,percent of total billed charges,38.8% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,2354.1,
Epidural Steroid Injection,60000387,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,2888,2310.4,,2166,75,,,percent of total billed charges,75% of total billed charges,1155.2,40,,,percent of total billed charges,40% of total billed charges,2287.3,79.2,,,percent of total billed charges,79.2% of total billed charges,2454.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2743.6,95,,,percent of total billed charges,95% of total billed charges,2310.4,80,,,percent of total billed charges,80% of total billed charges,2454.8,85,,,percent of total billed charges,85% of total billed charges,2599.2,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,1155.2,40,,,percent of total billed charges,40% of total billed charges,1155.2,40,,,percent of total billed charges,40% of total billed charges,2599.2,90,,,percent of total billed charges,90% of total billed charges,2194.88,76,,,percent of total billed charges,76% of total billed charges,1155.2,40,,,percent of total billed charges,40% of total billed charges,2454.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,2310.4,80,,,percent of total billed charges,80% of total billed charges,1120.54,38.8,,,percent of total billed charges,38.8% of total billed charges,2454.8,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,2743.6,
"93005 ED EKG 12 LEAD, TRACING ONLY CHARGE",42893005,CDM,730,RC,93005,HCPCS,OUTPATIENT,,,200.3,160.24,,150.23,75,,,percent of total billed charges,75% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,158.64,79.2,,,percent of total billed charges,79.2% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,190.29,95,,,percent of total billed charges,95% of total billed charges,160.24,80,,,percent of total billed charges,80% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,180.27,90,,,percent of total billed charges,90% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,34.77,100,,,fee schedule,100% of CO APG rates,57.48,100,,,fee schedule,100% of NM APC rate,80.12,40,,,percent of total billed charges,40% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,180.27,90,,,percent of total billed charges,90% of total billed charges,152.23,76,,,percent of total billed charges,76% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rate,160.24,80,,,percent of total billed charges,80% of total billed charges,77.72,38.8,,,percent of total billed charges,38.8% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of APG fee schedule,13.34,200,,,fee schedule,200% of CMS fee schedule,13.34,190.29,
Aph RBC ACDA AS1 LR 1,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913,730.4,,684.75,75,,,percent of total billed charges,75% of total billed charges,365.2,40,,,percent of total billed charges,40% of total billed charges,723.1,79.2,,,percent of total billed charges,79.2% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.35,95,,,percent of total billed charges,95% of total billed charges,730.4,80,,,percent of total billed charges,80% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,821.7,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.2,40,,,percent of total billed charges,40% of total billed charges,365.2,40,,,percent of total billed charges,40% of total billed charges,821.7,90,,,percent of total billed charges,90% of total billed charges,693.88,76,,,percent of total billed charges,76% of total billed charges,365.2,40,,,percent of total billed charges,40% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.4,80,,,percent of total billed charges,80% of total billed charges,354.24,38.8,,,percent of total billed charges,38.8% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.35,
Aph RBC CP2D AS3 LR 1,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph RBC CP2D AS3 LR 2,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph RBC ACDA AS1 LR 2,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913,730.4,,684.75,75,,,percent of total billed charges,75% of total billed charges,365.2,40,,,percent of total billed charges,40% of total billed charges,723.1,79.2,,,percent of total billed charges,79.2% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.35,95,,,percent of total billed charges,95% of total billed charges,730.4,80,,,percent of total billed charges,80% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,821.7,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.2,40,,,percent of total billed charges,40% of total billed charges,365.2,40,,,percent of total billed charges,40% of total billed charges,821.7,90,,,percent of total billed charges,90% of total billed charges,693.88,76,,,percent of total billed charges,76% of total billed charges,365.2,40,,,percent of total billed charges,40% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.4,80,,,percent of total billed charges,80% of total billed charges,354.24,38.8,,,percent of total billed charges,38.8% of total billed charges,776.05,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.35,
Aph FFP CP2D Thawed,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph RBC CP2D AS3 LR Irr 2,4050106,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,1397.2,1117.76,,1047.9,75,,,percent of total billed charges,75% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1106.58,79.2,,,percent of total billed charges,79.2% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,1327.34,95,,,percent of total billed charges,95% of total billed charges,1117.76,80,,,percent of total billed charges,80% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,1257.48,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,558.88,40,,,percent of total billed charges,40% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1257.48,90,,,percent of total billed charges,90% of total billed charges,1061.87,76,,,percent of total billed charges,76% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,1117.76,80,,,percent of total billed charges,80% of total billed charges,542.11,38.8,,,percent of total billed charges,38.8% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,1327.34,
Aph ARBC CP2D AS3 LR 1,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph RBC CP2D AS3 LR Irr 1,4050106,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,1397.2,1117.76,,1047.9,75,,,percent of total billed charges,75% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1106.58,79.2,,,percent of total billed charges,79.2% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,1327.34,95,,,percent of total billed charges,95% of total billed charges,1117.76,80,,,percent of total billed charges,80% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,1257.48,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,558.88,40,,,percent of total billed charges,40% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1257.48,90,,,percent of total billed charges,90% of total billed charges,1061.87,76,,,percent of total billed charges,76% of total billed charges,558.88,40,,,percent of total billed charges,40% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,1117.76,80,,,percent of total billed charges,80% of total billed charges,542.11,38.8,,,percent of total billed charges,38.8% of total billed charges,1187.62,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,1327.34,
Aph DRBC ACDA AS3,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
DRBC CPD AS1 500 LR,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
DRBC CP2D AS3 500 LR,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph DRBC CP2D AS3 LR,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph DRBC CP2D AS3 LR 1,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph DRBC CP2D AS3 LR 2,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph DRBC ACDA AS3 LR,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aph DRBC ACDA AS3 LR 1,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
Aerosol Initial,42294640,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
Aerosol Subsequent,42294645,CDM,412,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,76,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
EZPAP INITIAL,42294640,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
EZPAP SUBSEQUENT,42294645,CDM,412,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,76,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
Spirometry,42294010,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,283.5,226.8,,212.63,75,,,percent of total billed charges,75% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,224.53,79.2,,,percent of total billed charges,79.2% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,269.33,95,,,percent of total billed charges,95% of total billed charges,226.8,80,,,percent of total billed charges,80% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,255.15,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,113.4,40,,,percent of total billed charges,40% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,255.15,90,,,percent of total billed charges,90% of total billed charges,215.46,76,,,percent of total billed charges,76% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,226.8,80,,,percent of total billed charges,80% of total billed charges,110,38.8,,,percent of total billed charges,38.8% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,269.33,
Sigmoidoscopy,4600108,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1271,1016.8,,953.25,75,,,percent of total billed charges,75% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1006.63,79.2,,,percent of total billed charges,79.2% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1207.45,95,,,percent of total billed charges,95% of total billed charges,1016.8,80,,,percent of total billed charges,80% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,508.4,40,,,percent of total billed charges,40% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,965.96,76,,,percent of total billed charges,76% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1016.8,80,,,percent of total billed charges,80% of total billed charges,493.15,38.8,,,percent of total billed charges,38.8% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1207.45,
Aph Plasma ACDA Thawed,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Anoscopy,60000357,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1258.4,1006.72,,943.8,75,,,percent of total billed charges,75% of total billed charges,503.36,40,,,percent of total billed charges,40% of total billed charges,996.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1069.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1195.48,95,,,percent of total billed charges,95% of total billed charges,1006.72,80,,,percent of total billed charges,80% of total billed charges,1069.64,85,,,percent of total billed charges,85% of total billed charges,1132.56,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,503.36,40,,,percent of total billed charges,40% of total billed charges,503.36,40,,,percent of total billed charges,40% of total billed charges,1132.56,90,,,percent of total billed charges,90% of total billed charges,956.38,76,,,percent of total billed charges,76% of total billed charges,503.36,40,,,percent of total billed charges,40% of total billed charges,1069.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1006.72,80,,,percent of total billed charges,80% of total billed charges,488.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1069.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1195.48,
Bill Elution,40586860,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,130,104,,97.5,75,,,percent of total billed charges,75% of total billed charges,52,40,,,percent of total billed charges,40% of total billed charges,102.96,79.2,,,percent of total billed charges,79.2% of total billed charges,110.5,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,123.5,95,,,percent of total billed charges,95% of total billed charges,104,80,,,percent of total billed charges,80% of total billed charges,110.5,85,,,percent of total billed charges,85% of total billed charges,117,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,52,40,,,percent of total billed charges,40% of total billed charges,52,40,,,percent of total billed charges,40% of total billed charges,117,90,,,percent of total billed charges,90% of total billed charges,98.8,76,,,percent of total billed charges,76% of total billed charges,52,40,,,percent of total billed charges,40% of total billed charges,110.5,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,104,80,,,percent of total billed charges,80% of total billed charges,50.44,38.8,,,percent of total billed charges,38.8% of total billed charges,110.5,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,123.5,
Removal of tissue from wounds per session,60000308,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,570.3,456.24,GO,427.73,75,,,percent of total billed charges,75% of total billed charges,228.12,40,,,percent of total billed charges,40% of total billed charges,451.68,79.2,,,percent of total billed charges,79.2% of total billed charges,484.76,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,541.79,95,,,percent of total billed charges,95% of total billed charges,456.24,80,,,percent of total billed charges,80% of total billed charges,484.76,85,,,percent of total billed charges,85% of total billed charges,513.27,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,228.12,40,,,percent of total billed charges,40% of total billed charges,228.12,40,,,percent of total billed charges,40% of total billed charges,513.27,90,,,percent of total billed charges,90% of total billed charges,433.43,76,,,percent of total billed charges,76% of total billed charges,228.12,40,,,percent of total billed charges,40% of total billed charges,484.76,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,456.24,80,,,percent of total billed charges,80% of total billed charges,221.28,38.8,,,percent of total billed charges,38.8% of total billed charges,484.76,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,541.79,
PT Compression Bandage Application Charge,42597016,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,70.8,56.64,GP,53.1,75,,,percent of total billed charges,75% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,56.07,79.2,,,percent of total billed charges,79.2% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,67.26,95,,,percent of total billed charges,95% of total billed charges,56.64,80,,,percent of total billed charges,80% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,63.72,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,28.32,40,,,percent of total billed charges,40% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,63.72,90,,,percent of total billed charges,90% of total billed charges,53.81,76,,,percent of total billed charges,76% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,56.64,80,,,percent of total billed charges,80% of total billed charges,27.47,38.8,,,percent of total billed charges,38.8% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,67.26,
Bill Antigen Typing Class II (rare),40586902,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,259,207.2,,194.25,75,,,percent of total billed charges,75% of total billed charges,103.6,40,,,percent of total billed charges,40% of total billed charges,205.13,79.2,,,percent of total billed charges,79.2% of total billed charges,220.15,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,246.05,95,,,percent of total billed charges,95% of total billed charges,207.2,80,,,percent of total billed charges,80% of total billed charges,220.15,85,,,percent of total billed charges,85% of total billed charges,233.1,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,103.6,40,,,percent of total billed charges,40% of total billed charges,103.6,40,,,percent of total billed charges,40% of total billed charges,233.1,90,,,percent of total billed charges,90% of total billed charges,196.84,76,,,percent of total billed charges,76% of total billed charges,103.6,40,,,percent of total billed charges,40% of total billed charges,220.15,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,207.2,80,,,percent of total billed charges,80% of total billed charges,100.49,38.8,,,percent of total billed charges,38.8% of total billed charges,220.15,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,246.05,
x-match AHG Gel interp,40586922,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,227.1,181.68,,170.33,75,,,percent of total billed charges,75% of total billed charges,90.84,40,,,percent of total billed charges,40% of total billed charges,179.86,79.2,,,percent of total billed charges,79.2% of total billed charges,193.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,215.75,95,,,percent of total billed charges,95% of total billed charges,181.68,80,,,percent of total billed charges,80% of total billed charges,193.04,85,,,percent of total billed charges,85% of total billed charges,204.39,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,90.84,40,,,percent of total billed charges,40% of total billed charges,90.84,40,,,percent of total billed charges,40% of total billed charges,204.39,90,,,percent of total billed charges,90% of total billed charges,172.6,76,,,percent of total billed charges,76% of total billed charges,90.84,40,,,percent of total billed charges,40% of total billed charges,193.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,181.68,80,,,percent of total billed charges,80% of total billed charges,88.11,38.8,,,percent of total billed charges,38.8% of total billed charges,193.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,215.75,
x-match AHG Gel interp,40586922,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,227.1,181.68,,170.33,75,,,percent of total billed charges,75% of total billed charges,90.84,40,,,percent of total billed charges,40% of total billed charges,179.86,79.2,,,percent of total billed charges,79.2% of total billed charges,193.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,215.75,95,,,percent of total billed charges,95% of total billed charges,181.68,80,,,percent of total billed charges,80% of total billed charges,193.04,85,,,percent of total billed charges,85% of total billed charges,204.39,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,90.84,40,,,percent of total billed charges,40% of total billed charges,90.84,40,,,percent of total billed charges,40% of total billed charges,204.39,90,,,percent of total billed charges,90% of total billed charges,172.6,76,,,percent of total billed charges,76% of total billed charges,90.84,40,,,percent of total billed charges,40% of total billed charges,193.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,181.68,80,,,percent of total billed charges,80% of total billed charges,88.11,38.8,,,percent of total billed charges,38.8% of total billed charges,193.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,215.75,
CT Angio Pelvis w/ + w/o Cont,41172191,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1523.3,1218.64,TC,1142.48,75,,,percent of total billed charges,75% of total billed charges,609.32,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1294.81,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1447.14,95,,,percent of total billed charges,95% of total billed charges,1218.64,80,,,percent of total billed charges,80% of total billed charges,1294.81,85,,,percent of total billed charges,85% of total billed charges,1370.97,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,609.32,40,,,percent of total billed charges,40% of total billed charges,609.32,40,,,percent of total billed charges,40% of total billed charges,1370.97,90,,,percent of total billed charges,90% of total billed charges,1157.71,76,,,percent of total billed charges,76% of total billed charges,609.32,40,,,percent of total billed charges,40% of total billed charges,1294.81,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1218.64,80,,,percent of total billed charges,80% of total billed charges,591.04,38.8,,,percent of total billed charges,38.8% of total billed charges,1294.81,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1447.14,
77054 MA Ductogram or Galactogram Mult Bil,41577054,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,213.2,170.56,TC,159.9,75,,,percent of total billed charges,75% of total billed charges,85.28,40,,,percent of total billed charges,40% of total billed charges,168.85,79.2,,,percent of total billed charges,79.2% of total billed charges,181.22,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,202.54,95,,,percent of total billed charges,95% of total billed charges,170.56,80,,,percent of total billed charges,80% of total billed charges,181.22,85,,,percent of total billed charges,85% of total billed charges,191.88,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,213.2,100,,,fee schedule,100% of NM APC rate,85.28,40,,,percent of total billed charges,40% of total billed charges,85.28,40,,,percent of total billed charges,40% of total billed charges,191.88,90,,,percent of total billed charges,90% of total billed charges,162.03,76,,,percent of total billed charges,76% of total billed charges,85.28,40,,,percent of total billed charges,40% of total billed charges,181.22,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,170.56,80,,,percent of total billed charges,80% of total billed charges,82.72,38.8,,,percent of total billed charges,38.8% of total billed charges,181.22,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,82.72,213.2,
77054 MA Ductogram or Galactogram Mult Lt,41577054,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,210.8,168.64,TC,158.1,75,,,percent of total billed charges,75% of total billed charges,84.32,40,,,percent of total billed charges,40% of total billed charges,166.95,79.2,,,percent of total billed charges,79.2% of total billed charges,179.18,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,200.26,95,,,percent of total billed charges,95% of total billed charges,168.64,80,,,percent of total billed charges,80% of total billed charges,179.18,85,,,percent of total billed charges,85% of total billed charges,189.72,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,210.8,100,,,fee schedule,100% of NM APC rate,84.32,40,,,percent of total billed charges,40% of total billed charges,84.32,40,,,percent of total billed charges,40% of total billed charges,189.72,90,,,percent of total billed charges,90% of total billed charges,160.21,76,,,percent of total billed charges,76% of total billed charges,84.32,40,,,percent of total billed charges,40% of total billed charges,179.18,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,168.64,80,,,percent of total billed charges,80% of total billed charges,81.79,38.8,,,percent of total billed charges,38.8% of total billed charges,179.18,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,81.79,210.8,
MRA UE w/ + w/o Cont Lt,41373225,CDM,618,RC,71555,HCPCS,OUTPATIENT,,,2866.9,2293.52,TC,2150.18,75,,,percent of total billed charges,75% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,2723.56,95,,,percent of total billed charges,95% of total billed charges,2293.52,80,,,percent of total billed charges,80% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,2866.9,100,,,fee schedule,100% of NM fee schedule,1146.76,40,,,percent of total billed charges,40% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2580.21,90,,,percent of total billed charges,90% of total billed charges,2178.84,76,,,percent of total billed charges,76% of total billed charges,1146.76,40,,,percent of total billed charges,40% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2293.52,80,,,percent of total billed charges,80% of total billed charges,1112.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2436.87,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,735.02,200,,,fee schedule,200% of CMS fee schedule,657.92,2866.9,
US Breast Wire Placement Lt,41219285,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,353.5,282.8,TC,265.13,75,,,percent of total billed charges,75% of total billed charges,141.4,40,,,percent of total billed charges,40% of total billed charges,279.97,79.2,,,percent of total billed charges,79.2% of total billed charges,300.48,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,335.83,95,,,percent of total billed charges,95% of total billed charges,282.8,80,,,percent of total billed charges,80% of total billed charges,300.48,85,,,percent of total billed charges,85% of total billed charges,318.15,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,141.4,40,,,percent of total billed charges,40% of total billed charges,141.4,40,,,percent of total billed charges,40% of total billed charges,318.15,90,,,percent of total billed charges,90% of total billed charges,268.66,76,,,percent of total billed charges,76% of total billed charges,141.4,40,,,percent of total billed charges,40% of total billed charges,300.48,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,282.8,80,,,percent of total billed charges,80% of total billed charges,137.16,38.8,,,percent of total billed charges,38.8% of total billed charges,300.48,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,335.83,
US Breast Wire Placement Rt,41219285,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,353.5,282.8,TC,265.13,75,,,percent of total billed charges,75% of total billed charges,141.4,40,,,percent of total billed charges,40% of total billed charges,279.97,79.2,,,percent of total billed charges,79.2% of total billed charges,300.48,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,335.83,95,,,percent of total billed charges,95% of total billed charges,282.8,80,,,percent of total billed charges,80% of total billed charges,300.48,85,,,percent of total billed charges,85% of total billed charges,318.15,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,141.4,40,,,percent of total billed charges,40% of total billed charges,141.4,40,,,percent of total billed charges,40% of total billed charges,318.15,90,,,percent of total billed charges,90% of total billed charges,268.66,76,,,percent of total billed charges,76% of total billed charges,141.4,40,,,percent of total billed charges,40% of total billed charges,300.48,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,282.8,80,,,percent of total billed charges,80% of total billed charges,137.16,38.8,,,percent of total billed charges,38.8% of total billed charges,300.48,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,335.83,
US Renal Ltd,41276775,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,1173.5,938.8,,880.13,75,,,percent of total billed charges,75% of total billed charges,469.4,40,,,percent of total billed charges,40% of total billed charges,929.41,79.2,,,percent of total billed charges,79.2% of total billed charges,997.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,1114.83,95,,,percent of total billed charges,95% of total billed charges,938.8,80,,,percent of total billed charges,80% of total billed charges,997.48,85,,,percent of total billed charges,85% of total billed charges,1056.15,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,469.4,40,,,percent of total billed charges,40% of total billed charges,469.4,40,,,percent of total billed charges,40% of total billed charges,1056.15,90,,,percent of total billed charges,90% of total billed charges,891.86,76,,,percent of total billed charges,76% of total billed charges,469.4,40,,,percent of total billed charges,40% of total billed charges,997.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,938.8,80,,,percent of total billed charges,80% of total billed charges,455.32,38.8,,,percent of total billed charges,38.8% of total billed charges,997.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,1114.83,
97803 MEDICAL NUTR REASSESS EA 15MIN CHARGE,44097803,CDM,942,RC,97803,HCPCS,OUTPATIENT,,,226,180.8,,169.5,75,,,percent of total billed charges,75% of total billed charges,90.4,40,,,percent of total billed charges,40% of total billed charges,178.99,79.2,,,percent of total billed charges,79.2% of total billed charges,192.1,85,,,percent of total billed charges,85% of total billed charges,226,100,,,fee schedule,100% of CO APG rates,214.7,95,,,percent of total billed charges,95% of total billed charges,180.8,80,,,percent of total billed charges,80% of total billed charges,192.1,85,,,percent of total billed charges,85% of total billed charges,203.4,90,,,percent of total billed charges,90% of total billed charges,259.02,100,,,fee schedule,100% of CO APG rates,259.02,100,,,fee schedule,100% of CO APG rates,16.44,100,,,fee schedule,100% of NM fee schedule,90.4,40,,,percent of total billed charges,40% of total billed charges,90.4,40,,,percent of total billed charges,40% of total billed charges,203.4,90,,,percent of total billed charges,90% of total billed charges,171.76,76,,,percent of total billed charges,76% of total billed charges,90.4,40,,,percent of total billed charges,40% of total billed charges,192.1,85,,,percent of total billed charges,85% of total billed charges,259.02,100,,,fee schedule,100% of CO APG rate,180.8,80,,,percent of total billed charges,80% of total billed charges,87.69,38.8,,,percent of total billed charges,38.8% of total billed charges,192.1,85,,,percent of total billed charges,85% of total billed charges,259.02,100,,,fee schedule,100% of APG fee schedule,56.08,200,,,fee schedule,200% of CMS fee schedule,16.44,259.02,
PT Canalith Repositioning Charge,60000280,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,130.5,104.4,GP,97.88,75,,,percent of total billed charges,75% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,103.36,79.2,,,percent of total billed charges,79.2% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,123.98,95,,,percent of total billed charges,95% of total billed charges,104.4,80,,,percent of total billed charges,80% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,117.45,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,52.2,40,,,percent of total billed charges,40% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,117.45,90,,,percent of total billed charges,90% of total billed charges,99.18,76,,,percent of total billed charges,76% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,104.4,80,,,percent of total billed charges,80% of total billed charges,50.63,38.8,,,percent of total billed charges,38.8% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,123.98,
CT Clavicle w/ + w/o Cont Lt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Clavicle w/ + w/o Cont Rt,41173202,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,2080.5,1664.4,TC,1560.38,75,,,percent of total billed charges,75% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1976.48,95,,,percent of total billed charges,95% of total billed charges,1664.4,80,,,percent of total billed charges,80% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,832.2,40,,,percent of total billed charges,40% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1872.45,90,,,percent of total billed charges,90% of total billed charges,1581.18,76,,,percent of total billed charges,76% of total billed charges,832.2,40,,,percent of total billed charges,40% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1664.4,80,,,percent of total billed charges,80% of total billed charges,807.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1768.43,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1976.48,
CT Clavicle w/ Cont Lt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Clavicle w/ Cont Rt,41173201,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1504.7,1203.76,TC,1128.53,75,,,percent of total billed charges,75% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1429.47,95,,,percent of total billed charges,95% of total billed charges,1203.76,80,,,percent of total billed charges,80% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,601.88,40,,,percent of total billed charges,40% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1354.23,90,,,percent of total billed charges,90% of total billed charges,1143.57,76,,,percent of total billed charges,76% of total billed charges,601.88,40,,,percent of total billed charges,40% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1203.76,80,,,percent of total billed charges,80% of total billed charges,583.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1279,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1429.47,
CT Clavicle w/o Cont Lt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
CT Clavicle w/o Cont Rt,41173200,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,1303.5,1042.8,TC,977.63,75,,,percent of total billed charges,75% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1238.33,95,,,percent of total billed charges,95% of total billed charges,1042.8,80,,,percent of total billed charges,80% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,521.4,40,,,percent of total billed charges,40% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1173.15,90,,,percent of total billed charges,90% of total billed charges,990.66,76,,,percent of total billed charges,76% of total billed charges,521.4,40,,,percent of total billed charges,40% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1042.8,80,,,percent of total billed charges,80% of total billed charges,505.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1107.98,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,180.34,1238.33,
MRI Clavicle w/ + w/o Cont Lt,41373220,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Clavicle w/ + w/o Cont Rt,41373220,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,3218,2574.4,TC,2413.5,75,,,percent of total billed charges,75% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,3057.1,95,,,percent of total billed charges,95% of total billed charges,2574.4,80,,,percent of total billed charges,80% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1287.2,40,,,percent of total billed charges,40% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2896.2,90,,,percent of total billed charges,90% of total billed charges,2445.68,76,,,percent of total billed charges,76% of total billed charges,1287.2,40,,,percent of total billed charges,40% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2574.4,80,,,percent of total billed charges,80% of total billed charges,1248.58,38.8,,,percent of total billed charges,38.8% of total billed charges,2735.3,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,3057.1,
MRI Clavicle w/ Cont Lt,41373219,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Clavicle w/ Cont Rt,41373219,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2838.5,2270.8,TC,2128.88,75,,,percent of total billed charges,75% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2696.58,95,,,percent of total billed charges,95% of total billed charges,2270.8,80,,,percent of total billed charges,80% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1135.4,40,,,percent of total billed charges,40% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2554.65,90,,,percent of total billed charges,90% of total billed charges,2157.26,76,,,percent of total billed charges,76% of total billed charges,1135.4,40,,,percent of total billed charges,40% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2270.8,80,,,percent of total billed charges,80% of total billed charges,1101.34,38.8,,,percent of total billed charges,38.8% of total billed charges,2412.73,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2696.58,
MRI Clavicle w/o Cont Lt,41373218,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI Clavicle w/o Cont Rt,41373218,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
US Axilla Lt,60001053,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,346.8,277.44,TC,260.1,75,,,percent of total billed charges,75% of total billed charges,138.72,40,,,percent of total billed charges,40% of total billed charges,274.67,79.2,,,percent of total billed charges,79.2% of total billed charges,294.78,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,329.46,95,,,percent of total billed charges,95% of total billed charges,277.44,80,,,percent of total billed charges,80% of total billed charges,294.78,85,,,percent of total billed charges,85% of total billed charges,312.12,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,138.72,40,,,percent of total billed charges,40% of total billed charges,138.72,40,,,percent of total billed charges,40% of total billed charges,312.12,90,,,percent of total billed charges,90% of total billed charges,263.57,76,,,percent of total billed charges,76% of total billed charges,138.72,40,,,percent of total billed charges,40% of total billed charges,294.78,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,277.44,80,,,percent of total billed charges,80% of total billed charges,134.56,38.8,,,percent of total billed charges,38.8% of total billed charges,294.78,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,329.46,
US Axilla Rt,60001054,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,346.8,277.44,TC,260.1,75,,,percent of total billed charges,75% of total billed charges,138.72,40,,,percent of total billed charges,40% of total billed charges,274.67,79.2,,,percent of total billed charges,79.2% of total billed charges,294.78,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,329.46,95,,,percent of total billed charges,95% of total billed charges,277.44,80,,,percent of total billed charges,80% of total billed charges,294.78,85,,,percent of total billed charges,85% of total billed charges,312.12,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,138.72,40,,,percent of total billed charges,40% of total billed charges,138.72,40,,,percent of total billed charges,40% of total billed charges,312.12,90,,,percent of total billed charges,90% of total billed charges,263.57,76,,,percent of total billed charges,76% of total billed charges,138.72,40,,,percent of total billed charges,40% of total billed charges,294.78,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,277.44,80,,,percent of total billed charges,80% of total billed charges,134.56,38.8,,,percent of total billed charges,38.8% of total billed charges,294.78,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,329.46,
Attention Discharge Status G-9167,60000281,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,133.56,
Memory Discharge Status G-9170,60000282,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,133.56,
Growth Hormone LC,40083003,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,75.1,60.08,,56.33,75,,,percent of total billed charges,75% of total billed charges,30.04,40,,,percent of total billed charges,40% of total billed charges,59.48,79.2,,,percent of total billed charges,79.2% of total billed charges,63.84,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,71.35,95,,,percent of total billed charges,95% of total billed charges,60.08,80,,,percent of total billed charges,80% of total billed charges,63.84,85,,,percent of total billed charges,85% of total billed charges,67.59,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,30.04,40,,,percent of total billed charges,40% of total billed charges,30.04,40,,,percent of total billed charges,40% of total billed charges,67.59,90,,,percent of total billed charges,90% of total billed charges,57.08,76,,,percent of total billed charges,76% of total billed charges,30.04,40,,,percent of total billed charges,40% of total billed charges,63.84,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,60.08,80,,,percent of total billed charges,80% of total billed charges,29.14,38.8,,,percent of total billed charges,38.8% of total billed charges,63.84,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,71.35,
Complement C4a LC,40086160,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,285.7,228.56,,214.28,75,,,percent of total billed charges,75% of total billed charges,114.28,40,,,percent of total billed charges,40% of total billed charges,226.27,79.2,,,percent of total billed charges,79.2% of total billed charges,242.85,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,271.42,95,,,percent of total billed charges,95% of total billed charges,228.56,80,,,percent of total billed charges,80% of total billed charges,242.85,85,,,percent of total billed charges,85% of total billed charges,257.13,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,114.28,40,,,percent of total billed charges,40% of total billed charges,114.28,40,,,percent of total billed charges,40% of total billed charges,257.13,90,,,percent of total billed charges,90% of total billed charges,217.13,76,,,percent of total billed charges,76% of total billed charges,114.28,40,,,percent of total billed charges,40% of total billed charges,242.85,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,228.56,80,,,percent of total billed charges,80% of total billed charges,110.85,38.8,,,percent of total billed charges,38.8% of total billed charges,242.85,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,271.42,
Gastrin LC,40082941,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,32,25.6,,24,75,,,percent of total billed charges,75% of total billed charges,12.8,40,,,percent of total billed charges,40% of total billed charges,25.34,79.2,,,percent of total billed charges,79.2% of total billed charges,27.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,30.4,95,,,percent of total billed charges,95% of total billed charges,25.6,80,,,percent of total billed charges,80% of total billed charges,27.2,85,,,percent of total billed charges,85% of total billed charges,28.8,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.8,40,,,percent of total billed charges,40% of total billed charges,12.8,40,,,percent of total billed charges,40% of total billed charges,28.8,90,,,percent of total billed charges,90% of total billed charges,24.32,76,,,percent of total billed charges,76% of total billed charges,12.8,40,,,percent of total billed charges,40% of total billed charges,27.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,25.6,80,,,percent of total billed charges,80% of total billed charges,12.42,38.8,,,percent of total billed charges,38.8% of total billed charges,27.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,30.4,
"ACTH, Plasma LC",40082024,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,61.5,49.2,,46.13,75,,,percent of total billed charges,75% of total billed charges,24.6,40,,,percent of total billed charges,40% of total billed charges,48.71,79.2,,,percent of total billed charges,79.2% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,58.43,95,,,percent of total billed charges,95% of total billed charges,49.2,80,,,percent of total billed charges,80% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,55.35,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.6,40,,,percent of total billed charges,40% of total billed charges,24.6,40,,,percent of total billed charges,40% of total billed charges,55.35,90,,,percent of total billed charges,90% of total billed charges,46.74,76,,,percent of total billed charges,76% of total billed charges,24.6,40,,,percent of total billed charges,40% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,49.2,80,,,percent of total billed charges,80% of total billed charges,23.86,38.8,,,percent of total billed charges,38.8% of total billed charges,52.28,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,58.43,
Androstenedione LCMS LC,40082157,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,176.4,141.12,,132.3,75,,,percent of total billed charges,75% of total billed charges,70.56,40,,,percent of total billed charges,40% of total billed charges,139.71,79.2,,,percent of total billed charges,79.2% of total billed charges,149.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,167.58,95,,,percent of total billed charges,95% of total billed charges,141.12,80,,,percent of total billed charges,80% of total billed charges,149.94,85,,,percent of total billed charges,85% of total billed charges,158.76,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,70.56,40,,,percent of total billed charges,40% of total billed charges,70.56,40,,,percent of total billed charges,40% of total billed charges,158.76,90,,,percent of total billed charges,90% of total billed charges,134.06,76,,,percent of total billed charges,76% of total billed charges,70.56,40,,,percent of total billed charges,40% of total billed charges,149.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,141.12,80,,,percent of total billed charges,80% of total billed charges,68.44,38.8,,,percent of total billed charges,38.8% of total billed charges,149.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,167.58,
Hep B Surface Ab LC,40086706,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,23.4,18.72,,17.55,75,,,percent of total billed charges,75% of total billed charges,9.36,40,,,percent of total billed charges,40% of total billed charges,18.53,79.2,,,percent of total billed charges,79.2% of total billed charges,19.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,22.23,95,,,percent of total billed charges,95% of total billed charges,18.72,80,,,percent of total billed charges,80% of total billed charges,19.89,85,,,percent of total billed charges,85% of total billed charges,21.06,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,9.36,40,,,percent of total billed charges,40% of total billed charges,9.36,40,,,percent of total billed charges,40% of total billed charges,21.06,90,,,percent of total billed charges,90% of total billed charges,17.78,76,,,percent of total billed charges,76% of total billed charges,9.36,40,,,percent of total billed charges,40% of total billed charges,19.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,18.72,80,,,percent of total billed charges,80% of total billed charges,9.08,38.8,,,percent of total billed charges,38.8% of total billed charges,19.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,22.23,
Hep Be Ag LC,40087350,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,23.6,18.88,,17.7,75,,,percent of total billed charges,75% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,18.69,79.2,,,percent of total billed charges,79.2% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,22.42,95,,,percent of total billed charges,95% of total billed charges,18.88,80,,,percent of total billed charges,80% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,21.24,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,9.44,40,,,percent of total billed charges,40% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,21.24,90,,,percent of total billed charges,90% of total billed charges,17.94,76,,,percent of total billed charges,76% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,18.88,80,,,percent of total billed charges,80% of total billed charges,9.16,38.8,,,percent of total billed charges,38.8% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.16,33.1,
Thyroglobulin Ab LC,40086800,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,28.1,22.48,,21.08,75,,,percent of total billed charges,75% of total billed charges,11.24,40,,,percent of total billed charges,40% of total billed charges,22.26,79.2,,,percent of total billed charges,79.2% of total billed charges,23.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,26.7,95,,,percent of total billed charges,95% of total billed charges,22.48,80,,,percent of total billed charges,80% of total billed charges,23.89,85,,,percent of total billed charges,85% of total billed charges,25.29,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,11.24,40,,,percent of total billed charges,40% of total billed charges,11.24,40,,,percent of total billed charges,40% of total billed charges,25.29,90,,,percent of total billed charges,90% of total billed charges,21.36,76,,,percent of total billed charges,76% of total billed charges,11.24,40,,,percent of total billed charges,40% of total billed charges,23.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,22.48,80,,,percent of total billed charges,80% of total billed charges,10.9,38.8,,,percent of total billed charges,38.8% of total billed charges,23.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,26.7,
"Hep A Ab, Total LC",40086708,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,23.6,18.88,,17.7,75,,,percent of total billed charges,75% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,18.69,79.2,,,percent of total billed charges,79.2% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,22.42,95,,,percent of total billed charges,95% of total billed charges,18.88,80,,,percent of total billed charges,80% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,21.24,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,9.44,40,,,percent of total billed charges,40% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,21.24,90,,,percent of total billed charges,90% of total billed charges,17.94,76,,,percent of total billed charges,76% of total billed charges,9.44,40,,,percent of total billed charges,40% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,18.88,80,,,percent of total billed charges,80% of total billed charges,9.16,38.8,,,percent of total billed charges,38.8% of total billed charges,20.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,22.42,
"Hep A Ab, IgM LC",40086709,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,27.3,21.84,,20.48,75,,,percent of total billed charges,75% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,21.62,79.2,,,percent of total billed charges,79.2% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,25.94,95,,,percent of total billed charges,95% of total billed charges,21.84,80,,,percent of total billed charges,80% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,24.57,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,10.92,40,,,percent of total billed charges,40% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,24.57,90,,,percent of total billed charges,90% of total billed charges,20.75,76,,,percent of total billed charges,76% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,21.84,80,,,percent of total billed charges,80% of total billed charges,10.59,38.8,,,percent of total billed charges,38.8% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,25.94,
HLA B 27 Disease Association LC,40081374,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,58.5,46.8,,43.88,75,,,percent of total billed charges,75% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,46.33,79.2,,,percent of total billed charges,79.2% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,55.58,95,,,percent of total billed charges,95% of total billed charges,46.8,80,,,percent of total billed charges,80% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,23.4,40,,,percent of total billed charges,40% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,44.46,76,,,percent of total billed charges,76% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,46.8,80,,,percent of total billed charges,80% of total billed charges,22.7,38.8,,,percent of total billed charges,38.8% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.7,55.58,
HLA B5701 Test LC,40006926,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,543.3,434.64,,407.48,75,,,percent of total billed charges,75% of total billed charges,217.32,40,,,percent of total billed charges,40% of total billed charges,430.29,79.2,,,percent of total billed charges,79.2% of total billed charges,461.81,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,516.14,95,,,percent of total billed charges,95% of total billed charges,434.64,80,,,percent of total billed charges,80% of total billed charges,461.81,85,,,percent of total billed charges,85% of total billed charges,488.97,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,217.32,40,,,percent of total billed charges,40% of total billed charges,217.32,40,,,percent of total billed charges,40% of total billed charges,488.97,90,,,percent of total billed charges,90% of total billed charges,412.91,76,,,percent of total billed charges,76% of total billed charges,217.32,40,,,percent of total billed charges,40% of total billed charges,461.81,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,434.64,80,,,percent of total billed charges,80% of total billed charges,210.8,38.8,,,percent of total billed charges,38.8% of total billed charges,461.81,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,516.14,
Volatiles LC,40007062,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,53.9,43.12,,40.43,75,,,percent of total billed charges,75% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,42.69,79.2,,,percent of total billed charges,79.2% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,51.21,95,,,percent of total billed charges,95% of total billed charges,43.12,80,,,percent of total billed charges,80% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,48.51,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,21.56,40,,,percent of total billed charges,40% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,48.51,90,,,percent of total billed charges,90% of total billed charges,40.96,76,,,percent of total billed charges,76% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,43.12,80,,,percent of total billed charges,80% of total billed charges,20.91,38.8,,,percent of total billed charges,38.8% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,51.21,
"Heavy Metals Profile, Urine LC",40083825,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,114.6,91.68,,85.95,75,,,percent of total billed charges,75% of total billed charges,45.84,40,,,percent of total billed charges,40% of total billed charges,90.76,79.2,,,percent of total billed charges,79.2% of total billed charges,97.41,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,108.87,95,,,percent of total billed charges,95% of total billed charges,91.68,80,,,percent of total billed charges,80% of total billed charges,97.41,85,,,percent of total billed charges,85% of total billed charges,103.14,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,45.84,40,,,percent of total billed charges,40% of total billed charges,45.84,40,,,percent of total billed charges,40% of total billed charges,103.14,90,,,percent of total billed charges,90% of total billed charges,87.1,76,,,percent of total billed charges,76% of total billed charges,45.84,40,,,percent of total billed charges,40% of total billed charges,97.41,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,91.68,80,,,percent of total billed charges,80% of total billed charges,44.46,38.8,,,percent of total billed charges,38.8% of total billed charges,97.41,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,108.87,
Fungus Stain LC,40008136,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,29.6,23.68,,22.2,75,,,percent of total billed charges,75% of total billed charges,11.84,40,,,percent of total billed charges,40% of total billed charges,23.44,79.2,,,percent of total billed charges,79.2% of total billed charges,25.16,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,28.12,95,,,percent of total billed charges,95% of total billed charges,23.68,80,,,percent of total billed charges,80% of total billed charges,25.16,85,,,percent of total billed charges,85% of total billed charges,26.64,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,11.84,40,,,percent of total billed charges,40% of total billed charges,11.84,40,,,percent of total billed charges,40% of total billed charges,26.64,90,,,percent of total billed charges,90% of total billed charges,22.5,76,,,percent of total billed charges,76% of total billed charges,11.84,40,,,percent of total billed charges,40% of total billed charges,25.16,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,23.68,80,,,percent of total billed charges,80% of total billed charges,11.48,38.8,,,percent of total billed charges,38.8% of total billed charges,25.16,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,33.1,
Beta-2 Microglobulin LC,40082232,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,39,31.2,,29.25,75,,,percent of total billed charges,75% of total billed charges,15.6,40,,,percent of total billed charges,40% of total billed charges,30.89,79.2,,,percent of total billed charges,79.2% of total billed charges,33.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,37.05,95,,,percent of total billed charges,95% of total billed charges,31.2,80,,,percent of total billed charges,80% of total billed charges,33.15,85,,,percent of total billed charges,85% of total billed charges,35.1,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,15.6,40,,,percent of total billed charges,40% of total billed charges,15.6,40,,,percent of total billed charges,40% of total billed charges,35.1,90,,,percent of total billed charges,90% of total billed charges,29.64,76,,,percent of total billed charges,76% of total billed charges,15.6,40,,,percent of total billed charges,40% of total billed charges,33.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,31.2,80,,,percent of total billed charges,80% of total billed charges,15.13,38.8,,,percent of total billed charges,38.8% of total billed charges,33.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,37.05,
Insulin-Like Growth Factor I LC,40084305,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,81.2,64.96,,60.9,75,,,percent of total billed charges,75% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,64.31,79.2,,,percent of total billed charges,79.2% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,77.14,95,,,percent of total billed charges,95% of total billed charges,64.96,80,,,percent of total billed charges,80% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,32.48,40,,,percent of total billed charges,40% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,61.71,76,,,percent of total billed charges,76% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,64.96,80,,,percent of total billed charges,80% of total billed charges,31.51,38.8,,,percent of total billed charges,38.8% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,77.14,
"RPR, Rfx Qn RPR/Confirm TP LC",40086592,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,19.1,15.28,,14.33,75,,,percent of total billed charges,75% of total billed charges,7.64,40,,,percent of total billed charges,40% of total billed charges,15.13,79.2,,,percent of total billed charges,79.2% of total billed charges,16.24,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,18.15,95,,,percent of total billed charges,95% of total billed charges,15.28,80,,,percent of total billed charges,80% of total billed charges,16.24,85,,,percent of total billed charges,85% of total billed charges,17.19,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,7.64,40,,,percent of total billed charges,40% of total billed charges,7.64,40,,,percent of total billed charges,40% of total billed charges,17.19,90,,,percent of total billed charges,90% of total billed charges,14.52,76,,,percent of total billed charges,76% of total billed charges,7.64,40,,,percent of total billed charges,40% of total billed charges,16.24,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,15.28,80,,,percent of total billed charges,80% of total billed charges,7.41,38.8,,,percent of total billed charges,38.8% of total billed charges,16.24,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,18.15,
Antihistone Antibodies LC,40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,125.4,100.32,,94.05,75,,,percent of total billed charges,75% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,99.32,79.2,,,percent of total billed charges,79.2% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,119.13,95,,,percent of total billed charges,95% of total billed charges,100.32,80,,,percent of total billed charges,80% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.16,40,,,percent of total billed charges,40% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,95.3,76,,,percent of total billed charges,76% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,100.32,80,,,percent of total billed charges,80% of total billed charges,48.66,38.8,,,percent of total billed charges,38.8% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,119.13,
Antichromatin Antibodies LC,40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,125.4,100.32,,94.05,75,,,percent of total billed charges,75% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,99.32,79.2,,,percent of total billed charges,79.2% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,119.13,95,,,percent of total billed charges,95% of total billed charges,100.32,80,,,percent of total billed charges,80% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.16,40,,,percent of total billed charges,40% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,95.3,76,,,percent of total billed charges,76% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,100.32,80,,,percent of total billed charges,80% of total billed charges,48.66,38.8,,,percent of total billed charges,38.8% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,119.13,
Antithrombin Antigen LC,40085301,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,34.2,27.36,,25.65,75,,,percent of total billed charges,75% of total billed charges,13.68,40,,,percent of total billed charges,40% of total billed charges,27.09,79.2,,,percent of total billed charges,79.2% of total billed charges,29.07,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,32.49,95,,,percent of total billed charges,95% of total billed charges,27.36,80,,,percent of total billed charges,80% of total billed charges,29.07,85,,,percent of total billed charges,85% of total billed charges,30.78,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,13.68,40,,,percent of total billed charges,40% of total billed charges,13.68,40,,,percent of total billed charges,40% of total billed charges,30.78,90,,,percent of total billed charges,90% of total billed charges,25.99,76,,,percent of total billed charges,76% of total billed charges,13.68,40,,,percent of total billed charges,40% of total billed charges,29.07,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,27.36,80,,,percent of total billed charges,80% of total billed charges,13.27,38.8,,,percent of total billed charges,38.8% of total billed charges,29.07,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,32.49,
"Antithrombin III, Func/Immunol LC",40085300,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,53.9,43.12,,40.43,75,,,percent of total billed charges,75% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,42.69,79.2,,,percent of total billed charges,79.2% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,51.21,95,,,percent of total billed charges,95% of total billed charges,43.12,80,,,percent of total billed charges,80% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,48.51,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,21.56,40,,,percent of total billed charges,40% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,48.51,90,,,percent of total billed charges,90% of total billed charges,40.96,76,,,percent of total billed charges,76% of total billed charges,21.56,40,,,percent of total billed charges,40% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,43.12,80,,,percent of total billed charges,80% of total billed charges,20.91,38.8,,,percent of total billed charges,38.8% of total billed charges,45.82,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,51.21,
"Complement C1q, Quantitative LC",40086160,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,40.3,32.24,,30.23,75,,,percent of total billed charges,75% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,31.92,79.2,,,percent of total billed charges,79.2% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,38.29,95,,,percent of total billed charges,95% of total billed charges,32.24,80,,,percent of total billed charges,80% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,16.12,40,,,percent of total billed charges,40% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,30.63,76,,,percent of total billed charges,76% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,32.24,80,,,percent of total billed charges,80% of total billed charges,15.64,38.8,,,percent of total billed charges,38.8% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,38.29,
Heavy Metals Profile I LC,40083825,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,72.8,58.24,,54.6,75,,,percent of total billed charges,75% of total billed charges,29.12,40,,,percent of total billed charges,40% of total billed charges,57.66,79.2,,,percent of total billed charges,79.2% of total billed charges,61.88,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.16,95,,,percent of total billed charges,95% of total billed charges,58.24,80,,,percent of total billed charges,80% of total billed charges,61.88,85,,,percent of total billed charges,85% of total billed charges,65.52,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.12,40,,,percent of total billed charges,40% of total billed charges,29.12,40,,,percent of total billed charges,40% of total billed charges,65.52,90,,,percent of total billed charges,90% of total billed charges,55.33,76,,,percent of total billed charges,76% of total billed charges,29.12,40,,,percent of total billed charges,40% of total billed charges,61.88,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.24,80,,,percent of total billed charges,80% of total billed charges,28.25,38.8,,,percent of total billed charges,38.8% of total billed charges,61.88,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.16,
Systemic Lupus Profile A LC,40056499,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,137.2,109.76,,102.9,75,,,percent of total billed charges,75% of total billed charges,54.88,40,,,percent of total billed charges,40% of total billed charges,108.66,79.2,,,percent of total billed charges,79.2% of total billed charges,116.62,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,130.34,95,,,percent of total billed charges,95% of total billed charges,109.76,80,,,percent of total billed charges,80% of total billed charges,116.62,85,,,percent of total billed charges,85% of total billed charges,123.48,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,54.88,40,,,percent of total billed charges,40% of total billed charges,54.88,40,,,percent of total billed charges,40% of total billed charges,123.48,90,,,percent of total billed charges,90% of total billed charges,104.27,76,,,percent of total billed charges,76% of total billed charges,54.88,40,,,percent of total billed charges,40% of total billed charges,116.62,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,109.76,80,,,percent of total billed charges,80% of total billed charges,53.23,38.8,,,percent of total billed charges,38.8% of total billed charges,116.62,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,130.34,
Hepatitis B Virus (Profile VI) LC,40086707,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,25.1,20.08,,18.83,75,,,percent of total billed charges,75% of total billed charges,10.04,40,,,percent of total billed charges,40% of total billed charges,19.88,79.2,,,percent of total billed charges,79.2% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,23.85,95,,,percent of total billed charges,95% of total billed charges,20.08,80,,,percent of total billed charges,80% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,22.59,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,10.04,40,,,percent of total billed charges,40% of total billed charges,10.04,40,,,percent of total billed charges,40% of total billed charges,22.59,90,,,percent of total billed charges,90% of total billed charges,19.08,76,,,percent of total billed charges,76% of total billed charges,10.04,40,,,percent of total billed charges,40% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,20.08,80,,,percent of total billed charges,80% of total billed charges,9.74,38.8,,,percent of total billed charges,38.8% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,23.85,
"Nicotine and Metabolite, Urine Quant. LC",40080323,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,107.6,86.08,,80.7,75,,,percent of total billed charges,75% of total billed charges,43.04,40,,,percent of total billed charges,40% of total billed charges,85.22,79.2,,,percent of total billed charges,79.2% of total billed charges,91.46,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,102.22,95,,,percent of total billed charges,95% of total billed charges,86.08,80,,,percent of total billed charges,80% of total billed charges,91.46,85,,,percent of total billed charges,85% of total billed charges,96.84,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,43.04,40,,,percent of total billed charges,40% of total billed charges,43.04,40,,,percent of total billed charges,40% of total billed charges,96.84,90,,,percent of total billed charges,90% of total billed charges,81.78,76,,,percent of total billed charges,76% of total billed charges,43.04,40,,,percent of total billed charges,40% of total billed charges,91.46,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,86.08,80,,,percent of total billed charges,80% of total billed charges,41.75,38.8,,,percent of total billed charges,38.8% of total billed charges,91.46,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,102.22,
17-OH Progesterone LCMS,40083498,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,211.5,169.2,,158.63,75,,,percent of total billed charges,75% of total billed charges,84.6,40,,,percent of total billed charges,40% of total billed charges,167.51,79.2,,,percent of total billed charges,79.2% of total billed charges,179.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,200.93,95,,,percent of total billed charges,95% of total billed charges,169.2,80,,,percent of total billed charges,80% of total billed charges,179.78,85,,,percent of total billed charges,85% of total billed charges,190.35,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,84.6,40,,,percent of total billed charges,40% of total billed charges,84.6,40,,,percent of total billed charges,40% of total billed charges,190.35,90,,,percent of total billed charges,90% of total billed charges,160.74,76,,,percent of total billed charges,76% of total billed charges,84.6,40,,,percent of total billed charges,40% of total billed charges,179.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,169.2,80,,,percent of total billed charges,80% of total billed charges,82.06,38.8,,,percent of total billed charges,38.8% of total billed charges,179.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,200.93,
Clonazepam LC,40080346,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,41.1,32.88,,30.83,75,,,percent of total billed charges,75% of total billed charges,16.44,40,,,percent of total billed charges,40% of total billed charges,32.55,79.2,,,percent of total billed charges,79.2% of total billed charges,34.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,39.05,95,,,percent of total billed charges,95% of total billed charges,32.88,80,,,percent of total billed charges,80% of total billed charges,34.94,85,,,percent of total billed charges,85% of total billed charges,36.99,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,16.44,40,,,percent of total billed charges,40% of total billed charges,16.44,40,,,percent of total billed charges,40% of total billed charges,36.99,90,,,percent of total billed charges,90% of total billed charges,31.24,76,,,percent of total billed charges,76% of total billed charges,16.44,40,,,percent of total billed charges,40% of total billed charges,34.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,32.88,80,,,percent of total billed charges,80% of total billed charges,15.95,38.8,,,percent of total billed charges,38.8% of total billed charges,34.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,39.05,
von Willebrand Profile LC,40085246,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,331.2,264.96,,248.4,75,,,percent of total billed charges,75% of total billed charges,132.48,40,,,percent of total billed charges,40% of total billed charges,262.31,79.2,,,percent of total billed charges,79.2% of total billed charges,281.52,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,314.64,95,,,percent of total billed charges,95% of total billed charges,264.96,80,,,percent of total billed charges,80% of total billed charges,281.52,85,,,percent of total billed charges,85% of total billed charges,298.08,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,132.48,40,,,percent of total billed charges,40% of total billed charges,132.48,40,,,percent of total billed charges,40% of total billed charges,298.08,90,,,percent of total billed charges,90% of total billed charges,251.71,76,,,percent of total billed charges,76% of total billed charges,132.48,40,,,percent of total billed charges,40% of total billed charges,281.52,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,264.96,80,,,percent of total billed charges,80% of total billed charges,128.51,38.8,,,percent of total billed charges,38.8% of total billed charges,281.52,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,314.64,
AChR Binding Abs LC,40083519,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,87.2,69.76,,65.4,75,,,percent of total billed charges,75% of total billed charges,34.88,40,,,percent of total billed charges,40% of total billed charges,69.06,79.2,,,percent of total billed charges,79.2% of total billed charges,74.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,82.84,95,,,percent of total billed charges,95% of total billed charges,69.76,80,,,percent of total billed charges,80% of total billed charges,74.12,85,,,percent of total billed charges,85% of total billed charges,78.48,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,34.88,40,,,percent of total billed charges,40% of total billed charges,34.88,40,,,percent of total billed charges,40% of total billed charges,78.48,90,,,percent of total billed charges,90% of total billed charges,66.27,76,,,percent of total billed charges,76% of total billed charges,34.88,40,,,percent of total billed charges,40% of total billed charges,74.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,69.76,80,,,percent of total billed charges,80% of total billed charges,33.83,38.8,,,percent of total billed charges,38.8% of total billed charges,74.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,82.84,
Factor VIII Activity LC,40085240,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,126.6,101.28,,94.95,75,,,percent of total billed charges,75% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,100.27,79.2,,,percent of total billed charges,79.2% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,120.27,95,,,percent of total billed charges,95% of total billed charges,101.28,80,,,percent of total billed charges,80% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,50.64,40,,,percent of total billed charges,40% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,96.22,76,,,percent of total billed charges,76% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,101.28,80,,,percent of total billed charges,80% of total billed charges,49.12,38.8,,,percent of total billed charges,38.8% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,120.27,
"EBV Ab VCA, IgG LC",40086665,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,155.2,124.16,,116.4,75,,,percent of total billed charges,75% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,122.92,79.2,,,percent of total billed charges,79.2% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,147.44,95,,,percent of total billed charges,95% of total billed charges,124.16,80,,,percent of total billed charges,80% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,62.08,40,,,percent of total billed charges,40% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,117.95,76,,,percent of total billed charges,76% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,124.16,80,,,percent of total billed charges,80% of total billed charges,60.22,38.8,,,percent of total billed charges,38.8% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,147.44,
"Mumps Antibodies, IgG LC",40086735,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,28.2,22.56,,21.15,75,,,percent of total billed charges,75% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,22.33,79.2,,,percent of total billed charges,79.2% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,26.79,95,,,percent of total billed charges,95% of total billed charges,22.56,80,,,percent of total billed charges,80% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,25.38,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,11.28,40,,,percent of total billed charges,40% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,25.38,90,,,percent of total billed charges,90% of total billed charges,21.43,76,,,percent of total billed charges,76% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,22.56,80,,,percent of total billed charges,80% of total billed charges,10.94,38.8,,,percent of total billed charges,38.8% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,26.79,
"Rubeola Antibodies, IgG LC",40086765,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,29.7,23.76,,22.28,75,,,percent of total billed charges,75% of total billed charges,11.88,40,,,percent of total billed charges,40% of total billed charges,23.52,79.2,,,percent of total billed charges,79.2% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,28.22,95,,,percent of total billed charges,95% of total billed charges,23.76,80,,,percent of total billed charges,80% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,26.73,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,11.88,40,,,percent of total billed charges,40% of total billed charges,11.88,40,,,percent of total billed charges,40% of total billed charges,26.73,90,,,percent of total billed charges,90% of total billed charges,22.57,76,,,percent of total billed charges,76% of total billed charges,11.88,40,,,percent of total billed charges,40% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,23.76,80,,,percent of total billed charges,80% of total billed charges,11.52,38.8,,,percent of total billed charges,38.8% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,28.22,
"Cytomegalovirus (CMV) Ab, IgM LC",40086645,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,35.7,28.56,,26.78,75,,,percent of total billed charges,75% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,28.27,79.2,,,percent of total billed charges,79.2% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,33.92,95,,,percent of total billed charges,95% of total billed charges,28.56,80,,,percent of total billed charges,80% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,14.28,40,,,percent of total billed charges,40% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,32.13,90,,,percent of total billed charges,90% of total billed charges,27.13,76,,,percent of total billed charges,76% of total billed charges,14.28,40,,,percent of total billed charges,40% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,28.56,80,,,percent of total billed charges,80% of total billed charges,13.85,38.8,,,percent of total billed charges,38.8% of total billed charges,30.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,33.92,
"EBV Ab VCA, IgM LC",40086665,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,155.2,124.16,,116.4,75,,,percent of total billed charges,75% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,122.92,79.2,,,percent of total billed charges,79.2% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,147.44,95,,,percent of total billed charges,95% of total billed charges,124.16,80,,,percent of total billed charges,80% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,62.08,40,,,percent of total billed charges,40% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,117.95,76,,,percent of total billed charges,76% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,124.16,80,,,percent of total billed charges,80% of total billed charges,60.22,38.8,,,percent of total billed charges,38.8% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,147.44,
Vitamin B1 LC,40084425,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,39,31.2,,29.25,75,,,percent of total billed charges,75% of total billed charges,15.6,40,,,percent of total billed charges,40% of total billed charges,30.89,79.2,,,percent of total billed charges,79.2% of total billed charges,33.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,37.05,95,,,percent of total billed charges,95% of total billed charges,31.2,80,,,percent of total billed charges,80% of total billed charges,33.15,85,,,percent of total billed charges,85% of total billed charges,35.1,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,15.6,40,,,percent of total billed charges,40% of total billed charges,15.6,40,,,percent of total billed charges,40% of total billed charges,35.1,90,,,percent of total billed charges,90% of total billed charges,29.64,76,,,percent of total billed charges,76% of total billed charges,15.6,40,,,percent of total billed charges,40% of total billed charges,33.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,31.2,80,,,percent of total billed charges,80% of total billed charges,15.13,38.8,,,percent of total billed charges,38.8% of total billed charges,33.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,37.05,
Vitamin K1 LC,40084597,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,42.4,33.92,,31.8,75,,,percent of total billed charges,75% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,33.58,79.2,,,percent of total billed charges,79.2% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,40.28,95,,,percent of total billed charges,95% of total billed charges,33.92,80,,,percent of total billed charges,80% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,38.16,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,16.96,40,,,percent of total billed charges,40% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,38.16,90,,,percent of total billed charges,90% of total billed charges,32.22,76,,,percent of total billed charges,76% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,33.92,80,,,percent of total billed charges,80% of total billed charges,16.45,38.8,,,percent of total billed charges,38.8% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,40.28,
"Immunofixation, Urine LC",40086335,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,38.7,30.96,,29.03,75,,,percent of total billed charges,75% of total billed charges,15.48,40,,,percent of total billed charges,40% of total billed charges,30.65,79.2,,,percent of total billed charges,79.2% of total billed charges,32.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,36.77,95,,,percent of total billed charges,95% of total billed charges,30.96,80,,,percent of total billed charges,80% of total billed charges,32.9,85,,,percent of total billed charges,85% of total billed charges,34.83,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,15.48,40,,,percent of total billed charges,40% of total billed charges,15.48,40,,,percent of total billed charges,40% of total billed charges,34.83,90,,,percent of total billed charges,90% of total billed charges,29.41,76,,,percent of total billed charges,76% of total billed charges,15.48,40,,,percent of total billed charges,40% of total billed charges,32.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,30.96,80,,,percent of total billed charges,80% of total billed charges,15.02,38.8,,,percent of total billed charges,38.8% of total billed charges,32.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,36.77,
Epstein-Barr Virus PCR LC,40087798,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,257.6,206.08,,193.2,75,,,percent of total billed charges,75% of total billed charges,103.04,40,,,percent of total billed charges,40% of total billed charges,204.02,79.2,,,percent of total billed charges,79.2% of total billed charges,218.96,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,244.72,95,,,percent of total billed charges,95% of total billed charges,206.08,80,,,percent of total billed charges,80% of total billed charges,218.96,85,,,percent of total billed charges,85% of total billed charges,231.84,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,103.04,40,,,percent of total billed charges,40% of total billed charges,103.04,40,,,percent of total billed charges,40% of total billed charges,231.84,90,,,percent of total billed charges,90% of total billed charges,195.78,76,,,percent of total billed charges,76% of total billed charges,103.04,40,,,percent of total billed charges,40% of total billed charges,218.96,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,206.08,80,,,percent of total billed charges,80% of total billed charges,99.95,38.8,,,percent of total billed charges,38.8% of total billed charges,218.96,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,244.72,
HSV 1  IgG LC,40086695,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,95.7,76.56,,71.78,75,,,percent of total billed charges,75% of total billed charges,38.28,40,,,percent of total billed charges,40% of total billed charges,75.79,79.2,,,percent of total billed charges,79.2% of total billed charges,81.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,90.92,95,,,percent of total billed charges,95% of total billed charges,76.56,80,,,percent of total billed charges,80% of total billed charges,81.35,85,,,percent of total billed charges,85% of total billed charges,86.13,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,38.28,40,,,percent of total billed charges,40% of total billed charges,38.28,40,,,percent of total billed charges,40% of total billed charges,86.13,90,,,percent of total billed charges,90% of total billed charges,72.73,76,,,percent of total billed charges,76% of total billed charges,38.28,40,,,percent of total billed charges,40% of total billed charges,81.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,76.56,80,,,percent of total billed charges,80% of total billed charges,37.13,38.8,,,percent of total billed charges,38.8% of total billed charges,81.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,90.92,
West Nile Virus Antibody LC,40086789,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,106.3,85.04,,79.73,75,,,percent of total billed charges,75% of total billed charges,42.52,40,,,percent of total billed charges,40% of total billed charges,84.19,79.2,,,percent of total billed charges,79.2% of total billed charges,90.36,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,100.99,95,,,percent of total billed charges,95% of total billed charges,85.04,80,,,percent of total billed charges,80% of total billed charges,90.36,85,,,percent of total billed charges,85% of total billed charges,95.67,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,42.52,40,,,percent of total billed charges,40% of total billed charges,42.52,40,,,percent of total billed charges,40% of total billed charges,95.67,90,,,percent of total billed charges,90% of total billed charges,80.79,76,,,percent of total billed charges,76% of total billed charges,42.52,40,,,percent of total billed charges,40% of total billed charges,90.36,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,85.04,80,,,percent of total billed charges,80% of total billed charges,41.24,38.8,,,percent of total billed charges,38.8% of total billed charges,90.36,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,100.99,
"Microalbumin, 24 hr Urine LC",40040050,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,76.4,61.12,,57.3,75,,,percent of total billed charges,75% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,60.51,79.2,,,percent of total billed charges,79.2% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,72.58,95,,,percent of total billed charges,95% of total billed charges,61.12,80,,,percent of total billed charges,80% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,30.56,40,,,percent of total billed charges,40% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,58.06,76,,,percent of total billed charges,76% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,61.12,80,,,percent of total billed charges,80% of total billed charges,29.64,38.8,,,percent of total billed charges,38.8% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,72.58,
"PSA, Ultrasensitive W/O Serial LC",40084153,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,127.5,102,,95.63,75,,,percent of total billed charges,75% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,100.98,79.2,,,percent of total billed charges,79.2% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,121.13,95,,,percent of total billed charges,95% of total billed charges,102,80,,,percent of total billed charges,80% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,51,40,,,percent of total billed charges,40% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,96.9,76,,,percent of total billed charges,76% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,102,80,,,percent of total billed charges,80% of total billed charges,49.47,38.8,,,percent of total billed charges,38.8% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,121.13,
83519  GAD-65 Autoantibody LC,40083519,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,197.6,158.08,,148.2,75,,,percent of total billed charges,75% of total billed charges,79.04,40,,,percent of total billed charges,40% of total billed charges,156.5,79.2,,,percent of total billed charges,79.2% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,187.72,95,,,percent of total billed charges,95% of total billed charges,158.08,80,,,percent of total billed charges,80% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,177.84,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,79.04,40,,,percent of total billed charges,40% of total billed charges,79.04,40,,,percent of total billed charges,40% of total billed charges,177.84,90,,,percent of total billed charges,90% of total billed charges,150.18,76,,,percent of total billed charges,76% of total billed charges,79.04,40,,,percent of total billed charges,40% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,158.08,80,,,percent of total billed charges,80% of total billed charges,76.67,38.8,,,percent of total billed charges,38.8% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,187.72,
Cancer Antigen (CA) 15-3 LC,40086300,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,34.6,27.68,,25.95,75,,,percent of total billed charges,75% of total billed charges,13.84,40,,,percent of total billed charges,40% of total billed charges,27.4,79.2,,,percent of total billed charges,79.2% of total billed charges,29.41,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,32.87,95,,,percent of total billed charges,95% of total billed charges,27.68,80,,,percent of total billed charges,80% of total billed charges,29.41,85,,,percent of total billed charges,85% of total billed charges,31.14,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,13.84,40,,,percent of total billed charges,40% of total billed charges,13.84,40,,,percent of total billed charges,40% of total billed charges,31.14,90,,,percent of total billed charges,90% of total billed charges,26.3,76,,,percent of total billed charges,76% of total billed charges,13.84,40,,,percent of total billed charges,40% of total billed charges,29.41,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,27.68,80,,,percent of total billed charges,80% of total billed charges,13.42,38.8,,,percent of total billed charges,38.8% of total billed charges,29.41,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,32.87,
Histamine LC,40083088,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,257.9,206.32,,193.43,75,,,percent of total billed charges,75% of total billed charges,103.16,40,,,percent of total billed charges,40% of total billed charges,204.26,79.2,,,percent of total billed charges,79.2% of total billed charges,219.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,245.01,95,,,percent of total billed charges,95% of total billed charges,206.32,80,,,percent of total billed charges,80% of total billed charges,219.22,85,,,percent of total billed charges,85% of total billed charges,232.11,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,103.16,40,,,percent of total billed charges,40% of total billed charges,103.16,40,,,percent of total billed charges,40% of total billed charges,232.11,90,,,percent of total billed charges,90% of total billed charges,196,76,,,percent of total billed charges,76% of total billed charges,103.16,40,,,percent of total billed charges,40% of total billed charges,219.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,206.32,80,,,percent of total billed charges,80% of total billed charges,100.07,38.8,,,percent of total billed charges,38.8% of total billed charges,219.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,245.01,
94640 METER DOSE INAHL SUBS TX,42294640,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,94.2,75.36,,70.65,75,,,percent of total billed charges,75% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,74.61,79.2,,,percent of total billed charges,79.2% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,89.49,95,,,percent of total billed charges,95% of total billed charges,75.36,80,,,percent of total billed charges,80% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,94.2,100,,,fee schedule,100% of NM APC rate,37.68,40,,,percent of total billed charges,40% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,84.78,90,,,percent of total billed charges,90% of total billed charges,71.59,76,,,percent of total billed charges,76% of total billed charges,37.68,40,,,percent of total billed charges,40% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,75.36,80,,,percent of total billed charges,80% of total billed charges,36.55,38.8,,,percent of total billed charges,38.8% of total billed charges,80.07,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,94.2,
Immunoassay for analyte other than infectious agent antibody,40083516,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,118,94.4,,88.5,75,,,percent of total billed charges,75% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,93.46,79.2,,,percent of total billed charges,79.2% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,112.1,95,,,percent of total billed charges,95% of total billed charges,94.4,80,,,percent of total billed charges,80% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,47.2,40,,,percent of total billed charges,40% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,89.68,76,,,percent of total billed charges,76% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,94.4,80,,,percent of total billed charges,80% of total billed charges,45.78,38.8,,,percent of total billed charges,38.8% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,112.1,
B pertussis IgM Ab LC,40086615,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,66.2,52.96,,49.65,75,,,percent of total billed charges,75% of total billed charges,26.48,40,,,percent of total billed charges,40% of total billed charges,52.43,79.2,,,percent of total billed charges,79.2% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,62.89,95,,,percent of total billed charges,95% of total billed charges,52.96,80,,,percent of total billed charges,80% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,59.58,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,26.48,40,,,percent of total billed charges,40% of total billed charges,26.48,40,,,percent of total billed charges,40% of total billed charges,59.58,90,,,percent of total billed charges,90% of total billed charges,50.31,76,,,percent of total billed charges,76% of total billed charges,26.48,40,,,percent of total billed charges,40% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,52.96,80,,,percent of total billed charges,80% of total billed charges,25.69,38.8,,,percent of total billed charges,38.8% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,62.89,
Reticulin IgA Antibodies LC,40061760,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,101,80.8,,75.75,75,,,percent of total billed charges,75% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,79.99,79.2,,,percent of total billed charges,79.2% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,95.95,95,,,percent of total billed charges,95% of total billed charges,80.8,80,,,percent of total billed charges,80% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,40.4,40,,,percent of total billed charges,40% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,76.76,76,,,percent of total billed charges,76% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,80.8,80,,,percent of total billed charges,80% of total billed charges,39.19,38.8,,,percent of total billed charges,38.8% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,95.95,
"Helicobacter pylori, IgA LC",40086677,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,35.8,28.64,,26.85,75,,,percent of total billed charges,75% of total billed charges,14.32,40,,,percent of total billed charges,40% of total billed charges,28.35,79.2,,,percent of total billed charges,79.2% of total billed charges,30.43,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,34.01,95,,,percent of total billed charges,95% of total billed charges,28.64,80,,,percent of total billed charges,80% of total billed charges,30.43,85,,,percent of total billed charges,85% of total billed charges,32.22,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,14.32,40,,,percent of total billed charges,40% of total billed charges,14.32,40,,,percent of total billed charges,40% of total billed charges,32.22,90,,,percent of total billed charges,90% of total billed charges,27.21,76,,,percent of total billed charges,76% of total billed charges,14.32,40,,,percent of total billed charges,40% of total billed charges,30.43,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,28.64,80,,,percent of total billed charges,80% of total billed charges,13.89,38.8,,,percent of total billed charges,38.8% of total billed charges,30.43,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,34.01,
Immunoassay for analyte other than infectious agent antibody,40083516,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,118,94.4,,88.5,75,,,percent of total billed charges,75% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,93.46,79.2,,,percent of total billed charges,79.2% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,112.1,95,,,percent of total billed charges,95% of total billed charges,94.4,80,,,percent of total billed charges,80% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,47.2,40,,,percent of total billed charges,40% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,89.68,76,,,percent of total billed charges,76% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,94.4,80,,,percent of total billed charges,80% of total billed charges,45.78,38.8,,,percent of total billed charges,38.8% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,112.1,
Liver-Kidney Microsomal Ab LC,40086376,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,36.8,29.44,,27.6,75,,,percent of total billed charges,75% of total billed charges,14.72,40,,,percent of total billed charges,40% of total billed charges,29.15,79.2,,,percent of total billed charges,79.2% of total billed charges,31.28,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,34.96,95,,,percent of total billed charges,95% of total billed charges,29.44,80,,,percent of total billed charges,80% of total billed charges,31.28,85,,,percent of total billed charges,85% of total billed charges,33.12,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,14.72,40,,,percent of total billed charges,40% of total billed charges,14.72,40,,,percent of total billed charges,40% of total billed charges,33.12,90,,,percent of total billed charges,90% of total billed charges,27.97,76,,,percent of total billed charges,76% of total billed charges,14.72,40,,,percent of total billed charges,40% of total billed charges,31.28,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,29.44,80,,,percent of total billed charges,80% of total billed charges,14.28,38.8,,,percent of total billed charges,38.8% of total billed charges,31.28,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,34.96,
"Aspergillus Ab, Qn, DID LC",40086606,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,50.9,40.72,,38.18,75,,,percent of total billed charges,75% of total billed charges,20.36,40,,,percent of total billed charges,40% of total billed charges,40.31,79.2,,,percent of total billed charges,79.2% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,48.36,95,,,percent of total billed charges,95% of total billed charges,40.72,80,,,percent of total billed charges,80% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,45.81,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,20.36,40,,,percent of total billed charges,40% of total billed charges,20.36,40,,,percent of total billed charges,40% of total billed charges,45.81,90,,,percent of total billed charges,90% of total billed charges,38.68,76,,,percent of total billed charges,76% of total billed charges,20.36,40,,,percent of total billed charges,40% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,40.72,80,,,percent of total billed charges,80% of total billed charges,19.75,38.8,,,percent of total billed charges,38.8% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,48.36,
"Histoplasma Abs, Qn, DID LC",40086698,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,48.4,38.72,,36.3,75,,,percent of total billed charges,75% of total billed charges,19.36,40,,,percent of total billed charges,40% of total billed charges,38.33,79.2,,,percent of total billed charges,79.2% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,45.98,95,,,percent of total billed charges,95% of total billed charges,38.72,80,,,percent of total billed charges,80% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,43.56,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,19.36,40,,,percent of total billed charges,40% of total billed charges,19.36,40,,,percent of total billed charges,40% of total billed charges,43.56,90,,,percent of total billed charges,90% of total billed charges,36.78,76,,,percent of total billed charges,76% of total billed charges,19.36,40,,,percent of total billed charges,40% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,38.72,80,,,percent of total billed charges,80% of total billed charges,18.78,38.8,,,percent of total billed charges,38.8% of total billed charges,41.14,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,45.98,
Immunoassay for analyte other than infectious agent antibody,40083516,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,162.6,130.08,,121.95,75,,,percent of total billed charges,75% of total billed charges,65.04,40,,,percent of total billed charges,40% of total billed charges,128.78,79.2,,,percent of total billed charges,79.2% of total billed charges,138.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,154.47,95,,,percent of total billed charges,95% of total billed charges,130.08,80,,,percent of total billed charges,80% of total billed charges,138.21,85,,,percent of total billed charges,85% of total billed charges,146.34,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,65.04,40,,,percent of total billed charges,40% of total billed charges,65.04,40,,,percent of total billed charges,40% of total billed charges,146.34,90,,,percent of total billed charges,90% of total billed charges,123.58,76,,,percent of total billed charges,76% of total billed charges,65.04,40,,,percent of total billed charges,40% of total billed charges,138.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,130.08,80,,,percent of total billed charges,80% of total billed charges,63.09,38.8,,,percent of total billed charges,38.8% of total billed charges,138.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,154.47,
Anti-Centromere B Antibodies LC,40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,123.4,98.72,,92.55,75,,,percent of total billed charges,75% of total billed charges,49.36,40,,,percent of total billed charges,40% of total billed charges,97.73,79.2,,,percent of total billed charges,79.2% of total billed charges,104.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,117.23,95,,,percent of total billed charges,95% of total billed charges,98.72,80,,,percent of total billed charges,80% of total billed charges,104.89,85,,,percent of total billed charges,85% of total billed charges,111.06,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,49.36,40,,,percent of total billed charges,40% of total billed charges,49.36,40,,,percent of total billed charges,40% of total billed charges,111.06,90,,,percent of total billed charges,90% of total billed charges,93.78,76,,,percent of total billed charges,76% of total billed charges,49.36,40,,,percent of total billed charges,40% of total billed charges,104.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,98.72,80,,,percent of total billed charges,80% of total billed charges,47.88,38.8,,,percent of total billed charges,38.8% of total billed charges,104.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,117.23,
Celiac Disease Panel LC,40086255,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,137.1,109.68,,102.83,75,,,percent of total billed charges,75% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,108.58,79.2,,,percent of total billed charges,79.2% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,130.25,95,,,percent of total billed charges,95% of total billed charges,109.68,80,,,percent of total billed charges,80% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,123.39,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,54.84,40,,,percent of total billed charges,40% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,123.39,90,,,percent of total billed charges,90% of total billed charges,104.2,76,,,percent of total billed charges,76% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,109.68,80,,,percent of total billed charges,80% of total billed charges,53.19,38.8,,,percent of total billed charges,38.8% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,130.25,
QuantiFERON Client Incubated LC,40086480,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,96.3,77.04,,72.23,75,,,percent of total billed charges,75% of total billed charges,38.52,40,,,percent of total billed charges,40% of total billed charges,76.27,79.2,,,percent of total billed charges,79.2% of total billed charges,81.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,91.49,95,,,percent of total billed charges,95% of total billed charges,77.04,80,,,percent of total billed charges,80% of total billed charges,81.86,85,,,percent of total billed charges,85% of total billed charges,86.67,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,38.52,40,,,percent of total billed charges,40% of total billed charges,38.52,40,,,percent of total billed charges,40% of total billed charges,86.67,90,,,percent of total billed charges,90% of total billed charges,73.19,76,,,percent of total billed charges,76% of total billed charges,38.52,40,,,percent of total billed charges,40% of total billed charges,81.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,77.04,80,,,percent of total billed charges,80% of total billed charges,37.36,38.8,,,percent of total billed charges,38.8% of total billed charges,81.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,91.49,
Protein Elec + Interp LC,40084165,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,16.9,13.52,,12.68,75,,,percent of total billed charges,75% of total billed charges,6.76,40,,,percent of total billed charges,40% of total billed charges,13.38,79.2,,,percent of total billed charges,79.2% of total billed charges,14.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,16.06,95,,,percent of total billed charges,95% of total billed charges,13.52,80,,,percent of total billed charges,80% of total billed charges,14.37,85,,,percent of total billed charges,85% of total billed charges,15.21,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,6.76,40,,,percent of total billed charges,40% of total billed charges,6.76,40,,,percent of total billed charges,40% of total billed charges,15.21,90,,,percent of total billed charges,90% of total billed charges,12.84,76,,,percent of total billed charges,76% of total billed charges,6.76,40,,,percent of total billed charges,40% of total billed charges,14.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,13.52,80,,,percent of total billed charges,80% of total billed charges,6.56,38.8,,,percent of total billed charges,38.8% of total billed charges,14.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,16.06,
Helper T-Lymph-CD4 LC,40086361,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,51.8,41.44,,38.85,75,,,percent of total billed charges,75% of total billed charges,20.72,40,,,percent of total billed charges,40% of total billed charges,41.03,79.2,,,percent of total billed charges,79.2% of total billed charges,44.03,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,49.21,95,,,percent of total billed charges,95% of total billed charges,41.44,80,,,percent of total billed charges,80% of total billed charges,44.03,85,,,percent of total billed charges,85% of total billed charges,46.62,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,20.72,40,,,percent of total billed charges,40% of total billed charges,20.72,40,,,percent of total billed charges,40% of total billed charges,46.62,90,,,percent of total billed charges,90% of total billed charges,39.37,76,,,percent of total billed charges,76% of total billed charges,20.72,40,,,percent of total billed charges,40% of total billed charges,44.03,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,41.44,80,,,percent of total billed charges,80% of total billed charges,20.1,38.8,,,percent of total billed charges,38.8% of total billed charges,44.03,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,49.21,
Thiopurine Methyltransferase LC,40010750,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,391.8,313.44,,293.85,75,,,percent of total billed charges,75% of total billed charges,156.72,40,,,percent of total billed charges,40% of total billed charges,310.31,79.2,,,percent of total billed charges,79.2% of total billed charges,333.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,372.21,95,,,percent of total billed charges,95% of total billed charges,313.44,80,,,percent of total billed charges,80% of total billed charges,333.03,85,,,percent of total billed charges,85% of total billed charges,352.62,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,156.72,40,,,percent of total billed charges,40% of total billed charges,156.72,40,,,percent of total billed charges,40% of total billed charges,352.62,90,,,percent of total billed charges,90% of total billed charges,297.77,76,,,percent of total billed charges,76% of total billed charges,156.72,40,,,percent of total billed charges,40% of total billed charges,333.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,313.44,80,,,percent of total billed charges,80% of total billed charges,152.02,38.8,,,percent of total billed charges,38.8% of total billed charges,333.03,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,372.21,
Factor V Leiden Mutation LC,40081241,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,141.8,113.44,,106.35,75,,,percent of total billed charges,75% of total billed charges,56.72,40,,,percent of total billed charges,40% of total billed charges,112.31,79.2,,,percent of total billed charges,79.2% of total billed charges,120.53,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,134.71,95,,,percent of total billed charges,95% of total billed charges,113.44,80,,,percent of total billed charges,80% of total billed charges,120.53,85,,,percent of total billed charges,85% of total billed charges,127.62,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,56.72,40,,,percent of total billed charges,40% of total billed charges,56.72,40,,,percent of total billed charges,40% of total billed charges,127.62,90,,,percent of total billed charges,90% of total billed charges,107.77,76,,,percent of total billed charges,76% of total billed charges,56.72,40,,,percent of total billed charges,40% of total billed charges,120.53,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,113.44,80,,,percent of total billed charges,80% of total billed charges,55.02,38.8,,,percent of total billed charges,38.8% of total billed charges,120.53,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,134.71,
"Factor II, DNA Analysis LC",40081240,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,168.9,135.12,,126.68,75,,,percent of total billed charges,75% of total billed charges,67.56,40,,,percent of total billed charges,40% of total billed charges,133.77,79.2,,,percent of total billed charges,79.2% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,160.46,95,,,percent of total billed charges,95% of total billed charges,135.12,80,,,percent of total billed charges,80% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,152.01,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,67.56,40,,,percent of total billed charges,40% of total billed charges,67.56,40,,,percent of total billed charges,40% of total billed charges,152.01,90,,,percent of total billed charges,90% of total billed charges,128.36,76,,,percent of total billed charges,76% of total billed charges,67.56,40,,,percent of total billed charges,40% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,135.12,80,,,percent of total billed charges,80% of total billed charges,65.53,38.8,,,percent of total billed charges,38.8% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,160.46,
"Hered.Hemochromatosis, DNA LC",40081256,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,384.5,307.6,,288.38,75,,,percent of total billed charges,75% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,304.52,79.2,,,percent of total billed charges,79.2% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,365.28,95,,,percent of total billed charges,95% of total billed charges,307.6,80,,,percent of total billed charges,80% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,346.05,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,153.8,40,,,percent of total billed charges,40% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,346.05,90,,,percent of total billed charges,90% of total billed charges,292.22,76,,,percent of total billed charges,76% of total billed charges,153.8,40,,,percent of total billed charges,40% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,307.6,80,,,percent of total billed charges,80% of total billed charges,149.19,38.8,,,percent of total billed charges,38.8% of total billed charges,326.83,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,365.28,
"Alk Phosphatase, Bone Specific LC",40084080,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,92.9,74.32,,69.68,75,,,percent of total billed charges,75% of total billed charges,37.16,40,,,percent of total billed charges,40% of total billed charges,73.58,79.2,,,percent of total billed charges,79.2% of total billed charges,78.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,88.26,95,,,percent of total billed charges,95% of total billed charges,74.32,80,,,percent of total billed charges,80% of total billed charges,78.97,85,,,percent of total billed charges,85% of total billed charges,83.61,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,37.16,40,,,percent of total billed charges,40% of total billed charges,37.16,40,,,percent of total billed charges,40% of total billed charges,83.61,90,,,percent of total billed charges,90% of total billed charges,70.6,76,,,percent of total billed charges,76% of total billed charges,37.16,40,,,percent of total billed charges,40% of total billed charges,78.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,74.32,80,,,percent of total billed charges,80% of total billed charges,36.05,38.8,,,percent of total billed charges,38.8% of total billed charges,78.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,88.26,
"HCV RT-PCR, Quant (Non-Graph) LC",40087522,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,195.4,156.32,,146.55,75,,,percent of total billed charges,75% of total billed charges,78.16,40,,,percent of total billed charges,40% of total billed charges,154.76,79.2,,,percent of total billed charges,79.2% of total billed charges,166.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,185.63,95,,,percent of total billed charges,95% of total billed charges,156.32,80,,,percent of total billed charges,80% of total billed charges,166.09,85,,,percent of total billed charges,85% of total billed charges,175.86,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,78.16,40,,,percent of total billed charges,40% of total billed charges,78.16,40,,,percent of total billed charges,40% of total billed charges,175.86,90,,,percent of total billed charges,90% of total billed charges,148.5,76,,,percent of total billed charges,76% of total billed charges,78.16,40,,,percent of total billed charges,40% of total billed charges,166.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,156.32,80,,,percent of total billed charges,80% of total billed charges,75.82,38.8,,,percent of total billed charges,38.8% of total billed charges,166.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,185.63,
"HCV RNA by PCR, Qn Rfx Geno LC",40087522,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,204.5,163.6,,153.38,75,,,percent of total billed charges,75% of total billed charges,81.8,40,,,percent of total billed charges,40% of total billed charges,161.96,79.2,,,percent of total billed charges,79.2% of total billed charges,173.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,194.28,95,,,percent of total billed charges,95% of total billed charges,163.6,80,,,percent of total billed charges,80% of total billed charges,173.83,85,,,percent of total billed charges,85% of total billed charges,184.05,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,81.8,40,,,percent of total billed charges,40% of total billed charges,81.8,40,,,percent of total billed charges,40% of total billed charges,184.05,90,,,percent of total billed charges,90% of total billed charges,155.42,76,,,percent of total billed charges,76% of total billed charges,81.8,40,,,percent of total billed charges,40% of total billed charges,173.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,163.6,80,,,percent of total billed charges,80% of total billed charges,79.35,38.8,,,percent of total billed charges,38.8% of total billed charges,173.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,194.28,
"RNA, Real Time PCR (Non-Graph) LC",40087536,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,665.8,532.64,,499.35,75,,,percent of total billed charges,75% of total billed charges,266.32,40,,,percent of total billed charges,40% of total billed charges,527.31,79.2,,,percent of total billed charges,79.2% of total billed charges,565.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,632.51,95,,,percent of total billed charges,95% of total billed charges,532.64,80,,,percent of total billed charges,80% of total billed charges,565.93,85,,,percent of total billed charges,85% of total billed charges,599.22,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,266.32,40,,,percent of total billed charges,40% of total billed charges,266.32,40,,,percent of total billed charges,40% of total billed charges,599.22,90,,,percent of total billed charges,90% of total billed charges,506.01,76,,,percent of total billed charges,76% of total billed charges,266.32,40,,,percent of total billed charges,40% of total billed charges,565.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,532.64,80,,,percent of total billed charges,80% of total billed charges,258.33,38.8,,,percent of total billed charges,38.8% of total billed charges,565.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,632.51,
HCV Genotyping Non Reflex LC,40087902,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,850.3,680.24,,637.73,75,,,percent of total billed charges,75% of total billed charges,340.12,40,,,percent of total billed charges,40% of total billed charges,673.44,79.2,,,percent of total billed charges,79.2% of total billed charges,722.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,807.79,95,,,percent of total billed charges,95% of total billed charges,680.24,80,,,percent of total billed charges,80% of total billed charges,722.76,85,,,percent of total billed charges,85% of total billed charges,765.27,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,340.12,40,,,percent of total billed charges,40% of total billed charges,340.12,40,,,percent of total billed charges,40% of total billed charges,765.27,90,,,percent of total billed charges,90% of total billed charges,646.23,76,,,percent of total billed charges,76% of total billed charges,340.12,40,,,percent of total billed charges,40% of total billed charges,722.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,680.24,80,,,percent of total billed charges,80% of total billed charges,329.92,38.8,,,percent of total billed charges,38.8% of total billed charges,722.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,807.79,
Human Trans.Growth Fact.beta 1 LC,40083520,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,134,107.2,,100.5,75,,,percent of total billed charges,75% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,106.13,79.2,,,percent of total billed charges,79.2% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,127.3,95,,,percent of total billed charges,95% of total billed charges,107.2,80,,,percent of total billed charges,80% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,53.6,40,,,percent of total billed charges,40% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,101.84,76,,,percent of total billed charges,76% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,107.2,80,,,percent of total billed charges,80% of total billed charges,51.99,38.8,,,percent of total billed charges,38.8% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,127.3,
.Immunofixation Elect LC,40086334,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,57.3,45.84,,42.98,75,,,percent of total billed charges,75% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,45.38,79.2,,,percent of total billed charges,79.2% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,54.44,95,,,percent of total billed charges,95% of total billed charges,45.84,80,,,percent of total billed charges,80% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,51.57,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,22.92,40,,,percent of total billed charges,40% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,51.57,90,,,percent of total billed charges,90% of total billed charges,43.55,76,,,percent of total billed charges,76% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,45.84,80,,,percent of total billed charges,80% of total billed charges,22.23,38.8,,,percent of total billed charges,38.8% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,54.44,
.Fungus (Mycology) Cult LC,40087101,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,23.1,18.48,,17.33,75,,,percent of total billed charges,75% of total billed charges,9.24,40,,,percent of total billed charges,40% of total billed charges,18.3,79.2,,,percent of total billed charges,79.2% of total billed charges,19.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,21.95,95,,,percent of total billed charges,95% of total billed charges,18.48,80,,,percent of total billed charges,80% of total billed charges,19.64,85,,,percent of total billed charges,85% of total billed charges,20.79,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,9.24,40,,,percent of total billed charges,40% of total billed charges,9.24,40,,,percent of total billed charges,40% of total billed charges,20.79,90,,,percent of total billed charges,90% of total billed charges,17.56,76,,,percent of total billed charges,76% of total billed charges,9.24,40,,,percent of total billed charges,40% of total billed charges,19.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,18.48,80,,,percent of total billed charges,80% of total billed charges,8.96,38.8,,,percent of total billed charges,38.8% of total billed charges,19.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,8.96,33.1,
.RPR Qn+TP Ab LC,40012005,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,122.2,97.76,,91.65,75,,,percent of total billed charges,75% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,96.78,79.2,,,percent of total billed charges,79.2% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,116.09,95,,,percent of total billed charges,95% of total billed charges,97.76,80,,,percent of total billed charges,80% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,109.98,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,48.88,40,,,percent of total billed charges,40% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,109.98,90,,,percent of total billed charges,90% of total billed charges,92.87,76,,,percent of total billed charges,76% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,97.76,80,,,percent of total billed charges,80% of total billed charges,47.41,38.8,,,percent of total billed charges,38.8% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,116.09,
"Immunoglobulin A, Qn LC",40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,22.8,18.24,,17.1,75,,,percent of total billed charges,75% of total billed charges,9.12,40,,,percent of total billed charges,40% of total billed charges,18.06,79.2,,,percent of total billed charges,79.2% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,21.66,95,,,percent of total billed charges,95% of total billed charges,18.24,80,,,percent of total billed charges,80% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,20.52,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,9.12,40,,,percent of total billed charges,40% of total billed charges,9.12,40,,,percent of total billed charges,40% of total billed charges,20.52,90,,,percent of total billed charges,90% of total billed charges,17.33,76,,,percent of total billed charges,76% of total billed charges,9.12,40,,,percent of total billed charges,40% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,18.24,80,,,percent of total billed charges,80% of total billed charges,8.85,38.8,,,percent of total billed charges,38.8% of total billed charges,19.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,21.66,
Anti-dsDNA Antibodies LC,40086225,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,151,120.8,,113.25,75,,,percent of total billed charges,75% of total billed charges,60.4,40,,,percent of total billed charges,40% of total billed charges,119.59,79.2,,,percent of total billed charges,79.2% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,143.45,95,,,percent of total billed charges,95% of total billed charges,120.8,80,,,percent of total billed charges,80% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,135.9,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,60.4,40,,,percent of total billed charges,40% of total billed charges,60.4,40,,,percent of total billed charges,40% of total billed charges,135.9,90,,,percent of total billed charges,90% of total billed charges,114.76,76,,,percent of total billed charges,76% of total billed charges,60.4,40,,,percent of total billed charges,40% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,120.8,80,,,percent of total billed charges,80% of total billed charges,58.59,38.8,,,percent of total billed charges,38.8% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,143.45,
.Varicella Viral Identification LC,40087253,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,155.9,124.72,,116.93,75,,,percent of total billed charges,75% of total billed charges,62.36,40,,,percent of total billed charges,40% of total billed charges,123.47,79.2,,,percent of total billed charges,79.2% of total billed charges,132.52,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,148.11,95,,,percent of total billed charges,95% of total billed charges,124.72,80,,,percent of total billed charges,80% of total billed charges,132.52,85,,,percent of total billed charges,85% of total billed charges,140.31,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,62.36,40,,,percent of total billed charges,40% of total billed charges,62.36,40,,,percent of total billed charges,40% of total billed charges,140.31,90,,,percent of total billed charges,90% of total billed charges,118.48,76,,,percent of total billed charges,76% of total billed charges,62.36,40,,,percent of total billed charges,40% of total billed charges,132.52,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,124.72,80,,,percent of total billed charges,80% of total billed charges,60.49,38.8,,,percent of total billed charges,38.8% of total billed charges,132.52,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,148.11,
.%fPSA Reflex LC,30084030,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,25.1,20.08,,18.83,75,,,percent of total billed charges,75% of total billed charges,10.04,40,,,percent of total billed charges,40% of total billed charges,19.88,79.2,,,percent of total billed charges,79.2% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,23.85,95,,,percent of total billed charges,95% of total billed charges,20.08,80,,,percent of total billed charges,80% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,22.59,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,10.04,40,,,percent of total billed charges,40% of total billed charges,10.04,40,,,percent of total billed charges,40% of total billed charges,22.59,90,,,percent of total billed charges,90% of total billed charges,19.08,76,,,percent of total billed charges,76% of total billed charges,10.04,40,,,percent of total billed charges,40% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,20.08,80,,,percent of total billed charges,80% of total billed charges,9.74,38.8,,,percent of total billed charges,38.8% of total billed charges,21.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,23.85,
.Mtb AST Confirmation LC,40087190,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,194.9,155.92,,146.18,75,,,percent of total billed charges,75% of total billed charges,77.96,40,,,percent of total billed charges,40% of total billed charges,154.36,79.2,,,percent of total billed charges,79.2% of total billed charges,165.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,185.16,95,,,percent of total billed charges,95% of total billed charges,155.92,80,,,percent of total billed charges,80% of total billed charges,165.67,85,,,percent of total billed charges,85% of total billed charges,175.41,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,77.96,40,,,percent of total billed charges,40% of total billed charges,77.96,40,,,percent of total billed charges,40% of total billed charges,175.41,90,,,percent of total billed charges,90% of total billed charges,148.12,76,,,percent of total billed charges,76% of total billed charges,77.96,40,,,percent of total billed charges,40% of total billed charges,165.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,155.92,80,,,percent of total billed charges,80% of total billed charges,75.62,38.8,,,percent of total billed charges,38.8% of total billed charges,165.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,185.16,
.Change IG Pap to LB Pap LC,40098355,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
"VDRL, CSF LC",40006445,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,14.1,11.28,,10.58,75,,,percent of total billed charges,75% of total billed charges,5.64,40,,,percent of total billed charges,40% of total billed charges,11.17,79.2,,,percent of total billed charges,79.2% of total billed charges,11.99,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.4,95,,,percent of total billed charges,95% of total billed charges,11.28,80,,,percent of total billed charges,80% of total billed charges,11.99,85,,,percent of total billed charges,85% of total billed charges,12.69,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,5.64,40,,,percent of total billed charges,40% of total billed charges,5.64,40,,,percent of total billed charges,40% of total billed charges,12.69,90,,,percent of total billed charges,90% of total billed charges,10.72,76,,,percent of total billed charges,76% of total billed charges,5.64,40,,,percent of total billed charges,40% of total billed charges,11.99,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,11.28,80,,,percent of total billed charges,80% of total billed charges,5.47,38.8,,,percent of total billed charges,38.8% of total billed charges,11.99,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,13.74,
Enterovirus RT-PCR LC,40087498,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,240.9,192.72,,180.68,75,,,percent of total billed charges,75% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,190.79,79.2,,,percent of total billed charges,79.2% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,228.86,95,,,percent of total billed charges,95% of total billed charges,192.72,80,,,percent of total billed charges,80% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,216.81,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,96.36,40,,,percent of total billed charges,40% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,216.81,90,,,percent of total billed charges,90% of total billed charges,183.08,76,,,percent of total billed charges,76% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,192.72,80,,,percent of total billed charges,80% of total billed charges,93.47,38.8,,,percent of total billed charges,38.8% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,228.86,
B.pertussisB.parapertussis PCR LC,40087798,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,150.6,120.48,,112.95,75,,,percent of total billed charges,75% of total billed charges,60.24,40,,,percent of total billed charges,40% of total billed charges,119.28,79.2,,,percent of total billed charges,79.2% of total billed charges,128.01,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,143.07,95,,,percent of total billed charges,95% of total billed charges,120.48,80,,,percent of total billed charges,80% of total billed charges,128.01,85,,,percent of total billed charges,85% of total billed charges,135.54,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,60.24,40,,,percent of total billed charges,40% of total billed charges,60.24,40,,,percent of total billed charges,40% of total billed charges,135.54,90,,,percent of total billed charges,90% of total billed charges,114.46,76,,,percent of total billed charges,76% of total billed charges,60.24,40,,,percent of total billed charges,40% of total billed charges,128.01,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,120.48,80,,,percent of total billed charges,80% of total billed charges,58.43,38.8,,,percent of total billed charges,38.8% of total billed charges,128.01,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,143.07,
"West Nile Virus Antibody, CSF LC",40086789,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,93.3,74.64,,69.98,75,,,percent of total billed charges,75% of total billed charges,37.32,40,,,percent of total billed charges,40% of total billed charges,73.89,79.2,,,percent of total billed charges,79.2% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,88.64,95,,,percent of total billed charges,95% of total billed charges,74.64,80,,,percent of total billed charges,80% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,83.97,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,37.32,40,,,percent of total billed charges,40% of total billed charges,37.32,40,,,percent of total billed charges,40% of total billed charges,83.97,90,,,percent of total billed charges,90% of total billed charges,70.91,76,,,percent of total billed charges,76% of total billed charges,37.32,40,,,percent of total billed charges,40% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,74.64,80,,,percent of total billed charges,80% of total billed charges,36.2,38.8,,,percent of total billed charges,38.8% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,88.64,
Acid Fast Smear+Cult LC,40087116,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,56.8,45.44,,42.6,75,,,percent of total billed charges,75% of total billed charges,22.72,40,,,percent of total billed charges,40% of total billed charges,44.99,79.2,,,percent of total billed charges,79.2% of total billed charges,48.28,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,53.96,95,,,percent of total billed charges,95% of total billed charges,45.44,80,,,percent of total billed charges,80% of total billed charges,48.28,85,,,percent of total billed charges,85% of total billed charges,51.12,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,22.72,40,,,percent of total billed charges,40% of total billed charges,22.72,40,,,percent of total billed charges,40% of total billed charges,51.12,90,,,percent of total billed charges,90% of total billed charges,43.17,76,,,percent of total billed charges,76% of total billed charges,22.72,40,,,percent of total billed charges,40% of total billed charges,48.28,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,45.44,80,,,percent of total billed charges,80% of total billed charges,22.04,38.8,,,percent of total billed charges,38.8% of total billed charges,48.28,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,53.96,
"Pap IG, rfx HPV ASCU LC",40094074,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,40.1,32.08,,30.08,75,,,percent of total billed charges,75% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,31.76,79.2,,,percent of total billed charges,79.2% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,38.1,95,,,percent of total billed charges,95% of total billed charges,32.08,80,,,percent of total billed charges,80% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,16.04,40,,,percent of total billed charges,40% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,30.48,76,,,percent of total billed charges,76% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,32.08,80,,,percent of total billed charges,80% of total billed charges,15.56,38.8,,,percent of total billed charges,38.8% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,15.56,53.22,
"Pap IG, Ct-Ng TV rfx HPV ASCU LC",40096527,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,126.7,101.36,,95.03,75,,,percent of total billed charges,75% of total billed charges,50.68,40,,,percent of total billed charges,40% of total billed charges,100.35,79.2,,,percent of total billed charges,79.2% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,120.37,95,,,percent of total billed charges,95% of total billed charges,101.36,80,,,percent of total billed charges,80% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,114.03,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,50.68,40,,,percent of total billed charges,40% of total billed charges,50.68,40,,,percent of total billed charges,40% of total billed charges,114.03,90,,,percent of total billed charges,90% of total billed charges,96.29,76,,,percent of total billed charges,76% of total billed charges,50.68,40,,,percent of total billed charges,40% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,101.36,80,,,percent of total billed charges,80% of total billed charges,49.16,38.8,,,percent of total billed charges,38.8% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,120.37,
"Pap IG, Ct-Ng, rfx HPV all LC",40096565,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,72,57.6,,54,75,,,percent of total billed charges,75% of total billed charges,28.8,40,,,percent of total billed charges,40% of total billed charges,57.02,79.2,,,percent of total billed charges,79.2% of total billed charges,61.2,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,68.4,95,,,percent of total billed charges,95% of total billed charges,57.6,80,,,percent of total billed charges,80% of total billed charges,61.2,85,,,percent of total billed charges,85% of total billed charges,64.8,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,28.8,40,,,percent of total billed charges,40% of total billed charges,28.8,40,,,percent of total billed charges,40% of total billed charges,64.8,90,,,percent of total billed charges,90% of total billed charges,54.72,76,,,percent of total billed charges,76% of total billed charges,28.8,40,,,percent of total billed charges,40% of total billed charges,61.2,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,57.6,80,,,percent of total billed charges,80% of total billed charges,27.94,38.8,,,percent of total billed charges,38.8% of total billed charges,61.2,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,68.4,
"Pap IG, Ct-Ng, HPV-hr LC",40087624,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,132.1,105.68,,99.08,75,,,percent of total billed charges,75% of total billed charges,52.84,40,,,percent of total billed charges,40% of total billed charges,104.62,79.2,,,percent of total billed charges,79.2% of total billed charges,112.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,125.5,95,,,percent of total billed charges,95% of total billed charges,105.68,80,,,percent of total billed charges,80% of total billed charges,112.29,85,,,percent of total billed charges,85% of total billed charges,118.89,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,52.84,40,,,percent of total billed charges,40% of total billed charges,52.84,40,,,percent of total billed charges,40% of total billed charges,118.89,90,,,percent of total billed charges,90% of total billed charges,100.4,76,,,percent of total billed charges,76% of total billed charges,52.84,40,,,percent of total billed charges,40% of total billed charges,112.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,105.68,80,,,percent of total billed charges,80% of total billed charges,51.25,38.8,,,percent of total billed charges,38.8% of total billed charges,112.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,125.5,
Antiscleroderma-70 Antibodies LC,40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,319.6,255.68,,239.7,75,,,percent of total billed charges,75% of total billed charges,127.84,40,,,percent of total billed charges,40% of total billed charges,253.12,79.2,,,percent of total billed charges,79.2% of total billed charges,271.66,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,303.62,95,,,percent of total billed charges,95% of total billed charges,255.68,80,,,percent of total billed charges,80% of total billed charges,271.66,85,,,percent of total billed charges,85% of total billed charges,287.64,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,127.84,40,,,percent of total billed charges,40% of total billed charges,127.84,40,,,percent of total billed charges,40% of total billed charges,287.64,90,,,percent of total billed charges,90% of total billed charges,242.9,76,,,percent of total billed charges,76% of total billed charges,127.84,40,,,percent of total billed charges,40% of total billed charges,271.66,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,255.68,80,,,percent of total billed charges,80% of total billed charges,124,38.8,,,percent of total billed charges,38.8% of total billed charges,271.66,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,303.62,
"Glucose, Body Fluid",40082945,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Pregnancy Test Serum 2,40084703,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,121,96.8,,90.75,75,,,percent of total billed charges,75% of total billed charges,48.4,40,,,percent of total billed charges,40% of total billed charges,95.83,79.2,,,percent of total billed charges,79.2% of total billed charges,102.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,114.95,95,,,percent of total billed charges,95% of total billed charges,96.8,80,,,percent of total billed charges,80% of total billed charges,102.85,85,,,percent of total billed charges,85% of total billed charges,108.9,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,48.4,40,,,percent of total billed charges,40% of total billed charges,48.4,40,,,percent of total billed charges,40% of total billed charges,108.9,90,,,percent of total billed charges,90% of total billed charges,91.96,76,,,percent of total billed charges,76% of total billed charges,48.4,40,,,percent of total billed charges,40% of total billed charges,102.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,96.8,80,,,percent of total billed charges,80% of total billed charges,46.95,38.8,,,percent of total billed charges,38.8% of total billed charges,102.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,114.95,
Pregnancy Test Urine 2,40081025,CDM,307,RC,81002,HCPCS,OUTPATIENT,,,121,96.8,,90.75,75,,,percent of total billed charges,75% of total billed charges,48.4,40,,,percent of total billed charges,40% of total billed charges,95.83,79.2,,,percent of total billed charges,79.2% of total billed charges,102.85,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,114.95,95,,,percent of total billed charges,95% of total billed charges,96.8,80,,,percent of total billed charges,80% of total billed charges,102.85,85,,,percent of total billed charges,85% of total billed charges,108.9,90,,,percent of total billed charges,90% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,3.61,100,,,fee schedule,100% of CO APG rates,3.27,100,,,fee schedule,100% of NM fee schedule,48.4,40,,,percent of total billed charges,40% of total billed charges,48.4,40,,,percent of total billed charges,40% of total billed charges,108.9,90,,,percent of total billed charges,90% of total billed charges,91.96,76,,,percent of total billed charges,76% of total billed charges,48.4,40,,,percent of total billed charges,40% of total billed charges,102.85,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rate,96.8,80,,,percent of total billed charges,80% of total billed charges,46.95,38.8,,,percent of total billed charges,38.8% of total billed charges,102.85,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of APG fee schedule,6.96,200,,,fee schedule,200% of CMS fee schedule,3.27,114.95,
Lipid Panel 1,40080061,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,155.2,124.16,,116.4,75,,,percent of total billed charges,75% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,122.92,79.2,,,percent of total billed charges,79.2% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,147.44,95,,,percent of total billed charges,95% of total billed charges,124.16,80,,,percent of total billed charges,80% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,62.08,40,,,percent of total billed charges,40% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,117.95,76,,,percent of total billed charges,76% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,124.16,80,,,percent of total billed charges,80% of total billed charges,60.22,38.8,,,percent of total billed charges,38.8% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,147.44,
Hemogram 2,40085027,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,103.2,82.56,,77.4,75,,,percent of total billed charges,75% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,81.73,79.2,,,percent of total billed charges,79.2% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,98.04,95,,,percent of total billed charges,95% of total billed charges,82.56,80,,,percent of total billed charges,80% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,41.28,40,,,percent of total billed charges,40% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,78.43,76,,,percent of total billed charges,76% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,82.56,80,,,percent of total billed charges,80% of total billed charges,40.04,38.8,,,percent of total billed charges,38.8% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,98.04,
HIV 1/2 Ab,40086703,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,97.9,78.32,,73.43,75,,,percent of total billed charges,75% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,77.54,79.2,,,percent of total billed charges,79.2% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,93.01,95,,,percent of total billed charges,95% of total billed charges,78.32,80,,,percent of total billed charges,80% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,39.16,40,,,percent of total billed charges,40% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,74.4,76,,,percent of total billed charges,76% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,78.32,80,,,percent of total billed charges,80% of total billed charges,37.99,38.8,,,percent of total billed charges,38.8% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,93.01,
Influenza AB 1,40087804,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,103.9,83.12,,77.93,75,,,percent of total billed charges,75% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,82.29,79.2,,,percent of total billed charges,79.2% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,98.71,95,,,percent of total billed charges,95% of total billed charges,83.12,80,,,percent of total billed charges,80% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,41.56,40,,,percent of total billed charges,40% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,78.96,76,,,percent of total billed charges,76% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,83.12,80,,,percent of total billed charges,80% of total billed charges,40.31,38.8,,,percent of total billed charges,38.8% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,98.71,
Mono Screen 1,40086308,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,83,66.4,,62.25,75,,,percent of total billed charges,75% of total billed charges,33.2,40,,,percent of total billed charges,40% of total billed charges,65.74,79.2,,,percent of total billed charges,79.2% of total billed charges,70.55,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,78.85,95,,,percent of total billed charges,95% of total billed charges,66.4,80,,,percent of total billed charges,80% of total billed charges,70.55,85,,,percent of total billed charges,85% of total billed charges,74.7,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,33.2,40,,,percent of total billed charges,40% of total billed charges,33.2,40,,,percent of total billed charges,40% of total billed charges,74.7,90,,,percent of total billed charges,90% of total billed charges,63.08,76,,,percent of total billed charges,76% of total billed charges,33.2,40,,,percent of total billed charges,40% of total billed charges,70.55,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,66.4,80,,,percent of total billed charges,80% of total billed charges,32.2,38.8,,,percent of total billed charges,38.8% of total billed charges,70.55,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,78.85,
FIT Stool Occult Blood Diagnostic,40082274,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,112.4,89.92,,84.3,75,,,percent of total billed charges,75% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,89.02,79.2,,,percent of total billed charges,79.2% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,106.78,95,,,percent of total billed charges,95% of total billed charges,89.92,80,,,percent of total billed charges,80% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,101.16,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,44.96,40,,,percent of total billed charges,40% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,101.16,90,,,percent of total billed charges,90% of total billed charges,85.42,76,,,percent of total billed charges,76% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,89.92,80,,,percent of total billed charges,80% of total billed charges,43.61,38.8,,,percent of total billed charges,38.8% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,106.78,
HBsAg Screen LC,40087340,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,7.8,6.24,,5.85,75,,,percent of total billed charges,75% of total billed charges,3.12,40,,,percent of total billed charges,40% of total billed charges,6.18,79.2,,,percent of total billed charges,79.2% of total billed charges,6.63,85,,,percent of total billed charges,85% of total billed charges,7.8,100,,,fee schedule,100% of CO APG rates,7.41,95,,,percent of total billed charges,95% of total billed charges,6.24,80,,,percent of total billed charges,80% of total billed charges,6.63,85,,,percent of total billed charges,85% of total billed charges,7.02,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,3.12,40,,,percent of total billed charges,40% of total billed charges,3.12,40,,,percent of total billed charges,40% of total billed charges,7.02,90,,,percent of total billed charges,90% of total billed charges,5.93,76,,,percent of total billed charges,76% of total billed charges,3.12,40,,,percent of total billed charges,40% of total billed charges,6.63,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,6.24,80,,,percent of total billed charges,80% of total billed charges,3.03,38.8,,,percent of total billed charges,38.8% of total billed charges,6.63,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,3.03,33.06,
FIT Stool Occult Blood Screen,40082270,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,29.7,23.76,,22.28,75,,,percent of total billed charges,75% of total billed charges,11.88,40,,,percent of total billed charges,40% of total billed charges,23.52,79.2,,,percent of total billed charges,79.2% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,28.22,95,,,percent of total billed charges,95% of total billed charges,23.76,80,,,percent of total billed charges,80% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,26.73,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,11.88,40,,,percent of total billed charges,40% of total billed charges,11.88,40,,,percent of total billed charges,40% of total billed charges,26.73,90,,,percent of total billed charges,90% of total billed charges,22.57,76,,,percent of total billed charges,76% of total billed charges,11.88,40,,,percent of total billed charges,40% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,23.76,80,,,percent of total billed charges,80% of total billed charges,11.52,38.8,,,percent of total billed charges,38.8% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,28.22,
RSV 1,40087420,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,89.1,71.28,,66.83,75,,,percent of total billed charges,75% of total billed charges,35.64,40,,,percent of total billed charges,40% of total billed charges,70.57,79.2,,,percent of total billed charges,79.2% of total billed charges,75.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,84.65,95,,,percent of total billed charges,95% of total billed charges,71.28,80,,,percent of total billed charges,80% of total billed charges,75.74,85,,,percent of total billed charges,85% of total billed charges,80.19,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,35.64,40,,,percent of total billed charges,40% of total billed charges,35.64,40,,,percent of total billed charges,40% of total billed charges,80.19,90,,,percent of total billed charges,90% of total billed charges,67.72,76,,,percent of total billed charges,76% of total billed charges,35.64,40,,,percent of total billed charges,40% of total billed charges,75.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,71.28,80,,,percent of total billed charges,80% of total billed charges,34.57,38.8,,,percent of total billed charges,38.8% of total billed charges,75.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,84.65,
Strep A Screen 1,40087430,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,57.3,45.84,QW,42.98,75,,,percent of total billed charges,75% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,45.38,79.2,,,percent of total billed charges,79.2% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,54.44,95,,,percent of total billed charges,95% of total billed charges,45.84,80,,,percent of total billed charges,80% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,51.57,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,22.92,40,,,percent of total billed charges,40% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,51.57,90,,,percent of total billed charges,90% of total billed charges,43.55,76,,,percent of total billed charges,76% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,45.84,80,,,percent of total billed charges,80% of total billed charges,22.23,38.8,,,percent of total billed charges,38.8% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,54.44,
Aldosterone LC,40082088,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,310.1,248.08,,232.58,75,,,percent of total billed charges,75% of total billed charges,124.04,40,,,percent of total billed charges,40% of total billed charges,245.6,79.2,,,percent of total billed charges,79.2% of total billed charges,263.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,294.6,95,,,percent of total billed charges,95% of total billed charges,248.08,80,,,percent of total billed charges,80% of total billed charges,263.59,85,,,percent of total billed charges,85% of total billed charges,279.09,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,124.04,40,,,percent of total billed charges,40% of total billed charges,124.04,40,,,percent of total billed charges,40% of total billed charges,279.09,90,,,percent of total billed charges,90% of total billed charges,235.68,76,,,percent of total billed charges,76% of total billed charges,124.04,40,,,percent of total billed charges,40% of total billed charges,263.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,248.08,80,,,percent of total billed charges,80% of total billed charges,120.32,38.8,,,percent of total billed charges,38.8% of total billed charges,263.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,294.6,
Renin Activity LC,40084244,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,52,41.6,,39,75,,,percent of total billed charges,75% of total billed charges,20.8,40,,,percent of total billed charges,40% of total billed charges,41.18,79.2,,,percent of total billed charges,79.2% of total billed charges,44.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,49.4,95,,,percent of total billed charges,95% of total billed charges,41.6,80,,,percent of total billed charges,80% of total billed charges,44.2,85,,,percent of total billed charges,85% of total billed charges,46.8,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,20.8,40,,,percent of total billed charges,40% of total billed charges,20.8,40,,,percent of total billed charges,40% of total billed charges,46.8,90,,,percent of total billed charges,90% of total billed charges,39.52,76,,,percent of total billed charges,76% of total billed charges,20.8,40,,,percent of total billed charges,40% of total billed charges,44.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,41.6,80,,,percent of total billed charges,80% of total billed charges,20.18,38.8,,,percent of total billed charges,38.8% of total billed charges,44.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,49.4,
"Rubella Antibodies, IgG LC",40086762,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,24.4,19.52,,18.3,75,,,percent of total billed charges,75% of total billed charges,9.76,40,,,percent of total billed charges,40% of total billed charges,19.32,79.2,,,percent of total billed charges,79.2% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,23.18,95,,,percent of total billed charges,95% of total billed charges,19.52,80,,,percent of total billed charges,80% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,21.96,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,9.76,40,,,percent of total billed charges,40% of total billed charges,9.76,40,,,percent of total billed charges,40% of total billed charges,21.96,90,,,percent of total billed charges,90% of total billed charges,18.54,76,,,percent of total billed charges,76% of total billed charges,9.76,40,,,percent of total billed charges,40% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,19.52,80,,,percent of total billed charges,80% of total billed charges,9.47,38.8,,,percent of total billed charges,38.8% of total billed charges,20.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,23.18,
"Rubeola Ab, IgG, EIA LC",40086765,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,29.7,23.76,,22.28,75,,,percent of total billed charges,75% of total billed charges,11.88,40,,,percent of total billed charges,40% of total billed charges,23.52,79.2,,,percent of total billed charges,79.2% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,28.22,95,,,percent of total billed charges,95% of total billed charges,23.76,80,,,percent of total billed charges,80% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,26.73,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,11.88,40,,,percent of total billed charges,40% of total billed charges,11.88,40,,,percent of total billed charges,40% of total billed charges,26.73,90,,,percent of total billed charges,90% of total billed charges,22.57,76,,,percent of total billed charges,76% of total billed charges,11.88,40,,,percent of total billed charges,40% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,23.76,80,,,percent of total billed charges,80% of total billed charges,11.52,38.8,,,percent of total billed charges,38.8% of total billed charges,25.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,28.22,
"Varicella-Zoster Ab, IgM LC",40086787,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,40.7,32.56,,30.53,75,,,percent of total billed charges,75% of total billed charges,16.28,40,,,percent of total billed charges,40% of total billed charges,32.23,79.2,,,percent of total billed charges,79.2% of total billed charges,34.6,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,38.67,95,,,percent of total billed charges,95% of total billed charges,32.56,80,,,percent of total billed charges,80% of total billed charges,34.6,85,,,percent of total billed charges,85% of total billed charges,36.63,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,16.28,40,,,percent of total billed charges,40% of total billed charges,16.28,40,,,percent of total billed charges,40% of total billed charges,36.63,90,,,percent of total billed charges,90% of total billed charges,30.93,76,,,percent of total billed charges,76% of total billed charges,16.28,40,,,percent of total billed charges,40% of total billed charges,34.6,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,32.56,80,,,percent of total billed charges,80% of total billed charges,15.79,38.8,,,percent of total billed charges,38.8% of total billed charges,34.6,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,38.67,
"Creatinine, U LC",40082570,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,8.8,7.04,,6.6,75,,,percent of total billed charges,75% of total billed charges,3.52,40,,,percent of total billed charges,40% of total billed charges,6.97,79.2,,,percent of total billed charges,79.2% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,8.36,95,,,percent of total billed charges,95% of total billed charges,7.04,80,,,percent of total billed charges,80% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,7.92,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,3.52,40,,,percent of total billed charges,40% of total billed charges,3.52,40,,,percent of total billed charges,40% of total billed charges,7.92,90,,,percent of total billed charges,90% of total billed charges,6.69,76,,,percent of total billed charges,76% of total billed charges,3.52,40,,,percent of total billed charges,40% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,7.04,80,,,percent of total billed charges,80% of total billed charges,3.41,38.8,,,percent of total billed charges,38.8% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,3.41,8.76,
"Albumin, Urine LC",40082043,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,8.3,6.64,,6.23,75,,,percent of total billed charges,75% of total billed charges,3.32,40,,,percent of total billed charges,40% of total billed charges,6.57,79.2,,,percent of total billed charges,79.2% of total billed charges,7.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,7.89,95,,,percent of total billed charges,95% of total billed charges,6.64,80,,,percent of total billed charges,80% of total billed charges,7.06,85,,,percent of total billed charges,85% of total billed charges,7.47,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,3.32,40,,,percent of total billed charges,40% of total billed charges,3.32,40,,,percent of total billed charges,40% of total billed charges,7.47,90,,,percent of total billed charges,90% of total billed charges,6.31,76,,,percent of total billed charges,76% of total billed charges,3.32,40,,,percent of total billed charges,40% of total billed charges,7.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,6.64,80,,,percent of total billed charges,80% of total billed charges,3.22,38.8,,,percent of total billed charges,38.8% of total billed charges,7.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,3.22,8.76,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
CT,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
NG,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
HPV,40087624,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,151.24,
CT,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
NG,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
CT,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
NG,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
HPV,40087624,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,151.24,
CT,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
NG,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
TV,40087661,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
"EBV Early Antigen Ab, IgG LC",40086663,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,38.2,30.56,,28.65,75,,,percent of total billed charges,75% of total billed charges,15.28,40,,,percent of total billed charges,40% of total billed charges,30.25,79.2,,,percent of total billed charges,79.2% of total billed charges,32.47,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,36.29,95,,,percent of total billed charges,95% of total billed charges,30.56,80,,,percent of total billed charges,80% of total billed charges,32.47,85,,,percent of total billed charges,85% of total billed charges,34.38,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,15.28,40,,,percent of total billed charges,40% of total billed charges,15.28,40,,,percent of total billed charges,40% of total billed charges,34.38,90,,,percent of total billed charges,90% of total billed charges,29.03,76,,,percent of total billed charges,76% of total billed charges,15.28,40,,,percent of total billed charges,40% of total billed charges,32.47,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,30.56,80,,,percent of total billed charges,80% of total billed charges,14.82,38.8,,,percent of total billed charges,38.8% of total billed charges,32.47,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,36.29,
"EBV Ab VCA, IgG LC",40086665,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,155.2,124.16,,116.4,75,,,percent of total billed charges,75% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,122.92,79.2,,,percent of total billed charges,79.2% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,147.44,95,,,percent of total billed charges,95% of total billed charges,124.16,80,,,percent of total billed charges,80% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,62.08,40,,,percent of total billed charges,40% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,117.95,76,,,percent of total billed charges,76% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,124.16,80,,,percent of total billed charges,80% of total billed charges,60.22,38.8,,,percent of total billed charges,38.8% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,147.44,
"EBV Nuclear Antigen Ab, IgG LC",40086664,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,37.2,29.76,,27.9,75,,,percent of total billed charges,75% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,29.46,79.2,,,percent of total billed charges,79.2% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,35.34,95,,,percent of total billed charges,95% of total billed charges,29.76,80,,,percent of total billed charges,80% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,33.48,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,14.88,40,,,percent of total billed charges,40% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,33.48,90,,,percent of total billed charges,90% of total billed charges,28.27,76,,,percent of total billed charges,76% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,29.76,80,,,percent of total billed charges,80% of total billed charges,14.43,38.8,,,percent of total billed charges,38.8% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,35.34,
97802 MEDICAL NUTR INITIAL ASSESS PER 15 MIN CHARGE,44097802,CDM,942,RC,97803,HCPCS,OUTPATIENT,,,266.2,212.96,,199.65,75,,,percent of total billed charges,75% of total billed charges,106.48,40,,,percent of total billed charges,40% of total billed charges,210.83,79.2,,,percent of total billed charges,79.2% of total billed charges,226.27,85,,,percent of total billed charges,85% of total billed charges,259.02,100,,,fee schedule,100% of CO APG rates,252.89,95,,,percent of total billed charges,95% of total billed charges,212.96,80,,,percent of total billed charges,80% of total billed charges,226.27,85,,,percent of total billed charges,85% of total billed charges,239.58,90,,,percent of total billed charges,90% of total billed charges,259.02,100,,,fee schedule,100% of CO APG rates,259.02,100,,,fee schedule,100% of CO APG rates,16.44,100,,,fee schedule,100% of NM fee schedule,106.48,40,,,percent of total billed charges,40% of total billed charges,106.48,40,,,percent of total billed charges,40% of total billed charges,239.58,90,,,percent of total billed charges,90% of total billed charges,202.31,76,,,percent of total billed charges,76% of total billed charges,106.48,40,,,percent of total billed charges,40% of total billed charges,226.27,85,,,percent of total billed charges,85% of total billed charges,259.02,100,,,fee schedule,100% of CO APG rate,212.96,80,,,percent of total billed charges,80% of total billed charges,103.29,38.8,,,percent of total billed charges,38.8% of total billed charges,226.27,85,,,percent of total billed charges,85% of total billed charges,259.02,100,,,fee schedule,100% of APG fee schedule,56.08,200,,,fee schedule,200% of CMS fee schedule,16.44,259.02,
Ileoscopy,46000112,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,2076.9,1661.52,,1557.68,75,,,percent of total billed charges,75% of total billed charges,830.76,40,,,percent of total billed charges,40% of total billed charges,1644.9,79.2,,,percent of total billed charges,79.2% of total billed charges,1765.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1973.06,95,,,percent of total billed charges,95% of total billed charges,1661.52,80,,,percent of total billed charges,80% of total billed charges,1765.37,85,,,percent of total billed charges,85% of total billed charges,1869.21,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,830.76,40,,,percent of total billed charges,40% of total billed charges,830.76,40,,,percent of total billed charges,40% of total billed charges,1869.21,90,,,percent of total billed charges,90% of total billed charges,1578.44,76,,,percent of total billed charges,76% of total billed charges,830.76,40,,,percent of total billed charges,40% of total billed charges,1765.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1661.52,80,,,percent of total billed charges,80% of total billed charges,805.84,38.8,,,percent of total billed charges,38.8% of total billed charges,1765.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1973.06,
Sigmoidoscopy,4600108,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1271,1016.8,,953.25,75,,,percent of total billed charges,75% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1006.63,79.2,,,percent of total billed charges,79.2% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1207.45,95,,,percent of total billed charges,95% of total billed charges,1016.8,80,,,percent of total billed charges,80% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,508.4,40,,,percent of total billed charges,40% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,965.96,76,,,percent of total billed charges,76% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1016.8,80,,,percent of total billed charges,80% of total billed charges,493.15,38.8,,,percent of total billed charges,38.8% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1207.45,
Ionized Calcium Level,40082330,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,166.7,133.36,,125.03,75,,,percent of total billed charges,75% of total billed charges,66.68,40,,,percent of total billed charges,40% of total billed charges,132.03,79.2,,,percent of total billed charges,79.2% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,158.37,95,,,percent of total billed charges,95% of total billed charges,133.36,80,,,percent of total billed charges,80% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,150.03,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,66.68,40,,,percent of total billed charges,40% of total billed charges,66.68,40,,,percent of total billed charges,40% of total billed charges,150.03,90,,,percent of total billed charges,90% of total billed charges,126.69,76,,,percent of total billed charges,76% of total billed charges,66.68,40,,,percent of total billed charges,40% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,133.36,80,,,percent of total billed charges,80% of total billed charges,64.68,38.8,,,percent of total billed charges,38.8% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,158.37,
Hemogram 3,40085027,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,103.2,82.56,,77.4,75,,,percent of total billed charges,75% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,81.73,79.2,,,percent of total billed charges,79.2% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,98.04,95,,,percent of total billed charges,95% of total billed charges,82.56,80,,,percent of total billed charges,80% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,41.28,40,,,percent of total billed charges,40% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,78.43,76,,,percent of total billed charges,76% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,82.56,80,,,percent of total billed charges,80% of total billed charges,40.04,38.8,,,percent of total billed charges,38.8% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,98.04,
Protein Body Fluid,40084157,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Calcium Level Urine,40082340,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,59.4,47.52,,44.55,75,,,percent of total billed charges,75% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,47.04,79.2,,,percent of total billed charges,79.2% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,56.43,95,,,percent of total billed charges,95% of total billed charges,47.52,80,,,percent of total billed charges,80% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,23.76,40,,,percent of total billed charges,40% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,45.14,76,,,percent of total billed charges,76% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,47.52,80,,,percent of total billed charges,80% of total billed charges,23.05,38.8,,,percent of total billed charges,38.8% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,56.43,
BD DEXA Bone Density Scan,41477081,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,91.1,72.88,TC,68.33,75,,,percent of total billed charges,75% of total billed charges,36.44,40,,,percent of total billed charges,40% of total billed charges,72.15,79.2,,,percent of total billed charges,79.2% of total billed charges,77.44,85,,,percent of total billed charges,85% of total billed charges,91.1,100,,,fee schedule,100% of CO APG rates,86.55,95,,,percent of total billed charges,95% of total billed charges,72.88,80,,,percent of total billed charges,80% of total billed charges,77.44,85,,,percent of total billed charges,85% of total billed charges,81.99,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,91.1,100,,,fee schedule,100% of NM APC rate,36.44,40,,,percent of total billed charges,40% of total billed charges,36.44,40,,,percent of total billed charges,40% of total billed charges,81.99,90,,,percent of total billed charges,90% of total billed charges,69.24,76,,,percent of total billed charges,76% of total billed charges,36.44,40,,,percent of total billed charges,40% of total billed charges,77.44,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,72.88,80,,,percent of total billed charges,80% of total billed charges,35.35,38.8,,,percent of total billed charges,38.8% of total billed charges,77.44,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,35.35,104.58,
Creatinine Clearance 1,40082575,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,72.1,57.68,,54.08,75,,,percent of total billed charges,75% of total billed charges,28.84,40,,,percent of total billed charges,40% of total billed charges,57.1,79.2,,,percent of total billed charges,79.2% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,68.5,95,,,percent of total billed charges,95% of total billed charges,57.68,80,,,percent of total billed charges,80% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,64.89,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,28.84,40,,,percent of total billed charges,40% of total billed charges,28.84,40,,,percent of total billed charges,40% of total billed charges,64.89,90,,,percent of total billed charges,90% of total billed charges,54.8,76,,,percent of total billed charges,76% of total billed charges,28.84,40,,,percent of total billed charges,40% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,57.68,80,,,percent of total billed charges,80% of total billed charges,27.97,38.8,,,percent of total billed charges,38.8% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,68.5,
97016  VASOPNEUMATIC COMPRESSION,42597016,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,72.9,58.32,GP,54.68,75,,,percent of total billed charges,75% of total billed charges,29.16,40,,,percent of total billed charges,40% of total billed charges,57.74,79.2,,,percent of total billed charges,79.2% of total billed charges,61.97,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,69.26,95,,,percent of total billed charges,95% of total billed charges,58.32,80,,,percent of total billed charges,80% of total billed charges,61.97,85,,,percent of total billed charges,85% of total billed charges,65.61,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,29.16,40,,,percent of total billed charges,40% of total billed charges,29.16,40,,,percent of total billed charges,40% of total billed charges,65.61,90,,,percent of total billed charges,90% of total billed charges,55.4,76,,,percent of total billed charges,76% of total billed charges,29.16,40,,,percent of total billed charges,40% of total billed charges,61.97,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,58.32,80,,,percent of total billed charges,80% of total billed charges,28.29,38.8,,,percent of total billed charges,38.8% of total billed charges,61.97,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,69.26,
Urine Amylase 24 Hour,40082150,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,82.7,66.16,,62.03,75,,,percent of total billed charges,75% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,65.5,79.2,,,percent of total billed charges,79.2% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,78.57,95,,,percent of total billed charges,95% of total billed charges,66.16,80,,,percent of total billed charges,80% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,74.43,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,33.08,40,,,percent of total billed charges,40% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,74.43,90,,,percent of total billed charges,90% of total billed charges,62.85,76,,,percent of total billed charges,76% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,66.16,80,,,percent of total billed charges,80% of total billed charges,32.09,38.8,,,percent of total billed charges,38.8% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,78.57,
Amylase Level Urine,40082150,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
RBC LC,40085041,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,19.3,15.44,,14.48,75,,,percent of total billed charges,75% of total billed charges,7.72,40,,,percent of total billed charges,40% of total billed charges,15.29,79.2,,,percent of total billed charges,79.2% of total billed charges,16.41,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,18.34,95,,,percent of total billed charges,95% of total billed charges,15.44,80,,,percent of total billed charges,80% of total billed charges,16.41,85,,,percent of total billed charges,85% of total billed charges,17.37,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,7.72,40,,,percent of total billed charges,40% of total billed charges,7.72,40,,,percent of total billed charges,40% of total billed charges,17.37,90,,,percent of total billed charges,90% of total billed charges,14.67,76,,,percent of total billed charges,76% of total billed charges,7.72,40,,,percent of total billed charges,40% of total billed charges,16.41,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,15.44,80,,,percent of total billed charges,80% of total billed charges,7.49,38.8,,,percent of total billed charges,38.8% of total billed charges,16.41,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,18.34,
"G-6-PD, Quant LC",40082955,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,29.2,23.36,,21.9,75,,,percent of total billed charges,75% of total billed charges,11.68,40,,,percent of total billed charges,40% of total billed charges,23.13,79.2,,,percent of total billed charges,79.2% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,27.74,95,,,percent of total billed charges,95% of total billed charges,23.36,80,,,percent of total billed charges,80% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,26.28,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,11.68,40,,,percent of total billed charges,40% of total billed charges,11.68,40,,,percent of total billed charges,40% of total billed charges,26.28,90,,,percent of total billed charges,90% of total billed charges,22.19,76,,,percent of total billed charges,76% of total billed charges,11.68,40,,,percent of total billed charges,40% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,23.36,80,,,percent of total billed charges,80% of total billed charges,11.33,38.8,,,percent of total billed charges,38.8% of total billed charges,24.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,27.74,
96361 IV HYDRATION EA ADD HR CHARGE,60000444,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,127.7,102.16,,95.78,75,,,percent of total billed charges,75% of total billed charges,51.08,40,,,percent of total billed charges,40% of total billed charges,101.14,79.2,,,percent of total billed charges,79.2% of total billed charges,108.55,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,121.32,95,,,percent of total billed charges,95% of total billed charges,102.16,80,,,percent of total billed charges,80% of total billed charges,108.55,85,,,percent of total billed charges,85% of total billed charges,114.93,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,51.08,40,,,percent of total billed charges,40% of total billed charges,51.08,40,,,percent of total billed charges,40% of total billed charges,114.93,90,,,percent of total billed charges,90% of total billed charges,97.05,76,,,percent of total billed charges,76% of total billed charges,51.08,40,,,percent of total billed charges,40% of total billed charges,108.55,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,102.16,80,,,percent of total billed charges,80% of total billed charges,49.55,38.8,,,percent of total billed charges,38.8% of total billed charges,108.55,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,49.55,121.32,
ABSC 4,40586850,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,108.2,86.56,,81.15,75,,,percent of total billed charges,75% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,85.69,79.2,,,percent of total billed charges,79.2% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,102.79,95,,,percent of total billed charges,95% of total billed charges,86.56,80,,,percent of total billed charges,80% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,97.38,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,43.28,40,,,percent of total billed charges,40% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,97.38,90,,,percent of total billed charges,90% of total billed charges,82.23,76,,,percent of total billed charges,76% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,86.56,80,,,percent of total billed charges,80% of total billed charges,41.98,38.8,,,percent of total billed charges,38.8% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,102.79,
Bill Cold Agglutinin Titer.,40586157,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,466.9,373.52,,350.18,75,,,percent of total billed charges,75% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,369.78,79.2,,,percent of total billed charges,79.2% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,443.56,95,,,percent of total billed charges,95% of total billed charges,373.52,80,,,percent of total billed charges,80% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,186.76,40,,,percent of total billed charges,40% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,420.21,90,,,percent of total billed charges,90% of total billed charges,354.84,76,,,percent of total billed charges,76% of total billed charges,186.76,40,,,percent of total billed charges,40% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,373.52,80,,,percent of total billed charges,80% of total billed charges,181.16,38.8,,,percent of total billed charges,38.8% of total billed charges,396.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,443.56,
Hep B Surface Ag,40087340,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,111.6,89.28,,83.7,75,,,percent of total billed charges,75% of total billed charges,44.64,40,,,percent of total billed charges,40% of total billed charges,88.39,79.2,,,percent of total billed charges,79.2% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,106.02,95,,,percent of total billed charges,95% of total billed charges,89.28,80,,,percent of total billed charges,80% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,100.44,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,44.64,40,,,percent of total billed charges,40% of total billed charges,44.64,40,,,percent of total billed charges,40% of total billed charges,100.44,90,,,percent of total billed charges,90% of total billed charges,84.82,76,,,percent of total billed charges,76% of total billed charges,44.64,40,,,percent of total billed charges,40% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,89.28,80,,,percent of total billed charges,80% of total billed charges,43.3,38.8,,,percent of total billed charges,38.8% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,106.02,
"Vitamin D, 25-Hydroxy",40082306,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,278.3,222.64,,208.73,75,,,percent of total billed charges,75% of total billed charges,111.32,40,,,percent of total billed charges,40% of total billed charges,220.41,79.2,,,percent of total billed charges,79.2% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,264.39,95,,,percent of total billed charges,95% of total billed charges,222.64,80,,,percent of total billed charges,80% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,250.47,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,111.32,40,,,percent of total billed charges,40% of total billed charges,111.32,40,,,percent of total billed charges,40% of total billed charges,250.47,90,,,percent of total billed charges,90% of total billed charges,211.51,76,,,percent of total billed charges,76% of total billed charges,111.32,40,,,percent of total billed charges,40% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,222.64,80,,,percent of total billed charges,80% of total billed charges,107.98,38.8,,,percent of total billed charges,38.8% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,264.39,
Folate Level,40082746,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,138.2,110.56,,103.65,75,,,percent of total billed charges,75% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,109.45,79.2,,,percent of total billed charges,79.2% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,131.29,95,,,percent of total billed charges,95% of total billed charges,110.56,80,,,percent of total billed charges,80% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,55.28,40,,,percent of total billed charges,40% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,105.03,76,,,percent of total billed charges,76% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,110.56,80,,,percent of total billed charges,80% of total billed charges,53.62,38.8,,,percent of total billed charges,38.8% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,131.29,
Hepatitis C Antibody,40086803,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,140.4,112.32,,105.3,75,,,percent of total billed charges,75% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,111.2,79.2,,,percent of total billed charges,79.2% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,133.38,95,,,percent of total billed charges,95% of total billed charges,112.32,80,,,percent of total billed charges,80% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,126.36,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,56.16,40,,,percent of total billed charges,40% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,126.36,90,,,percent of total billed charges,90% of total billed charges,106.7,76,,,percent of total billed charges,76% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,112.32,80,,,percent of total billed charges,80% of total billed charges,54.48,38.8,,,percent of total billed charges,38.8% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,133.38,
LDH Body Fluid,40083615,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Albumin Body Fluid,40082042,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Hepatitis B Surface Antibody,40086706,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,111.6,89.28,,83.7,75,,,percent of total billed charges,75% of total billed charges,44.64,40,,,percent of total billed charges,40% of total billed charges,88.39,79.2,,,percent of total billed charges,79.2% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,106.02,95,,,percent of total billed charges,95% of total billed charges,89.28,80,,,percent of total billed charges,80% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,100.44,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,44.64,40,,,percent of total billed charges,40% of total billed charges,44.64,40,,,percent of total billed charges,40% of total billed charges,100.44,90,,,percent of total billed charges,90% of total billed charges,84.82,76,,,percent of total billed charges,76% of total billed charges,44.64,40,,,percent of total billed charges,40% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,89.28,80,,,percent of total billed charges,80% of total billed charges,43.3,38.8,,,percent of total billed charges,38.8% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,106.02,
.Glucola Dose,40082950,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,52.3,41.84,,39.23,75,,,percent of total billed charges,75% of total billed charges,20.92,40,,,percent of total billed charges,40% of total billed charges,41.42,79.2,,,percent of total billed charges,79.2% of total billed charges,44.46,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,49.69,95,,,percent of total billed charges,95% of total billed charges,41.84,80,,,percent of total billed charges,80% of total billed charges,44.46,85,,,percent of total billed charges,85% of total billed charges,47.07,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,20.92,40,,,percent of total billed charges,40% of total billed charges,20.92,40,,,percent of total billed charges,40% of total billed charges,47.07,90,,,percent of total billed charges,90% of total billed charges,39.75,76,,,percent of total billed charges,76% of total billed charges,20.92,40,,,percent of total billed charges,40% of total billed charges,44.46,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,41.84,80,,,percent of total billed charges,80% of total billed charges,20.29,38.8,,,percent of total billed charges,38.8% of total billed charges,44.46,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,49.69,
"Glucose 1 hr challenge, Pregnancy",40082950,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
"Glucose Tolerance 2 hr, Gest Diabetes",40082951,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
"Glucose Tolerance 3 hr, Gest Diabetes",40082951,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
92526 ST TX SWAL DYSFUNC CHARGE,42692526,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,759,607.2,GN,569.25,75,,,percent of total billed charges,75% of total billed charges,303.6,40,,,percent of total billed charges,40% of total billed charges,601.13,79.2,,,percent of total billed charges,79.2% of total billed charges,645.15,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,721.05,95,,,percent of total billed charges,95% of total billed charges,607.2,80,,,percent of total billed charges,80% of total billed charges,645.15,85,,,percent of total billed charges,85% of total billed charges,683.1,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,303.6,40,,,percent of total billed charges,40% of total billed charges,303.6,40,,,percent of total billed charges,40% of total billed charges,683.1,90,,,percent of total billed charges,90% of total billed charges,576.84,76,,,percent of total billed charges,76% of total billed charges,303.6,40,,,percent of total billed charges,40% of total billed charges,645.15,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,607.2,80,,,percent of total billed charges,80% of total billed charges,294.49,38.8,,,percent of total billed charges,38.8% of total billed charges,645.15,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,721.05,
"90471 IMMUNIZATION ADMIN, SINGLE VACCINE CHARGE",60000305,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,135.2,108.16,,101.4,75,,,percent of total billed charges,75% of total billed charges,54.08,40,,,percent of total billed charges,40% of total billed charges,107.08,79.2,,,percent of total billed charges,79.2% of total billed charges,114.92,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,128.44,95,,,percent of total billed charges,95% of total billed charges,108.16,80,,,percent of total billed charges,80% of total billed charges,114.92,85,,,percent of total billed charges,85% of total billed charges,121.68,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,54.08,40,,,percent of total billed charges,40% of total billed charges,54.08,40,,,percent of total billed charges,40% of total billed charges,121.68,90,,,percent of total billed charges,90% of total billed charges,102.75,76,,,percent of total billed charges,76% of total billed charges,54.08,40,,,percent of total billed charges,40% of total billed charges,114.92,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,108.16,80,,,percent of total billed charges,80% of total billed charges,52.46,38.8,,,percent of total billed charges,38.8% of total billed charges,114.92,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,42,128.44,
96376 EACH SEQ IV PUSH-SAME DRUG CHARGE,30096376,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,110.6,88.48,,82.95,75,,,percent of total billed charges,75% of total billed charges,44.24,40,,,percent of total billed charges,40% of total billed charges,87.6,79.2,,,percent of total billed charges,79.2% of total billed charges,94.01,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,105.07,95,,,percent of total billed charges,95% of total billed charges,88.48,80,,,percent of total billed charges,80% of total billed charges,94.01,85,,,percent of total billed charges,85% of total billed charges,99.54,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,110.6,100,,,fee schedule,100% of NM APC rate,44.24,40,,,percent of total billed charges,40% of total billed charges,44.24,40,,,percent of total billed charges,40% of total billed charges,99.54,90,,,percent of total billed charges,90% of total billed charges,84.06,76,,,percent of total billed charges,76% of total billed charges,44.24,40,,,percent of total billed charges,40% of total billed charges,94.01,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,88.48,80,,,percent of total billed charges,80% of total billed charges,42.91,38.8,,,percent of total billed charges,38.8% of total billed charges,94.01,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,42.91,110.6,
"90472 IMMUNIZAITON ADMIN, EA ADD VACCINE CHARGE",31090472,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,63.4,50.72,,47.55,75,,,percent of total billed charges,75% of total billed charges,25.36,40,,,percent of total billed charges,40% of total billed charges,50.21,79.2,,,percent of total billed charges,79.2% of total billed charges,53.89,85,,,percent of total billed charges,85% of total billed charges,63.4,100,,,fee schedule,100% of CO APG rates,60.23,95,,,percent of total billed charges,95% of total billed charges,50.72,80,,,percent of total billed charges,80% of total billed charges,53.89,85,,,percent of total billed charges,85% of total billed charges,57.06,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,63.4,100,,,fee schedule,100% of NM APC rate,25.36,40,,,percent of total billed charges,40% of total billed charges,25.36,40,,,percent of total billed charges,40% of total billed charges,57.06,90,,,percent of total billed charges,90% of total billed charges,48.18,76,,,percent of total billed charges,76% of total billed charges,25.36,40,,,percent of total billed charges,40% of total billed charges,53.89,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,50.72,80,,,percent of total billed charges,80% of total billed charges,24.6,38.8,,,percent of total billed charges,38.8% of total billed charges,53.89,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,126.8,200,,,fee schedule,200% of CMS fee schedule,24.6,215.49,
CT Angio Abdomen +Pelvis w/ + w/o Cont,41172191,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,2085.9,1668.72,TC,1564.43,75,,,percent of total billed charges,75% of total billed charges,834.36,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1773.02,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1981.61,95,,,percent of total billed charges,95% of total billed charges,1668.72,80,,,percent of total billed charges,80% of total billed charges,1773.02,85,,,percent of total billed charges,85% of total billed charges,1877.31,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,834.36,40,,,percent of total billed charges,40% of total billed charges,834.36,40,,,percent of total billed charges,40% of total billed charges,1877.31,90,,,percent of total billed charges,90% of total billed charges,1585.28,76,,,percent of total billed charges,76% of total billed charges,834.36,40,,,percent of total billed charges,40% of total billed charges,1773.02,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1668.72,80,,,percent of total billed charges,80% of total billed charges,809.33,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.02,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1981.61,
US Renal Comp,41276770,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,609.3,487.44,TC,456.98,75,,,percent of total billed charges,75% of total billed charges,243.72,40,,,percent of total billed charges,40% of total billed charges,482.57,79.2,,,percent of total billed charges,79.2% of total billed charges,517.91,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,578.84,95,,,percent of total billed charges,95% of total billed charges,487.44,80,,,percent of total billed charges,80% of total billed charges,517.91,85,,,percent of total billed charges,85% of total billed charges,548.37,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,243.72,40,,,percent of total billed charges,40% of total billed charges,243.72,40,,,percent of total billed charges,40% of total billed charges,548.37,90,,,percent of total billed charges,90% of total billed charges,463.07,76,,,percent of total billed charges,76% of total billed charges,243.72,40,,,percent of total billed charges,40% of total billed charges,517.91,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,487.44,80,,,percent of total billed charges,80% of total billed charges,236.41,38.8,,,percent of total billed charges,38.8% of total billed charges,517.91,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,578.84,
Mono Screen,40086308,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,83,66.4,,62.25,75,,,percent of total billed charges,75% of total billed charges,33.2,40,,,percent of total billed charges,40% of total billed charges,65.74,79.2,,,percent of total billed charges,79.2% of total billed charges,70.55,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,78.85,95,,,percent of total billed charges,95% of total billed charges,66.4,80,,,percent of total billed charges,80% of total billed charges,70.55,85,,,percent of total billed charges,85% of total billed charges,74.7,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,33.2,40,,,percent of total billed charges,40% of total billed charges,33.2,40,,,percent of total billed charges,40% of total billed charges,74.7,90,,,percent of total billed charges,90% of total billed charges,63.08,76,,,percent of total billed charges,76% of total billed charges,33.2,40,,,percent of total billed charges,40% of total billed charges,70.55,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,66.4,80,,,percent of total billed charges,80% of total billed charges,32.2,38.8,,,percent of total billed charges,38.8% of total billed charges,70.55,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,78.85,
OT BODY POS CURRENT STATUS,60000359,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT BODY POS CURRENT STATUS,60000359,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT BODY POS CURRENT STATUS,60000359,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT BODY POS CURRENT STATUS,60000359,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT BODY POS CURRENT STATUS,60000359,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
"0 percent impaired, limited or restricted",CH,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CI,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT BODY POS GOAL STATUS,60000367,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT BODY POS GOAL STATUS,60000367,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT BODY POS GOAL STATUS,60000367,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT BODY POS GOAL STATUS,60000367,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT BODY POS GOAL STATUS,60000367,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT BODY POS GOAL STATUS,60000367,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT CARRY CURRENT STATUS,60000360,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT CARRY CURRENT STATUS,60000360,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT CARRY CURRENT STATUS,60000360,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT CARRY CURRENT STATUS,60000360,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT CARRY CURRENT STATUS,60000360,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT CARRY CURRENT STATUS,60000360,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY CURRENT STATUS,60000358,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY CURRENT STATUS,60000358,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY CURRENT STATUS,60000358,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY CURRENT STATUS,60000358,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY CURRENT STATUS,60000358,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY CURRENT STATUS,60000358,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY GOAL STATUS,60000366,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY GOAL STATUS,60000366,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY GOAL STATUS,60000366,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY GOAL STATUS,60000366,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY GOAL STATUS,60000366,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT MOBILITY GOAL STATUS,60000366,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT SUB PT/OT CURRENT STATUS,60000363,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT SUB PT/OT CURRENT STATUS,60000363,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT SUB PT/OT CURRENT STATUS,60000363,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT SUB PT/OT CURRENT STATUS,60000363,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT SUB PT/OT CURRENT STATUS,60000363,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
OT SUB PT/OT CURRENT STATUS,60000363,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,65.96,
PT Other Primary Goal Status G-8991,425G8991,CDM,424,RC,,,OUTPATIENT,,,,,CN,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,0.02,,,,other,not separately reimbursable,0.02,0.02,
Comprehensive Metabolic Panel 4,40080053,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,144.6,115.68,,108.45,75,,,percent of total billed charges,75% of total billed charges,57.84,40,,,percent of total billed charges,40% of total billed charges,114.52,79.2,,,percent of total billed charges,79.2% of total billed charges,122.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,137.37,95,,,percent of total billed charges,95% of total billed charges,115.68,80,,,percent of total billed charges,80% of total billed charges,122.91,85,,,percent of total billed charges,85% of total billed charges,130.14,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,57.84,40,,,percent of total billed charges,40% of total billed charges,57.84,40,,,percent of total billed charges,40% of total billed charges,130.14,90,,,percent of total billed charges,90% of total billed charges,109.9,76,,,percent of total billed charges,76% of total billed charges,57.84,40,,,percent of total billed charges,40% of total billed charges,122.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,115.68,80,,,percent of total billed charges,80% of total billed charges,56.1,38.8,,,percent of total billed charges,38.8% of total billed charges,122.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,137.37,
Cortisol Total,40082533,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,164.7,131.76,,123.53,75,,,percent of total billed charges,75% of total billed charges,65.88,40,,,percent of total billed charges,40% of total billed charges,130.44,79.2,,,percent of total billed charges,79.2% of total billed charges,140,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,156.47,95,,,percent of total billed charges,95% of total billed charges,131.76,80,,,percent of total billed charges,80% of total billed charges,140,85,,,percent of total billed charges,85% of total billed charges,148.23,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,65.88,40,,,percent of total billed charges,40% of total billed charges,65.88,40,,,percent of total billed charges,40% of total billed charges,148.23,90,,,percent of total billed charges,90% of total billed charges,125.17,76,,,percent of total billed charges,76% of total billed charges,65.88,40,,,percent of total billed charges,40% of total billed charges,140,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,131.76,80,,,percent of total billed charges,80% of total billed charges,63.9,38.8,,,percent of total billed charges,38.8% of total billed charges,140,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,156.47,
Creatinine Level 1,40082565,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
Creatinine Body Fluid,40082570,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Cryptosporidium Ag,40087328,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,93.3,74.64,,69.98,75,,,percent of total billed charges,75% of total billed charges,37.32,40,,,percent of total billed charges,40% of total billed charges,73.89,79.2,,,percent of total billed charges,79.2% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,88.64,95,,,percent of total billed charges,95% of total billed charges,74.64,80,,,percent of total billed charges,80% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,83.97,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,37.32,40,,,percent of total billed charges,40% of total billed charges,37.32,40,,,percent of total billed charges,40% of total billed charges,83.97,90,,,percent of total billed charges,90% of total billed charges,70.91,76,,,percent of total billed charges,76% of total billed charges,37.32,40,,,percent of total billed charges,40% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,74.64,80,,,percent of total billed charges,80% of total billed charges,36.2,38.8,,,percent of total billed charges,38.8% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,88.64,
Synovial Fluid Crystal Exam,40089060,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,53,42.4,,39.75,75,,,percent of total billed charges,75% of total billed charges,21.2,40,,,percent of total billed charges,40% of total billed charges,41.98,79.2,,,percent of total billed charges,79.2% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,50.35,95,,,percent of total billed charges,95% of total billed charges,42.4,80,,,percent of total billed charges,80% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,47.7,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,21.2,40,,,percent of total billed charges,40% of total billed charges,21.2,40,,,percent of total billed charges,40% of total billed charges,47.7,90,,,percent of total billed charges,90% of total billed charges,40.28,76,,,percent of total billed charges,76% of total billed charges,21.2,40,,,percent of total billed charges,40% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,42.4,80,,,percent of total billed charges,80% of total billed charges,20.56,38.8,,,percent of total billed charges,38.8% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,50.35,
Giardia Antigen,40087329,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,149.6,119.68,,112.2,75,,,percent of total billed charges,75% of total billed charges,59.84,40,,,percent of total billed charges,40% of total billed charges,118.48,79.2,,,percent of total billed charges,79.2% of total billed charges,127.16,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,142.12,95,,,percent of total billed charges,95% of total billed charges,119.68,80,,,percent of total billed charges,80% of total billed charges,127.16,85,,,percent of total billed charges,85% of total billed charges,134.64,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,59.84,40,,,percent of total billed charges,40% of total billed charges,59.84,40,,,percent of total billed charges,40% of total billed charges,134.64,90,,,percent of total billed charges,90% of total billed charges,113.7,76,,,percent of total billed charges,76% of total billed charges,59.84,40,,,percent of total billed charges,40% of total billed charges,127.16,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,119.68,80,,,percent of total billed charges,80% of total billed charges,58.04,38.8,,,percent of total billed charges,38.8% of total billed charges,127.16,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,142.12,
Measles IgG,40086765,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,151,120.8,,113.25,75,,,percent of total billed charges,75% of total billed charges,60.4,40,,,percent of total billed charges,40% of total billed charges,119.59,79.2,,,percent of total billed charges,79.2% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,143.45,95,,,percent of total billed charges,95% of total billed charges,120.8,80,,,percent of total billed charges,80% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,135.9,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,60.4,40,,,percent of total billed charges,40% of total billed charges,60.4,40,,,percent of total billed charges,40% of total billed charges,135.9,90,,,percent of total billed charges,90% of total billed charges,114.76,76,,,percent of total billed charges,76% of total billed charges,60.4,40,,,percent of total billed charges,40% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,120.8,80,,,percent of total billed charges,80% of total billed charges,58.59,38.8,,,percent of total billed charges,38.8% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,143.45,
Mumps IgG,40086735,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,127.5,102,,95.63,75,,,percent of total billed charges,75% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,100.98,79.2,,,percent of total billed charges,79.2% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,121.13,95,,,percent of total billed charges,95% of total billed charges,102,80,,,percent of total billed charges,80% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,51,40,,,percent of total billed charges,40% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,96.9,76,,,percent of total billed charges,76% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,102,80,,,percent of total billed charges,80% of total billed charges,49.47,38.8,,,percent of total billed charges,38.8% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,121.13,
Rubella IgG 1,40086762,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,124.4,99.52,,93.3,75,,,percent of total billed charges,75% of total billed charges,49.76,40,,,percent of total billed charges,40% of total billed charges,98.52,79.2,,,percent of total billed charges,79.2% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,118.18,95,,,percent of total billed charges,95% of total billed charges,99.52,80,,,percent of total billed charges,80% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,111.96,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,49.76,40,,,percent of total billed charges,40% of total billed charges,49.76,40,,,percent of total billed charges,40% of total billed charges,111.96,90,,,percent of total billed charges,90% of total billed charges,94.54,76,,,percent of total billed charges,76% of total billed charges,49.76,40,,,percent of total billed charges,40% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,99.52,80,,,percent of total billed charges,80% of total billed charges,48.27,38.8,,,percent of total billed charges,38.8% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,118.18,
Varicella-Zoster IgG,40086787,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,31.2,24.96,,23.4,75,,,percent of total billed charges,75% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,24.71,79.2,,,percent of total billed charges,79.2% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,29.64,95,,,percent of total billed charges,95% of total billed charges,24.96,80,,,percent of total billed charges,80% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,12.48,40,,,percent of total billed charges,40% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,28.08,90,,,percent of total billed charges,90% of total billed charges,23.71,76,,,percent of total billed charges,76% of total billed charges,12.48,40,,,percent of total billed charges,40% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,24.96,80,,,percent of total billed charges,80% of total billed charges,12.11,38.8,,,percent of total billed charges,38.8% of total billed charges,26.52,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,29.64,
Potassium Level Stool,40084999,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,163.4,130.72,,122.55,75,,,percent of total billed charges,75% of total billed charges,65.36,40,,,percent of total billed charges,40% of total billed charges,129.41,79.2,,,percent of total billed charges,79.2% of total billed charges,138.89,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,155.23,95,,,percent of total billed charges,95% of total billed charges,130.72,80,,,percent of total billed charges,80% of total billed charges,138.89,85,,,percent of total billed charges,85% of total billed charges,147.06,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,65.36,40,,,percent of total billed charges,40% of total billed charges,65.36,40,,,percent of total billed charges,40% of total billed charges,147.06,90,,,percent of total billed charges,90% of total billed charges,124.18,76,,,percent of total billed charges,76% of total billed charges,65.36,40,,,percent of total billed charges,40% of total billed charges,138.89,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,130.72,80,,,percent of total billed charges,80% of total billed charges,63.4,38.8,,,percent of total billed charges,38.8% of total billed charges,138.89,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,155.23,
Sodium Level Stool,40084302,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
T3 Total,40084480,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,151,120.8,,113.25,75,,,percent of total billed charges,75% of total billed charges,60.4,40,,,percent of total billed charges,40% of total billed charges,119.59,79.2,,,percent of total billed charges,79.2% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,143.45,95,,,percent of total billed charges,95% of total billed charges,120.8,80,,,percent of total billed charges,80% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,135.9,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,60.4,40,,,percent of total billed charges,40% of total billed charges,60.4,40,,,percent of total billed charges,40% of total billed charges,135.9,90,,,percent of total billed charges,90% of total billed charges,114.76,76,,,percent of total billed charges,76% of total billed charges,60.4,40,,,percent of total billed charges,40% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,120.8,80,,,percent of total billed charges,80% of total billed charges,58.59,38.8,,,percent of total billed charges,38.8% of total billed charges,128.35,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,143.45,
Testosterone Total,40084403,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,208.2,166.56,,156.15,75,,,percent of total billed charges,75% of total billed charges,83.28,40,,,percent of total billed charges,40% of total billed charges,164.89,79.2,,,percent of total billed charges,79.2% of total billed charges,176.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,197.79,95,,,percent of total billed charges,95% of total billed charges,166.56,80,,,percent of total billed charges,80% of total billed charges,176.97,85,,,percent of total billed charges,85% of total billed charges,187.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,83.28,40,,,percent of total billed charges,40% of total billed charges,83.28,40,,,percent of total billed charges,40% of total billed charges,187.38,90,,,percent of total billed charges,90% of total billed charges,158.23,76,,,percent of total billed charges,76% of total billed charges,83.28,40,,,percent of total billed charges,40% of total billed charges,176.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,166.56,80,,,percent of total billed charges,80% of total billed charges,80.78,38.8,,,percent of total billed charges,38.8% of total billed charges,176.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,197.79,
Alpha Fetoprotein,40082105,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,138.2,110.56,,103.65,75,,,percent of total billed charges,75% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,109.45,79.2,,,percent of total billed charges,79.2% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,131.29,95,,,percent of total billed charges,95% of total billed charges,110.56,80,,,percent of total billed charges,80% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,55.28,40,,,percent of total billed charges,40% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,105.03,76,,,percent of total billed charges,76% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,110.56,80,,,percent of total billed charges,80% of total billed charges,53.62,38.8,,,percent of total billed charges,38.8% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,131.29,
Acetone/Ketone,40082009,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,50.1,40.08,,37.58,75,,,percent of total billed charges,75% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,39.68,79.2,,,percent of total billed charges,79.2% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,47.6,95,,,percent of total billed charges,95% of total billed charges,40.08,80,,,percent of total billed charges,80% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,45.09,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,20.04,40,,,percent of total billed charges,40% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,45.09,90,,,percent of total billed charges,90% of total billed charges,38.08,76,,,percent of total billed charges,76% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,40.08,80,,,percent of total billed charges,80% of total billed charges,19.44,38.8,,,percent of total billed charges,38.8% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,47.6,
Basic Metabolic Panel 4,40080048,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,112.8,90.24,,84.6,75,,,percent of total billed charges,75% of total billed charges,45.12,40,,,percent of total billed charges,40% of total billed charges,89.34,79.2,,,percent of total billed charges,79.2% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,107.16,95,,,percent of total billed charges,95% of total billed charges,90.24,80,,,percent of total billed charges,80% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,101.52,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,45.12,40,,,percent of total billed charges,40% of total billed charges,45.12,40,,,percent of total billed charges,40% of total billed charges,101.52,90,,,percent of total billed charges,90% of total billed charges,85.73,76,,,percent of total billed charges,76% of total billed charges,45.12,40,,,percent of total billed charges,40% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,90.24,80,,,percent of total billed charges,80% of total billed charges,43.77,38.8,,,percent of total billed charges,38.8% of total billed charges,95.88,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,107.16,
Neonatal Bili 1,40082247,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
CA-125,40086304,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,200.9,160.72,,150.68,75,,,percent of total billed charges,75% of total billed charges,80.36,40,,,percent of total billed charges,40% of total billed charges,159.11,79.2,,,percent of total billed charges,79.2% of total billed charges,170.77,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,190.86,95,,,percent of total billed charges,95% of total billed charges,160.72,80,,,percent of total billed charges,80% of total billed charges,170.77,85,,,percent of total billed charges,85% of total billed charges,180.81,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,80.36,40,,,percent of total billed charges,40% of total billed charges,80.36,40,,,percent of total billed charges,40% of total billed charges,180.81,90,,,percent of total billed charges,90% of total billed charges,152.68,76,,,percent of total billed charges,76% of total billed charges,80.36,40,,,percent of total billed charges,40% of total billed charges,170.77,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,160.72,80,,,percent of total billed charges,80% of total billed charges,77.95,38.8,,,percent of total billed charges,38.8% of total billed charges,170.77,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,190.86,
Follicle Stimulating Hormone,40083001,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,156.2,124.96,,117.15,75,,,percent of total billed charges,75% of total billed charges,62.48,40,,,percent of total billed charges,40% of total billed charges,123.71,79.2,,,percent of total billed charges,79.2% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,148.39,95,,,percent of total billed charges,95% of total billed charges,124.96,80,,,percent of total billed charges,80% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,140.58,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,62.48,40,,,percent of total billed charges,40% of total billed charges,62.48,40,,,percent of total billed charges,40% of total billed charges,140.58,90,,,percent of total billed charges,90% of total billed charges,118.71,76,,,percent of total billed charges,76% of total billed charges,62.48,40,,,percent of total billed charges,40% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,124.96,80,,,percent of total billed charges,80% of total billed charges,60.61,38.8,,,percent of total billed charges,38.8% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,148.39,
Luteinizing Hormone,40083002,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,160.5,128.4,,120.38,75,,,percent of total billed charges,75% of total billed charges,64.2,40,,,percent of total billed charges,40% of total billed charges,127.12,79.2,,,percent of total billed charges,79.2% of total billed charges,136.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,152.48,95,,,percent of total billed charges,95% of total billed charges,128.4,80,,,percent of total billed charges,80% of total billed charges,136.43,85,,,percent of total billed charges,85% of total billed charges,144.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,64.2,40,,,percent of total billed charges,40% of total billed charges,64.2,40,,,percent of total billed charges,40% of total billed charges,144.45,90,,,percent of total billed charges,90% of total billed charges,121.98,76,,,percent of total billed charges,76% of total billed charges,64.2,40,,,percent of total billed charges,40% of total billed charges,136.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,128.4,80,,,percent of total billed charges,80% of total billed charges,62.27,38.8,,,percent of total billed charges,38.8% of total billed charges,136.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,152.48,
Body Fluid Cell Count,40089051,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,75.4,60.32,,56.55,75,,,percent of total billed charges,75% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,59.72,79.2,,,percent of total billed charges,79.2% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,71.63,95,,,percent of total billed charges,95% of total billed charges,60.32,80,,,percent of total billed charges,80% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,30.16,40,,,percent of total billed charges,40% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,57.3,76,,,percent of total billed charges,76% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,60.32,80,,,percent of total billed charges,80% of total billed charges,29.26,38.8,,,percent of total billed charges,38.8% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,71.63,
Gram Stain 2,40087205,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,54.1,43.28,,40.58,75,,,percent of total billed charges,75% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,42.85,79.2,,,percent of total billed charges,79.2% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,51.4,95,,,percent of total billed charges,95% of total billed charges,43.28,80,,,percent of total billed charges,80% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,21.64,40,,,percent of total billed charges,40% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,41.12,76,,,percent of total billed charges,76% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,43.28,80,,,percent of total billed charges,80% of total billed charges,20.99,38.8,,,percent of total billed charges,38.8% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,51.4,
"Microalbumin, 24 Hr Urine 1",40082043,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,76.4,61.12,,57.3,75,,,percent of total billed charges,75% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,60.51,79.2,,,percent of total billed charges,79.2% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,72.58,95,,,percent of total billed charges,95% of total billed charges,61.12,80,,,percent of total billed charges,80% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,30.56,40,,,percent of total billed charges,40% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,58.06,76,,,percent of total billed charges,76% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,61.12,80,,,percent of total billed charges,80% of total billed charges,29.64,38.8,,,percent of total billed charges,38.8% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,72.58,
Arterial Blood Gas 6,40082803,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.3,116.24,,108.98,75,,,percent of total billed charges,75% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,115.08,79.2,,,percent of total billed charges,79.2% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.04,95,,,percent of total billed charges,95% of total billed charges,116.24,80,,,percent of total billed charges,80% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,130.77,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.12,40,,,percent of total billed charges,40% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,130.77,90,,,percent of total billed charges,90% of total billed charges,110.43,76,,,percent of total billed charges,76% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.24,80,,,percent of total billed charges,80% of total billed charges,56.38,38.8,,,percent of total billed charges,38.8% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.04,
Helicobacter Pylori,40086677,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,138.32,
Lactic Acid Arterial,40083605,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,108.2,86.56,,81.15,75,,,percent of total billed charges,75% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,85.69,79.2,,,percent of total billed charges,79.2% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,102.79,95,,,percent of total billed charges,95% of total billed charges,86.56,80,,,percent of total billed charges,80% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,97.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,43.28,40,,,percent of total billed charges,40% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,97.38,90,,,percent of total billed charges,90% of total billed charges,82.23,76,,,percent of total billed charges,76% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,86.56,80,,,percent of total billed charges,80% of total billed charges,41.98,38.8,,,percent of total billed charges,38.8% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,102.79,
Iron Binding Capacity,40083550,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,94.7,75.76,,71.03,75,,,percent of total billed charges,75% of total billed charges,37.88,40,,,percent of total billed charges,40% of total billed charges,75,79.2,,,percent of total billed charges,79.2% of total billed charges,80.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,89.97,95,,,percent of total billed charges,95% of total billed charges,75.76,80,,,percent of total billed charges,80% of total billed charges,80.5,85,,,percent of total billed charges,85% of total billed charges,85.23,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,37.88,40,,,percent of total billed charges,40% of total billed charges,37.88,40,,,percent of total billed charges,40% of total billed charges,85.23,90,,,percent of total billed charges,90% of total billed charges,71.97,76,,,percent of total billed charges,76% of total billed charges,37.88,40,,,percent of total billed charges,40% of total billed charges,80.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,75.76,80,,,percent of total billed charges,80% of total billed charges,36.74,38.8,,,percent of total billed charges,38.8% of total billed charges,80.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,89.97,
KOH,40087220,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,42.4,33.92,,31.8,75,,,percent of total billed charges,75% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,33.58,79.2,,,percent of total billed charges,79.2% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,40.28,95,,,percent of total billed charges,95% of total billed charges,33.92,80,,,percent of total billed charges,80% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,38.16,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,16.96,40,,,percent of total billed charges,40% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,38.16,90,,,percent of total billed charges,90% of total billed charges,32.22,76,,,percent of total billed charges,76% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,33.92,80,,,percent of total billed charges,80% of total billed charges,16.45,38.8,,,percent of total billed charges,38.8% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,40.28,
Methadone Screen Urine,40080358,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,111.4,89.12,,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,105.83,
Methamphetamine Screen Urine,40080306,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,111.4,89.12,,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,105.83,
MDMA Screen Urine,40080306,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,111.4,89.12,,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,105.83,
Oxycodone Screen Urine,40080306,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,111.4,89.12,,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,105.83,
Phencyclidine Screen Urine,40080306,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,124.4,99.52,,93.3,75,,,percent of total billed charges,75% of total billed charges,49.76,40,,,percent of total billed charges,40% of total billed charges,98.52,79.2,,,percent of total billed charges,79.2% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,118.18,95,,,percent of total billed charges,95% of total billed charges,99.52,80,,,percent of total billed charges,80% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,111.96,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,49.76,40,,,percent of total billed charges,40% of total billed charges,49.76,40,,,percent of total billed charges,40% of total billed charges,111.96,90,,,percent of total billed charges,90% of total billed charges,94.54,76,,,percent of total billed charges,76% of total billed charges,49.76,40,,,percent of total billed charges,40% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,99.52,80,,,percent of total billed charges,80% of total billed charges,48.27,38.8,,,percent of total billed charges,38.8% of total billed charges,105.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,118.18,
RBC Antibody Identification,40586870,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,280.2,224.16,,210.15,75,,,percent of total billed charges,75% of total billed charges,112.08,40,,,percent of total billed charges,40% of total billed charges,221.92,79.2,,,percent of total billed charges,79.2% of total billed charges,238.17,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,266.19,95,,,percent of total billed charges,95% of total billed charges,224.16,80,,,percent of total billed charges,80% of total billed charges,238.17,85,,,percent of total billed charges,85% of total billed charges,252.18,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,112.08,40,,,percent of total billed charges,40% of total billed charges,112.08,40,,,percent of total billed charges,40% of total billed charges,252.18,90,,,percent of total billed charges,90% of total billed charges,212.95,76,,,percent of total billed charges,76% of total billed charges,112.08,40,,,percent of total billed charges,40% of total billed charges,238.17,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,224.16,80,,,percent of total billed charges,80% of total billed charges,108.72,38.8,,,percent of total billed charges,38.8% of total billed charges,238.17,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,266.19,
Urine Drug Screen 7,40080306,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,111.4,89.12,,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,105.83,
Phosphorus Level Urine,40084105,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
PTH Intact,40083970,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,314.4,251.52,,235.8,75,,,percent of total billed charges,75% of total billed charges,125.76,40,,,percent of total billed charges,40% of total billed charges,249,79.2,,,percent of total billed charges,79.2% of total billed charges,267.24,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,298.68,95,,,percent of total billed charges,95% of total billed charges,251.52,80,,,percent of total billed charges,80% of total billed charges,267.24,85,,,percent of total billed charges,85% of total billed charges,282.96,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,125.76,40,,,percent of total billed charges,40% of total billed charges,125.76,40,,,percent of total billed charges,40% of total billed charges,282.96,90,,,percent of total billed charges,90% of total billed charges,238.94,76,,,percent of total billed charges,76% of total billed charges,125.76,40,,,percent of total billed charges,40% of total billed charges,267.24,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,251.52,80,,,percent of total billed charges,80% of total billed charges,121.99,38.8,,,percent of total billed charges,38.8% of total billed charges,267.24,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,298.68,
"PH, Fecal",40083986,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,70,56,,52.5,75,,,percent of total billed charges,75% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,55.44,79.2,,,percent of total billed charges,79.2% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,66.5,95,,,percent of total billed charges,95% of total billed charges,56,80,,,percent of total billed charges,80% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,63,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,28,40,,,percent of total billed charges,40% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,63,90,,,percent of total billed charges,90% of total billed charges,53.2,76,,,percent of total billed charges,76% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,56,80,,,percent of total billed charges,80% of total billed charges,27.16,38.8,,,percent of total billed charges,38.8% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,66.5,
Procalcitonin,40084145,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,156.2,124.96,,117.15,75,,,percent of total billed charges,75% of total billed charges,62.48,40,,,percent of total billed charges,40% of total billed charges,123.71,79.2,,,percent of total billed charges,79.2% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,148.39,95,,,percent of total billed charges,95% of total billed charges,124.96,80,,,percent of total billed charges,80% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,140.58,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,62.48,40,,,percent of total billed charges,40% of total billed charges,62.48,40,,,percent of total billed charges,40% of total billed charges,140.58,90,,,percent of total billed charges,90% of total billed charges,118.71,76,,,percent of total billed charges,76% of total billed charges,62.48,40,,,percent of total billed charges,40% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,124.96,80,,,percent of total billed charges,80% of total billed charges,60.61,38.8,,,percent of total billed charges,38.8% of total billed charges,132.77,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,148.39,
Progesterone,40084144,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,168.9,135.12,,126.68,75,,,percent of total billed charges,75% of total billed charges,67.56,40,,,percent of total billed charges,40% of total billed charges,133.77,79.2,,,percent of total billed charges,79.2% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,160.46,95,,,percent of total billed charges,95% of total billed charges,135.12,80,,,percent of total billed charges,80% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,152.01,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,67.56,40,,,percent of total billed charges,40% of total billed charges,67.56,40,,,percent of total billed charges,40% of total billed charges,152.01,90,,,percent of total billed charges,90% of total billed charges,128.36,76,,,percent of total billed charges,76% of total billed charges,67.56,40,,,percent of total billed charges,40% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,135.12,80,,,percent of total billed charges,80% of total billed charges,65.53,38.8,,,percent of total billed charges,38.8% of total billed charges,143.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,160.46,
Prolactin,40084146,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,182.8,146.24,,137.1,75,,,percent of total billed charges,75% of total billed charges,73.12,40,,,percent of total billed charges,40% of total billed charges,144.78,79.2,,,percent of total billed charges,79.2% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,173.66,95,,,percent of total billed charges,95% of total billed charges,146.24,80,,,percent of total billed charges,80% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,73.12,40,,,percent of total billed charges,40% of total billed charges,73.12,40,,,percent of total billed charges,40% of total billed charges,164.52,90,,,percent of total billed charges,90% of total billed charges,138.93,76,,,percent of total billed charges,76% of total billed charges,73.12,40,,,percent of total billed charges,40% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,146.24,80,,,percent of total billed charges,80% of total billed charges,70.93,38.8,,,percent of total billed charges,38.8% of total billed charges,155.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,173.66,
Wet Mount 2,40000001,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,32.8,26.24,,24.6,75,,,percent of total billed charges,75% of total billed charges,13.12,40,,,percent of total billed charges,40% of total billed charges,25.98,79.2,,,percent of total billed charges,79.2% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,31.16,95,,,percent of total billed charges,95% of total billed charges,26.24,80,,,percent of total billed charges,80% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,13.12,40,,,percent of total billed charges,40% of total billed charges,13.12,40,,,percent of total billed charges,40% of total billed charges,29.52,90,,,percent of total billed charges,90% of total billed charges,24.93,76,,,percent of total billed charges,76% of total billed charges,13.12,40,,,percent of total billed charges,40% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,26.24,80,,,percent of total billed charges,80% of total billed charges,12.73,38.8,,,percent of total billed charges,38.8% of total billed charges,27.88,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,33.1,
Rapid Plasma Reagin,40086592,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,53.3,42.64,,39.98,75,,,percent of total billed charges,75% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,42.21,79.2,,,percent of total billed charges,79.2% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,50.64,95,,,percent of total billed charges,95% of total billed charges,42.64,80,,,percent of total billed charges,80% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,47.97,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,21.32,40,,,percent of total billed charges,40% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,47.97,90,,,percent of total billed charges,90% of total billed charges,40.51,76,,,percent of total billed charges,76% of total billed charges,21.32,40,,,percent of total billed charges,40% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,42.64,80,,,percent of total billed charges,80% of total billed charges,20.68,38.8,,,percent of total billed charges,38.8% of total billed charges,45.31,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,50.64,
Syphili Test Quant,40086593,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,57.5,46,,43.13,75,,,percent of total billed charges,75% of total billed charges,23,40,,,percent of total billed charges,40% of total billed charges,45.54,79.2,,,percent of total billed charges,79.2% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,54.63,95,,,percent of total billed charges,95% of total billed charges,46,80,,,percent of total billed charges,80% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,51.75,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,23,40,,,percent of total billed charges,40% of total billed charges,23,40,,,percent of total billed charges,40% of total billed charges,51.75,90,,,percent of total billed charges,90% of total billed charges,43.7,76,,,percent of total billed charges,76% of total billed charges,23,40,,,percent of total billed charges,40% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,46,80,,,percent of total billed charges,80% of total billed charges,22.31,38.8,,,percent of total billed charges,38.8% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,54.63,
Urine Culture Screen,40087086,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,77.4,61.92,,58.05,75,,,percent of total billed charges,75% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,61.3,79.2,,,percent of total billed charges,79.2% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,73.53,95,,,percent of total billed charges,95% of total billed charges,61.92,80,,,percent of total billed charges,80% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,69.66,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,30.96,40,,,percent of total billed charges,40% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,69.66,90,,,percent of total billed charges,90% of total billed charges,58.82,76,,,percent of total billed charges,76% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,61.92,80,,,percent of total billed charges,80% of total billed charges,30.03,38.8,,,percent of total billed charges,38.8% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,73.53,
UA Micro 4,40081015,CDM,307,RC,81002,HCPCS,OUTPATIENT,,,24.3,19.44,,18.23,75,,,percent of total billed charges,75% of total billed charges,9.72,40,,,percent of total billed charges,40% of total billed charges,19.25,79.2,,,percent of total billed charges,79.2% of total billed charges,20.66,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,23.09,95,,,percent of total billed charges,95% of total billed charges,19.44,80,,,percent of total billed charges,80% of total billed charges,20.66,85,,,percent of total billed charges,85% of total billed charges,21.87,90,,,percent of total billed charges,90% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,3.61,100,,,fee schedule,100% of CO APG rates,3.27,100,,,fee schedule,100% of NM fee schedule,9.72,40,,,percent of total billed charges,40% of total billed charges,9.72,40,,,percent of total billed charges,40% of total billed charges,21.87,90,,,percent of total billed charges,90% of total billed charges,18.47,76,,,percent of total billed charges,76% of total billed charges,9.72,40,,,percent of total billed charges,40% of total billed charges,20.66,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rate,19.44,80,,,percent of total billed charges,80% of total billed charges,9.43,38.8,,,percent of total billed charges,38.8% of total billed charges,20.66,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of APG fee schedule,6.96,200,,,fee schedule,200% of CMS fee schedule,3.27,23.09,
Transferrin Level,40084466,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,107.4,85.92,,80.55,75,,,percent of total billed charges,75% of total billed charges,42.96,40,,,percent of total billed charges,40% of total billed charges,85.06,79.2,,,percent of total billed charges,79.2% of total billed charges,91.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,102.03,95,,,percent of total billed charges,95% of total billed charges,85.92,80,,,percent of total billed charges,80% of total billed charges,91.29,85,,,percent of total billed charges,85% of total billed charges,96.66,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,42.96,40,,,percent of total billed charges,40% of total billed charges,42.96,40,,,percent of total billed charges,40% of total billed charges,96.66,90,,,percent of total billed charges,90% of total billed charges,81.62,76,,,percent of total billed charges,76% of total billed charges,42.96,40,,,percent of total billed charges,40% of total billed charges,91.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,85.92,80,,,percent of total billed charges,80% of total billed charges,41.67,38.8,,,percent of total billed charges,38.8% of total billed charges,91.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,102.03,
Sigmoidoscopy,4600108,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1271,1016.8,,953.25,75,,,percent of total billed charges,75% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1006.63,79.2,,,percent of total billed charges,79.2% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1207.45,95,,,percent of total billed charges,95% of total billed charges,1016.8,80,,,percent of total billed charges,80% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,508.4,40,,,percent of total billed charges,40% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1143.9,90,,,percent of total billed charges,90% of total billed charges,965.96,76,,,percent of total billed charges,76% of total billed charges,508.4,40,,,percent of total billed charges,40% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1016.8,80,,,percent of total billed charges,80% of total billed charges,493.15,38.8,,,percent of total billed charges,38.8% of total billed charges,1080.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1207.45,
Blood Gasses Measurement,40082800,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.3,116.24,,108.98,75,,,percent of total billed charges,75% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,115.08,79.2,,,percent of total billed charges,79.2% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.04,95,,,percent of total billed charges,95% of total billed charges,116.24,80,,,percent of total billed charges,80% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,130.77,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.12,40,,,percent of total billed charges,40% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,130.77,90,,,percent of total billed charges,90% of total billed charges,110.43,76,,,percent of total billed charges,76% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.24,80,,,percent of total billed charges,80% of total billed charges,56.38,38.8,,,percent of total billed charges,38.8% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.04,
Bld Gases pH Arterial,40082800,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.3,116.24,,108.98,75,,,percent of total billed charges,75% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,115.08,79.2,,,percent of total billed charges,79.2% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.04,95,,,percent of total billed charges,95% of total billed charges,116.24,80,,,percent of total billed charges,80% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,130.77,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.12,40,,,percent of total billed charges,40% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,130.77,90,,,percent of total billed charges,90% of total billed charges,110.43,76,,,percent of total billed charges,76% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.24,80,,,percent of total billed charges,80% of total billed charges,56.38,38.8,,,percent of total billed charges,38.8% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.04,
43752 NASO GASTRIC TUBE PLACEMENT BY PHYSICIAN CHARGE,30043752,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,976.6,781.28,,732.45,75,,,percent of total billed charges,75% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,773.47,79.2,,,percent of total billed charges,79.2% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,927.77,95,,,percent of total billed charges,95% of total billed charges,781.28,80,,,percent of total billed charges,80% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,878.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,390.64,40,,,percent of total billed charges,40% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,878.94,90,,,percent of total billed charges,90% of total billed charges,742.22,76,,,percent of total billed charges,76% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,781.28,80,,,percent of total billed charges,80% of total billed charges,378.92,38.8,,,percent of total billed charges,38.8% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,927.77,
93225 HOLTER HOOKUP CHARGE,42893225,CDM,731,RC,93225,HCPCS,OUTPATIENT,,,376,300.8,,282,75,,,percent of total billed charges,75% of total billed charges,150.4,40,,,percent of total billed charges,40% of total billed charges,297.79,79.2,,,percent of total billed charges,79.2% of total billed charges,319.6,85,,,percent of total billed charges,85% of total billed charges,89.98,100,,,fee schedule,100% of CO APG rates,357.2,95,,,percent of total billed charges,95% of total billed charges,300.8,80,,,percent of total billed charges,80% of total billed charges,319.6,85,,,percent of total billed charges,85% of total billed charges,338.4,90,,,percent of total billed charges,90% of total billed charges,89.98,100,,,fee schedule,100% of CO APG rates,89.98,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,150.4,40,,,percent of total billed charges,40% of total billed charges,150.4,40,,,percent of total billed charges,40% of total billed charges,338.4,90,,,percent of total billed charges,90% of total billed charges,285.76,76,,,percent of total billed charges,76% of total billed charges,150.4,40,,,percent of total billed charges,40% of total billed charges,319.6,85,,,percent of total billed charges,85% of total billed charges,89.98,100,,,fee schedule,100% of CO APG rate,300.8,80,,,percent of total billed charges,80% of total billed charges,145.89,38.8,,,percent of total billed charges,38.8% of total billed charges,319.6,85,,,percent of total billed charges,85% of total billed charges,89.98,100,,,fee schedule,100% of APG fee schedule,38.96,200,,,fee schedule,200% of CMS fee schedule,38.96,357.2,
Bill Antibody ID Each,40586870,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,288.5,230.8,,216.38,75,,,percent of total billed charges,75% of total billed charges,115.4,40,,,percent of total billed charges,40% of total billed charges,228.49,79.2,,,percent of total billed charges,79.2% of total billed charges,245.23,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,274.08,95,,,percent of total billed charges,95% of total billed charges,230.8,80,,,percent of total billed charges,80% of total billed charges,245.23,85,,,percent of total billed charges,85% of total billed charges,259.65,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,115.4,40,,,percent of total billed charges,40% of total billed charges,115.4,40,,,percent of total billed charges,40% of total billed charges,259.65,90,,,percent of total billed charges,90% of total billed charges,219.26,76,,,percent of total billed charges,76% of total billed charges,115.4,40,,,percent of total billed charges,40% of total billed charges,245.23,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,230.8,80,,,percent of total billed charges,80% of total billed charges,111.94,38.8,,,percent of total billed charges,38.8% of total billed charges,245.23,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,274.08,
Aph ARBC CP2D AS3 LR 2,4050109,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,913.4,730.72,,685.05,75,,,percent of total billed charges,75% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,723.41,79.2,,,percent of total billed charges,79.2% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,867.73,95,,,percent of total billed charges,95% of total billed charges,730.72,80,,,percent of total billed charges,80% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,365.36,40,,,percent of total billed charges,40% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,822.06,90,,,percent of total billed charges,90% of total billed charges,694.18,76,,,percent of total billed charges,76% of total billed charges,365.36,40,,,percent of total billed charges,40% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,730.72,80,,,percent of total billed charges,80% of total billed charges,354.4,38.8,,,percent of total billed charges,38.8% of total billed charges,776.39,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,867.73,
HS C-Reactive Protein,40086141,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,119.2,95.36,,89.4,75,,,percent of total billed charges,75% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,94.41,79.2,,,percent of total billed charges,79.2% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,113.24,95,,,percent of total billed charges,95% of total billed charges,95.36,80,,,percent of total billed charges,80% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,107.28,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,47.68,40,,,percent of total billed charges,40% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,107.28,90,,,percent of total billed charges,90% of total billed charges,90.59,76,,,percent of total billed charges,76% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,95.36,80,,,percent of total billed charges,80% of total billed charges,46.25,38.8,,,percent of total billed charges,38.8% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,113.24,
Anaerobic Culture CDR,40087075,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,79.6,63.68,,59.7,75,,,percent of total billed charges,75% of total billed charges,31.84,40,,,percent of total billed charges,40% of total billed charges,63.04,79.2,,,percent of total billed charges,79.2% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,75.62,95,,,percent of total billed charges,95% of total billed charges,63.68,80,,,percent of total billed charges,80% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,71.64,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,31.84,40,,,percent of total billed charges,40% of total billed charges,31.84,40,,,percent of total billed charges,40% of total billed charges,71.64,90,,,percent of total billed charges,90% of total billed charges,60.5,76,,,percent of total billed charges,76% of total billed charges,31.84,40,,,percent of total billed charges,40% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,63.68,80,,,percent of total billed charges,80% of total billed charges,30.88,38.8,,,percent of total billed charges,38.8% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,75.62,
Blood Culture CDR,40087040,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,103.9,83.12,,77.93,75,,,percent of total billed charges,75% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,82.29,79.2,,,percent of total billed charges,79.2% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,98.71,95,,,percent of total billed charges,95% of total billed charges,83.12,80,,,percent of total billed charges,80% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,41.56,40,,,percent of total billed charges,40% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,78.96,76,,,percent of total billed charges,76% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,83.12,80,,,percent of total billed charges,80% of total billed charges,40.31,38.8,,,percent of total billed charges,38.8% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,98.71,
"Culture, bacterial; aerobic isolate, additional methods requ",40087077,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,59.4,47.52,,44.55,75,,,percent of total billed charges,75% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,47.04,79.2,,,percent of total billed charges,79.2% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,56.43,95,,,percent of total billed charges,95% of total billed charges,47.52,80,,,percent of total billed charges,80% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,23.76,40,,,percent of total billed charges,40% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,45.14,76,,,percent of total billed charges,76% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,47.52,80,,,percent of total billed charges,80% of total billed charges,23.05,38.8,,,percent of total billed charges,38.8% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,56.43,
Fungus Culture CDR,40087106,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,77.4,61.92,,58.05,75,,,percent of total billed charges,75% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,61.3,79.2,,,percent of total billed charges,79.2% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,73.53,95,,,percent of total billed charges,95% of total billed charges,61.92,80,,,percent of total billed charges,80% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,69.66,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,30.96,40,,,percent of total billed charges,40% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,69.66,90,,,percent of total billed charges,90% of total billed charges,58.82,76,,,percent of total billed charges,76% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,61.92,80,,,percent of total billed charges,80% of total billed charges,30.03,38.8,,,percent of total billed charges,38.8% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,73.53,
GBSID CDR,40087802,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,89.1,71.28,,66.83,75,,,percent of total billed charges,75% of total billed charges,35.64,40,,,percent of total billed charges,40% of total billed charges,70.57,79.2,,,percent of total billed charges,79.2% of total billed charges,75.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,84.65,95,,,percent of total billed charges,95% of total billed charges,71.28,80,,,percent of total billed charges,80% of total billed charges,75.74,85,,,percent of total billed charges,85% of total billed charges,80.19,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,35.64,40,,,percent of total billed charges,40% of total billed charges,35.64,40,,,percent of total billed charges,40% of total billed charges,80.19,90,,,percent of total billed charges,90% of total billed charges,67.72,76,,,percent of total billed charges,76% of total billed charges,35.64,40,,,percent of total billed charges,40% of total billed charges,75.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,71.28,80,,,percent of total billed charges,80% of total billed charges,34.57,38.8,,,percent of total billed charges,38.8% of total billed charges,75.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,84.65,
Genital Culture CDR,40087070,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,140,112,,105,75,,,percent of total billed charges,75% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,110.88,79.2,,,percent of total billed charges,79.2% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,133,95,,,percent of total billed charges,95% of total billed charges,112,80,,,percent of total billed charges,80% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,126,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,56,40,,,percent of total billed charges,40% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,126,90,,,percent of total billed charges,90% of total billed charges,106.4,76,,,percent of total billed charges,76% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,112,80,,,percent of total billed charges,80% of total billed charges,54.32,38.8,,,percent of total billed charges,38.8% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,133,
Gram Stain CDR,40087205,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,54.1,43.28,,40.58,75,,,percent of total billed charges,75% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,42.85,79.2,,,percent of total billed charges,79.2% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,51.4,95,,,percent of total billed charges,95% of total billed charges,43.28,80,,,percent of total billed charges,80% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,21.64,40,,,percent of total billed charges,40% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,41.12,76,,,percent of total billed charges,76% of total billed charges,21.64,40,,,percent of total billed charges,40% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,43.28,80,,,percent of total billed charges,80% of total billed charges,20.99,38.8,,,percent of total billed charges,38.8% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,51.4,
HBsAg Screen CDR,40087340,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,98.6,78.88,,73.95,75,,,percent of total billed charges,75% of total billed charges,39.44,40,,,percent of total billed charges,40% of total billed charges,78.09,79.2,,,percent of total billed charges,79.2% of total billed charges,83.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,93.67,95,,,percent of total billed charges,95% of total billed charges,78.88,80,,,percent of total billed charges,80% of total billed charges,83.81,85,,,percent of total billed charges,85% of total billed charges,88.74,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,39.44,40,,,percent of total billed charges,40% of total billed charges,39.44,40,,,percent of total billed charges,40% of total billed charges,88.74,90,,,percent of total billed charges,90% of total billed charges,74.94,76,,,percent of total billed charges,76% of total billed charges,39.44,40,,,percent of total billed charges,40% of total billed charges,83.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,78.88,80,,,percent of total billed charges,80% of total billed charges,38.26,38.8,,,percent of total billed charges,38.8% of total billed charges,83.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,93.67,
"Homocystine, Plasma CDR",40083090,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,138.2,110.56,,103.65,75,,,percent of total billed charges,75% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,109.45,79.2,,,percent of total billed charges,79.2% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,131.29,95,,,percent of total billed charges,95% of total billed charges,110.56,80,,,percent of total billed charges,80% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,55.28,40,,,percent of total billed charges,40% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,124.38,90,,,percent of total billed charges,90% of total billed charges,105.03,76,,,percent of total billed charges,76% of total billed charges,55.28,40,,,percent of total billed charges,40% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,110.56,80,,,percent of total billed charges,80% of total billed charges,53.62,38.8,,,percent of total billed charges,38.8% of total billed charges,117.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,131.29,
MRSA NARE Screen Cdr,40087081,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,59.4,47.52,,44.55,75,,,percent of total billed charges,75% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,47.04,79.2,,,percent of total billed charges,79.2% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,56.43,95,,,percent of total billed charges,95% of total billed charges,47.52,80,,,percent of total billed charges,80% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,23.76,40,,,percent of total billed charges,40% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,45.14,76,,,percent of total billed charges,76% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,47.52,80,,,percent of total billed charges,80% of total billed charges,23.05,38.8,,,percent of total billed charges,38.8% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,56.43,
Tissue Culture CDR,40088233,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,534.8,427.84,,401.1,75,,,percent of total billed charges,75% of total billed charges,213.92,40,,,percent of total billed charges,40% of total billed charges,423.56,79.2,,,percent of total billed charges,79.2% of total billed charges,454.58,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,508.06,95,,,percent of total billed charges,95% of total billed charges,427.84,80,,,percent of total billed charges,80% of total billed charges,454.58,85,,,percent of total billed charges,85% of total billed charges,481.32,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,213.92,40,,,percent of total billed charges,40% of total billed charges,213.92,40,,,percent of total billed charges,40% of total billed charges,481.32,90,,,percent of total billed charges,90% of total billed charges,406.45,76,,,percent of total billed charges,76% of total billed charges,213.92,40,,,percent of total billed charges,40% of total billed charges,454.58,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,427.84,80,,,percent of total billed charges,80% of total billed charges,207.5,38.8,,,percent of total billed charges,38.8% of total billed charges,454.58,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,508.06,
Transferrin CDR,40084466,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,122.2,97.76,,91.65,75,,,percent of total billed charges,75% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,96.78,79.2,,,percent of total billed charges,79.2% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,116.09,95,,,percent of total billed charges,95% of total billed charges,97.76,80,,,percent of total billed charges,80% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,109.98,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,48.88,40,,,percent of total billed charges,40% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,109.98,90,,,percent of total billed charges,90% of total billed charges,92.87,76,,,percent of total billed charges,76% of total billed charges,48.88,40,,,percent of total billed charges,40% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,97.76,80,,,percent of total billed charges,80% of total billed charges,47.41,38.8,,,percent of total billed charges,38.8% of total billed charges,103.87,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,116.09,
Urine Culture CDR,40087088,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,99.8,79.84,,74.85,75,,,percent of total billed charges,75% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,79.04,79.2,,,percent of total billed charges,79.2% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,94.81,95,,,percent of total billed charges,95% of total billed charges,79.84,80,,,percent of total billed charges,80% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,89.82,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,39.92,40,,,percent of total billed charges,40% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,89.82,90,,,percent of total billed charges,90% of total billed charges,75.85,76,,,percent of total billed charges,76% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,79.84,80,,,percent of total billed charges,80% of total billed charges,38.72,38.8,,,percent of total billed charges,38.8% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,94.81,
Vaginal Group B Strep CDR,40087081,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,59.4,47.52,,44.55,75,,,percent of total billed charges,75% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,47.04,79.2,,,percent of total billed charges,79.2% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,56.43,95,,,percent of total billed charges,95% of total billed charges,47.52,80,,,percent of total billed charges,80% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,23.76,40,,,percent of total billed charges,40% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,45.14,76,,,percent of total billed charges,76% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,47.52,80,,,percent of total billed charges,80% of total billed charges,23.05,38.8,,,percent of total billed charges,38.8% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,56.43,
Vancomycin Peak CDR,40080202,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
Vitamin B12 CDR,40082607,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,140.4,112.32,,105.3,75,,,percent of total billed charges,75% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,111.2,79.2,,,percent of total billed charges,79.2% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,133.38,95,,,percent of total billed charges,95% of total billed charges,112.32,80,,,percent of total billed charges,80% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,126.36,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,56.16,40,,,percent of total billed charges,40% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,126.36,90,,,percent of total billed charges,90% of total billed charges,106.7,76,,,percent of total billed charges,76% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,112.32,80,,,percent of total billed charges,80% of total billed charges,54.48,38.8,,,percent of total billed charges,38.8% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,133.38,
Vitamin D 25 OH CDR,40082306,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,278.3,222.64,,208.73,75,,,percent of total billed charges,75% of total billed charges,111.32,40,,,percent of total billed charges,40% of total billed charges,220.41,79.2,,,percent of total billed charges,79.2% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,264.39,95,,,percent of total billed charges,95% of total billed charges,222.64,80,,,percent of total billed charges,80% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,250.47,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,111.32,40,,,percent of total billed charges,40% of total billed charges,111.32,40,,,percent of total billed charges,40% of total billed charges,250.47,90,,,percent of total billed charges,90% of total billed charges,211.51,76,,,percent of total billed charges,76% of total billed charges,111.32,40,,,percent of total billed charges,40% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,222.64,80,,,percent of total billed charges,80% of total billed charges,107.98,38.8,,,percent of total billed charges,38.8% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,264.39,
"23540 CLOSED TX OF ACROMIOCLAVICULAR DISLOCATION, W/O MANIPU",3123540,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,987,789.6,,740.25,75,,,percent of total billed charges,75% of total billed charges,394.8,40,,,percent of total billed charges,40% of total billed charges,781.7,79.2,,,percent of total billed charges,79.2% of total billed charges,838.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,937.65,95,,,percent of total billed charges,95% of total billed charges,789.6,80,,,percent of total billed charges,80% of total billed charges,838.95,85,,,percent of total billed charges,85% of total billed charges,888.3,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,394.8,40,,,percent of total billed charges,40% of total billed charges,394.8,40,,,percent of total billed charges,40% of total billed charges,888.3,90,,,percent of total billed charges,90% of total billed charges,750.12,76,,,percent of total billed charges,76% of total billed charges,394.8,40,,,percent of total billed charges,40% of total billed charges,838.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,789.6,80,,,percent of total billed charges,80% of total billed charges,382.96,38.8,,,percent of total billed charges,38.8% of total billed charges,838.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,937.65,
OT Physical Performance Test Charges,60000283,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,128.7,102.96,GO,96.53,75,,,percent of total billed charges,75% of total billed charges,51.48,40,,,percent of total billed charges,40% of total billed charges,101.93,79.2,,,percent of total billed charges,79.2% of total billed charges,109.4,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,122.27,95,,,percent of total billed charges,95% of total billed charges,102.96,80,,,percent of total billed charges,80% of total billed charges,109.4,85,,,percent of total billed charges,85% of total billed charges,115.83,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,51.48,40,,,percent of total billed charges,40% of total billed charges,51.48,40,,,percent of total billed charges,40% of total billed charges,115.83,90,,,percent of total billed charges,90% of total billed charges,97.81,76,,,percent of total billed charges,76% of total billed charges,51.48,40,,,percent of total billed charges,40% of total billed charges,109.4,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,102.96,80,,,percent of total billed charges,80% of total billed charges,49.94,38.8,,,percent of total billed charges,38.8% of total billed charges,109.4,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,122.27,
DRILL BIT 2.7X125MM,46052331,CDM,270,RC,,,OUTPATIENT,,,631.5,505.2,,473.63,75,,,percent of total billed charges,75% of total billed charges,252.6,40,,,percent of total billed charges,40% of total billed charges,500.15,79.2,,,percent of total billed charges,79.2% of total billed charges,536.78,85,,,percent of total billed charges,85% of total billed charges,631.5,100,,,fee schedule,100% of CO APG rates,599.93,95,,,percent of total billed charges,95% of total billed charges,505.2,80,,,percent of total billed charges,80% of total billed charges,536.78,85,,,percent of total billed charges,85% of total billed charges,568.35,90,,,percent of total billed charges,90% of total billed charges,631.5,100,,,fee schedule,100% of CO APG rates,631.5,100,,,fee schedule,100% of CO APG rates,631.5,100,,,fee schedule,100% of NM fee schedule,252.6,40,,,percent of total billed charges,40% of total billed charges,252.6,40,,,percent of total billed charges,40% of total billed charges,568.35,90,,,percent of total billed charges,90% of total billed charges,479.94,76,,,percent of total billed charges,76% of total billed charges,252.6,40,,,percent of total billed charges,40% of total billed charges,536.78,85,,,percent of total billed charges,85% of total billed charges,631.5,100,,,fee schedule,100% of CO APG rate,505.2,80,,,percent of total billed charges,80% of total billed charges,245.02,38.8,,,percent of total billed charges,38.8% of total billed charges,536.78,85,,,percent of total billed charges,85% of total billed charges,631.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,245.02,631.5,
DRILL BIT 3.5X125MM,46052332,CDM,270,RC,,,OUTPATIENT,,,631.5,505.2,,473.63,75,,,percent of total billed charges,75% of total billed charges,252.6,40,,,percent of total billed charges,40% of total billed charges,500.15,79.2,,,percent of total billed charges,79.2% of total billed charges,536.78,85,,,percent of total billed charges,85% of total billed charges,631.5,100,,,fee schedule,100% of CO APG rates,599.93,95,,,percent of total billed charges,95% of total billed charges,505.2,80,,,percent of total billed charges,80% of total billed charges,536.78,85,,,percent of total billed charges,85% of total billed charges,568.35,90,,,percent of total billed charges,90% of total billed charges,631.5,100,,,fee schedule,100% of CO APG rates,631.5,100,,,fee schedule,100% of CO APG rates,631.5,100,,,fee schedule,100% of NM fee schedule,252.6,40,,,percent of total billed charges,40% of total billed charges,252.6,40,,,percent of total billed charges,40% of total billed charges,568.35,90,,,percent of total billed charges,90% of total billed charges,479.94,76,,,percent of total billed charges,76% of total billed charges,252.6,40,,,percent of total billed charges,40% of total billed charges,536.78,85,,,percent of total billed charges,85% of total billed charges,631.5,100,,,fee schedule,100% of CO APG rate,505.2,80,,,percent of total billed charges,80% of total billed charges,245.02,38.8,,,percent of total billed charges,38.8% of total billed charges,536.78,85,,,percent of total billed charges,85% of total billed charges,631.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,245.02,631.5,
DEVELOPMENT TEST INTERPTREP,60000354,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,163.1,130.48,GN,122.33,75,,,percent of total billed charges,75% of total billed charges,65.24,40,,,percent of total billed charges,40% of total billed charges,129.18,79.2,,,percent of total billed charges,79.2% of total billed charges,138.64,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,154.95,95,,,percent of total billed charges,95% of total billed charges,130.48,80,,,percent of total billed charges,80% of total billed charges,138.64,85,,,percent of total billed charges,85% of total billed charges,146.79,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,65.24,40,,,percent of total billed charges,40% of total billed charges,65.24,40,,,percent of total billed charges,40% of total billed charges,146.79,90,,,percent of total billed charges,90% of total billed charges,123.96,76,,,percent of total billed charges,76% of total billed charges,65.24,40,,,percent of total billed charges,40% of total billed charges,138.64,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,130.48,80,,,percent of total billed charges,80% of total billed charges,63.28,38.8,,,percent of total billed charges,38.8% of total billed charges,138.64,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,154.95,
96374 INJ IVP THER DX INTRV S/I DRUG,42196374,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,265.3,212.24,,198.98,75,,,percent of total billed charges,75% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,210.12,79.2,,,percent of total billed charges,79.2% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,252.04,95,,,percent of total billed charges,95% of total billed charges,212.24,80,,,percent of total billed charges,80% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,106.12,40,,,percent of total billed charges,40% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,201.63,76,,,percent of total billed charges,76% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,212.24,80,,,percent of total billed charges,80% of total billed charges,102.94,38.8,,,percent of total billed charges,38.8% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,252.04,
"96402 - Chemo Adm, Subq Or IM Horm - Patient Supplied Med",60000726,CDM,331,RC,96402,HCPCS,OUTPATIENT,,,314,251.2,,235.5,75,,,percent of total billed charges,75% of total billed charges,125.6,40,,,percent of total billed charges,40% of total billed charges,248.69,79.2,,,percent of total billed charges,79.2% of total billed charges,266.9,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,298.3,95,,,percent of total billed charges,95% of total billed charges,251.2,80,,,percent of total billed charges,80% of total billed charges,266.9,85,,,percent of total billed charges,85% of total billed charges,282.6,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,125.6,40,,,percent of total billed charges,40% of total billed charges,125.6,40,,,percent of total billed charges,40% of total billed charges,282.6,90,,,percent of total billed charges,90% of total billed charges,238.64,76,,,percent of total billed charges,76% of total billed charges,125.6,40,,,percent of total billed charges,40% of total billed charges,266.9,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,251.2,80,,,percent of total billed charges,80% of total billed charges,121.83,38.8,,,percent of total billed charges,38.8% of total billed charges,266.9,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,70.94,200,,,fee schedule,200% of CMS fee schedule,58.22,298.3,
Bill AB TITER,40586886,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,539.7,431.76,,404.78,75,,,percent of total billed charges,75% of total billed charges,215.88,40,,,percent of total billed charges,40% of total billed charges,427.44,79.2,,,percent of total billed charges,79.2% of total billed charges,458.75,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,512.72,95,,,percent of total billed charges,95% of total billed charges,431.76,80,,,percent of total billed charges,80% of total billed charges,458.75,85,,,percent of total billed charges,85% of total billed charges,485.73,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,215.88,40,,,percent of total billed charges,40% of total billed charges,215.88,40,,,percent of total billed charges,40% of total billed charges,485.73,90,,,percent of total billed charges,90% of total billed charges,410.17,76,,,percent of total billed charges,76% of total billed charges,215.88,40,,,percent of total billed charges,40% of total billed charges,458.75,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,431.76,80,,,percent of total billed charges,80% of total billed charges,209.4,38.8,,,percent of total billed charges,38.8% of total billed charges,458.75,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,512.72,
Environmental Culture CDR,40087070,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,140,112,,105,75,,,percent of total billed charges,75% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,110.88,79.2,,,percent of total billed charges,79.2% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,133,95,,,percent of total billed charges,95% of total billed charges,112,80,,,percent of total billed charges,80% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,126,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,56,40,,,percent of total billed charges,40% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,126,90,,,percent of total billed charges,90% of total billed charges,106.4,76,,,percent of total billed charges,76% of total billed charges,56,40,,,percent of total billed charges,40% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,112,80,,,percent of total billed charges,80% of total billed charges,54.32,38.8,,,percent of total billed charges,38.8% of total billed charges,119,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,133,
"AChR Blocking Abs, Serum LC",40083519,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,117.8,94.24,,88.35,75,,,percent of total billed charges,75% of total billed charges,47.12,40,,,percent of total billed charges,40% of total billed charges,93.3,79.2,,,percent of total billed charges,79.2% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,111.91,95,,,percent of total billed charges,95% of total billed charges,94.24,80,,,percent of total billed charges,80% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,106.02,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,47.12,40,,,percent of total billed charges,40% of total billed charges,47.12,40,,,percent of total billed charges,40% of total billed charges,106.02,90,,,percent of total billed charges,90% of total billed charges,89.53,76,,,percent of total billed charges,76% of total billed charges,47.12,40,,,percent of total billed charges,40% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,94.24,80,,,percent of total billed charges,80% of total billed charges,45.71,38.8,,,percent of total billed charges,38.8% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,111.91,
Aerobic Bacterial Culture LC,40087070,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,15.1,12.08,,11.33,75,,,percent of total billed charges,75% of total billed charges,6.04,40,,,percent of total billed charges,40% of total billed charges,11.96,79.2,,,percent of total billed charges,79.2% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,14.35,95,,,percent of total billed charges,95% of total billed charges,12.08,80,,,percent of total billed charges,80% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,13.59,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,6.04,40,,,percent of total billed charges,40% of total billed charges,6.04,40,,,percent of total billed charges,40% of total billed charges,13.59,90,,,percent of total billed charges,90% of total billed charges,11.48,76,,,percent of total billed charges,76% of total billed charges,6.04,40,,,percent of total billed charges,40% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,12.08,80,,,percent of total billed charges,80% of total billed charges,5.86,38.8,,,percent of total billed charges,38.8% of total billed charges,12.84,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,5.86,33.1,
"Aldosterone, Urine LC",40004291,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.7,48.56,,45.53,75,,,percent of total billed charges,75% of total billed charges,24.28,40,,,percent of total billed charges,40% of total billed charges,48.07,79.2,,,percent of total billed charges,79.2% of total billed charges,51.6,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.67,95,,,percent of total billed charges,95% of total billed charges,48.56,80,,,percent of total billed charges,80% of total billed charges,51.6,85,,,percent of total billed charges,85% of total billed charges,54.63,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.28,40,,,percent of total billed charges,40% of total billed charges,24.28,40,,,percent of total billed charges,40% of total billed charges,54.63,90,,,percent of total billed charges,90% of total billed charges,46.13,76,,,percent of total billed charges,76% of total billed charges,24.28,40,,,percent of total billed charges,40% of total billed charges,51.6,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.56,80,,,percent of total billed charges,80% of total billed charges,23.55,38.8,,,percent of total billed charges,38.8% of total billed charges,51.6,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.67,
"Allergen Profile, Food-Milk LC",40086003,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,135.7,108.56,,101.78,75,,,percent of total billed charges,75% of total billed charges,54.28,40,,,percent of total billed charges,40% of total billed charges,107.47,79.2,,,percent of total billed charges,79.2% of total billed charges,115.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,128.92,95,,,percent of total billed charges,95% of total billed charges,108.56,80,,,percent of total billed charges,80% of total billed charges,115.35,85,,,percent of total billed charges,85% of total billed charges,122.13,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,54.28,40,,,percent of total billed charges,40% of total billed charges,54.28,40,,,percent of total billed charges,40% of total billed charges,122.13,90,,,percent of total billed charges,90% of total billed charges,103.13,76,,,percent of total billed charges,76% of total billed charges,54.28,40,,,percent of total billed charges,40% of total billed charges,115.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,108.56,80,,,percent of total billed charges,80% of total billed charges,52.65,38.8,,,percent of total billed charges,38.8% of total billed charges,115.35,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,128.92,
"Amikacin Trough, Serum LC",40080150,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
"Amino Acid Profile, Qn, Plasma LC",40082139,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,282,225.6,,211.5,75,,,percent of total billed charges,75% of total billed charges,112.8,40,,,percent of total billed charges,40% of total billed charges,223.34,79.2,,,percent of total billed charges,79.2% of total billed charges,239.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,267.9,95,,,percent of total billed charges,95% of total billed charges,225.6,80,,,percent of total billed charges,80% of total billed charges,239.7,85,,,percent of total billed charges,85% of total billed charges,253.8,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,112.8,40,,,percent of total billed charges,40% of total billed charges,112.8,40,,,percent of total billed charges,40% of total billed charges,253.8,90,,,percent of total billed charges,90% of total billed charges,214.32,76,,,percent of total billed charges,76% of total billed charges,112.8,40,,,percent of total billed charges,40% of total billed charges,239.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,225.6,80,,,percent of total billed charges,80% of total billed charges,109.42,38.8,,,percent of total billed charges,38.8% of total billed charges,239.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,267.9,
"Ammonia, Plasma LC",40007054,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,37.9,30.32,,28.43,75,,,percent of total billed charges,75% of total billed charges,15.16,40,,,percent of total billed charges,40% of total billed charges,30.02,79.2,,,percent of total billed charges,79.2% of total billed charges,32.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,36.01,95,,,percent of total billed charges,95% of total billed charges,30.32,80,,,percent of total billed charges,80% of total billed charges,32.22,85,,,percent of total billed charges,85% of total billed charges,34.11,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,15.16,40,,,percent of total billed charges,40% of total billed charges,15.16,40,,,percent of total billed charges,40% of total billed charges,34.11,90,,,percent of total billed charges,90% of total billed charges,28.8,76,,,percent of total billed charges,76% of total billed charges,15.16,40,,,percent of total billed charges,40% of total billed charges,32.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,30.32,80,,,percent of total billed charges,80% of total billed charges,14.71,38.8,,,percent of total billed charges,38.8% of total billed charges,32.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,36.01,
Anaerobic Culture LC,40087075,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,31.8,25.44,,23.85,75,,,percent of total billed charges,75% of total billed charges,12.72,40,,,percent of total billed charges,40% of total billed charges,25.19,79.2,,,percent of total billed charges,79.2% of total billed charges,27.03,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,30.21,95,,,percent of total billed charges,95% of total billed charges,25.44,80,,,percent of total billed charges,80% of total billed charges,27.03,85,,,percent of total billed charges,85% of total billed charges,28.62,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,12.72,40,,,percent of total billed charges,40% of total billed charges,12.72,40,,,percent of total billed charges,40% of total billed charges,28.62,90,,,percent of total billed charges,90% of total billed charges,24.17,76,,,percent of total billed charges,76% of total billed charges,12.72,40,,,percent of total billed charges,40% of total billed charges,27.03,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,25.44,80,,,percent of total billed charges,80% of total billed charges,12.34,38.8,,,percent of total billed charges,38.8% of total billed charges,27.03,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,33.1,
"Cardiolipin (phospholipid) antibody, each Ig class",40086147,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,134,107.2,,100.5,75,,,percent of total billed charges,75% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,106.13,79.2,,,percent of total billed charges,79.2% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,127.3,95,,,percent of total billed charges,95% of total billed charges,107.2,80,,,percent of total billed charges,80% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,53.6,40,,,percent of total billed charges,40% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,101.84,76,,,percent of total billed charges,76% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,107.2,80,,,percent of total billed charges,80% of total billed charges,51.99,38.8,,,percent of total billed charges,38.8% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,127.3,
Anti-DNase B Strep Antibodies LC,40096289,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,50.9,40.72,,38.18,75,,,percent of total billed charges,75% of total billed charges,20.36,40,,,percent of total billed charges,40% of total billed charges,40.31,79.2,,,percent of total billed charges,79.2% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,48.36,95,,,percent of total billed charges,95% of total billed charges,40.72,80,,,percent of total billed charges,80% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,45.81,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,20.36,40,,,percent of total billed charges,40% of total billed charges,20.36,40,,,percent of total billed charges,40% of total billed charges,45.81,90,,,percent of total billed charges,90% of total billed charges,38.68,76,,,percent of total billed charges,76% of total billed charges,20.36,40,,,percent of total billed charges,40% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,40.72,80,,,percent of total billed charges,80% of total billed charges,19.75,38.8,,,percent of total billed charges,38.8% of total billed charges,43.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,48.36,
Immunoassay for analyte other than infectious agent antibody,40083516,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,118,94.4,,88.5,75,,,percent of total billed charges,75% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,93.46,79.2,,,percent of total billed charges,79.2% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,112.1,95,,,percent of total billed charges,95% of total billed charges,94.4,80,,,percent of total billed charges,80% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,47.2,40,,,percent of total billed charges,40% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,89.68,76,,,percent of total billed charges,76% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,94.4,80,,,percent of total billed charges,80% of total billed charges,45.78,38.8,,,percent of total billed charges,38.8% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,112.1,
Immunoassay for analyte other than infectious agent antibody,40082716,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,118,94.4,,88.5,75,,,percent of total billed charges,75% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,93.46,79.2,,,percent of total billed charges,79.2% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,112.1,95,,,percent of total billed charges,95% of total billed charges,94.4,80,,,percent of total billed charges,80% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,47.2,40,,,percent of total billed charges,40% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,89.68,76,,,percent of total billed charges,76% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,94.4,80,,,percent of total billed charges,80% of total billed charges,45.78,38.8,,,percent of total billed charges,38.8% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,112.1,
Antipancreatic Islet Cells LC,40086341,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,127.3,101.84,,95.48,75,,,percent of total billed charges,75% of total billed charges,50.92,40,,,percent of total billed charges,40% of total billed charges,100.82,79.2,,,percent of total billed charges,79.2% of total billed charges,108.21,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,120.94,95,,,percent of total billed charges,95% of total billed charges,101.84,80,,,percent of total billed charges,80% of total billed charges,108.21,85,,,percent of total billed charges,85% of total billed charges,114.57,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.92,40,,,percent of total billed charges,40% of total billed charges,50.92,40,,,percent of total billed charges,40% of total billed charges,114.57,90,,,percent of total billed charges,90% of total billed charges,96.75,76,,,percent of total billed charges,76% of total billed charges,50.92,40,,,percent of total billed charges,40% of total billed charges,108.21,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,101.84,80,,,percent of total billed charges,80% of total billed charges,49.39,38.8,,,percent of total billed charges,38.8% of total billed charges,108.21,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,120.94,
Anti-Ribonucleic Acid Ab LC,40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,626.4,501.12,,469.8,75,,,percent of total billed charges,75% of total billed charges,250.56,40,,,percent of total billed charges,40% of total billed charges,496.11,79.2,,,percent of total billed charges,79.2% of total billed charges,532.44,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,595.08,95,,,percent of total billed charges,95% of total billed charges,501.12,80,,,percent of total billed charges,80% of total billed charges,532.44,85,,,percent of total billed charges,85% of total billed charges,563.76,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,250.56,40,,,percent of total billed charges,40% of total billed charges,250.56,40,,,percent of total billed charges,40% of total billed charges,563.76,90,,,percent of total billed charges,90% of total billed charges,476.06,76,,,percent of total billed charges,76% of total billed charges,250.56,40,,,percent of total billed charges,40% of total billed charges,532.44,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,501.12,80,,,percent of total billed charges,80% of total billed charges,243.04,38.8,,,percent of total billed charges,38.8% of total billed charges,532.44,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,595.08,
Immunoassay for analyte other than infectious agent antibody,40083516,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,313.3,250.64,,234.98,75,,,percent of total billed charges,75% of total billed charges,125.32,40,,,percent of total billed charges,40% of total billed charges,248.13,79.2,,,percent of total billed charges,79.2% of total billed charges,266.31,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,297.64,95,,,percent of total billed charges,95% of total billed charges,250.64,80,,,percent of total billed charges,80% of total billed charges,266.31,85,,,percent of total billed charges,85% of total billed charges,281.97,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,125.32,40,,,percent of total billed charges,40% of total billed charges,125.32,40,,,percent of total billed charges,40% of total billed charges,281.97,90,,,percent of total billed charges,90% of total billed charges,238.11,76,,,percent of total billed charges,76% of total billed charges,125.32,40,,,percent of total billed charges,40% of total billed charges,266.31,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,250.64,80,,,percent of total billed charges,80% of total billed charges,121.56,38.8,,,percent of total billed charges,38.8% of total billed charges,266.31,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,297.64,
"Arsenic Exposure Profile, Ur LC",40082175,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,171.3,137.04,,128.48,75,,,percent of total billed charges,75% of total billed charges,68.52,40,,,percent of total billed charges,40% of total billed charges,135.67,79.2,,,percent of total billed charges,79.2% of total billed charges,145.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,162.74,95,,,percent of total billed charges,95% of total billed charges,137.04,80,,,percent of total billed charges,80% of total billed charges,145.61,85,,,percent of total billed charges,85% of total billed charges,154.17,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,68.52,40,,,percent of total billed charges,40% of total billed charges,68.52,40,,,percent of total billed charges,40% of total billed charges,154.17,90,,,percent of total billed charges,90% of total billed charges,130.19,76,,,percent of total billed charges,76% of total billed charges,68.52,40,,,percent of total billed charges,40% of total billed charges,145.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,137.04,80,,,percent of total billed charges,80% of total billed charges,66.46,38.8,,,percent of total billed charges,38.8% of total billed charges,145.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,162.74,
"Arsenic, Blood LC",40082175,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.6,58.88,,55.2,75,,,percent of total billed charges,75% of total billed charges,29.44,40,,,percent of total billed charges,40% of total billed charges,58.29,79.2,,,percent of total billed charges,79.2% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.92,95,,,percent of total billed charges,95% of total billed charges,58.88,80,,,percent of total billed charges,80% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,66.24,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.44,40,,,percent of total billed charges,40% of total billed charges,29.44,40,,,percent of total billed charges,40% of total billed charges,66.24,90,,,percent of total billed charges,90% of total billed charges,55.94,76,,,percent of total billed charges,76% of total billed charges,29.44,40,,,percent of total billed charges,40% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.88,80,,,percent of total billed charges,80% of total billed charges,28.56,38.8,,,percent of total billed charges,38.8% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.92,
1.2X10MM BONE SCREWSCROSSPINSELFT,46050583,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.2X12MM BONE SCREWSCROSSPINSELFT,46050584,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.2X14MM BONE SCREWSCROSSPINSELFT,46050585,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.2X16MM BONE SCREWSCROSSPINSELFT,46050586,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.2X18MM BONE SCREWSCROSSPINSELFT,46050587,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.2X20MM BONE SCREWSCROSSPINSELFT,46050588,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.2X4MM BONE SCREWSCROSSPINSELFT,46050589,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.2X5MM BONE SCREWSCROSSPINSELFT,46050590,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.2X6MM BONE SCREWSCROSSPINSELFT,46050591,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.2X7MM BONE SCREWSCROSSPINSELFT,46050592,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.2X8MM BONE SCREWSCROSSPINSELFT,46050593,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.2X9MM BONE SCREWSCROSSPINSELFT,46050594,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
1.4X3MM EMERG SCREWSCROSSPINSELFT,46050595,CDM,278,RC,,,OUTPATIENT,,,265.8,212.64,,199.35,75,,,percent of total billed charges,75% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,210.51,79.2,,,percent of total billed charges,79.2% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,252.51,95,,,percent of total billed charges,95% of total billed charges,212.64,80,,,percent of total billed charges,80% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of NM fee schedule,106.32,40,,,percent of total billed charges,40% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,202.01,76,,,percent of total billed charges,76% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rate,212.64,80,,,percent of total billed charges,80% of total billed charges,103.13,38.8,,,percent of total billed charges,38.8% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.13,265.8,
1.4X5MM EMERG SCREWSCROSSPINSELFT,46050596,CDM,278,RC,,,OUTPATIENT,,,265.8,212.64,,199.35,75,,,percent of total billed charges,75% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,210.51,79.2,,,percent of total billed charges,79.2% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,252.51,95,,,percent of total billed charges,95% of total billed charges,212.64,80,,,percent of total billed charges,80% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of NM fee schedule,106.32,40,,,percent of total billed charges,40% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,202.01,76,,,percent of total billed charges,76% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rate,212.64,80,,,percent of total billed charges,80% of total billed charges,103.13,38.8,,,percent of total billed charges,38.8% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.13,265.8,
1.4X7MM EMERG SCREWSCROSSPINSELFT,46050597,CDM,278,RC,,,OUTPATIENT,,,265.8,212.64,,199.35,75,,,percent of total billed charges,75% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,210.51,79.2,,,percent of total billed charges,79.2% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,252.51,95,,,percent of total billed charges,95% of total billed charges,212.64,80,,,percent of total billed charges,80% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of NM fee schedule,106.32,40,,,percent of total billed charges,40% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,202.01,76,,,percent of total billed charges,76% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rate,212.64,80,,,percent of total billed charges,80% of total billed charges,103.13,38.8,,,percent of total billed charges,38.8% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.13,265.8,
1.4X9MM EMERG SCREWSCROSSPINSELFT,46050598,CDM,278,RC,,,OUTPATIENT,,,265.8,212.64,,199.35,75,,,percent of total billed charges,75% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,210.51,79.2,,,percent of total billed charges,79.2% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,252.51,95,,,percent of total billed charges,95% of total billed charges,212.64,80,,,percent of total billed charges,80% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of NM fee schedule,106.32,40,,,percent of total billed charges,40% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,202.01,76,,,percent of total billed charges,76% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rate,212.64,80,,,percent of total billed charges,80% of total billed charges,103.13,38.8,,,percent of total billed charges,38.8% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.13,265.8,
"1.7 S PROFYLE HAND LOCK 3-D PLATE,2X2+2H",46050599,CDM,278,RC,,,OUTPATIENT,,,1210.1,968.08,,907.58,75,,,percent of total billed charges,75% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,958.4,79.2,,,percent of total billed charges,79.2% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rates,1149.6,95,,,percent of total billed charges,95% of total billed charges,968.08,80,,,percent of total billed charges,80% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1089.09,90,,,percent of total billed charges,90% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rates,1210.1,100,,,fee schedule,100% of CO APG rates,1210.1,100,,,fee schedule,100% of NM fee schedule,484.04,40,,,percent of total billed charges,40% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,1089.09,90,,,percent of total billed charges,90% of total billed charges,919.68,76,,,percent of total billed charges,76% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rate,968.08,80,,,percent of total billed charges,80% of total billed charges,469.52,38.8,,,percent of total billed charges,38.8% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,469.52,1210.1,
"1.7 S PROFYLE HAND LOCK 3-D PLATE,2X2H",46050600,CDM,278,RC,,,OUTPATIENT,,,932.8,746.24,,699.6,75,,,percent of total billed charges,75% of total billed charges,373.12,40,,,percent of total billed charges,40% of total billed charges,738.78,79.2,,,percent of total billed charges,79.2% of total billed charges,792.88,85,,,percent of total billed charges,85% of total billed charges,932.8,100,,,fee schedule,100% of CO APG rates,886.16,95,,,percent of total billed charges,95% of total billed charges,746.24,80,,,percent of total billed charges,80% of total billed charges,792.88,85,,,percent of total billed charges,85% of total billed charges,839.52,90,,,percent of total billed charges,90% of total billed charges,932.8,100,,,fee schedule,100% of CO APG rates,932.8,100,,,fee schedule,100% of CO APG rates,932.8,100,,,fee schedule,100% of NM fee schedule,373.12,40,,,percent of total billed charges,40% of total billed charges,373.12,40,,,percent of total billed charges,40% of total billed charges,839.52,90,,,percent of total billed charges,90% of total billed charges,708.93,76,,,percent of total billed charges,76% of total billed charges,373.12,40,,,percent of total billed charges,40% of total billed charges,792.88,85,,,percent of total billed charges,85% of total billed charges,932.8,100,,,fee schedule,100% of CO APG rate,746.24,80,,,percent of total billed charges,80% of total billed charges,361.93,38.8,,,percent of total billed charges,38.8% of total billed charges,792.88,85,,,percent of total billed charges,85% of total billed charges,932.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,361.93,932.8,
"1.7 S PROFYLE HAND LOCK 3-D PLATE,3X2H",46050601,CDM,278,RC,,,OUTPATIENT,,,1210.1,968.08,,907.58,75,,,percent of total billed charges,75% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,958.4,79.2,,,percent of total billed charges,79.2% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rates,1149.6,95,,,percent of total billed charges,95% of total billed charges,968.08,80,,,percent of total billed charges,80% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1089.09,90,,,percent of total billed charges,90% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rates,1210.1,100,,,fee schedule,100% of CO APG rates,1210.1,100,,,fee schedule,100% of NM fee schedule,484.04,40,,,percent of total billed charges,40% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,1089.09,90,,,percent of total billed charges,90% of total billed charges,919.68,76,,,percent of total billed charges,76% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rate,968.08,80,,,percent of total billed charges,80% of total billed charges,469.52,38.8,,,percent of total billed charges,38.8% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,469.52,1210.1,
"1.7 S PROFYLE HAND LOCK 3-D PLATE,4X2H",46050602,CDM,278,RC,,,OUTPATIENT,,,1455.9,1164.72,,1091.93,75,,,percent of total billed charges,75% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1153.07,79.2,,,percent of total billed charges,79.2% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rates,1383.11,95,,,percent of total billed charges,95% of total billed charges,1164.72,80,,,percent of total billed charges,80% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1310.31,90,,,percent of total billed charges,90% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rates,1455.9,100,,,fee schedule,100% of CO APG rates,1455.9,100,,,fee schedule,100% of NM fee schedule,582.36,40,,,percent of total billed charges,40% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1310.31,90,,,percent of total billed charges,90% of total billed charges,1106.48,76,,,percent of total billed charges,76% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rate,1164.72,80,,,percent of total billed charges,80% of total billed charges,564.89,38.8,,,percent of total billed charges,38.8% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,564.89,1455.9,
"1.7 S PROFYLE HAND LOCK 3-D REPL PL,4X2H",46050603,CDM,278,RC,,,OUTPATIENT,,,1455.9,1164.72,,1091.93,75,,,percent of total billed charges,75% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1153.07,79.2,,,percent of total billed charges,79.2% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rates,1383.11,95,,,percent of total billed charges,95% of total billed charges,1164.72,80,,,percent of total billed charges,80% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1310.31,90,,,percent of total billed charges,90% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rates,1455.9,100,,,fee schedule,100% of CO APG rates,1455.9,100,,,fee schedule,100% of NM fee schedule,582.36,40,,,percent of total billed charges,40% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1310.31,90,,,percent of total billed charges,90% of total billed charges,1106.48,76,,,percent of total billed charges,76% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rate,1164.72,80,,,percent of total billed charges,80% of total billed charges,564.89,38.8,,,percent of total billed charges,38.8% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,564.89,1455.9,
"1.7 S PROFYLE HAND LOCK L-PLATE,LE,6H",46050604,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
"1.7 S PROFYLE HAND LOCK L-PLATE,RI,6H",46050605,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
"1.7 S PROFYLE HAND LOCK PLATE,STRAI,16H",46050606,CDM,278,RC,,,OUTPATIENT,,,1055.7,844.56,,791.78,75,,,percent of total billed charges,75% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,836.11,79.2,,,percent of total billed charges,79.2% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rates,1002.92,95,,,percent of total billed charges,95% of total billed charges,844.56,80,,,percent of total billed charges,80% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,950.13,90,,,percent of total billed charges,90% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rates,1055.7,100,,,fee schedule,100% of CO APG rates,1055.7,100,,,fee schedule,100% of NM fee schedule,422.28,40,,,percent of total billed charges,40% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,950.13,90,,,percent of total billed charges,90% of total billed charges,802.33,76,,,percent of total billed charges,76% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rate,844.56,80,,,percent of total billed charges,80% of total billed charges,409.61,38.8,,,percent of total billed charges,38.8% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,409.61,1055.7,
"1.7 S PROFYLE HAND LOCK PLATE,STRAI,4H",46050607,CDM,278,RC,,,OUTPATIENT,,,554.6,443.68,,415.95,75,,,percent of total billed charges,75% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,439.24,79.2,,,percent of total billed charges,79.2% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,526.87,95,,,percent of total billed charges,95% of total billed charges,443.68,80,,,percent of total billed charges,80% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of NM fee schedule,221.84,40,,,percent of total billed charges,40% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,421.5,76,,,percent of total billed charges,76% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rate,443.68,80,,,percent of total billed charges,80% of total billed charges,215.18,38.8,,,percent of total billed charges,38.8% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,215.18,554.6,
"1.7 S PROFYLE HAND LOCK ROTATION PLATE,5H",46050608,CDM,278,RC,,,OUTPATIENT,,,1455.9,1164.72,,1091.93,75,,,percent of total billed charges,75% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1153.07,79.2,,,percent of total billed charges,79.2% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rates,1383.11,95,,,percent of total billed charges,95% of total billed charges,1164.72,80,,,percent of total billed charges,80% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1310.31,90,,,percent of total billed charges,90% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rates,1455.9,100,,,fee schedule,100% of CO APG rates,1455.9,100,,,fee schedule,100% of NM fee schedule,582.36,40,,,percent of total billed charges,40% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1310.31,90,,,percent of total billed charges,90% of total billed charges,1106.48,76,,,percent of total billed charges,76% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rate,1164.72,80,,,percent of total billed charges,80% of total billed charges,564.89,38.8,,,percent of total billed charges,38.8% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,564.89,1455.9,
"1.7 S PROFYLE HAND LOCK T-PLATE,NAR,10H",46050609,CDM,278,RC,,,OUTPATIENT,,,856.1,684.88,,642.08,75,,,percent of total billed charges,75% of total billed charges,342.44,40,,,percent of total billed charges,40% of total billed charges,678.03,79.2,,,percent of total billed charges,79.2% of total billed charges,727.69,85,,,percent of total billed charges,85% of total billed charges,856.1,100,,,fee schedule,100% of CO APG rates,813.3,95,,,percent of total billed charges,95% of total billed charges,684.88,80,,,percent of total billed charges,80% of total billed charges,727.69,85,,,percent of total billed charges,85% of total billed charges,770.49,90,,,percent of total billed charges,90% of total billed charges,856.1,100,,,fee schedule,100% of CO APG rates,856.1,100,,,fee schedule,100% of CO APG rates,856.1,100,,,fee schedule,100% of NM fee schedule,342.44,40,,,percent of total billed charges,40% of total billed charges,342.44,40,,,percent of total billed charges,40% of total billed charges,770.49,90,,,percent of total billed charges,90% of total billed charges,650.64,76,,,percent of total billed charges,76% of total billed charges,342.44,40,,,percent of total billed charges,40% of total billed charges,727.69,85,,,percent of total billed charges,85% of total billed charges,856.1,100,,,fee schedule,100% of CO APG rate,684.88,80,,,percent of total billed charges,80% of total billed charges,332.17,38.8,,,percent of total billed charges,38.8% of total billed charges,727.69,85,,,percent of total billed charges,85% of total billed charges,856.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,332.17,856.1,
"1.7 S PROFYLE HAND LOCK T-PLATE,NAR,6H",46050610,CDM,278,RC,,,OUTPATIENT,,,804.6,643.68,,603.45,75,,,percent of total billed charges,75% of total billed charges,321.84,40,,,percent of total billed charges,40% of total billed charges,637.24,79.2,,,percent of total billed charges,79.2% of total billed charges,683.91,85,,,percent of total billed charges,85% of total billed charges,804.6,100,,,fee schedule,100% of CO APG rates,764.37,95,,,percent of total billed charges,95% of total billed charges,643.68,80,,,percent of total billed charges,80% of total billed charges,683.91,85,,,percent of total billed charges,85% of total billed charges,724.14,90,,,percent of total billed charges,90% of total billed charges,804.6,100,,,fee schedule,100% of CO APG rates,804.6,100,,,fee schedule,100% of CO APG rates,804.6,100,,,fee schedule,100% of NM fee schedule,321.84,40,,,percent of total billed charges,40% of total billed charges,321.84,40,,,percent of total billed charges,40% of total billed charges,724.14,90,,,percent of total billed charges,90% of total billed charges,611.5,76,,,percent of total billed charges,76% of total billed charges,321.84,40,,,percent of total billed charges,40% of total billed charges,683.91,85,,,percent of total billed charges,85% of total billed charges,804.6,100,,,fee schedule,100% of CO APG rate,643.68,80,,,percent of total billed charges,80% of total billed charges,312.18,38.8,,,percent of total billed charges,38.8% of total billed charges,683.91,85,,,percent of total billed charges,85% of total billed charges,804.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,312.18,804.6,
"1.7 S PROFYLE HAND LOCK T-PLATE,REG,7H",46050611,CDM,278,RC,,,OUTPATIENT,,,804.6,643.68,,603.45,75,,,percent of total billed charges,75% of total billed charges,321.84,40,,,percent of total billed charges,40% of total billed charges,637.24,79.2,,,percent of total billed charges,79.2% of total billed charges,683.91,85,,,percent of total billed charges,85% of total billed charges,804.6,100,,,fee schedule,100% of CO APG rates,764.37,95,,,percent of total billed charges,95% of total billed charges,643.68,80,,,percent of total billed charges,80% of total billed charges,683.91,85,,,percent of total billed charges,85% of total billed charges,724.14,90,,,percent of total billed charges,90% of total billed charges,804.6,100,,,fee schedule,100% of CO APG rates,804.6,100,,,fee schedule,100% of CO APG rates,804.6,100,,,fee schedule,100% of NM fee schedule,321.84,40,,,percent of total billed charges,40% of total billed charges,321.84,40,,,percent of total billed charges,40% of total billed charges,724.14,90,,,percent of total billed charges,90% of total billed charges,611.5,76,,,percent of total billed charges,76% of total billed charges,321.84,40,,,percent of total billed charges,40% of total billed charges,683.91,85,,,percent of total billed charges,85% of total billed charges,804.6,100,,,fee schedule,100% of CO APG rate,643.68,80,,,percent of total billed charges,80% of total billed charges,312.18,38.8,,,percent of total billed charges,38.8% of total billed charges,683.91,85,,,percent of total billed charges,85% of total billed charges,804.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,312.18,804.6,
"1.7 S PROFYLE HAND LOCK T-PLATE,WIDE,8H",46050612,CDM,278,RC,,,OUTPATIENT,,,884.4,707.52,,663.3,75,,,percent of total billed charges,75% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,700.44,79.2,,,percent of total billed charges,79.2% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rates,840.18,95,,,percent of total billed charges,95% of total billed charges,707.52,80,,,percent of total billed charges,80% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,795.96,90,,,percent of total billed charges,90% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rates,884.4,100,,,fee schedule,100% of CO APG rates,884.4,100,,,fee schedule,100% of NM fee schedule,353.76,40,,,percent of total billed charges,40% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,795.96,90,,,percent of total billed charges,90% of total billed charges,672.14,76,,,percent of total billed charges,76% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rate,707.52,80,,,percent of total billed charges,80% of total billed charges,343.15,38.8,,,percent of total billed charges,38.8% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,343.15,884.4,
"1.7 S PROFYLE HAND LOCK Z-PLATE,NAR,9H",46050613,CDM,278,RC,,,OUTPATIENT,,,925.4,740.32,,694.05,75,,,percent of total billed charges,75% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,732.92,79.2,,,percent of total billed charges,79.2% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rates,879.13,95,,,percent of total billed charges,95% of total billed charges,740.32,80,,,percent of total billed charges,80% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,832.86,90,,,percent of total billed charges,90% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rates,925.4,100,,,fee schedule,100% of CO APG rates,925.4,100,,,fee schedule,100% of NM fee schedule,370.16,40,,,percent of total billed charges,40% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,832.86,90,,,percent of total billed charges,90% of total billed charges,703.3,76,,,percent of total billed charges,76% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rate,740.32,80,,,percent of total billed charges,80% of total billed charges,359.06,38.8,,,percent of total billed charges,38.8% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,359.06,925.4,
1.7X10MM BONE SCREWSCROSSPINSELFTAPPING,46050614,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"1.7X10MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050615,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
1.7X11MM BONE SCREWSCROSSPINSELFTAPPING,46050616,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"1.7X11MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050617,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
1.7X12MM BONE SCREWSCROSSPINSELFTAPPING,46050618,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"1.7X12MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050619,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X13MM BONE SCREWSCROSSPINSELFTAPPING,46050620,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X13MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050621,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X14MM BONE SCREWSCROSSPINSELFTAPPING,46050622,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X14MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050623,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X15MM BONE SCREWSCROSSPINSELFTAPPING,46050624,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X15MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050625,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X16MM BONE SCREWSCROSSPINSELFTAPPING,46050626,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X16MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050627,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X18MM BONE SCREWSCROSSPINSELFTAPPING,46050628,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X18MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050629,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X20MM BONE SCREWSCROSSPINSELFTAPPING,46050630,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X20MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050631,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X22MM BONE SCREWSCROSSPINSELFTAPPING,46050632,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X22MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050633,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X24MM BONE SCREWSCROSSPINSELFTAPPING,46050634,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X24MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050635,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X5MM BONE SCREWSCROSSPINSELFTAPPING,46050636,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X5MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050637,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X6MM BONE SCREWSCROSSPINSELFTAPPING,46050638,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X6MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050639,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X7MM BONE SCREWSCROSSPINSELFTAPPING,46050640,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X7MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050641,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X8MM BONE SCREWSCROSSPINSELFTAPPING,46050642,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X8MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050643,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.7X9MM BONE SCREWSCROSSPINSELFTAPPING,46050644,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,491.6,200,,,percent of total billed charges,200% of total billed charges,95.37,491.6,
"1.7X9MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050645,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,546.2,200,,,percent of total billed charges,200% of total billed charges,105.96,546.2,
1.9X10MM EMERG SCREWSCROSSPINSELFT,46050646,CDM,278,RC,,,OUTPATIENT,,,265.8,212.64,,199.35,75,,,percent of total billed charges,75% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,210.51,79.2,,,percent of total billed charges,79.2% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,252.51,95,,,percent of total billed charges,95% of total billed charges,212.64,80,,,percent of total billed charges,80% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of NM fee schedule,106.32,40,,,percent of total billed charges,40% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,202.01,76,,,percent of total billed charges,76% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rate,212.64,80,,,percent of total billed charges,80% of total billed charges,103.13,38.8,,,percent of total billed charges,38.8% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of APG fee schedule,531.6,200,,,percent of total billed charges,200% of total billed charges,103.13,531.6,
1.9X12MM EMERG SCREWSCROSSPINSELFT,46050647,CDM,278,RC,,,OUTPATIENT,,,265.8,212.64,,199.35,75,,,percent of total billed charges,75% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,210.51,79.2,,,percent of total billed charges,79.2% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,252.51,95,,,percent of total billed charges,95% of total billed charges,212.64,80,,,percent of total billed charges,80% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of NM fee schedule,106.32,40,,,percent of total billed charges,40% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,202.01,76,,,percent of total billed charges,76% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rate,212.64,80,,,percent of total billed charges,80% of total billed charges,103.13,38.8,,,percent of total billed charges,38.8% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of APG fee schedule,531.6,200,,,percent of total billed charges,200% of total billed charges,103.13,531.6,
1.9X5MM EMERG SCREWSCROSSPINSELFT,46050648,CDM,278,RC,,,OUTPATIENT,,,265.8,212.64,,199.35,75,,,percent of total billed charges,75% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,210.51,79.2,,,percent of total billed charges,79.2% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,252.51,95,,,percent of total billed charges,95% of total billed charges,212.64,80,,,percent of total billed charges,80% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of NM fee schedule,106.32,40,,,percent of total billed charges,40% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,202.01,76,,,percent of total billed charges,76% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rate,212.64,80,,,percent of total billed charges,80% of total billed charges,103.13,38.8,,,percent of total billed charges,38.8% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of APG fee schedule,531.6,200,,,percent of total billed charges,200% of total billed charges,103.13,531.6,
1.9X8MM EMERG SCREWSCROSSPINSELFT,46050649,CDM,278,RC,,,OUTPATIENT,,,265.8,212.64,,199.35,75,,,percent of total billed charges,75% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,210.51,79.2,,,percent of total billed charges,79.2% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,252.51,95,,,percent of total billed charges,95% of total billed charges,212.64,80,,,percent of total billed charges,80% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of NM fee schedule,106.32,40,,,percent of total billed charges,40% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,202.01,76,,,percent of total billed charges,76% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rate,212.64,80,,,percent of total billed charges,80% of total billed charges,103.13,38.8,,,percent of total billed charges,38.8% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of APG fee schedule,531.6,200,,,percent of total billed charges,200% of total billed charges,103.13,531.6,
"2.3 M PROFYLE HAND LOCK 3-D PLATE,2X2+2H",46050650,CDM,278,RC,,,OUTPATIENT,,,1210.1,968.08,,907.58,75,,,percent of total billed charges,75% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,958.4,79.2,,,percent of total billed charges,79.2% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rates,1149.6,95,,,percent of total billed charges,95% of total billed charges,968.08,80,,,percent of total billed charges,80% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1089.09,90,,,percent of total billed charges,90% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rates,1210.1,100,,,fee schedule,100% of CO APG rates,1210.1,100,,,fee schedule,100% of NM fee schedule,484.04,40,,,percent of total billed charges,40% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,1089.09,90,,,percent of total billed charges,90% of total billed charges,919.68,76,,,percent of total billed charges,76% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rate,968.08,80,,,percent of total billed charges,80% of total billed charges,469.52,38.8,,,percent of total billed charges,38.8% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,469.52,1210.1,
"2.3 M PROFYLE HAND LOCK 3-D PLATE,2X2H",46050651,CDM,278,RC,,,OUTPATIENT,,,1122.9,898.32,,842.18,75,,,percent of total billed charges,75% of total billed charges,449.16,40,,,percent of total billed charges,40% of total billed charges,889.34,79.2,,,percent of total billed charges,79.2% of total billed charges,954.47,85,,,percent of total billed charges,85% of total billed charges,1122.9,100,,,fee schedule,100% of CO APG rates,1066.76,95,,,percent of total billed charges,95% of total billed charges,898.32,80,,,percent of total billed charges,80% of total billed charges,954.47,85,,,percent of total billed charges,85% of total billed charges,1010.61,90,,,percent of total billed charges,90% of total billed charges,1122.9,100,,,fee schedule,100% of CO APG rates,1122.9,100,,,fee schedule,100% of CO APG rates,1122.9,100,,,fee schedule,100% of NM fee schedule,449.16,40,,,percent of total billed charges,40% of total billed charges,449.16,40,,,percent of total billed charges,40% of total billed charges,1010.61,90,,,percent of total billed charges,90% of total billed charges,853.4,76,,,percent of total billed charges,76% of total billed charges,449.16,40,,,percent of total billed charges,40% of total billed charges,954.47,85,,,percent of total billed charges,85% of total billed charges,1122.9,100,,,fee schedule,100% of CO APG rate,898.32,80,,,percent of total billed charges,80% of total billed charges,435.69,38.8,,,percent of total billed charges,38.8% of total billed charges,954.47,85,,,percent of total billed charges,85% of total billed charges,1122.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,435.69,1122.9,
"2.3 M PROFYLE HAND LOCK 3-D PLATE,3X2H",46050652,CDM,278,RC,,,OUTPATIENT,,,1210.1,968.08,,907.58,75,,,percent of total billed charges,75% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,958.4,79.2,,,percent of total billed charges,79.2% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rates,1149.6,95,,,percent of total billed charges,95% of total billed charges,968.08,80,,,percent of total billed charges,80% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1089.09,90,,,percent of total billed charges,90% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rates,1210.1,100,,,fee schedule,100% of CO APG rates,1210.1,100,,,fee schedule,100% of NM fee schedule,484.04,40,,,percent of total billed charges,40% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,1089.09,90,,,percent of total billed charges,90% of total billed charges,919.68,76,,,percent of total billed charges,76% of total billed charges,484.04,40,,,percent of total billed charges,40% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of CO APG rate,968.08,80,,,percent of total billed charges,80% of total billed charges,469.52,38.8,,,percent of total billed charges,38.8% of total billed charges,1028.59,85,,,percent of total billed charges,85% of total billed charges,1210.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,469.52,1210.1,
"2.3 M PROFYLE HAND LOCK 3-D PLATE,4X2H",46050653,CDM,278,RC,,,OUTPATIENT,,,1455.9,1164.72,,1091.93,75,,,percent of total billed charges,75% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1153.07,79.2,,,percent of total billed charges,79.2% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rates,1383.11,95,,,percent of total billed charges,95% of total billed charges,1164.72,80,,,percent of total billed charges,80% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1310.31,90,,,percent of total billed charges,90% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rates,1455.9,100,,,fee schedule,100% of CO APG rates,1455.9,100,,,fee schedule,100% of NM fee schedule,582.36,40,,,percent of total billed charges,40% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1310.31,90,,,percent of total billed charges,90% of total billed charges,1106.48,76,,,percent of total billed charges,76% of total billed charges,582.36,40,,,percent of total billed charges,40% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of CO APG rate,1164.72,80,,,percent of total billed charges,80% of total billed charges,564.89,38.8,,,percent of total billed charges,38.8% of total billed charges,1237.52,85,,,percent of total billed charges,85% of total billed charges,1455.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,564.89,1455.9,
"2.3 M PROFYLE HAND LOCK 3-D REPL PL,4X2H",46050654,CDM,278,RC,,,OUTPATIENT,,,1367.6,1094.08,,1025.7,75,,,percent of total billed charges,75% of total billed charges,547.04,40,,,percent of total billed charges,40% of total billed charges,1083.14,79.2,,,percent of total billed charges,79.2% of total billed charges,1162.46,85,,,percent of total billed charges,85% of total billed charges,1367.6,100,,,fee schedule,100% of CO APG rates,1299.22,95,,,percent of total billed charges,95% of total billed charges,1094.08,80,,,percent of total billed charges,80% of total billed charges,1162.46,85,,,percent of total billed charges,85% of total billed charges,1230.84,90,,,percent of total billed charges,90% of total billed charges,1367.6,100,,,fee schedule,100% of CO APG rates,1367.6,100,,,fee schedule,100% of CO APG rates,1367.6,100,,,fee schedule,100% of NM fee schedule,547.04,40,,,percent of total billed charges,40% of total billed charges,547.04,40,,,percent of total billed charges,40% of total billed charges,1230.84,90,,,percent of total billed charges,90% of total billed charges,1039.38,76,,,percent of total billed charges,76% of total billed charges,547.04,40,,,percent of total billed charges,40% of total billed charges,1162.46,85,,,percent of total billed charges,85% of total billed charges,1367.6,100,,,fee schedule,100% of CO APG rate,1094.08,80,,,percent of total billed charges,80% of total billed charges,530.63,38.8,,,percent of total billed charges,38.8% of total billed charges,1162.46,85,,,percent of total billed charges,85% of total billed charges,1367.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,530.63,1367.6,
"2.3 M PROFYLE HAND LOCK LE MC V PLATE,5H",46050655,CDM,278,RC,,,OUTPATIENT,,,1753.1,1402.48,,1314.83,75,,,percent of total billed charges,75% of total billed charges,701.24,40,,,percent of total billed charges,40% of total billed charges,1388.46,79.2,,,percent of total billed charges,79.2% of total billed charges,1490.14,85,,,percent of total billed charges,85% of total billed charges,1753.1,100,,,fee schedule,100% of CO APG rates,1665.45,95,,,percent of total billed charges,95% of total billed charges,1402.48,80,,,percent of total billed charges,80% of total billed charges,1490.14,85,,,percent of total billed charges,85% of total billed charges,1577.79,90,,,percent of total billed charges,90% of total billed charges,1753.1,100,,,fee schedule,100% of CO APG rates,1753.1,100,,,fee schedule,100% of CO APG rates,1753.1,100,,,fee schedule,100% of NM fee schedule,701.24,40,,,percent of total billed charges,40% of total billed charges,701.24,40,,,percent of total billed charges,40% of total billed charges,1577.79,90,,,percent of total billed charges,90% of total billed charges,1332.36,76,,,percent of total billed charges,76% of total billed charges,701.24,40,,,percent of total billed charges,40% of total billed charges,1490.14,85,,,percent of total billed charges,85% of total billed charges,1753.1,100,,,fee schedule,100% of CO APG rate,1402.48,80,,,percent of total billed charges,80% of total billed charges,680.2,38.8,,,percent of total billed charges,38.8% of total billed charges,1490.14,85,,,percent of total billed charges,85% of total billed charges,1753.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,680.2,1753.1,
"2.3 M PROFYLE HAND LOCK L-PLATE,LE,6H",46050656,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
"2.3 M PROFYLE HAND LOCK L-PLATE,RI,6H",46050657,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
"2.3 M PROFYLE HAND LOCK PLATE,STRAI,16H",46050659,CDM,278,RC,,,OUTPATIENT,,,1100.8,880.64,,825.6,75,,,percent of total billed charges,75% of total billed charges,440.32,40,,,percent of total billed charges,40% of total billed charges,871.83,79.2,,,percent of total billed charges,79.2% of total billed charges,935.68,85,,,percent of total billed charges,85% of total billed charges,1100.8,100,,,fee schedule,100% of CO APG rates,1045.76,95,,,percent of total billed charges,95% of total billed charges,880.64,80,,,percent of total billed charges,80% of total billed charges,935.68,85,,,percent of total billed charges,85% of total billed charges,990.72,90,,,percent of total billed charges,90% of total billed charges,1100.8,100,,,fee schedule,100% of CO APG rates,1100.8,100,,,fee schedule,100% of CO APG rates,1100.8,100,,,fee schedule,100% of NM fee schedule,440.32,40,,,percent of total billed charges,40% of total billed charges,440.32,40,,,percent of total billed charges,40% of total billed charges,990.72,90,,,percent of total billed charges,90% of total billed charges,836.61,76,,,percent of total billed charges,76% of total billed charges,440.32,40,,,percent of total billed charges,40% of total billed charges,935.68,85,,,percent of total billed charges,85% of total billed charges,1100.8,100,,,fee schedule,100% of CO APG rate,880.64,80,,,percent of total billed charges,80% of total billed charges,427.11,38.8,,,percent of total billed charges,38.8% of total billed charges,935.68,85,,,percent of total billed charges,85% of total billed charges,1100.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,427.11,1100.8,
"2.3 M PROFYLE HAND LOCK RI MC V PLATE,5H",46050661,CDM,278,RC,,,OUTPATIENT,,,1753.1,1402.48,,1314.83,75,,,percent of total billed charges,75% of total billed charges,701.24,40,,,percent of total billed charges,40% of total billed charges,1388.46,79.2,,,percent of total billed charges,79.2% of total billed charges,1490.14,85,,,percent of total billed charges,85% of total billed charges,1753.1,100,,,fee schedule,100% of CO APG rates,1665.45,95,,,percent of total billed charges,95% of total billed charges,1402.48,80,,,percent of total billed charges,80% of total billed charges,1490.14,85,,,percent of total billed charges,85% of total billed charges,1577.79,90,,,percent of total billed charges,90% of total billed charges,1753.1,100,,,fee schedule,100% of CO APG rates,1753.1,100,,,fee schedule,100% of CO APG rates,1753.1,100,,,fee schedule,100% of NM fee schedule,701.24,40,,,percent of total billed charges,40% of total billed charges,701.24,40,,,percent of total billed charges,40% of total billed charges,1577.79,90,,,percent of total billed charges,90% of total billed charges,1332.36,76,,,percent of total billed charges,76% of total billed charges,701.24,40,,,percent of total billed charges,40% of total billed charges,1490.14,85,,,percent of total billed charges,85% of total billed charges,1753.1,100,,,fee schedule,100% of CO APG rate,1402.48,80,,,percent of total billed charges,80% of total billed charges,680.2,38.8,,,percent of total billed charges,38.8% of total billed charges,1490.14,85,,,percent of total billed charges,85% of total billed charges,1753.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,680.2,1753.1,
"2.3 M PROFYLE HAND LOCK ROTATION PLATE,5H",46050662,CDM,278,RC,,,OUTPATIENT,,,1738.4,1390.72,,1303.8,75,,,percent of total billed charges,75% of total billed charges,695.36,40,,,percent of total billed charges,40% of total billed charges,1376.81,79.2,,,percent of total billed charges,79.2% of total billed charges,1477.64,85,,,percent of total billed charges,85% of total billed charges,1738.4,100,,,fee schedule,100% of CO APG rates,1651.48,95,,,percent of total billed charges,95% of total billed charges,1390.72,80,,,percent of total billed charges,80% of total billed charges,1477.64,85,,,percent of total billed charges,85% of total billed charges,1564.56,90,,,percent of total billed charges,90% of total billed charges,1738.4,100,,,fee schedule,100% of CO APG rates,1738.4,100,,,fee schedule,100% of CO APG rates,1738.4,100,,,fee schedule,100% of NM fee schedule,695.36,40,,,percent of total billed charges,40% of total billed charges,695.36,40,,,percent of total billed charges,40% of total billed charges,1564.56,90,,,percent of total billed charges,90% of total billed charges,1321.18,76,,,percent of total billed charges,76% of total billed charges,695.36,40,,,percent of total billed charges,40% of total billed charges,1477.64,85,,,percent of total billed charges,85% of total billed charges,1738.4,100,,,fee schedule,100% of CO APG rate,1390.72,80,,,percent of total billed charges,80% of total billed charges,674.5,38.8,,,percent of total billed charges,38.8% of total billed charges,1477.64,85,,,percent of total billed charges,85% of total billed charges,1738.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,674.5,1738.4,
"2.3 M PROFYLE HAND LOCK T-PLATE,NAR,6H",46050663,CDM,278,RC,,,OUTPATIENT,,,756.3,605.04,,567.23,75,,,percent of total billed charges,75% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,598.99,79.2,,,percent of total billed charges,79.2% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rates,718.49,95,,,percent of total billed charges,95% of total billed charges,605.04,80,,,percent of total billed charges,80% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,680.67,90,,,percent of total billed charges,90% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rates,756.3,100,,,fee schedule,100% of CO APG rates,756.3,100,,,fee schedule,100% of NM fee schedule,302.52,40,,,percent of total billed charges,40% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,680.67,90,,,percent of total billed charges,90% of total billed charges,574.79,76,,,percent of total billed charges,76% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rate,605.04,80,,,percent of total billed charges,80% of total billed charges,293.44,38.8,,,percent of total billed charges,38.8% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,293.44,756.3,
"2.3 M PROFYLE HAND LOCK T-PLATE,REG,7H",46050664,CDM,278,RC,,,OUTPATIENT,,,831.9,665.52,,623.93,75,,,percent of total billed charges,75% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,658.86,79.2,,,percent of total billed charges,79.2% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rates,790.31,95,,,percent of total billed charges,95% of total billed charges,665.52,80,,,percent of total billed charges,80% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,748.71,90,,,percent of total billed charges,90% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rates,831.9,100,,,fee schedule,100% of CO APG rates,831.9,100,,,fee schedule,100% of NM fee schedule,332.76,40,,,percent of total billed charges,40% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,748.71,90,,,percent of total billed charges,90% of total billed charges,632.24,76,,,percent of total billed charges,76% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rate,665.52,80,,,percent of total billed charges,80% of total billed charges,322.78,38.8,,,percent of total billed charges,38.8% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,322.78,831.9,
"2.3 M PROFYLE HAND LOCK T-PLATE,WIDE,8H",46050665,CDM,278,RC,,,OUTPATIENT,,,884.4,707.52,,663.3,75,,,percent of total billed charges,75% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,700.44,79.2,,,percent of total billed charges,79.2% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rates,840.18,95,,,percent of total billed charges,95% of total billed charges,707.52,80,,,percent of total billed charges,80% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,795.96,90,,,percent of total billed charges,90% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rates,884.4,100,,,fee schedule,100% of CO APG rates,884.4,100,,,fee schedule,100% of NM fee schedule,353.76,40,,,percent of total billed charges,40% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,795.96,90,,,percent of total billed charges,90% of total billed charges,672.14,76,,,percent of total billed charges,76% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rate,707.52,80,,,percent of total billed charges,80% of total billed charges,343.15,38.8,,,percent of total billed charges,38.8% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,343.15,884.4,
"2.3 M PROFYLE HAND LOCK Y-PLATE,NAR,7H",46050666,CDM,278,RC,,,OUTPATIENT,,,956.9,765.52,,717.68,75,,,percent of total billed charges,75% of total billed charges,382.76,40,,,percent of total billed charges,40% of total billed charges,757.86,79.2,,,percent of total billed charges,79.2% of total billed charges,813.37,85,,,percent of total billed charges,85% of total billed charges,956.9,100,,,fee schedule,100% of CO APG rates,909.06,95,,,percent of total billed charges,95% of total billed charges,765.52,80,,,percent of total billed charges,80% of total billed charges,813.37,85,,,percent of total billed charges,85% of total billed charges,861.21,90,,,percent of total billed charges,90% of total billed charges,956.9,100,,,fee schedule,100% of CO APG rates,956.9,100,,,fee schedule,100% of CO APG rates,956.9,100,,,fee schedule,100% of NM fee schedule,382.76,40,,,percent of total billed charges,40% of total billed charges,382.76,40,,,percent of total billed charges,40% of total billed charges,861.21,90,,,percent of total billed charges,90% of total billed charges,727.24,76,,,percent of total billed charges,76% of total billed charges,382.76,40,,,percent of total billed charges,40% of total billed charges,813.37,85,,,percent of total billed charges,85% of total billed charges,956.9,100,,,fee schedule,100% of CO APG rate,765.52,80,,,percent of total billed charges,80% of total billed charges,371.28,38.8,,,percent of total billed charges,38.8% of total billed charges,813.37,85,,,percent of total billed charges,85% of total billed charges,956.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,371.28,956.9,
"2.3 M PROFYLE HAND LOCK Z-PLATE,NAR,13H",46050667,CDM,278,RC,,,OUTPATIENT,,,925.4,740.32,,694.05,75,,,percent of total billed charges,75% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,732.92,79.2,,,percent of total billed charges,79.2% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rates,879.13,95,,,percent of total billed charges,95% of total billed charges,740.32,80,,,percent of total billed charges,80% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,832.86,90,,,percent of total billed charges,90% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rates,925.4,100,,,fee schedule,100% of CO APG rates,925.4,100,,,fee schedule,100% of NM fee schedule,370.16,40,,,percent of total billed charges,40% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,832.86,90,,,percent of total billed charges,90% of total billed charges,703.3,76,,,percent of total billed charges,76% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rate,740.32,80,,,percent of total billed charges,80% of total billed charges,359.06,38.8,,,percent of total billed charges,38.8% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,359.06,925.4,
2.3X11MM BONE SCREWSCROSSPINSELFTAPPING,46050670,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
2.3X12MM BONE SCREWSCROSSPINSELFTAPPING,46050672,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
2.3X13MM BONE SCREWSCROSSPINSELFTAPPING,46050674,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
2.3X13MM LOCKING SCREWSCROSSPINSELFT,46050675,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
2.3X14MM BONE SCREWSCROSSPINSELFTAPPING,46050676,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"2.3X14MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050677,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
2.3X15MM BONE SCREWSCROSSPINSELFTAPPING,46050678,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
2.3X16MM BONE SCREWSCROSSPINSELFTAPPING,46050680,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
2.3X18MM BONE SCREWSCROSSPINSELFTAPPING,46050682,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"2.3X18MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050683,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
2.3X20MM BONE SCREWSCROSSPINSELFTAPPING,46050684,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"2.3X20MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050685,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
2.3X22MM BONE SCREWSCROSSPINSELFTAPPING,46050686,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"2.3X22MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050687,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
2.3X24MM BONE SCREWSCROSSPINSELFTAPPING,46050688,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"2.3X24MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050689,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
2.3X26MM BONE SCREWSCROSSPINSELFTAPPING,46050690,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"2.3X26MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050691,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
2.3X6MM BONE SCREWSCROSSPINSELFTAPPING,46050692,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"2.3X6MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050693,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
2.3X8MM BONE SCREWSCROSSPINSELFTAPPING,46050694,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"2.3X8MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050695,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
2.3X9MM BONE SCREWSCROSSPINSELFTAPPING,46050696,CDM,278,RC,,,OUTPATIENT,,,245.8,196.64,,184.35,75,,,percent of total billed charges,75% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,194.67,79.2,,,percent of total billed charges,79.2% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,233.51,95,,,percent of total billed charges,95% of total billed charges,196.64,80,,,percent of total billed charges,80% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of CO APG rates,245.8,100,,,fee schedule,100% of NM fee schedule,98.32,40,,,percent of total billed charges,40% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,221.22,90,,,percent of total billed charges,90% of total billed charges,186.81,76,,,percent of total billed charges,76% of total billed charges,98.32,40,,,percent of total billed charges,40% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of CO APG rate,196.64,80,,,percent of total billed charges,80% of total billed charges,95.37,38.8,,,percent of total billed charges,38.8% of total billed charges,208.93,85,,,percent of total billed charges,85% of total billed charges,245.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.37,245.8,
"2.3X9MM LOCKING SCREWS,CROSS-PIN,SELF-T",46050697,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
2.5X12MM EMERG SCREWSCROSSPINSELFT,46050699,CDM,278,RC,,,OUTPATIENT,,,265.8,212.64,,199.35,75,,,percent of total billed charges,75% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,210.51,79.2,,,percent of total billed charges,79.2% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,252.51,95,,,percent of total billed charges,95% of total billed charges,212.64,80,,,percent of total billed charges,80% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of NM fee schedule,106.32,40,,,percent of total billed charges,40% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,202.01,76,,,percent of total billed charges,76% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rate,212.64,80,,,percent of total billed charges,80% of total billed charges,103.13,38.8,,,percent of total billed charges,38.8% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.13,265.8,
2.5X6MM EMERG SCREWSCROSSPINSELFT,46050700,CDM,278,RC,,,OUTPATIENT,,,265.8,212.64,,199.35,75,,,percent of total billed charges,75% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,210.51,79.2,,,percent of total billed charges,79.2% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,252.51,95,,,percent of total billed charges,95% of total billed charges,212.64,80,,,percent of total billed charges,80% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of NM fee schedule,106.32,40,,,percent of total billed charges,40% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,202.01,76,,,percent of total billed charges,76% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rate,212.64,80,,,percent of total billed charges,80% of total billed charges,103.13,38.8,,,percent of total billed charges,38.8% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.13,265.8,
2.5X8MM EMERG SCREWSCROSSPINSELFT,46050701,CDM,278,RC,,,OUTPATIENT,,,265.8,212.64,,199.35,75,,,percent of total billed charges,75% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,210.51,79.2,,,percent of total billed charges,79.2% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,252.51,95,,,percent of total billed charges,95% of total billed charges,212.64,80,,,percent of total billed charges,80% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of CO APG rates,265.8,100,,,fee schedule,100% of NM fee schedule,106.32,40,,,percent of total billed charges,40% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,239.22,90,,,percent of total billed charges,90% of total billed charges,202.01,76,,,percent of total billed charges,76% of total billed charges,106.32,40,,,percent of total billed charges,40% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of CO APG rate,212.64,80,,,percent of total billed charges,80% of total billed charges,103.13,38.8,,,percent of total billed charges,38.8% of total billed charges,225.93,85,,,percent of total billed charges,85% of total billed charges,265.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.13,265.8,
3-D PLATE LEFT,46050702,CDM,278,RC,,,OUTPATIENT,,,1288.8,1031.04,,966.6,75,,,percent of total billed charges,75% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1020.73,79.2,,,percent of total billed charges,79.2% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rates,1224.36,95,,,percent of total billed charges,95% of total billed charges,1031.04,80,,,percent of total billed charges,80% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1159.92,90,,,percent of total billed charges,90% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rates,1288.8,100,,,fee schedule,100% of CO APG rates,1288.8,100,,,fee schedule,100% of NM fee schedule,515.52,40,,,percent of total billed charges,40% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1159.92,90,,,percent of total billed charges,90% of total billed charges,979.49,76,,,percent of total billed charges,76% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rate,1031.04,80,,,percent of total billed charges,80% of total billed charges,500.05,38.8,,,percent of total billed charges,38.8% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,500.05,1288.8,
3-D PLATE RIGHT,46050703,CDM,278,RC,,,OUTPATIENT,,,1288.8,1031.04,,966.6,75,,,percent of total billed charges,75% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1020.73,79.2,,,percent of total billed charges,79.2% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rates,1224.36,95,,,percent of total billed charges,95% of total billed charges,1031.04,80,,,percent of total billed charges,80% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1159.92,90,,,percent of total billed charges,90% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rates,1288.8,100,,,fee schedule,100% of CO APG rates,1288.8,100,,,fee schedule,100% of NM fee schedule,515.52,40,,,percent of total billed charges,40% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1159.92,90,,,percent of total billed charges,90% of total billed charges,979.49,76,,,percent of total billed charges,76% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rate,1031.04,80,,,percent of total billed charges,80% of total billed charges,500.05,38.8,,,percent of total billed charges,38.8% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,500.05,1288.8,
4.0 LOCKING INSERT,46050704,CDM,278,RC,,,OUTPATIENT,,,193.3,154.64,,144.98,75,,,percent of total billed charges,75% of total billed charges,77.32,40,,,percent of total billed charges,40% of total billed charges,153.09,79.2,,,percent of total billed charges,79.2% of total billed charges,164.31,85,,,percent of total billed charges,85% of total billed charges,193.3,100,,,fee schedule,100% of CO APG rates,183.64,95,,,percent of total billed charges,95% of total billed charges,154.64,80,,,percent of total billed charges,80% of total billed charges,164.31,85,,,percent of total billed charges,85% of total billed charges,173.97,90,,,percent of total billed charges,90% of total billed charges,193.3,100,,,fee schedule,100% of CO APG rates,193.3,100,,,fee schedule,100% of CO APG rates,193.3,100,,,fee schedule,100% of NM fee schedule,77.32,40,,,percent of total billed charges,40% of total billed charges,77.32,40,,,percent of total billed charges,40% of total billed charges,173.97,90,,,percent of total billed charges,90% of total billed charges,146.91,76,,,percent of total billed charges,76% of total billed charges,77.32,40,,,percent of total billed charges,40% of total billed charges,164.31,85,,,percent of total billed charges,85% of total billed charges,193.3,100,,,fee schedule,100% of CO APG rate,154.64,80,,,percent of total billed charges,80% of total billed charges,75,38.8,,,percent of total billed charges,38.8% of total billed charges,164.31,85,,,percent of total billed charges,85% of total billed charges,193.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,75,193.3,
ASNIS III SS CANNULATED SCR 4X14MM,46050705,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X16MM,46050706,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X18MM,46050707,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X20MM,46050708,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X22MM,46050709,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X24MM,46050710,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X26MM,46050711,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X28MM,46050712,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X30MM,46050713,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X32MM,46050714,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X34MM,46050715,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X36MM,46050716,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X38MM,46050717,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
4.0MM PARTIAL THREAD CANNULATED 40MM,46050718,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X42MM,46050719,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X44MM,46050720,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X46MM,46050721,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X48MM,46050722,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X50MM,46050723,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X55MM,46050724,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X60MM,46050725,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS WASHER 4.0MM,46050726,CDM,278,RC,,,OUTPATIENT,,,114.5,91.6,,85.88,75,,,percent of total billed charges,75% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,90.68,79.2,,,percent of total billed charges,79.2% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,114.5,100,,,fee schedule,100% of CO APG rates,108.78,95,,,percent of total billed charges,95% of total billed charges,91.6,80,,,percent of total billed charges,80% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,103.05,90,,,percent of total billed charges,90% of total billed charges,114.5,100,,,fee schedule,100% of CO APG rates,114.5,100,,,fee schedule,100% of CO APG rates,114.5,100,,,fee schedule,100% of NM fee schedule,45.8,40,,,percent of total billed charges,40% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,103.05,90,,,percent of total billed charges,90% of total billed charges,87.02,76,,,percent of total billed charges,76% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,114.5,100,,,fee schedule,100% of CO APG rate,91.6,80,,,percent of total billed charges,80% of total billed charges,44.43,38.8,,,percent of total billed charges,38.8% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,114.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44.43,114.5,
AXSOS CABLE PLUG - 4.0 MM LOCKING SET,46050727,CDM,270,RC,,,OUTPATIENT,,,201,160.8,,150.75,75,,,percent of total billed charges,75% of total billed charges,80.4,40,,,percent of total billed charges,40% of total billed charges,159.19,79.2,,,percent of total billed charges,79.2% of total billed charges,170.85,85,,,percent of total billed charges,85% of total billed charges,201,100,,,fee schedule,100% of CO APG rates,190.95,95,,,percent of total billed charges,95% of total billed charges,160.8,80,,,percent of total billed charges,80% of total billed charges,170.85,85,,,percent of total billed charges,85% of total billed charges,180.9,90,,,percent of total billed charges,90% of total billed charges,201,100,,,fee schedule,100% of CO APG rates,201,100,,,fee schedule,100% of CO APG rates,201,100,,,fee schedule,100% of NM fee schedule,80.4,40,,,percent of total billed charges,40% of total billed charges,80.4,40,,,percent of total billed charges,40% of total billed charges,180.9,90,,,percent of total billed charges,90% of total billed charges,152.76,76,,,percent of total billed charges,76% of total billed charges,80.4,40,,,percent of total billed charges,40% of total billed charges,170.85,85,,,percent of total billed charges,85% of total billed charges,201,100,,,fee schedule,100% of CO APG rate,160.8,80,,,percent of total billed charges,80% of total billed charges,77.99,38.8,,,percent of total billed charges,38.8% of total billed charges,170.85,85,,,percent of total billed charges,85% of total billed charges,201,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,77.99,201,
BONE SCREW T10 3.5X14MM,46050730,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X16MM,46050731,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X18MM,46050732,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X22MM,46050734,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X24MM,46050735,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X26MM,46050736,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X28MM,46050737,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X30MM,46050738,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X32MM,46050739,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X34MM,46050740,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X36MM,46050741,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X38MM,46050742,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X40MM,46050743,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X42MM,46050744,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X44MM,46050745,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X46MM,46050746,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X48MM,46050747,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X50MM,46050748,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X55MM,46050749,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X60MM,46050750,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X65MM,46050751,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T10 3.5X70MM,46050752,CDM,278,RC,,,OUTPATIENT,,,273.1,218.48,,204.83,75,,,percent of total billed charges,75% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,216.3,79.2,,,percent of total billed charges,79.2% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,259.45,95,,,percent of total billed charges,95% of total billed charges,218.48,80,,,percent of total billed charges,80% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of CO APG rates,273.1,100,,,fee schedule,100% of NM fee schedule,109.24,40,,,percent of total billed charges,40% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,245.79,90,,,percent of total billed charges,90% of total billed charges,207.56,76,,,percent of total billed charges,76% of total billed charges,109.24,40,,,percent of total billed charges,40% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of CO APG rate,218.48,80,,,percent of total billed charges,80% of total billed charges,105.96,38.8,,,percent of total billed charges,38.8% of total billed charges,232.14,85,,,percent of total billed charges,85% of total billed charges,273.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.96,273.1,
BONE SCREW T7 2.7X10 MM VARIAX FOOT,46050753,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X12MM VARIAX FOOT,46050754,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X14 MM VARIAX FOOT,46050755,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X16 MM VARIAX FOOT,46050756,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X18 MM VARIAX FOOT,46050757,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X20 MM VARIAX FOOT,46050758,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X22 MM VARIAX FOOT,46050759,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X24 MM VARIAX FOOT,46050760,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X26MM,46050761,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X28MM,46050762,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X30MM,46050763,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X32MM,46050764,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X34MM,46050765,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X36MM,46050766,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X38MM,46050767,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X40MM,46050768,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X45MM,46050769,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X50MM,46050770,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BONE SCREW T7 2.7X8MM,46050771,CDM,278,RC,,,OUTPATIENT,,,234.2,187.36,,175.65,75,,,percent of total billed charges,75% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,185.49,79.2,,,percent of total billed charges,79.2% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,222.49,95,,,percent of total billed charges,95% of total billed charges,187.36,80,,,percent of total billed charges,80% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of CO APG rates,234.2,100,,,fee schedule,100% of NM fee schedule,93.68,40,,,percent of total billed charges,40% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,210.78,90,,,percent of total billed charges,90% of total billed charges,177.99,76,,,percent of total billed charges,76% of total billed charges,93.68,40,,,percent of total billed charges,40% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of CO APG rate,187.36,80,,,percent of total billed charges,80% of total billed charges,90.87,38.8,,,percent of total billed charges,38.8% of total billed charges,199.07,85,,,percent of total billed charges,85% of total billed charges,234.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.87,234.2,
BROAD STRAIGHT PLATE LONG,46050772,CDM,278,RC,,,OUTPATIENT,,,1168,934.4,,876,75,,,percent of total billed charges,75% of total billed charges,467.2,40,,,percent of total billed charges,40% of total billed charges,925.06,79.2,,,percent of total billed charges,79.2% of total billed charges,992.8,85,,,percent of total billed charges,85% of total billed charges,1168,100,,,fee schedule,100% of CO APG rates,1109.6,95,,,percent of total billed charges,95% of total billed charges,934.4,80,,,percent of total billed charges,80% of total billed charges,992.8,85,,,percent of total billed charges,85% of total billed charges,1051.2,90,,,percent of total billed charges,90% of total billed charges,1168,100,,,fee schedule,100% of CO APG rates,1168,100,,,fee schedule,100% of CO APG rates,1168,100,,,fee schedule,100% of NM fee schedule,467.2,40,,,percent of total billed charges,40% of total billed charges,467.2,40,,,percent of total billed charges,40% of total billed charges,1051.2,90,,,percent of total billed charges,90% of total billed charges,887.68,76,,,percent of total billed charges,76% of total billed charges,467.2,40,,,percent of total billed charges,40% of total billed charges,992.8,85,,,percent of total billed charges,85% of total billed charges,1168,100,,,fee schedule,100% of CO APG rate,934.4,80,,,percent of total billed charges,80% of total billed charges,453.18,38.8,,,percent of total billed charges,38.8% of total billed charges,992.8,85,,,percent of total billed charges,85% of total billed charges,1168,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,453.18,1168,
BROAD STRAIGHT PLATE MEDIUM,46050773,CDM,278,RC,,,OUTPATIENT,,,1062,849.6,,796.5,75,,,percent of total billed charges,75% of total billed charges,424.8,40,,,percent of total billed charges,40% of total billed charges,841.1,79.2,,,percent of total billed charges,79.2% of total billed charges,902.7,85,,,percent of total billed charges,85% of total billed charges,1062,100,,,fee schedule,100% of CO APG rates,1008.9,95,,,percent of total billed charges,95% of total billed charges,849.6,80,,,percent of total billed charges,80% of total billed charges,902.7,85,,,percent of total billed charges,85% of total billed charges,955.8,90,,,percent of total billed charges,90% of total billed charges,1062,100,,,fee schedule,100% of CO APG rates,1062,100,,,fee schedule,100% of CO APG rates,1062,100,,,fee schedule,100% of NM fee schedule,424.8,40,,,percent of total billed charges,40% of total billed charges,424.8,40,,,percent of total billed charges,40% of total billed charges,955.8,90,,,percent of total billed charges,90% of total billed charges,807.12,76,,,percent of total billed charges,76% of total billed charges,424.8,40,,,percent of total billed charges,40% of total billed charges,902.7,85,,,percent of total billed charges,85% of total billed charges,1062,100,,,fee schedule,100% of CO APG rate,849.6,80,,,percent of total billed charges,80% of total billed charges,412.06,38.8,,,percent of total billed charges,38.8% of total billed charges,902.7,85,,,percent of total billed charges,85% of total billed charges,1062,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,412.06,1062,
BROAD STRAIGHT PLATE SHORT,46050774,CDM,278,RC,,,OUTPATIENT,,,1018.9,815.12,,764.18,75,,,percent of total billed charges,75% of total billed charges,407.56,40,,,percent of total billed charges,40% of total billed charges,806.97,79.2,,,percent of total billed charges,79.2% of total billed charges,866.07,85,,,percent of total billed charges,85% of total billed charges,1018.9,100,,,fee schedule,100% of CO APG rates,967.96,95,,,percent of total billed charges,95% of total billed charges,815.12,80,,,percent of total billed charges,80% of total billed charges,866.07,85,,,percent of total billed charges,85% of total billed charges,917.01,90,,,percent of total billed charges,90% of total billed charges,1018.9,100,,,fee schedule,100% of CO APG rates,1018.9,100,,,fee schedule,100% of CO APG rates,1018.9,100,,,fee schedule,100% of NM fee schedule,407.56,40,,,percent of total billed charges,40% of total billed charges,407.56,40,,,percent of total billed charges,40% of total billed charges,917.01,90,,,percent of total billed charges,90% of total billed charges,774.36,76,,,percent of total billed charges,76% of total billed charges,407.56,40,,,percent of total billed charges,40% of total billed charges,866.07,85,,,percent of total billed charges,85% of total billed charges,1018.9,100,,,fee schedule,100% of CO APG rate,815.12,80,,,percent of total billed charges,80% of total billed charges,395.33,38.8,,,percent of total billed charges,38.8% of total billed charges,866.07,85,,,percent of total billed charges,85% of total billed charges,1018.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,395.33,1018.9,
CALCANEUS MESH PLATE LARGE,46050775,CDM,278,RC,,,OUTPATIENT,,,1716.4,1373.12,,1287.3,75,,,percent of total billed charges,75% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1359.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1630.58,95,,,percent of total billed charges,95% of total billed charges,1373.12,80,,,percent of total billed charges,80% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of NM fee schedule,686.56,40,,,percent of total billed charges,40% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1304.46,76,,,percent of total billed charges,76% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rate,1373.12,80,,,percent of total billed charges,80% of total billed charges,665.96,38.8,,,percent of total billed charges,38.8% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,665.96,1716.4,
CALCANEUS MESH PLATE MEDIUM,46050776,CDM,278,RC,,,OUTPATIENT,,,1716.4,1373.12,,1287.3,75,,,percent of total billed charges,75% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1359.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1630.58,95,,,percent of total billed charges,95% of total billed charges,1373.12,80,,,percent of total billed charges,80% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of NM fee schedule,686.56,40,,,percent of total billed charges,40% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1304.46,76,,,percent of total billed charges,76% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rate,1373.12,80,,,percent of total billed charges,80% of total billed charges,665.96,38.8,,,percent of total billed charges,38.8% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,665.96,1716.4,
"CALCANEUS MESH PLATE, SMALL",46050777,CDM,278,RC,,,OUTPATIENT,,,1716.4,1373.12,,1287.3,75,,,percent of total billed charges,75% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1359.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1630.58,95,,,percent of total billed charges,95% of total billed charges,1373.12,80,,,percent of total billed charges,80% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of NM fee schedule,686.56,40,,,percent of total billed charges,40% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1304.46,76,,,percent of total billed charges,76% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rate,1373.12,80,,,percent of total billed charges,80% of total billed charges,665.96,38.8,,,percent of total billed charges,38.8% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,665.96,1716.4,
CALCANEUS STANDARD PLATE LARGE,46050778,CDM,278,RC,,,OUTPATIENT,,,1716.4,1373.12,,1287.3,75,,,percent of total billed charges,75% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1359.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1630.58,95,,,percent of total billed charges,95% of total billed charges,1373.12,80,,,percent of total billed charges,80% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of NM fee schedule,686.56,40,,,percent of total billed charges,40% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1304.46,76,,,percent of total billed charges,76% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rate,1373.12,80,,,percent of total billed charges,80% of total billed charges,665.96,38.8,,,percent of total billed charges,38.8% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,665.96,1716.4,
CALCANEUS STANDARD PLATE MEDIUM,46050779,CDM,278,RC,,,OUTPATIENT,,,1716.4,1373.12,,1287.3,75,,,percent of total billed charges,75% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1359.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1630.58,95,,,percent of total billed charges,95% of total billed charges,1373.12,80,,,percent of total billed charges,80% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of NM fee schedule,686.56,40,,,percent of total billed charges,40% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1304.46,76,,,percent of total billed charges,76% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rate,1373.12,80,,,percent of total billed charges,80% of total billed charges,665.96,38.8,,,percent of total billed charges,38.8% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,665.96,1716.4,
CALCANEUS STANDARD PLATE SMALL,46050780,CDM,278,RC,,,OUTPATIENT,,,1716.4,1373.12,,1287.3,75,,,percent of total billed charges,75% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1359.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1630.58,95,,,percent of total billed charges,95% of total billed charges,1373.12,80,,,percent of total billed charges,80% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of NM fee schedule,686.56,40,,,percent of total billed charges,40% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1304.46,76,,,percent of total billed charges,76% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rate,1373.12,80,,,percent of total billed charges,80% of total billed charges,665.96,38.8,,,percent of total billed charges,38.8% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,665.96,1716.4,
CANCELLOUS SCREW 4.0 SS FULL THREAD X10,46050781,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X12,46050782,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X14,46050783,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X16,46050784,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X18,46050785,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X20,46050786,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X22,46050787,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X24,46050788,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X26,46050789,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X28,46050790,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X30,46050791,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X32,46050792,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X34,46050793,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X36,46050794,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X38,46050795,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X40,46050796,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X45,46050797,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X50,46050798,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X55,46050799,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS FULL THREAD X60,46050800,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X10,46050801,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X12,46050802,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X14,46050803,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X16,46050804,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X18,46050805,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X20,46050806,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X22,46050807,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X24,46050808,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X26,46050809,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X28,46050810,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X30,46050811,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X32,46050812,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X34,46050813,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X36,46050814,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X38,46050815,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X40,46050816,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X45,46050817,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X50,46050818,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X55,46050819,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X60,46050820,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANNULATED SCREW WASHER SS,46050821,CDM,278,RC,,,OUTPATIENT,,,110.3,88.24,,82.73,75,,,percent of total billed charges,75% of total billed charges,44.12,40,,,percent of total billed charges,40% of total billed charges,87.36,79.2,,,percent of total billed charges,79.2% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,110.3,100,,,fee schedule,100% of CO APG rates,104.79,95,,,percent of total billed charges,95% of total billed charges,88.24,80,,,percent of total billed charges,80% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,99.27,90,,,percent of total billed charges,90% of total billed charges,110.3,100,,,fee schedule,100% of CO APG rates,110.3,100,,,fee schedule,100% of CO APG rates,110.3,100,,,fee schedule,100% of NM fee schedule,44.12,40,,,percent of total billed charges,40% of total billed charges,44.12,40,,,percent of total billed charges,40% of total billed charges,99.27,90,,,percent of total billed charges,90% of total billed charges,83.83,76,,,percent of total billed charges,76% of total billed charges,44.12,40,,,percent of total billed charges,40% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,110.3,100,,,fee schedule,100% of CO APG rate,88.24,80,,,percent of total billed charges,80% of total billed charges,42.8,38.8,,,percent of total billed charges,38.8% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,110.3,100,,,fee schedule,100% of APG fee schedule,220.6,200,,,percent of total billed charges,200% of total billed charges,42.8,220.6,
CURVED PLATE 4 HOLES,46050831,CDM,278,RC,,,OUTPATIENT,,,1055.7,844.56,,791.78,75,,,percent of total billed charges,75% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,836.11,79.2,,,percent of total billed charges,79.2% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rates,1002.92,95,,,percent of total billed charges,95% of total billed charges,844.56,80,,,percent of total billed charges,80% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,950.13,90,,,percent of total billed charges,90% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rates,1055.7,100,,,fee schedule,100% of CO APG rates,1055.7,100,,,fee schedule,100% of NM fee schedule,422.28,40,,,percent of total billed charges,40% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,950.13,90,,,percent of total billed charges,90% of total billed charges,802.33,76,,,percent of total billed charges,76% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rate,844.56,80,,,percent of total billed charges,80% of total billed charges,409.61,38.8,,,percent of total billed charges,38.8% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of APG fee schedule,2111.4,200,,,percent of total billed charges,200% of total billed charges,409.61,2111.4,
CURVED PLATE 5 HOLES LEFT,46050832,CDM,278,RC,,,OUTPATIENT,,,1147,917.6,,860.25,75,,,percent of total billed charges,75% of total billed charges,458.8,40,,,percent of total billed charges,40% of total billed charges,908.42,79.2,,,percent of total billed charges,79.2% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,1147,100,,,fee schedule,100% of CO APG rates,1089.65,95,,,percent of total billed charges,95% of total billed charges,917.6,80,,,percent of total billed charges,80% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,1032.3,90,,,percent of total billed charges,90% of total billed charges,1147,100,,,fee schedule,100% of CO APG rates,1147,100,,,fee schedule,100% of CO APG rates,1147,100,,,fee schedule,100% of NM fee schedule,458.8,40,,,percent of total billed charges,40% of total billed charges,458.8,40,,,percent of total billed charges,40% of total billed charges,1032.3,90,,,percent of total billed charges,90% of total billed charges,871.72,76,,,percent of total billed charges,76% of total billed charges,458.8,40,,,percent of total billed charges,40% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,1147,100,,,fee schedule,100% of CO APG rate,917.6,80,,,percent of total billed charges,80% of total billed charges,445.04,38.8,,,percent of total billed charges,38.8% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,1147,100,,,fee schedule,100% of APG fee schedule,2294,200,,,percent of total billed charges,200% of total billed charges,445.04,2294,
CURVED PLATE 5 HOLES RIGHT,46050833,CDM,278,RC,,,OUTPATIENT,,,1147,917.6,,860.25,75,,,percent of total billed charges,75% of total billed charges,458.8,40,,,percent of total billed charges,40% of total billed charges,908.42,79.2,,,percent of total billed charges,79.2% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,1147,100,,,fee schedule,100% of CO APG rates,1089.65,95,,,percent of total billed charges,95% of total billed charges,917.6,80,,,percent of total billed charges,80% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,1032.3,90,,,percent of total billed charges,90% of total billed charges,1147,100,,,fee schedule,100% of CO APG rates,1147,100,,,fee schedule,100% of CO APG rates,1147,100,,,fee schedule,100% of NM fee schedule,458.8,40,,,percent of total billed charges,40% of total billed charges,458.8,40,,,percent of total billed charges,40% of total billed charges,1032.3,90,,,percent of total billed charges,90% of total billed charges,871.72,76,,,percent of total billed charges,76% of total billed charges,458.8,40,,,percent of total billed charges,40% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,1147,100,,,fee schedule,100% of CO APG rate,917.6,80,,,percent of total billed charges,80% of total billed charges,445.04,38.8,,,percent of total billed charges,38.8% of total billed charges,974.95,85,,,percent of total billed charges,85% of total billed charges,1147,100,,,fee schedule,100% of APG fee schedule,2294,200,,,percent of total billed charges,200% of total billed charges,445.04,2294,
CURVED PLATE 6 HOLES,46050834,CDM,278,RC,,,OUTPATIENT,,,1288.8,1031.04,,966.6,75,,,percent of total billed charges,75% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1020.73,79.2,,,percent of total billed charges,79.2% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rates,1224.36,95,,,percent of total billed charges,95% of total billed charges,1031.04,80,,,percent of total billed charges,80% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1159.92,90,,,percent of total billed charges,90% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rates,1288.8,100,,,fee schedule,100% of CO APG rates,1288.8,100,,,fee schedule,100% of NM fee schedule,515.52,40,,,percent of total billed charges,40% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1159.92,90,,,percent of total billed charges,90% of total billed charges,979.49,76,,,percent of total billed charges,76% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rate,1031.04,80,,,percent of total billed charges,80% of total billed charges,500.05,38.8,,,percent of total billed charges,38.8% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of APG fee schedule,2577.6,200,,,percent of total billed charges,200% of total billed charges,500.05,2577.6,
DISTAL VOLAR RADIUS  3 HOLE LT,46050835,CDM,278,RC,,,OUTPATIENT,,,1668,1334.4,,1251,75,,,percent of total billed charges,75% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1321.06,79.2,,,percent of total billed charges,79.2% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of CO APG rates,1584.6,95,,,percent of total billed charges,95% of total billed charges,1334.4,80,,,percent of total billed charges,80% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1501.2,90,,,percent of total billed charges,90% of total billed charges,1668,100,,,fee schedule,100% of CO APG rates,1668,100,,,fee schedule,100% of CO APG rates,1668,100,,,fee schedule,100% of NM fee schedule,667.2,40,,,percent of total billed charges,40% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1501.2,90,,,percent of total billed charges,90% of total billed charges,1267.68,76,,,percent of total billed charges,76% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of CO APG rate,1334.4,80,,,percent of total billed charges,80% of total billed charges,647.18,38.8,,,percent of total billed charges,38.8% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of APG fee schedule,3336,200,,,percent of total billed charges,200% of total billed charges,647.18,3336,
DISTAL VOLAR RADIUS  3 HOLE RT,46050836,CDM,278,RC,,,OUTPATIENT,,,1668,1334.4,,1251,75,,,percent of total billed charges,75% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1321.06,79.2,,,percent of total billed charges,79.2% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of CO APG rates,1584.6,95,,,percent of total billed charges,95% of total billed charges,1334.4,80,,,percent of total billed charges,80% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1501.2,90,,,percent of total billed charges,90% of total billed charges,1668,100,,,fee schedule,100% of CO APG rates,1668,100,,,fee schedule,100% of CO APG rates,1668,100,,,fee schedule,100% of NM fee schedule,667.2,40,,,percent of total billed charges,40% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1501.2,90,,,percent of total billed charges,90% of total billed charges,1267.68,76,,,percent of total billed charges,76% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of CO APG rate,1334.4,80,,,percent of total billed charges,80% of total billed charges,647.18,38.8,,,percent of total billed charges,38.8% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of APG fee schedule,3336,200,,,percent of total billed charges,200% of total billed charges,647.18,3336,
DISTAL VOLAR RADIUS  4 HOLE LT,46050837,CDM,278,RC,,,OUTPATIENT,,,1668,1334.4,,1251,75,,,percent of total billed charges,75% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1321.06,79.2,,,percent of total billed charges,79.2% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of CO APG rates,1584.6,95,,,percent of total billed charges,95% of total billed charges,1334.4,80,,,percent of total billed charges,80% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1501.2,90,,,percent of total billed charges,90% of total billed charges,1668,100,,,fee schedule,100% of CO APG rates,1668,100,,,fee schedule,100% of CO APG rates,1668,100,,,fee schedule,100% of NM fee schedule,667.2,40,,,percent of total billed charges,40% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1501.2,90,,,percent of total billed charges,90% of total billed charges,1267.68,76,,,percent of total billed charges,76% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of CO APG rate,1334.4,80,,,percent of total billed charges,80% of total billed charges,647.18,38.8,,,percent of total billed charges,38.8% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of APG fee schedule,3336,200,,,percent of total billed charges,200% of total billed charges,647.18,3336,
DISTAL VOLAR RADIUS  4 HOLE RT,46050838,CDM,278,RC,,,OUTPATIENT,,,1668,1334.4,,1251,75,,,percent of total billed charges,75% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1321.06,79.2,,,percent of total billed charges,79.2% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of CO APG rates,1584.6,95,,,percent of total billed charges,95% of total billed charges,1334.4,80,,,percent of total billed charges,80% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1501.2,90,,,percent of total billed charges,90% of total billed charges,1668,100,,,fee schedule,100% of CO APG rates,1668,100,,,fee schedule,100% of CO APG rates,1668,100,,,fee schedule,100% of NM fee schedule,667.2,40,,,percent of total billed charges,40% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1501.2,90,,,percent of total billed charges,90% of total billed charges,1267.68,76,,,percent of total billed charges,76% of total billed charges,667.2,40,,,percent of total billed charges,40% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of CO APG rate,1334.4,80,,,percent of total billed charges,80% of total billed charges,647.18,38.8,,,percent of total billed charges,38.8% of total billed charges,1417.8,85,,,percent of total billed charges,85% of total billed charges,1668,100,,,fee schedule,100% of APG fee schedule,3336,200,,,percent of total billed charges,200% of total billed charges,647.18,3336,
DRILL BIT  3.1MM X 204MM,46050839,CDM,270,RC,,,OUTPATIENT,,,459.9,367.92,,344.93,75,,,percent of total billed charges,75% of total billed charges,183.96,40,,,percent of total billed charges,40% of total billed charges,364.24,79.2,,,percent of total billed charges,79.2% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,459.9,100,,,fee schedule,100% of CO APG rates,436.91,95,,,percent of total billed charges,95% of total billed charges,367.92,80,,,percent of total billed charges,80% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,413.91,90,,,percent of total billed charges,90% of total billed charges,459.9,100,,,fee schedule,100% of CO APG rates,459.9,100,,,fee schedule,100% of CO APG rates,459.9,100,,,fee schedule,100% of NM fee schedule,183.96,40,,,percent of total billed charges,40% of total billed charges,183.96,40,,,percent of total billed charges,40% of total billed charges,413.91,90,,,percent of total billed charges,90% of total billed charges,349.52,76,,,percent of total billed charges,76% of total billed charges,183.96,40,,,percent of total billed charges,40% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,459.9,100,,,fee schedule,100% of CO APG rate,367.92,80,,,percent of total billed charges,80% of total billed charges,178.44,38.8,,,percent of total billed charges,38.8% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,459.9,100,,,fee schedule,100% of APG fee schedule,919.8,200,,,percent of total billed charges,200% of total billed charges,178.44,919.8,
DRILL BIT 2.5X125MM (GOLD),46050840,CDM,270,RC,,,OUTPATIENT,,,464.4,371.52,,348.3,75,,,percent of total billed charges,75% of total billed charges,185.76,40,,,percent of total billed charges,40% of total billed charges,367.8,79.2,,,percent of total billed charges,79.2% of total billed charges,394.74,85,,,percent of total billed charges,85% of total billed charges,464.4,100,,,fee schedule,100% of CO APG rates,441.18,95,,,percent of total billed charges,95% of total billed charges,371.52,80,,,percent of total billed charges,80% of total billed charges,394.74,85,,,percent of total billed charges,85% of total billed charges,417.96,90,,,percent of total billed charges,90% of total billed charges,464.4,100,,,fee schedule,100% of CO APG rates,464.4,100,,,fee schedule,100% of CO APG rates,464.4,100,,,fee schedule,100% of NM fee schedule,185.76,40,,,percent of total billed charges,40% of total billed charges,185.76,40,,,percent of total billed charges,40% of total billed charges,417.96,90,,,percent of total billed charges,90% of total billed charges,352.94,76,,,percent of total billed charges,76% of total billed charges,185.76,40,,,percent of total billed charges,40% of total billed charges,394.74,85,,,percent of total billed charges,85% of total billed charges,464.4,100,,,fee schedule,100% of CO APG rate,371.52,80,,,percent of total billed charges,80% of total billed charges,180.19,38.8,,,percent of total billed charges,38.8% of total billed charges,394.74,85,,,percent of total billed charges,85% of total billed charges,464.4,100,,,fee schedule,100% of APG fee schedule,928.8,200,,,percent of total billed charges,200% of total billed charges,180.19,928.8,
DRILL F 1.2MM SCREW WL 22MM AO QUICK,46050841,CDM,270,RC,,,OUTPATIENT,,,450.1,360.08,,337.58,75,,,percent of total billed charges,75% of total billed charges,180.04,40,,,percent of total billed charges,40% of total billed charges,356.48,79.2,,,percent of total billed charges,79.2% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,450.1,100,,,fee schedule,100% of CO APG rates,427.6,95,,,percent of total billed charges,95% of total billed charges,360.08,80,,,percent of total billed charges,80% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,405.09,90,,,percent of total billed charges,90% of total billed charges,450.1,100,,,fee schedule,100% of CO APG rates,450.1,100,,,fee schedule,100% of CO APG rates,450.1,100,,,fee schedule,100% of NM fee schedule,180.04,40,,,percent of total billed charges,40% of total billed charges,180.04,40,,,percent of total billed charges,40% of total billed charges,405.09,90,,,percent of total billed charges,90% of total billed charges,342.08,76,,,percent of total billed charges,76% of total billed charges,180.04,40,,,percent of total billed charges,40% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,450.1,100,,,fee schedule,100% of CO APG rate,360.08,80,,,percent of total billed charges,80% of total billed charges,174.64,38.8,,,percent of total billed charges,38.8% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,450.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.64,450.1,
H-PLATE LARGE,46050842,CDM,278,RC,,,OUTPATIENT,,,1092.4,873.92,,819.3,75,,,percent of total billed charges,75% of total billed charges,436.96,40,,,percent of total billed charges,40% of total billed charges,865.18,79.2,,,percent of total billed charges,79.2% of total billed charges,928.54,85,,,percent of total billed charges,85% of total billed charges,1092.4,100,,,fee schedule,100% of CO APG rates,1037.78,95,,,percent of total billed charges,95% of total billed charges,873.92,80,,,percent of total billed charges,80% of total billed charges,928.54,85,,,percent of total billed charges,85% of total billed charges,983.16,90,,,percent of total billed charges,90% of total billed charges,1092.4,100,,,fee schedule,100% of CO APG rates,1092.4,100,,,fee schedule,100% of CO APG rates,1092.4,100,,,fee schedule,100% of NM fee schedule,436.96,40,,,percent of total billed charges,40% of total billed charges,436.96,40,,,percent of total billed charges,40% of total billed charges,983.16,90,,,percent of total billed charges,90% of total billed charges,830.22,76,,,percent of total billed charges,76% of total billed charges,436.96,40,,,percent of total billed charges,40% of total billed charges,928.54,85,,,percent of total billed charges,85% of total billed charges,1092.4,100,,,fee schedule,100% of CO APG rate,873.92,80,,,percent of total billed charges,80% of total billed charges,423.85,38.8,,,percent of total billed charges,38.8% of total billed charges,928.54,85,,,percent of total billed charges,85% of total billed charges,1092.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,423.85,1092.4,
H-PLATE MEDIUM,46050843,CDM,278,RC,,,OUTPATIENT,,,1288.8,1031.04,,966.6,75,,,percent of total billed charges,75% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1020.73,79.2,,,percent of total billed charges,79.2% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rates,1224.36,95,,,percent of total billed charges,95% of total billed charges,1031.04,80,,,percent of total billed charges,80% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1159.92,90,,,percent of total billed charges,90% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rates,1288.8,100,,,fee schedule,100% of CO APG rates,1288.8,100,,,fee schedule,100% of NM fee schedule,515.52,40,,,percent of total billed charges,40% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1159.92,90,,,percent of total billed charges,90% of total billed charges,979.49,76,,,percent of total billed charges,76% of total billed charges,515.52,40,,,percent of total billed charges,40% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of CO APG rate,1031.04,80,,,percent of total billed charges,80% of total billed charges,500.05,38.8,,,percent of total billed charges,38.8% of total billed charges,1095.48,85,,,percent of total billed charges,85% of total billed charges,1288.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,500.05,1288.8,
H-PLATE SMALL,46050844,CDM,278,RC,,,OUTPATIENT,,,1039.9,831.92,,779.93,75,,,percent of total billed charges,75% of total billed charges,415.96,40,,,percent of total billed charges,40% of total billed charges,823.6,79.2,,,percent of total billed charges,79.2% of total billed charges,883.92,85,,,percent of total billed charges,85% of total billed charges,1039.9,100,,,fee schedule,100% of CO APG rates,987.91,95,,,percent of total billed charges,95% of total billed charges,831.92,80,,,percent of total billed charges,80% of total billed charges,883.92,85,,,percent of total billed charges,85% of total billed charges,935.91,90,,,percent of total billed charges,90% of total billed charges,1039.9,100,,,fee schedule,100% of CO APG rates,1039.9,100,,,fee schedule,100% of CO APG rates,1039.9,100,,,fee schedule,100% of NM fee schedule,415.96,40,,,percent of total billed charges,40% of total billed charges,415.96,40,,,percent of total billed charges,40% of total billed charges,935.91,90,,,percent of total billed charges,90% of total billed charges,790.32,76,,,percent of total billed charges,76% of total billed charges,415.96,40,,,percent of total billed charges,40% of total billed charges,883.92,85,,,percent of total billed charges,85% of total billed charges,1039.9,100,,,fee schedule,100% of CO APG rate,831.92,80,,,percent of total billed charges,80% of total billed charges,403.48,38.8,,,percent of total billed charges,38.8% of total billed charges,883.92,85,,,percent of total billed charges,85% of total billed charges,1039.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,403.48,1039.9,
"L PROFYLE HAND COMP L-PLATE,LE,6H",46050845,CDM,278,RC,,,OUTPATIENT,,,905.4,724.32,,679.05,75,,,percent of total billed charges,75% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,717.08,79.2,,,percent of total billed charges,79.2% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,860.13,95,,,percent of total billed charges,95% of total billed charges,724.32,80,,,percent of total billed charges,80% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of NM fee schedule,362.16,40,,,percent of total billed charges,40% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,688.1,76,,,percent of total billed charges,76% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rate,724.32,80,,,percent of total billed charges,80% of total billed charges,351.3,38.8,,,percent of total billed charges,38.8% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,351.3,905.4,
"L PROFYLE HAND COMP L-PLATE,RI,6H",46050846,CDM,278,RC,,,OUTPATIENT,,,905.4,724.32,,679.05,75,,,percent of total billed charges,75% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,717.08,79.2,,,percent of total billed charges,79.2% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,860.13,95,,,percent of total billed charges,95% of total billed charges,724.32,80,,,percent of total billed charges,80% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of NM fee schedule,362.16,40,,,percent of total billed charges,40% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,688.1,76,,,percent of total billed charges,76% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rate,724.32,80,,,percent of total billed charges,80% of total billed charges,351.3,38.8,,,percent of total billed charges,38.8% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,351.3,905.4,
"L PROFYLE HAND COMP PLATE,STRAI,BAR,4H",46050847,CDM,278,RC,,,OUTPATIENT,,,721.6,577.28,,541.2,75,,,percent of total billed charges,75% of total billed charges,288.64,40,,,percent of total billed charges,40% of total billed charges,571.51,79.2,,,percent of total billed charges,79.2% of total billed charges,613.36,85,,,percent of total billed charges,85% of total billed charges,721.6,100,,,fee schedule,100% of CO APG rates,685.52,95,,,percent of total billed charges,95% of total billed charges,577.28,80,,,percent of total billed charges,80% of total billed charges,613.36,85,,,percent of total billed charges,85% of total billed charges,649.44,90,,,percent of total billed charges,90% of total billed charges,721.6,100,,,fee schedule,100% of CO APG rates,721.6,100,,,fee schedule,100% of CO APG rates,721.6,100,,,fee schedule,100% of NM fee schedule,288.64,40,,,percent of total billed charges,40% of total billed charges,288.64,40,,,percent of total billed charges,40% of total billed charges,649.44,90,,,percent of total billed charges,90% of total billed charges,548.42,76,,,percent of total billed charges,76% of total billed charges,288.64,40,,,percent of total billed charges,40% of total billed charges,613.36,85,,,percent of total billed charges,85% of total billed charges,721.6,100,,,fee schedule,100% of CO APG rate,577.28,80,,,percent of total billed charges,80% of total billed charges,279.98,38.8,,,percent of total billed charges,38.8% of total billed charges,613.36,85,,,percent of total billed charges,85% of total billed charges,721.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,279.98,721.6,
"L PROFYLE HAND COMP PLATE,STRAI,BAR,5H",46050848,CDM,278,RC,,,OUTPATIENT,,,766.8,613.44,,575.1,75,,,percent of total billed charges,75% of total billed charges,306.72,40,,,percent of total billed charges,40% of total billed charges,607.31,79.2,,,percent of total billed charges,79.2% of total billed charges,651.78,85,,,percent of total billed charges,85% of total billed charges,766.8,100,,,fee schedule,100% of CO APG rates,728.46,95,,,percent of total billed charges,95% of total billed charges,613.44,80,,,percent of total billed charges,80% of total billed charges,651.78,85,,,percent of total billed charges,85% of total billed charges,690.12,90,,,percent of total billed charges,90% of total billed charges,766.8,100,,,fee schedule,100% of CO APG rates,766.8,100,,,fee schedule,100% of CO APG rates,766.8,100,,,fee schedule,100% of NM fee schedule,306.72,40,,,percent of total billed charges,40% of total billed charges,306.72,40,,,percent of total billed charges,40% of total billed charges,690.12,90,,,percent of total billed charges,90% of total billed charges,582.77,76,,,percent of total billed charges,76% of total billed charges,306.72,40,,,percent of total billed charges,40% of total billed charges,651.78,85,,,percent of total billed charges,85% of total billed charges,766.8,100,,,fee schedule,100% of CO APG rate,613.44,80,,,percent of total billed charges,80% of total billed charges,297.52,38.8,,,percent of total billed charges,38.8% of total billed charges,651.78,85,,,percent of total billed charges,85% of total billed charges,766.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,297.52,766.8,
"L PROFYLE HAND COMP PLATE,STRAI,BAR,6H",46050849,CDM,278,RC,,,OUTPATIENT,,,884.4,707.52,,663.3,75,,,percent of total billed charges,75% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,700.44,79.2,,,percent of total billed charges,79.2% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rates,840.18,95,,,percent of total billed charges,95% of total billed charges,707.52,80,,,percent of total billed charges,80% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,795.96,90,,,percent of total billed charges,90% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rates,884.4,100,,,fee schedule,100% of CO APG rates,884.4,100,,,fee schedule,100% of NM fee schedule,353.76,40,,,percent of total billed charges,40% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,795.96,90,,,percent of total billed charges,90% of total billed charges,672.14,76,,,percent of total billed charges,76% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rate,707.52,80,,,percent of total billed charges,80% of total billed charges,343.15,38.8,,,percent of total billed charges,38.8% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,343.15,884.4,
"L PROFYLE HAND COMP PLATE,STRAI,BAR,8H",46050850,CDM,278,RC,,,OUTPATIENT,,,956.9,765.52,,717.68,75,,,percent of total billed charges,75% of total billed charges,382.76,40,,,percent of total billed charges,40% of total billed charges,757.86,79.2,,,percent of total billed charges,79.2% of total billed charges,813.37,85,,,percent of total billed charges,85% of total billed charges,956.9,100,,,fee schedule,100% of CO APG rates,909.06,95,,,percent of total billed charges,95% of total billed charges,765.52,80,,,percent of total billed charges,80% of total billed charges,813.37,85,,,percent of total billed charges,85% of total billed charges,861.21,90,,,percent of total billed charges,90% of total billed charges,956.9,100,,,fee schedule,100% of CO APG rates,956.9,100,,,fee schedule,100% of CO APG rates,956.9,100,,,fee schedule,100% of NM fee schedule,382.76,40,,,percent of total billed charges,40% of total billed charges,382.76,40,,,percent of total billed charges,40% of total billed charges,861.21,90,,,percent of total billed charges,90% of total billed charges,727.24,76,,,percent of total billed charges,76% of total billed charges,382.76,40,,,percent of total billed charges,40% of total billed charges,813.37,85,,,percent of total billed charges,85% of total billed charges,956.9,100,,,fee schedule,100% of CO APG rate,765.52,80,,,percent of total billed charges,80% of total billed charges,371.28,38.8,,,percent of total billed charges,38.8% of total billed charges,813.37,85,,,percent of total billed charges,85% of total billed charges,956.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,371.28,956.9,
"L PROFYLE HAND COMP T-PLATE,6H",46050851,CDM,278,RC,,,OUTPATIENT,,,905.4,724.32,,679.05,75,,,percent of total billed charges,75% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,717.08,79.2,,,percent of total billed charges,79.2% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,860.13,95,,,percent of total billed charges,95% of total billed charges,724.32,80,,,percent of total billed charges,80% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of NM fee schedule,362.16,40,,,percent of total billed charges,40% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,688.1,76,,,percent of total billed charges,76% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rate,724.32,80,,,percent of total billed charges,80% of total billed charges,351.3,38.8,,,percent of total billed charges,38.8% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,351.3,905.4,
"L PROFYLE HAND COMP T-PLATE,NAR,10H",46050852,CDM,278,RC,,,OUTPATIENT,,,984.2,787.36,,738.15,75,,,percent of total billed charges,75% of total billed charges,393.68,40,,,percent of total billed charges,40% of total billed charges,779.49,79.2,,,percent of total billed charges,79.2% of total billed charges,836.57,85,,,percent of total billed charges,85% of total billed charges,984.2,100,,,fee schedule,100% of CO APG rates,934.99,95,,,percent of total billed charges,95% of total billed charges,787.36,80,,,percent of total billed charges,80% of total billed charges,836.57,85,,,percent of total billed charges,85% of total billed charges,885.78,90,,,percent of total billed charges,90% of total billed charges,984.2,100,,,fee schedule,100% of CO APG rates,984.2,100,,,fee schedule,100% of CO APG rates,984.2,100,,,fee schedule,100% of NM fee schedule,393.68,40,,,percent of total billed charges,40% of total billed charges,393.68,40,,,percent of total billed charges,40% of total billed charges,885.78,90,,,percent of total billed charges,90% of total billed charges,747.99,76,,,percent of total billed charges,76% of total billed charges,393.68,40,,,percent of total billed charges,40% of total billed charges,836.57,85,,,percent of total billed charges,85% of total billed charges,984.2,100,,,fee schedule,100% of CO APG rate,787.36,80,,,percent of total billed charges,80% of total billed charges,381.87,38.8,,,percent of total billed charges,38.8% of total billed charges,836.57,85,,,percent of total billed charges,85% of total billed charges,984.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,381.87,984.2,
"L PROFYLE HAND COMP T-PLATE,NAR,6H",46050853,CDM,278,RC,,,OUTPATIENT,,,905.4,724.32,,679.05,75,,,percent of total billed charges,75% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,717.08,79.2,,,percent of total billed charges,79.2% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,860.13,95,,,percent of total billed charges,95% of total billed charges,724.32,80,,,percent of total billed charges,80% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of NM fee schedule,362.16,40,,,percent of total billed charges,40% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,688.1,76,,,percent of total billed charges,76% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rate,724.32,80,,,percent of total billed charges,80% of total billed charges,351.3,38.8,,,percent of total billed charges,38.8% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,351.3,905.4,
"L PROFYLE HAND COMP T-PLATE,OBLI,LE,6H",46050854,CDM,278,RC,,,OUTPATIENT,,,905.4,724.32,,679.05,75,,,percent of total billed charges,75% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,717.08,79.2,,,percent of total billed charges,79.2% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,860.13,95,,,percent of total billed charges,95% of total billed charges,724.32,80,,,percent of total billed charges,80% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of NM fee schedule,362.16,40,,,percent of total billed charges,40% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,688.1,76,,,percent of total billed charges,76% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rate,724.32,80,,,percent of total billed charges,80% of total billed charges,351.3,38.8,,,percent of total billed charges,38.8% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,351.3,905.4,
"L PROFYLE HAND COMP T-PLATE,OBLI,RI,6H",46050855,CDM,278,RC,,,OUTPATIENT,,,905.4,724.32,,679.05,75,,,percent of total billed charges,75% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,717.08,79.2,,,percent of total billed charges,79.2% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,860.13,95,,,percent of total billed charges,95% of total billed charges,724.32,80,,,percent of total billed charges,80% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of CO APG rates,905.4,100,,,fee schedule,100% of NM fee schedule,362.16,40,,,percent of total billed charges,40% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,814.86,90,,,percent of total billed charges,90% of total billed charges,688.1,76,,,percent of total billed charges,76% of total billed charges,362.16,40,,,percent of total billed charges,40% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of CO APG rate,724.32,80,,,percent of total billed charges,80% of total billed charges,351.3,38.8,,,percent of total billed charges,38.8% of total billed charges,769.59,85,,,percent of total billed charges,85% of total billed charges,905.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,351.3,905.4,
LOCKING 1/3 TUB PLATE 10 HOLE / L128MM,46050856,CDM,278,RC,,,OUTPATIENT,,,546.2,436.96,,409.65,75,,,percent of total billed charges,75% of total billed charges,218.48,40,,,percent of total billed charges,40% of total billed charges,432.59,79.2,,,percent of total billed charges,79.2% of total billed charges,464.27,85,,,percent of total billed charges,85% of total billed charges,546.2,100,,,fee schedule,100% of CO APG rates,518.89,95,,,percent of total billed charges,95% of total billed charges,436.96,80,,,percent of total billed charges,80% of total billed charges,464.27,85,,,percent of total billed charges,85% of total billed charges,491.58,90,,,percent of total billed charges,90% of total billed charges,546.2,100,,,fee schedule,100% of CO APG rates,546.2,100,,,fee schedule,100% of CO APG rates,546.2,100,,,fee schedule,100% of NM fee schedule,218.48,40,,,percent of total billed charges,40% of total billed charges,218.48,40,,,percent of total billed charges,40% of total billed charges,491.58,90,,,percent of total billed charges,90% of total billed charges,415.11,76,,,percent of total billed charges,76% of total billed charges,218.48,40,,,percent of total billed charges,40% of total billed charges,464.27,85,,,percent of total billed charges,85% of total billed charges,546.2,100,,,fee schedule,100% of CO APG rate,436.96,80,,,percent of total billed charges,80% of total billed charges,211.93,38.8,,,percent of total billed charges,38.8% of total billed charges,464.27,85,,,percent of total billed charges,85% of total billed charges,546.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,211.93,546.2,
LOCKING 1/3 TUB PLATE 4 HOLE / L50MM,46050857,CDM,278,RC,,,OUTPATIENT,,,505.2,404.16,,378.9,75,,,percent of total billed charges,75% of total billed charges,202.08,40,,,percent of total billed charges,40% of total billed charges,400.12,79.2,,,percent of total billed charges,79.2% of total billed charges,429.42,85,,,percent of total billed charges,85% of total billed charges,505.2,100,,,fee schedule,100% of CO APG rates,479.94,95,,,percent of total billed charges,95% of total billed charges,404.16,80,,,percent of total billed charges,80% of total billed charges,429.42,85,,,percent of total billed charges,85% of total billed charges,454.68,90,,,percent of total billed charges,90% of total billed charges,505.2,100,,,fee schedule,100% of CO APG rates,505.2,100,,,fee schedule,100% of CO APG rates,505.2,100,,,fee schedule,100% of NM fee schedule,202.08,40,,,percent of total billed charges,40% of total billed charges,202.08,40,,,percent of total billed charges,40% of total billed charges,454.68,90,,,percent of total billed charges,90% of total billed charges,383.95,76,,,percent of total billed charges,76% of total billed charges,202.08,40,,,percent of total billed charges,40% of total billed charges,429.42,85,,,percent of total billed charges,85% of total billed charges,505.2,100,,,fee schedule,100% of CO APG rate,404.16,80,,,percent of total billed charges,80% of total billed charges,196.02,38.8,,,percent of total billed charges,38.8% of total billed charges,429.42,85,,,percent of total billed charges,85% of total billed charges,505.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,196.02,505.2,
LOCKING 1/3 TUB PLATE 6 HOLE / L76MM,46050858,CDM,278,RC,,,OUTPATIENT,,,505.2,404.16,,378.9,75,,,percent of total billed charges,75% of total billed charges,202.08,40,,,percent of total billed charges,40% of total billed charges,400.12,79.2,,,percent of total billed charges,79.2% of total billed charges,429.42,85,,,percent of total billed charges,85% of total billed charges,505.2,100,,,fee schedule,100% of CO APG rates,479.94,95,,,percent of total billed charges,95% of total billed charges,404.16,80,,,percent of total billed charges,80% of total billed charges,429.42,85,,,percent of total billed charges,85% of total billed charges,454.68,90,,,percent of total billed charges,90% of total billed charges,505.2,100,,,fee schedule,100% of CO APG rates,505.2,100,,,fee schedule,100% of CO APG rates,505.2,100,,,fee schedule,100% of NM fee schedule,202.08,40,,,percent of total billed charges,40% of total billed charges,202.08,40,,,percent of total billed charges,40% of total billed charges,454.68,90,,,percent of total billed charges,90% of total billed charges,383.95,76,,,percent of total billed charges,76% of total billed charges,202.08,40,,,percent of total billed charges,40% of total billed charges,429.42,85,,,percent of total billed charges,85% of total billed charges,505.2,100,,,fee schedule,100% of CO APG rate,404.16,80,,,percent of total billed charges,80% of total billed charges,196.02,38.8,,,percent of total billed charges,38.8% of total billed charges,429.42,85,,,percent of total billed charges,85% of total billed charges,505.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,196.02,505.2,
LOCKING 1/3 TUB PLATE 8 HOLE / L102MM,46050859,CDM,278,RC,,,OUTPATIENT,,,546.2,436.96,,409.65,75,,,percent of total billed charges,75% of total billed charges,218.48,40,,,percent of total billed charges,40% of total billed charges,432.59,79.2,,,percent of total billed charges,79.2% of total billed charges,464.27,85,,,percent of total billed charges,85% of total billed charges,546.2,100,,,fee schedule,100% of CO APG rates,518.89,95,,,percent of total billed charges,95% of total billed charges,436.96,80,,,percent of total billed charges,80% of total billed charges,464.27,85,,,percent of total billed charges,85% of total billed charges,491.58,90,,,percent of total billed charges,90% of total billed charges,546.2,100,,,fee schedule,100% of CO APG rates,546.2,100,,,fee schedule,100% of CO APG rates,546.2,100,,,fee schedule,100% of NM fee schedule,218.48,40,,,percent of total billed charges,40% of total billed charges,218.48,40,,,percent of total billed charges,40% of total billed charges,491.58,90,,,percent of total billed charges,90% of total billed charges,415.11,76,,,percent of total billed charges,76% of total billed charges,218.48,40,,,percent of total billed charges,40% of total billed charges,464.27,85,,,percent of total billed charges,85% of total billed charges,546.2,100,,,fee schedule,100% of CO APG rate,436.96,80,,,percent of total billed charges,80% of total billed charges,211.93,38.8,,,percent of total billed charges,38.8% of total billed charges,464.27,85,,,percent of total billed charges,85% of total billed charges,546.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,211.93,546.2,
LOCKING COMPR PLATE 10 HOLE / L136MM,46050860,CDM,278,RC,,,OUTPATIENT,,,621.8,497.44,,466.35,75,,,percent of total billed charges,75% of total billed charges,248.72,40,,,percent of total billed charges,40% of total billed charges,492.47,79.2,,,percent of total billed charges,79.2% of total billed charges,528.53,85,,,percent of total billed charges,85% of total billed charges,621.8,100,,,fee schedule,100% of CO APG rates,590.71,95,,,percent of total billed charges,95% of total billed charges,497.44,80,,,percent of total billed charges,80% of total billed charges,528.53,85,,,percent of total billed charges,85% of total billed charges,559.62,90,,,percent of total billed charges,90% of total billed charges,621.8,100,,,fee schedule,100% of CO APG rates,621.8,100,,,fee schedule,100% of CO APG rates,621.8,100,,,fee schedule,100% of NM fee schedule,248.72,40,,,percent of total billed charges,40% of total billed charges,248.72,40,,,percent of total billed charges,40% of total billed charges,559.62,90,,,percent of total billed charges,90% of total billed charges,472.57,76,,,percent of total billed charges,76% of total billed charges,248.72,40,,,percent of total billed charges,40% of total billed charges,528.53,85,,,percent of total billed charges,85% of total billed charges,621.8,100,,,fee schedule,100% of CO APG rate,497.44,80,,,percent of total billed charges,80% of total billed charges,241.26,38.8,,,percent of total billed charges,38.8% of total billed charges,528.53,85,,,percent of total billed charges,85% of total billed charges,621.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,241.26,621.8,
LOCKING COMPR PLATE 4 HOLE / L58MM,46050861,CDM,278,RC,,,OUTPATIENT,,,429.6,343.68,,322.2,75,,,percent of total billed charges,75% of total billed charges,171.84,40,,,percent of total billed charges,40% of total billed charges,340.24,79.2,,,percent of total billed charges,79.2% of total billed charges,365.16,85,,,percent of total billed charges,85% of total billed charges,429.6,100,,,fee schedule,100% of CO APG rates,408.12,95,,,percent of total billed charges,95% of total billed charges,343.68,80,,,percent of total billed charges,80% of total billed charges,365.16,85,,,percent of total billed charges,85% of total billed charges,386.64,90,,,percent of total billed charges,90% of total billed charges,429.6,100,,,fee schedule,100% of CO APG rates,429.6,100,,,fee schedule,100% of CO APG rates,429.6,100,,,fee schedule,100% of NM fee schedule,171.84,40,,,percent of total billed charges,40% of total billed charges,171.84,40,,,percent of total billed charges,40% of total billed charges,386.64,90,,,percent of total billed charges,90% of total billed charges,326.5,76,,,percent of total billed charges,76% of total billed charges,171.84,40,,,percent of total billed charges,40% of total billed charges,365.16,85,,,percent of total billed charges,85% of total billed charges,429.6,100,,,fee schedule,100% of CO APG rate,343.68,80,,,percent of total billed charges,80% of total billed charges,166.68,38.8,,,percent of total billed charges,38.8% of total billed charges,365.16,85,,,percent of total billed charges,85% of total billed charges,429.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,166.68,429.6,
LOCKING COMPR PLATE 6 HOLE / L84MM,46050862,CDM,278,RC,,,OUTPATIENT,,,525.2,420.16,,393.9,75,,,percent of total billed charges,75% of total billed charges,210.08,40,,,percent of total billed charges,40% of total billed charges,415.96,79.2,,,percent of total billed charges,79.2% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,525.2,100,,,fee schedule,100% of CO APG rates,498.94,95,,,percent of total billed charges,95% of total billed charges,420.16,80,,,percent of total billed charges,80% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,472.68,90,,,percent of total billed charges,90% of total billed charges,525.2,100,,,fee schedule,100% of CO APG rates,525.2,100,,,fee schedule,100% of CO APG rates,525.2,100,,,fee schedule,100% of NM fee schedule,210.08,40,,,percent of total billed charges,40% of total billed charges,210.08,40,,,percent of total billed charges,40% of total billed charges,472.68,90,,,percent of total billed charges,90% of total billed charges,399.15,76,,,percent of total billed charges,76% of total billed charges,210.08,40,,,percent of total billed charges,40% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,525.2,100,,,fee schedule,100% of CO APG rate,420.16,80,,,percent of total billed charges,80% of total billed charges,203.78,38.8,,,percent of total billed charges,38.8% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,525.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.78,525.2,
LOCKING COMPR PLATE 7 HOLE / L97MM,46050863,CDM,278,RC,,,OUTPATIENT,,,525.2,420.16,,393.9,75,,,percent of total billed charges,75% of total billed charges,210.08,40,,,percent of total billed charges,40% of total billed charges,415.96,79.2,,,percent of total billed charges,79.2% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,525.2,100,,,fee schedule,100% of CO APG rates,498.94,95,,,percent of total billed charges,95% of total billed charges,420.16,80,,,percent of total billed charges,80% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,472.68,90,,,percent of total billed charges,90% of total billed charges,525.2,100,,,fee schedule,100% of CO APG rates,525.2,100,,,fee schedule,100% of CO APG rates,525.2,100,,,fee schedule,100% of NM fee schedule,210.08,40,,,percent of total billed charges,40% of total billed charges,210.08,40,,,percent of total billed charges,40% of total billed charges,472.68,90,,,percent of total billed charges,90% of total billed charges,399.15,76,,,percent of total billed charges,76% of total billed charges,210.08,40,,,percent of total billed charges,40% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,525.2,100,,,fee schedule,100% of CO APG rate,420.16,80,,,percent of total billed charges,80% of total billed charges,203.78,38.8,,,percent of total billed charges,38.8% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,525.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.78,525.2,
LOCKING COMPR PLATE 8 HOLE / L110MM,46050864,CDM,278,RC,,,OUTPATIENT,,,621.8,497.44,,466.35,75,,,percent of total billed charges,75% of total billed charges,248.72,40,,,percent of total billed charges,40% of total billed charges,492.47,79.2,,,percent of total billed charges,79.2% of total billed charges,528.53,85,,,percent of total billed charges,85% of total billed charges,621.8,100,,,fee schedule,100% of CO APG rates,590.71,95,,,percent of total billed charges,95% of total billed charges,497.44,80,,,percent of total billed charges,80% of total billed charges,528.53,85,,,percent of total billed charges,85% of total billed charges,559.62,90,,,percent of total billed charges,90% of total billed charges,621.8,100,,,fee schedule,100% of CO APG rates,621.8,100,,,fee schedule,100% of CO APG rates,621.8,100,,,fee schedule,100% of NM fee schedule,248.72,40,,,percent of total billed charges,40% of total billed charges,248.72,40,,,percent of total billed charges,40% of total billed charges,559.62,90,,,percent of total billed charges,90% of total billed charges,472.57,76,,,percent of total billed charges,76% of total billed charges,248.72,40,,,percent of total billed charges,40% of total billed charges,528.53,85,,,percent of total billed charges,85% of total billed charges,621.8,100,,,fee schedule,100% of CO APG rate,497.44,80,,,percent of total billed charges,80% of total billed charges,241.26,38.8,,,percent of total billed charges,38.8% of total billed charges,528.53,85,,,percent of total billed charges,85% of total billed charges,621.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,241.26,621.8,
LOCKING RECON PLATE 10 HOLE / L120MM,46050865,CDM,278,RC,,,OUTPATIENT,,,1649.1,1319.28,,1236.83,75,,,percent of total billed charges,75% of total billed charges,659.64,40,,,percent of total billed charges,40% of total billed charges,1306.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1401.74,85,,,percent of total billed charges,85% of total billed charges,1649.1,100,,,fee schedule,100% of CO APG rates,1566.65,95,,,percent of total billed charges,95% of total billed charges,1319.28,80,,,percent of total billed charges,80% of total billed charges,1401.74,85,,,percent of total billed charges,85% of total billed charges,1484.19,90,,,percent of total billed charges,90% of total billed charges,1649.1,100,,,fee schedule,100% of CO APG rates,1649.1,100,,,fee schedule,100% of CO APG rates,1649.1,100,,,fee schedule,100% of NM fee schedule,659.64,40,,,percent of total billed charges,40% of total billed charges,659.64,40,,,percent of total billed charges,40% of total billed charges,1484.19,90,,,percent of total billed charges,90% of total billed charges,1253.32,76,,,percent of total billed charges,76% of total billed charges,659.64,40,,,percent of total billed charges,40% of total billed charges,1401.74,85,,,percent of total billed charges,85% of total billed charges,1649.1,100,,,fee schedule,100% of CO APG rate,1319.28,80,,,percent of total billed charges,80% of total billed charges,639.85,38.8,,,percent of total billed charges,38.8% of total billed charges,1401.74,85,,,percent of total billed charges,85% of total billed charges,1649.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,639.85,1649.1,
LOCKING RECON PLATE 4 HOLE / L48MM,46050866,CDM,278,RC,,,OUTPATIENT,,,1240.5,992.4,,930.38,75,,,percent of total billed charges,75% of total billed charges,496.2,40,,,percent of total billed charges,40% of total billed charges,982.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1054.43,85,,,percent of total billed charges,85% of total billed charges,1240.5,100,,,fee schedule,100% of CO APG rates,1178.48,95,,,percent of total billed charges,95% of total billed charges,992.4,80,,,percent of total billed charges,80% of total billed charges,1054.43,85,,,percent of total billed charges,85% of total billed charges,1116.45,90,,,percent of total billed charges,90% of total billed charges,1240.5,100,,,fee schedule,100% of CO APG rates,1240.5,100,,,fee schedule,100% of CO APG rates,1240.5,100,,,fee schedule,100% of NM fee schedule,496.2,40,,,percent of total billed charges,40% of total billed charges,496.2,40,,,percent of total billed charges,40% of total billed charges,1116.45,90,,,percent of total billed charges,90% of total billed charges,942.78,76,,,percent of total billed charges,76% of total billed charges,496.2,40,,,percent of total billed charges,40% of total billed charges,1054.43,85,,,percent of total billed charges,85% of total billed charges,1240.5,100,,,fee schedule,100% of CO APG rate,992.4,80,,,percent of total billed charges,80% of total billed charges,481.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1054.43,85,,,percent of total billed charges,85% of total billed charges,1240.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,481.31,1240.5,
LOCKING RECON PLATE 6 HOLE / L72MM,46050867,CDM,278,RC,,,OUTPATIENT,,,1456.9,1165.52,,1092.68,75,,,percent of total billed charges,75% of total billed charges,582.76,40,,,percent of total billed charges,40% of total billed charges,1153.86,79.2,,,percent of total billed charges,79.2% of total billed charges,1238.37,85,,,percent of total billed charges,85% of total billed charges,1456.9,100,,,fee schedule,100% of CO APG rates,1384.06,95,,,percent of total billed charges,95% of total billed charges,1165.52,80,,,percent of total billed charges,80% of total billed charges,1238.37,85,,,percent of total billed charges,85% of total billed charges,1311.21,90,,,percent of total billed charges,90% of total billed charges,1456.9,100,,,fee schedule,100% of CO APG rates,1456.9,100,,,fee schedule,100% of CO APG rates,1456.9,100,,,fee schedule,100% of NM fee schedule,582.76,40,,,percent of total billed charges,40% of total billed charges,582.76,40,,,percent of total billed charges,40% of total billed charges,1311.21,90,,,percent of total billed charges,90% of total billed charges,1107.24,76,,,percent of total billed charges,76% of total billed charges,582.76,40,,,percent of total billed charges,40% of total billed charges,1238.37,85,,,percent of total billed charges,85% of total billed charges,1456.9,100,,,fee schedule,100% of CO APG rate,1165.52,80,,,percent of total billed charges,80% of total billed charges,565.28,38.8,,,percent of total billed charges,38.8% of total billed charges,1238.37,85,,,percent of total billed charges,85% of total billed charges,1456.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,565.28,1456.9,
LOCKING RECON PLATE 8 HOLE / L96MM,46050868,CDM,278,RC,,,OUTPATIENT,,,1597.7,1278.16,,1198.28,75,,,percent of total billed charges,75% of total billed charges,639.08,40,,,percent of total billed charges,40% of total billed charges,1265.38,79.2,,,percent of total billed charges,79.2% of total billed charges,1358.05,85,,,percent of total billed charges,85% of total billed charges,1597.7,100,,,fee schedule,100% of CO APG rates,1517.82,95,,,percent of total billed charges,95% of total billed charges,1278.16,80,,,percent of total billed charges,80% of total billed charges,1358.05,85,,,percent of total billed charges,85% of total billed charges,1437.93,90,,,percent of total billed charges,90% of total billed charges,1597.7,100,,,fee schedule,100% of CO APG rates,1597.7,100,,,fee schedule,100% of CO APG rates,1597.7,100,,,fee schedule,100% of NM fee schedule,639.08,40,,,percent of total billed charges,40% of total billed charges,639.08,40,,,percent of total billed charges,40% of total billed charges,1437.93,90,,,percent of total billed charges,90% of total billed charges,1214.25,76,,,percent of total billed charges,76% of total billed charges,639.08,40,,,percent of total billed charges,40% of total billed charges,1358.05,85,,,percent of total billed charges,85% of total billed charges,1597.7,100,,,fee schedule,100% of CO APG rate,1278.16,80,,,percent of total billed charges,80% of total billed charges,619.91,38.8,,,percent of total billed charges,38.8% of total billed charges,1358.05,85,,,percent of total billed charges,85% of total billed charges,1597.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,619.91,1597.7,
LOCKING SCREW AXSOS 3.0MM / L10MM,46050869,CDM,278,RC,,,OUTPATIENT,,,274.2,219.36,,205.65,75,,,percent of total billed charges,75% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,217.17,79.2,,,percent of total billed charges,79.2% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,260.49,95,,,percent of total billed charges,95% of total billed charges,219.36,80,,,percent of total billed charges,80% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of NM fee schedule,109.68,40,,,percent of total billed charges,40% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,208.39,76,,,percent of total billed charges,76% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rate,219.36,80,,,percent of total billed charges,80% of total billed charges,106.39,38.8,,,percent of total billed charges,38.8% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.39,274.2,
LOCKING SCREW AXSOS 3.0MM / L12MM,46050870,CDM,278,RC,,,OUTPATIENT,,,274.2,219.36,,205.65,75,,,percent of total billed charges,75% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,217.17,79.2,,,percent of total billed charges,79.2% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,260.49,95,,,percent of total billed charges,95% of total billed charges,219.36,80,,,percent of total billed charges,80% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of NM fee schedule,109.68,40,,,percent of total billed charges,40% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,208.39,76,,,percent of total billed charges,76% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rate,219.36,80,,,percent of total billed charges,80% of total billed charges,106.39,38.8,,,percent of total billed charges,38.8% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.39,274.2,
LOCKING SCREW AXSOS 3.0MM / L14MM,46050871,CDM,278,RC,,,OUTPATIENT,,,297.3,237.84,,222.98,75,,,percent of total billed charges,75% of total billed charges,118.92,40,,,percent of total billed charges,40% of total billed charges,235.46,79.2,,,percent of total billed charges,79.2% of total billed charges,252.71,85,,,percent of total billed charges,85% of total billed charges,297.3,100,,,fee schedule,100% of CO APG rates,282.44,95,,,percent of total billed charges,95% of total billed charges,237.84,80,,,percent of total billed charges,80% of total billed charges,252.71,85,,,percent of total billed charges,85% of total billed charges,267.57,90,,,percent of total billed charges,90% of total billed charges,297.3,100,,,fee schedule,100% of CO APG rates,297.3,100,,,fee schedule,100% of CO APG rates,297.3,100,,,fee schedule,100% of NM fee schedule,118.92,40,,,percent of total billed charges,40% of total billed charges,118.92,40,,,percent of total billed charges,40% of total billed charges,267.57,90,,,percent of total billed charges,90% of total billed charges,225.95,76,,,percent of total billed charges,76% of total billed charges,118.92,40,,,percent of total billed charges,40% of total billed charges,252.71,85,,,percent of total billed charges,85% of total billed charges,297.3,100,,,fee schedule,100% of CO APG rate,237.84,80,,,percent of total billed charges,80% of total billed charges,115.35,38.8,,,percent of total billed charges,38.8% of total billed charges,252.71,85,,,percent of total billed charges,85% of total billed charges,297.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,115.35,297.3,
LOCKING SCREW AXSOS 3.0MM / L16MM,46050872,CDM,278,RC,,,OUTPATIENT,,,274.2,219.36,,205.65,75,,,percent of total billed charges,75% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,217.17,79.2,,,percent of total billed charges,79.2% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,260.49,95,,,percent of total billed charges,95% of total billed charges,219.36,80,,,percent of total billed charges,80% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of NM fee schedule,109.68,40,,,percent of total billed charges,40% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,208.39,76,,,percent of total billed charges,76% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rate,219.36,80,,,percent of total billed charges,80% of total billed charges,106.39,38.8,,,percent of total billed charges,38.8% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.39,274.2,
LOCKING SCREW AXSOS 3.0MM / L18MM,46050873,CDM,278,RC,,,OUTPATIENT,,,274.2,219.36,,205.65,75,,,percent of total billed charges,75% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,217.17,79.2,,,percent of total billed charges,79.2% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,260.49,95,,,percent of total billed charges,95% of total billed charges,219.36,80,,,percent of total billed charges,80% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of NM fee schedule,109.68,40,,,percent of total billed charges,40% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,208.39,76,,,percent of total billed charges,76% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rate,219.36,80,,,percent of total billed charges,80% of total billed charges,106.39,38.8,,,percent of total billed charges,38.8% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.39,274.2,
LOCKING SCREW AXSOS 3.0MM / L20MM,46050874,CDM,278,RC,,,OUTPATIENT,,,274.2,219.36,,205.65,75,,,percent of total billed charges,75% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,217.17,79.2,,,percent of total billed charges,79.2% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,260.49,95,,,percent of total billed charges,95% of total billed charges,219.36,80,,,percent of total billed charges,80% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of NM fee schedule,109.68,40,,,percent of total billed charges,40% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,208.39,76,,,percent of total billed charges,76% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rate,219.36,80,,,percent of total billed charges,80% of total billed charges,106.39,38.8,,,percent of total billed charges,38.8% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.39,274.2,
LOCKING SCREW AXSOS 3.0MM / L22MM,46050875,CDM,278,RC,,,OUTPATIENT,,,274.2,219.36,,205.65,75,,,percent of total billed charges,75% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,217.17,79.2,,,percent of total billed charges,79.2% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,260.49,95,,,percent of total billed charges,95% of total billed charges,219.36,80,,,percent of total billed charges,80% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of NM fee schedule,109.68,40,,,percent of total billed charges,40% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,208.39,76,,,percent of total billed charges,76% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rate,219.36,80,,,percent of total billed charges,80% of total billed charges,106.39,38.8,,,percent of total billed charges,38.8% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.39,274.2,
LOCKING SCREW AXSOS 3.0MM / L24MM,46050876,CDM,278,RC,,,OUTPATIENT,,,274.2,219.36,,205.65,75,,,percent of total billed charges,75% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,217.17,79.2,,,percent of total billed charges,79.2% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,260.49,95,,,percent of total billed charges,95% of total billed charges,219.36,80,,,percent of total billed charges,80% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of NM fee schedule,109.68,40,,,percent of total billed charges,40% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,208.39,76,,,percent of total billed charges,76% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rate,219.36,80,,,percent of total billed charges,80% of total billed charges,106.39,38.8,,,percent of total billed charges,38.8% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.39,274.2,
LOCKING SCREW AXSOS 3.0MM / L26MM,46050877,CDM,278,RC,,,OUTPATIENT,,,274.2,219.36,,205.65,75,,,percent of total billed charges,75% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,217.17,79.2,,,percent of total billed charges,79.2% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,260.49,95,,,percent of total billed charges,95% of total billed charges,219.36,80,,,percent of total billed charges,80% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of NM fee schedule,109.68,40,,,percent of total billed charges,40% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,208.39,76,,,percent of total billed charges,76% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rate,219.36,80,,,percent of total billed charges,80% of total billed charges,106.39,38.8,,,percent of total billed charges,38.8% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.39,274.2,
LOCKING SCREW AXSOS 3.0MM / L28MM,46050878,CDM,278,RC,,,OUTPATIENT,,,274.2,219.36,,205.65,75,,,percent of total billed charges,75% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,217.17,79.2,,,percent of total billed charges,79.2% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,260.49,95,,,percent of total billed charges,95% of total billed charges,219.36,80,,,percent of total billed charges,80% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of NM fee schedule,109.68,40,,,percent of total billed charges,40% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,208.39,76,,,percent of total billed charges,76% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rate,219.36,80,,,percent of total billed charges,80% of total billed charges,106.39,38.8,,,percent of total billed charges,38.8% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.39,274.2,
LOCKING SCREW AXSOS 3.0MM / L30MM,46050879,CDM,278,RC,,,OUTPATIENT,,,274.2,219.36,,205.65,75,,,percent of total billed charges,75% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,217.17,79.2,,,percent of total billed charges,79.2% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,260.49,95,,,percent of total billed charges,95% of total billed charges,219.36,80,,,percent of total billed charges,80% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of NM fee schedule,109.68,40,,,percent of total billed charges,40% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,208.39,76,,,percent of total billed charges,76% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rate,219.36,80,,,percent of total billed charges,80% of total billed charges,106.39,38.8,,,percent of total billed charges,38.8% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.39,274.2,
LOCKING SCREW AXSOS 3.0MM / L8MM,46050880,CDM,278,RC,,,OUTPATIENT,,,274.2,219.36,,205.65,75,,,percent of total billed charges,75% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,217.17,79.2,,,percent of total billed charges,79.2% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,260.49,95,,,percent of total billed charges,95% of total billed charges,219.36,80,,,percent of total billed charges,80% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of CO APG rates,274.2,100,,,fee schedule,100% of NM fee schedule,109.68,40,,,percent of total billed charges,40% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,246.78,90,,,percent of total billed charges,90% of total billed charges,208.39,76,,,percent of total billed charges,76% of total billed charges,109.68,40,,,percent of total billed charges,40% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of CO APG rate,219.36,80,,,percent of total billed charges,80% of total billed charges,106.39,38.8,,,percent of total billed charges,38.8% of total billed charges,233.07,85,,,percent of total billed charges,85% of total billed charges,274.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.39,274.2,
LOCKING SCREW AXSOS 4.0MM / L14MM,46050881,CDM,278,RC,,,OUTPATIENT,,,435.9,348.72,,326.93,75,,,percent of total billed charges,75% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,345.23,79.2,,,percent of total billed charges,79.2% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rates,414.11,95,,,percent of total billed charges,95% of total billed charges,348.72,80,,,percent of total billed charges,80% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,392.31,90,,,percent of total billed charges,90% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rates,435.9,100,,,fee schedule,100% of CO APG rates,435.9,100,,,fee schedule,100% of NM fee schedule,174.36,40,,,percent of total billed charges,40% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,392.31,90,,,percent of total billed charges,90% of total billed charges,331.28,76,,,percent of total billed charges,76% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rate,348.72,80,,,percent of total billed charges,80% of total billed charges,169.13,38.8,,,percent of total billed charges,38.8% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,169.13,435.9,
LOCKING SCREW AXSOS 4.0MM / L16MM,46050882,CDM,278,RC,,,OUTPATIENT,,,440.1,352.08,,330.08,75,,,percent of total billed charges,75% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,348.56,79.2,,,percent of total billed charges,79.2% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,418.1,95,,,percent of total billed charges,95% of total billed charges,352.08,80,,,percent of total billed charges,80% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of NM fee schedule,176.04,40,,,percent of total billed charges,40% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,334.48,76,,,percent of total billed charges,76% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rate,352.08,80,,,percent of total billed charges,80% of total billed charges,170.76,38.8,,,percent of total billed charges,38.8% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,170.76,440.1,
LOCKING SCREW AXSOS 4.0MM / L18MM,46050883,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L20MM,46050884,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L22MM,46050885,CDM,278,RC,,,OUTPATIENT,,,422.3,337.84,,316.73,75,,,percent of total billed charges,75% of total billed charges,168.92,40,,,percent of total billed charges,40% of total billed charges,334.46,79.2,,,percent of total billed charges,79.2% of total billed charges,358.96,85,,,percent of total billed charges,85% of total billed charges,422.3,100,,,fee schedule,100% of CO APG rates,401.19,95,,,percent of total billed charges,95% of total billed charges,337.84,80,,,percent of total billed charges,80% of total billed charges,358.96,85,,,percent of total billed charges,85% of total billed charges,380.07,90,,,percent of total billed charges,90% of total billed charges,422.3,100,,,fee schedule,100% of CO APG rates,422.3,100,,,fee schedule,100% of CO APG rates,422.3,100,,,fee schedule,100% of NM fee schedule,168.92,40,,,percent of total billed charges,40% of total billed charges,168.92,40,,,percent of total billed charges,40% of total billed charges,380.07,90,,,percent of total billed charges,90% of total billed charges,320.95,76,,,percent of total billed charges,76% of total billed charges,168.92,40,,,percent of total billed charges,40% of total billed charges,358.96,85,,,percent of total billed charges,85% of total billed charges,422.3,100,,,fee schedule,100% of CO APG rate,337.84,80,,,percent of total billed charges,80% of total billed charges,163.85,38.8,,,percent of total billed charges,38.8% of total billed charges,358.96,85,,,percent of total billed charges,85% of total billed charges,422.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,163.85,422.3,
LOCKING SCREW AXSOS 4.0MM / L24MM,46050886,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L26MM,46050887,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L28MM,46050888,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L30MM,46050889,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L32MM,46050890,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L34MM,46050891,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L36MM,46050892,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L38MM,46050893,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L40MM,46050894,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L42MM,46050895,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L44MM,46050896,CDM,278,RC,,,OUTPATIENT,,,461.1,368.88,,345.83,75,,,percent of total billed charges,75% of total billed charges,184.44,40,,,percent of total billed charges,40% of total billed charges,365.19,79.2,,,percent of total billed charges,79.2% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,461.1,100,,,fee schedule,100% of CO APG rates,438.05,95,,,percent of total billed charges,95% of total billed charges,368.88,80,,,percent of total billed charges,80% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,414.99,90,,,percent of total billed charges,90% of total billed charges,461.1,100,,,fee schedule,100% of CO APG rates,461.1,100,,,fee schedule,100% of CO APG rates,461.1,100,,,fee schedule,100% of NM fee schedule,184.44,40,,,percent of total billed charges,40% of total billed charges,184.44,40,,,percent of total billed charges,40% of total billed charges,414.99,90,,,percent of total billed charges,90% of total billed charges,350.44,76,,,percent of total billed charges,76% of total billed charges,184.44,40,,,percent of total billed charges,40% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,461.1,100,,,fee schedule,100% of CO APG rate,368.88,80,,,percent of total billed charges,80% of total billed charges,178.91,38.8,,,percent of total billed charges,38.8% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,461.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.91,461.1,
LOCKING SCREW AXSOS 4.0MM / L46MM,46050897,CDM,278,RC,,,OUTPATIENT,,,466.4,373.12,,349.8,75,,,percent of total billed charges,75% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,369.39,79.2,,,percent of total billed charges,79.2% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,443.08,95,,,percent of total billed charges,95% of total billed charges,373.12,80,,,percent of total billed charges,80% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of NM fee schedule,186.56,40,,,percent of total billed charges,40% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,354.46,76,,,percent of total billed charges,76% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rate,373.12,80,,,percent of total billed charges,80% of total billed charges,180.96,38.8,,,percent of total billed charges,38.8% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,180.96,466.4,
LOCKING SCREW AXSOS 4.0MM / L48MM,46050898,CDM,278,RC,,,OUTPATIENT,,,444.3,355.44,,333.23,75,,,percent of total billed charges,75% of total billed charges,177.72,40,,,percent of total billed charges,40% of total billed charges,351.89,79.2,,,percent of total billed charges,79.2% of total billed charges,377.66,85,,,percent of total billed charges,85% of total billed charges,444.3,100,,,fee schedule,100% of CO APG rates,422.09,95,,,percent of total billed charges,95% of total billed charges,355.44,80,,,percent of total billed charges,80% of total billed charges,377.66,85,,,percent of total billed charges,85% of total billed charges,399.87,90,,,percent of total billed charges,90% of total billed charges,444.3,100,,,fee schedule,100% of CO APG rates,444.3,100,,,fee schedule,100% of CO APG rates,444.3,100,,,fee schedule,100% of NM fee schedule,177.72,40,,,percent of total billed charges,40% of total billed charges,177.72,40,,,percent of total billed charges,40% of total billed charges,399.87,90,,,percent of total billed charges,90% of total billed charges,337.67,76,,,percent of total billed charges,76% of total billed charges,177.72,40,,,percent of total billed charges,40% of total billed charges,377.66,85,,,percent of total billed charges,85% of total billed charges,444.3,100,,,fee schedule,100% of CO APG rate,355.44,80,,,percent of total billed charges,80% of total billed charges,172.39,38.8,,,percent of total billed charges,38.8% of total billed charges,377.66,85,,,percent of total billed charges,85% of total billed charges,444.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,172.39,444.3,
LOCKING SCREW AXSOS 4.0MM / L50MM,46050899,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L55MM,46050900,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0MM / L60MM,46050901,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW T10 3.5X18MM,46050906,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X20MM,46050907,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X22MM,46050908,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X24MM,46050909,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X26MM,46050910,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X28MM,46050911,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X30MM,46050912,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X32MM,46050913,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X34MM,46050914,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X36MM,46050915,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X38MM,46050916,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X40MM,46050917,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X42MM,46050918,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X44MM,46050919,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X46MM,46050920,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X48MM,46050921,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X50MM,46050922,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X55MM,46050923,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X60MM,46050924,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X65MM,46050925,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T10 3.5X70MM,46050926,CDM,278,RC,,,OUTPATIENT,,,485.3,388.24,,363.98,75,,,percent of total billed charges,75% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,384.36,79.2,,,percent of total billed charges,79.2% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,461.04,95,,,percent of total billed charges,95% of total billed charges,388.24,80,,,percent of total billed charges,80% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of CO APG rates,485.3,100,,,fee schedule,100% of NM fee schedule,194.12,40,,,percent of total billed charges,40% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,436.77,90,,,percent of total billed charges,90% of total billed charges,368.83,76,,,percent of total billed charges,76% of total billed charges,194.12,40,,,percent of total billed charges,40% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of CO APG rate,388.24,80,,,percent of total billed charges,80% of total billed charges,188.3,38.8,,,percent of total billed charges,38.8% of total billed charges,412.51,85,,,percent of total billed charges,85% of total billed charges,485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.3,485.3,
LOCKING SCREW T7 2.7X10MM,46050927,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X12MM,46050928,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X14MM,46050929,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X16MM,46050930,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X18MM,46050931,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X20MM,46050932,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X22MM,46050933,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X24MM,46050934,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X26MM,46050935,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X28MM,46050936,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X30MM,46050937,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X32MM,46050938,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X34MM,46050939,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X36MM,46050940,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X38MM,46050941,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X40MM,46050942,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X45MM,46050943,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X50MM,46050944,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW T7 2.7X8MM,46050945,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
L-PLATE LEFT,46050946,CDM,278,RC,,,OUTPATIENT,,,866.6,693.28,,649.95,75,,,percent of total billed charges,75% of total billed charges,346.64,40,,,percent of total billed charges,40% of total billed charges,686.35,79.2,,,percent of total billed charges,79.2% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,866.6,100,,,fee schedule,100% of CO APG rates,823.27,95,,,percent of total billed charges,95% of total billed charges,693.28,80,,,percent of total billed charges,80% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,779.94,90,,,percent of total billed charges,90% of total billed charges,866.6,100,,,fee schedule,100% of CO APG rates,866.6,100,,,fee schedule,100% of CO APG rates,866.6,100,,,fee schedule,100% of NM fee schedule,346.64,40,,,percent of total billed charges,40% of total billed charges,346.64,40,,,percent of total billed charges,40% of total billed charges,779.94,90,,,percent of total billed charges,90% of total billed charges,658.62,76,,,percent of total billed charges,76% of total billed charges,346.64,40,,,percent of total billed charges,40% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,866.6,100,,,fee schedule,100% of CO APG rate,693.28,80,,,percent of total billed charges,80% of total billed charges,336.24,38.8,,,percent of total billed charges,38.8% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,866.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,336.24,866.6,
L-PLATE RIGHT,46050947,CDM,278,RC,,,OUTPATIENT,,,866.6,693.28,,649.95,75,,,percent of total billed charges,75% of total billed charges,346.64,40,,,percent of total billed charges,40% of total billed charges,686.35,79.2,,,percent of total billed charges,79.2% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,866.6,100,,,fee schedule,100% of CO APG rates,823.27,95,,,percent of total billed charges,95% of total billed charges,693.28,80,,,percent of total billed charges,80% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,779.94,90,,,percent of total billed charges,90% of total billed charges,866.6,100,,,fee schedule,100% of CO APG rates,866.6,100,,,fee schedule,100% of CO APG rates,866.6,100,,,fee schedule,100% of NM fee schedule,346.64,40,,,percent of total billed charges,40% of total billed charges,346.64,40,,,percent of total billed charges,40% of total billed charges,779.94,90,,,percent of total billed charges,90% of total billed charges,658.62,76,,,percent of total billed charges,76% of total billed charges,346.64,40,,,percent of total billed charges,40% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,866.6,100,,,fee schedule,100% of CO APG rate,693.28,80,,,percent of total billed charges,80% of total billed charges,336.24,38.8,,,percent of total billed charges,38.8% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,866.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,336.24,866.6,
"M PROFYLE HAND COMP CONDY-PLATE,LE,6H",46050948,CDM,278,RC,,,OUTPATIENT,,,831.9,665.52,,623.93,75,,,percent of total billed charges,75% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,658.86,79.2,,,percent of total billed charges,79.2% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rates,790.31,95,,,percent of total billed charges,95% of total billed charges,665.52,80,,,percent of total billed charges,80% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,748.71,90,,,percent of total billed charges,90% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rates,831.9,100,,,fee schedule,100% of CO APG rates,831.9,100,,,fee schedule,100% of NM fee schedule,332.76,40,,,percent of total billed charges,40% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,748.71,90,,,percent of total billed charges,90% of total billed charges,632.24,76,,,percent of total billed charges,76% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rate,665.52,80,,,percent of total billed charges,80% of total billed charges,322.78,38.8,,,percent of total billed charges,38.8% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,322.78,831.9,
"M PROFYLE HAND COMP CONDY-PLATE,RI,6H",46050949,CDM,278,RC,,,OUTPATIENT,,,831.9,665.52,,623.93,75,,,percent of total billed charges,75% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,658.86,79.2,,,percent of total billed charges,79.2% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rates,790.31,95,,,percent of total billed charges,95% of total billed charges,665.52,80,,,percent of total billed charges,80% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,748.71,90,,,percent of total billed charges,90% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rates,831.9,100,,,fee schedule,100% of CO APG rates,831.9,100,,,fee schedule,100% of NM fee schedule,332.76,40,,,percent of total billed charges,40% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,748.71,90,,,percent of total billed charges,90% of total billed charges,632.24,76,,,percent of total billed charges,76% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rate,665.52,80,,,percent of total billed charges,80% of total billed charges,322.78,38.8,,,percent of total billed charges,38.8% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,322.78,831.9,
"M PROFYLE HAND COMP L-PLATE,LE,6H",46050950,CDM,278,RC,,,OUTPATIENT,,,756.3,605.04,,567.23,75,,,percent of total billed charges,75% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,598.99,79.2,,,percent of total billed charges,79.2% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rates,718.49,95,,,percent of total billed charges,95% of total billed charges,605.04,80,,,percent of total billed charges,80% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,680.67,90,,,percent of total billed charges,90% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rates,756.3,100,,,fee schedule,100% of CO APG rates,756.3,100,,,fee schedule,100% of NM fee schedule,302.52,40,,,percent of total billed charges,40% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,680.67,90,,,percent of total billed charges,90% of total billed charges,574.79,76,,,percent of total billed charges,76% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rate,605.04,80,,,percent of total billed charges,80% of total billed charges,293.44,38.8,,,percent of total billed charges,38.8% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,293.44,756.3,
"M PROFYLE HAND COMP L-PLATE,RI,6H",46050951,CDM,278,RC,,,OUTPATIENT,,,756.3,605.04,,567.23,75,,,percent of total billed charges,75% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,598.99,79.2,,,percent of total billed charges,79.2% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rates,718.49,95,,,percent of total billed charges,95% of total billed charges,605.04,80,,,percent of total billed charges,80% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,680.67,90,,,percent of total billed charges,90% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rates,756.3,100,,,fee schedule,100% of CO APG rates,756.3,100,,,fee schedule,100% of NM fee schedule,302.52,40,,,percent of total billed charges,40% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,680.67,90,,,percent of total billed charges,90% of total billed charges,574.79,76,,,percent of total billed charges,76% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rate,605.04,80,,,percent of total billed charges,80% of total billed charges,293.44,38.8,,,percent of total billed charges,38.8% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,293.44,756.3,
"M PROFYLE HAND COMP PLATE,STRAI,6H",46050952,CDM,278,RC,,,OUTPATIENT,,,756.3,605.04,,567.23,75,,,percent of total billed charges,75% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,598.99,79.2,,,percent of total billed charges,79.2% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rates,718.49,95,,,percent of total billed charges,95% of total billed charges,605.04,80,,,percent of total billed charges,80% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,680.67,90,,,percent of total billed charges,90% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rates,756.3,100,,,fee schedule,100% of CO APG rates,756.3,100,,,fee schedule,100% of NM fee schedule,302.52,40,,,percent of total billed charges,40% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,680.67,90,,,percent of total billed charges,90% of total billed charges,574.79,76,,,percent of total billed charges,76% of total billed charges,302.52,40,,,percent of total billed charges,40% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of CO APG rate,605.04,80,,,percent of total billed charges,80% of total billed charges,293.44,38.8,,,percent of total billed charges,38.8% of total billed charges,642.86,85,,,percent of total billed charges,85% of total billed charges,756.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,293.44,756.3,
"M PROFYLE HAND COMP PLATE,STRAI,BAR,4H",46050953,CDM,278,RC,,,OUTPATIENT,,,607.1,485.68,,455.33,75,,,percent of total billed charges,75% of total billed charges,242.84,40,,,percent of total billed charges,40% of total billed charges,480.82,79.2,,,percent of total billed charges,79.2% of total billed charges,516.04,85,,,percent of total billed charges,85% of total billed charges,607.1,100,,,fee schedule,100% of CO APG rates,576.75,95,,,percent of total billed charges,95% of total billed charges,485.68,80,,,percent of total billed charges,80% of total billed charges,516.04,85,,,percent of total billed charges,85% of total billed charges,546.39,90,,,percent of total billed charges,90% of total billed charges,607.1,100,,,fee schedule,100% of CO APG rates,607.1,100,,,fee schedule,100% of CO APG rates,607.1,100,,,fee schedule,100% of NM fee schedule,242.84,40,,,percent of total billed charges,40% of total billed charges,242.84,40,,,percent of total billed charges,40% of total billed charges,546.39,90,,,percent of total billed charges,90% of total billed charges,461.4,76,,,percent of total billed charges,76% of total billed charges,242.84,40,,,percent of total billed charges,40% of total billed charges,516.04,85,,,percent of total billed charges,85% of total billed charges,607.1,100,,,fee schedule,100% of CO APG rate,485.68,80,,,percent of total billed charges,80% of total billed charges,235.55,38.8,,,percent of total billed charges,38.8% of total billed charges,516.04,85,,,percent of total billed charges,85% of total billed charges,607.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,235.55,607.1,
"M PROFYLE HAND COMP T-PLATE,NAR,6H",46050954,CDM,278,RC,,,OUTPATIENT,,,831.9,665.52,,623.93,75,,,percent of total billed charges,75% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,658.86,79.2,,,percent of total billed charges,79.2% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rates,790.31,95,,,percent of total billed charges,95% of total billed charges,665.52,80,,,percent of total billed charges,80% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,748.71,90,,,percent of total billed charges,90% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rates,831.9,100,,,fee schedule,100% of CO APG rates,831.9,100,,,fee schedule,100% of NM fee schedule,332.76,40,,,percent of total billed charges,40% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,748.71,90,,,percent of total billed charges,90% of total billed charges,632.24,76,,,percent of total billed charges,76% of total billed charges,332.76,40,,,percent of total billed charges,40% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of CO APG rate,665.52,80,,,percent of total billed charges,80% of total billed charges,322.78,38.8,,,percent of total billed charges,38.8% of total billed charges,707.12,85,,,percent of total billed charges,85% of total billed charges,831.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,322.78,831.9,
"M PROFYLE HAND COMP T-PLATE,REG,7H",46050955,CDM,278,RC,,,OUTPATIENT,,,884.4,707.52,,663.3,75,,,percent of total billed charges,75% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,700.44,79.2,,,percent of total billed charges,79.2% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rates,840.18,95,,,percent of total billed charges,95% of total billed charges,707.52,80,,,percent of total billed charges,80% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,795.96,90,,,percent of total billed charges,90% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rates,884.4,100,,,fee schedule,100% of CO APG rates,884.4,100,,,fee schedule,100% of NM fee schedule,353.76,40,,,percent of total billed charges,40% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,795.96,90,,,percent of total billed charges,90% of total billed charges,672.14,76,,,percent of total billed charges,76% of total billed charges,353.76,40,,,percent of total billed charges,40% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of CO APG rate,707.52,80,,,percent of total billed charges,80% of total billed charges,343.15,38.8,,,percent of total billed charges,38.8% of total billed charges,751.74,85,,,percent of total billed charges,85% of total billed charges,884.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,343.15,884.4,
"M PROFYLE HAND COMP Y-PLATE,NAR,7H",46050956,CDM,278,RC,,,OUTPATIENT,,,984.2,787.36,,738.15,75,,,percent of total billed charges,75% of total billed charges,393.68,40,,,percent of total billed charges,40% of total billed charges,779.49,79.2,,,percent of total billed charges,79.2% of total billed charges,836.57,85,,,percent of total billed charges,85% of total billed charges,984.2,100,,,fee schedule,100% of CO APG rates,934.99,95,,,percent of total billed charges,95% of total billed charges,787.36,80,,,percent of total billed charges,80% of total billed charges,836.57,85,,,percent of total billed charges,85% of total billed charges,885.78,90,,,percent of total billed charges,90% of total billed charges,984.2,100,,,fee schedule,100% of CO APG rates,984.2,100,,,fee schedule,100% of CO APG rates,984.2,100,,,fee schedule,100% of NM fee schedule,393.68,40,,,percent of total billed charges,40% of total billed charges,393.68,40,,,percent of total billed charges,40% of total billed charges,885.78,90,,,percent of total billed charges,90% of total billed charges,747.99,76,,,percent of total billed charges,76% of total billed charges,393.68,40,,,percent of total billed charges,40% of total billed charges,836.57,85,,,percent of total billed charges,85% of total billed charges,984.2,100,,,fee schedule,100% of CO APG rate,787.36,80,,,percent of total billed charges,80% of total billed charges,381.87,38.8,,,percent of total billed charges,38.8% of total billed charges,836.57,85,,,percent of total billed charges,85% of total billed charges,984.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,381.87,984.2,
"M PROFYLE HAND T-PLATE,WIDE,8H",46050957,CDM,278,RC,,,OUTPATIENT,,,786.8,629.44,,590.1,75,,,percent of total billed charges,75% of total billed charges,314.72,40,,,percent of total billed charges,40% of total billed charges,623.15,79.2,,,percent of total billed charges,79.2% of total billed charges,668.78,85,,,percent of total billed charges,85% of total billed charges,786.8,100,,,fee schedule,100% of CO APG rates,747.46,95,,,percent of total billed charges,95% of total billed charges,629.44,80,,,percent of total billed charges,80% of total billed charges,668.78,85,,,percent of total billed charges,85% of total billed charges,708.12,90,,,percent of total billed charges,90% of total billed charges,786.8,100,,,fee schedule,100% of CO APG rates,786.8,100,,,fee schedule,100% of CO APG rates,786.8,100,,,fee schedule,100% of NM fee schedule,314.72,40,,,percent of total billed charges,40% of total billed charges,314.72,40,,,percent of total billed charges,40% of total billed charges,708.12,90,,,percent of total billed charges,90% of total billed charges,597.97,76,,,percent of total billed charges,76% of total billed charges,314.72,40,,,percent of total billed charges,40% of total billed charges,668.78,85,,,percent of total billed charges,85% of total billed charges,786.8,100,,,fee schedule,100% of CO APG rate,629.44,80,,,percent of total billed charges,80% of total billed charges,305.28,38.8,,,percent of total billed charges,38.8% of total billed charges,668.78,85,,,percent of total billed charges,85% of total billed charges,786.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,305.28,786.8,
M ROTATIONAL PLATE,46050958,CDM,278,RC,,,OUTPATIENT,,,1330.9,1064.72,,998.18,75,,,percent of total billed charges,75% of total billed charges,532.36,40,,,percent of total billed charges,40% of total billed charges,1054.07,79.2,,,percent of total billed charges,79.2% of total billed charges,1131.27,85,,,percent of total billed charges,85% of total billed charges,1330.9,100,,,fee schedule,100% of CO APG rates,1264.36,95,,,percent of total billed charges,95% of total billed charges,1064.72,80,,,percent of total billed charges,80% of total billed charges,1131.27,85,,,percent of total billed charges,85% of total billed charges,1197.81,90,,,percent of total billed charges,90% of total billed charges,1330.9,100,,,fee schedule,100% of CO APG rates,1330.9,100,,,fee schedule,100% of CO APG rates,1330.9,100,,,fee schedule,100% of NM fee schedule,532.36,40,,,percent of total billed charges,40% of total billed charges,532.36,40,,,percent of total billed charges,40% of total billed charges,1197.81,90,,,percent of total billed charges,90% of total billed charges,1011.48,76,,,percent of total billed charges,76% of total billed charges,532.36,40,,,percent of total billed charges,40% of total billed charges,1131.27,85,,,percent of total billed charges,85% of total billed charges,1330.9,100,,,fee schedule,100% of CO APG rate,1064.72,80,,,percent of total billed charges,80% of total billed charges,516.39,38.8,,,percent of total billed charges,38.8% of total billed charges,1131.27,85,,,percent of total billed charges,85% of total billed charges,1330.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,516.39,1330.9,
OBLIQUE T-PLATE  LEFT,46050959,CDM,278,RC,,,OUTPATIENT,,,1073.5,858.8,,805.13,75,,,percent of total billed charges,75% of total billed charges,429.4,40,,,percent of total billed charges,40% of total billed charges,850.21,79.2,,,percent of total billed charges,79.2% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,1073.5,100,,,fee schedule,100% of CO APG rates,1019.83,95,,,percent of total billed charges,95% of total billed charges,858.8,80,,,percent of total billed charges,80% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,966.15,90,,,percent of total billed charges,90% of total billed charges,1073.5,100,,,fee schedule,100% of CO APG rates,1073.5,100,,,fee schedule,100% of CO APG rates,1073.5,100,,,fee schedule,100% of NM fee schedule,429.4,40,,,percent of total billed charges,40% of total billed charges,429.4,40,,,percent of total billed charges,40% of total billed charges,966.15,90,,,percent of total billed charges,90% of total billed charges,815.86,76,,,percent of total billed charges,76% of total billed charges,429.4,40,,,percent of total billed charges,40% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,1073.5,100,,,fee schedule,100% of CO APG rate,858.8,80,,,percent of total billed charges,80% of total billed charges,416.52,38.8,,,percent of total billed charges,38.8% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,1073.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,416.52,1073.5,
OBLIQUE T-PLATE  RIGHT,46050960,CDM,278,RC,,,OUTPATIENT,,,1073.5,858.8,,805.13,75,,,percent of total billed charges,75% of total billed charges,429.4,40,,,percent of total billed charges,40% of total billed charges,850.21,79.2,,,percent of total billed charges,79.2% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,1073.5,100,,,fee schedule,100% of CO APG rates,1019.83,95,,,percent of total billed charges,95% of total billed charges,858.8,80,,,percent of total billed charges,80% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,966.15,90,,,percent of total billed charges,90% of total billed charges,1073.5,100,,,fee schedule,100% of CO APG rates,1073.5,100,,,fee schedule,100% of CO APG rates,1073.5,100,,,fee schedule,100% of NM fee schedule,429.4,40,,,percent of total billed charges,40% of total billed charges,429.4,40,,,percent of total billed charges,40% of total billed charges,966.15,90,,,percent of total billed charges,90% of total billed charges,815.86,76,,,percent of total billed charges,76% of total billed charges,429.4,40,,,percent of total billed charges,40% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,1073.5,100,,,fee schedule,100% of CO APG rate,858.8,80,,,percent of total billed charges,80% of total billed charges,416.52,38.8,,,percent of total billed charges,38.8% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,1073.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,416.52,1073.5,
ONE THIRD TUB. PLATE 10 HOLE SS,46050961,CDM,278,RC,,,OUTPATIENT,,,204.8,163.84,,153.6,75,,,percent of total billed charges,75% of total billed charges,81.92,40,,,percent of total billed charges,40% of total billed charges,162.2,79.2,,,percent of total billed charges,79.2% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,204.8,100,,,fee schedule,100% of CO APG rates,194.56,95,,,percent of total billed charges,95% of total billed charges,163.84,80,,,percent of total billed charges,80% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,184.32,90,,,percent of total billed charges,90% of total billed charges,204.8,100,,,fee schedule,100% of CO APG rates,204.8,100,,,fee schedule,100% of CO APG rates,204.8,100,,,fee schedule,100% of NM fee schedule,81.92,40,,,percent of total billed charges,40% of total billed charges,81.92,40,,,percent of total billed charges,40% of total billed charges,184.32,90,,,percent of total billed charges,90% of total billed charges,155.65,76,,,percent of total billed charges,76% of total billed charges,81.92,40,,,percent of total billed charges,40% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,204.8,100,,,fee schedule,100% of CO APG rate,163.84,80,,,percent of total billed charges,80% of total billed charges,79.46,38.8,,,percent of total billed charges,38.8% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,204.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,79.46,204.8,
ONE THIRD TUB. PLATE 4 HOLE SS,46050962,CDM,278,RC,,,OUTPATIENT,,,179.6,143.68,,134.7,75,,,percent of total billed charges,75% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,142.24,79.2,,,percent of total billed charges,79.2% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rates,170.62,95,,,percent of total billed charges,95% of total billed charges,143.68,80,,,percent of total billed charges,80% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,161.64,90,,,percent of total billed charges,90% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rates,179.6,100,,,fee schedule,100% of CO APG rates,179.6,100,,,fee schedule,100% of NM fee schedule,71.84,40,,,percent of total billed charges,40% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,161.64,90,,,percent of total billed charges,90% of total billed charges,136.5,76,,,percent of total billed charges,76% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rate,143.68,80,,,percent of total billed charges,80% of total billed charges,69.68,38.8,,,percent of total billed charges,38.8% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,69.68,179.6,
ONE THIRD TUB. PLATE 5 HOLE SS,46050963,CDM,278,RC,,,OUTPATIENT,,,179.6,143.68,,134.7,75,,,percent of total billed charges,75% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,142.24,79.2,,,percent of total billed charges,79.2% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rates,170.62,95,,,percent of total billed charges,95% of total billed charges,143.68,80,,,percent of total billed charges,80% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,161.64,90,,,percent of total billed charges,90% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rates,179.6,100,,,fee schedule,100% of CO APG rates,179.6,100,,,fee schedule,100% of NM fee schedule,71.84,40,,,percent of total billed charges,40% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,161.64,90,,,percent of total billed charges,90% of total billed charges,136.5,76,,,percent of total billed charges,76% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rate,143.68,80,,,percent of total billed charges,80% of total billed charges,69.68,38.8,,,percent of total billed charges,38.8% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,69.68,179.6,
ONE THIRD TUB. PLATE 6 HOLE SS,46050964,CDM,278,RC,,,OUTPATIENT,,,179.6,143.68,,134.7,75,,,percent of total billed charges,75% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,142.24,79.2,,,percent of total billed charges,79.2% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rates,170.62,95,,,percent of total billed charges,95% of total billed charges,143.68,80,,,percent of total billed charges,80% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,161.64,90,,,percent of total billed charges,90% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rates,179.6,100,,,fee schedule,100% of CO APG rates,179.6,100,,,fee schedule,100% of NM fee schedule,71.84,40,,,percent of total billed charges,40% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,161.64,90,,,percent of total billed charges,90% of total billed charges,136.5,76,,,percent of total billed charges,76% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rate,143.68,80,,,percent of total billed charges,80% of total billed charges,69.68,38.8,,,percent of total billed charges,38.8% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,69.68,179.6,
ONE THIRD TUB. PLATE 8 HOLE SS,46050965,CDM,278,RC,,,OUTPATIENT,,,204.8,163.84,,153.6,75,,,percent of total billed charges,75% of total billed charges,81.92,40,,,percent of total billed charges,40% of total billed charges,162.2,79.2,,,percent of total billed charges,79.2% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,204.8,100,,,fee schedule,100% of CO APG rates,194.56,95,,,percent of total billed charges,95% of total billed charges,163.84,80,,,percent of total billed charges,80% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,184.32,90,,,percent of total billed charges,90% of total billed charges,204.8,100,,,fee schedule,100% of CO APG rates,204.8,100,,,fee schedule,100% of CO APG rates,204.8,100,,,fee schedule,100% of NM fee schedule,81.92,40,,,percent of total billed charges,40% of total billed charges,81.92,40,,,percent of total billed charges,40% of total billed charges,184.32,90,,,percent of total billed charges,90% of total billed charges,155.65,76,,,percent of total billed charges,76% of total billed charges,81.92,40,,,percent of total billed charges,40% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,204.8,100,,,fee schedule,100% of CO APG rate,163.84,80,,,percent of total billed charges,80% of total billed charges,79.46,38.8,,,percent of total billed charges,38.8% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,204.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,79.46,204.8,
PROFYLE/M 3-D PLATE 2X2 HOLE,46050966,CDM,278,RC,,,OUTPATIENT,,,592.4,473.92,,444.3,75,,,percent of total billed charges,75% of total billed charges,236.96,40,,,percent of total billed charges,40% of total billed charges,469.18,79.2,,,percent of total billed charges,79.2% of total billed charges,503.54,85,,,percent of total billed charges,85% of total billed charges,592.4,100,,,fee schedule,100% of CO APG rates,562.78,95,,,percent of total billed charges,95% of total billed charges,473.92,80,,,percent of total billed charges,80% of total billed charges,503.54,85,,,percent of total billed charges,85% of total billed charges,533.16,90,,,percent of total billed charges,90% of total billed charges,592.4,100,,,fee schedule,100% of CO APG rates,592.4,100,,,fee schedule,100% of CO APG rates,592.4,100,,,fee schedule,100% of NM fee schedule,236.96,40,,,percent of total billed charges,40% of total billed charges,236.96,40,,,percent of total billed charges,40% of total billed charges,533.16,90,,,percent of total billed charges,90% of total billed charges,450.22,76,,,percent of total billed charges,76% of total billed charges,236.96,40,,,percent of total billed charges,40% of total billed charges,503.54,85,,,percent of total billed charges,85% of total billed charges,592.4,100,,,fee schedule,100% of CO APG rate,473.92,80,,,percent of total billed charges,80% of total billed charges,229.85,38.8,,,percent of total billed charges,38.8% of total billed charges,503.54,85,,,percent of total billed charges,85% of total billed charges,592.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,229.85,592.4,
PROFYLE/M 3D PLATE 2X2+2H,46050967,CDM,278,RC,,,OUTPATIENT,,,880.2,704.16,,660.15,75,,,percent of total billed charges,75% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,697.12,79.2,,,percent of total billed charges,79.2% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rates,836.19,95,,,percent of total billed charges,95% of total billed charges,704.16,80,,,percent of total billed charges,80% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,792.18,90,,,percent of total billed charges,90% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rates,880.2,100,,,fee schedule,100% of CO APG rates,880.2,100,,,fee schedule,100% of NM fee schedule,352.08,40,,,percent of total billed charges,40% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,792.18,90,,,percent of total billed charges,90% of total billed charges,668.95,76,,,percent of total billed charges,76% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rate,704.16,80,,,percent of total billed charges,80% of total billed charges,341.52,38.8,,,percent of total billed charges,38.8% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,341.52,880.2,
PROFYLE/M 3-D PLATE 3X2 HOLE,46050968,CDM,278,RC,,,OUTPATIENT,,,880.2,704.16,,660.15,75,,,percent of total billed charges,75% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,697.12,79.2,,,percent of total billed charges,79.2% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rates,836.19,95,,,percent of total billed charges,95% of total billed charges,704.16,80,,,percent of total billed charges,80% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,792.18,90,,,percent of total billed charges,90% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rates,880.2,100,,,fee schedule,100% of CO APG rates,880.2,100,,,fee schedule,100% of NM fee schedule,352.08,40,,,percent of total billed charges,40% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,792.18,90,,,percent of total billed charges,90% of total billed charges,668.95,76,,,percent of total billed charges,76% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rate,704.16,80,,,percent of total billed charges,80% of total billed charges,341.52,38.8,,,percent of total billed charges,38.8% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,341.52,880.2,
PROFYLE/M 3-D PLATE 4X2 HOLE,46050969,CDM,278,RC,,,OUTPATIENT,,,925.4,740.32,,694.05,75,,,percent of total billed charges,75% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,732.92,79.2,,,percent of total billed charges,79.2% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rates,879.13,95,,,percent of total billed charges,95% of total billed charges,740.32,80,,,percent of total billed charges,80% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,832.86,90,,,percent of total billed charges,90% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rates,925.4,100,,,fee schedule,100% of CO APG rates,925.4,100,,,fee schedule,100% of NM fee schedule,370.16,40,,,percent of total billed charges,40% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,832.86,90,,,percent of total billed charges,90% of total billed charges,703.3,76,,,percent of total billed charges,76% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rate,740.32,80,,,percent of total billed charges,80% of total billed charges,359.06,38.8,,,percent of total billed charges,38.8% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,359.06,925.4,
PROFYLE/M PLATE L 90DG REG LT 6H,46050970,CDM,278,RC,,,OUTPATIENT,,,466.4,373.12,,349.8,75,,,percent of total billed charges,75% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,369.39,79.2,,,percent of total billed charges,79.2% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,443.08,95,,,percent of total billed charges,95% of total billed charges,373.12,80,,,percent of total billed charges,80% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of NM fee schedule,186.56,40,,,percent of total billed charges,40% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,354.46,76,,,percent of total billed charges,76% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rate,373.12,80,,,percent of total billed charges,80% of total billed charges,180.96,38.8,,,percent of total billed charges,38.8% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,180.96,466.4,
PROFYLE/M PLATE L 90DG REG RT 6H,46050971,CDM,278,RC,,,OUTPATIENT,,,466.4,373.12,,349.8,75,,,percent of total billed charges,75% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,369.39,79.2,,,percent of total billed charges,79.2% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,443.08,95,,,percent of total billed charges,95% of total billed charges,373.12,80,,,percent of total billed charges,80% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of NM fee schedule,186.56,40,,,percent of total billed charges,40% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,354.46,76,,,percent of total billed charges,76% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rate,373.12,80,,,percent of total billed charges,80% of total billed charges,180.96,38.8,,,percent of total billed charges,38.8% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,180.96,466.4,
PROFYLE/M PLATE STR 16H,46050972,CDM,278,RC,,,OUTPATIENT,,,800.4,640.32,,600.3,75,,,percent of total billed charges,75% of total billed charges,320.16,40,,,percent of total billed charges,40% of total billed charges,633.92,79.2,,,percent of total billed charges,79.2% of total billed charges,680.34,85,,,percent of total billed charges,85% of total billed charges,800.4,100,,,fee schedule,100% of CO APG rates,760.38,95,,,percent of total billed charges,95% of total billed charges,640.32,80,,,percent of total billed charges,80% of total billed charges,680.34,85,,,percent of total billed charges,85% of total billed charges,720.36,90,,,percent of total billed charges,90% of total billed charges,800.4,100,,,fee schedule,100% of CO APG rates,800.4,100,,,fee schedule,100% of CO APG rates,800.4,100,,,fee schedule,100% of NM fee schedule,320.16,40,,,percent of total billed charges,40% of total billed charges,320.16,40,,,percent of total billed charges,40% of total billed charges,720.36,90,,,percent of total billed charges,90% of total billed charges,608.3,76,,,percent of total billed charges,76% of total billed charges,320.16,40,,,percent of total billed charges,40% of total billed charges,680.34,85,,,percent of total billed charges,85% of total billed charges,800.4,100,,,fee schedule,100% of CO APG rate,640.32,80,,,percent of total billed charges,80% of total billed charges,310.56,38.8,,,percent of total billed charges,38.8% of total billed charges,680.34,85,,,percent of total billed charges,85% of total billed charges,800.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,310.56,800.4,
PROFYLE/M PLATE STR 4H,46050973,CDM,278,RC,,,OUTPATIENT,,,343.5,274.8,,257.63,75,,,percent of total billed charges,75% of total billed charges,137.4,40,,,percent of total billed charges,40% of total billed charges,272.05,79.2,,,percent of total billed charges,79.2% of total billed charges,291.98,85,,,percent of total billed charges,85% of total billed charges,343.5,100,,,fee schedule,100% of CO APG rates,326.33,95,,,percent of total billed charges,95% of total billed charges,274.8,80,,,percent of total billed charges,80% of total billed charges,291.98,85,,,percent of total billed charges,85% of total billed charges,309.15,90,,,percent of total billed charges,90% of total billed charges,343.5,100,,,fee schedule,100% of CO APG rates,343.5,100,,,fee schedule,100% of CO APG rates,343.5,100,,,fee schedule,100% of NM fee schedule,137.4,40,,,percent of total billed charges,40% of total billed charges,137.4,40,,,percent of total billed charges,40% of total billed charges,309.15,90,,,percent of total billed charges,90% of total billed charges,261.06,76,,,percent of total billed charges,76% of total billed charges,137.4,40,,,percent of total billed charges,40% of total billed charges,291.98,85,,,percent of total billed charges,85% of total billed charges,343.5,100,,,fee schedule,100% of CO APG rate,274.8,80,,,percent of total billed charges,80% of total billed charges,133.28,38.8,,,percent of total billed charges,38.8% of total billed charges,291.98,85,,,percent of total billed charges,85% of total billed charges,343.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,133.28,343.5,
PROFYLE/M PLATE STR MED 4H,46050974,CDM,278,RC,,,OUTPATIENT,,,343.5,274.8,,257.63,75,,,percent of total billed charges,75% of total billed charges,137.4,40,,,percent of total billed charges,40% of total billed charges,272.05,79.2,,,percent of total billed charges,79.2% of total billed charges,291.98,85,,,percent of total billed charges,85% of total billed charges,343.5,100,,,fee schedule,100% of CO APG rates,326.33,95,,,percent of total billed charges,95% of total billed charges,274.8,80,,,percent of total billed charges,80% of total billed charges,291.98,85,,,percent of total billed charges,85% of total billed charges,309.15,90,,,percent of total billed charges,90% of total billed charges,343.5,100,,,fee schedule,100% of CO APG rates,343.5,100,,,fee schedule,100% of CO APG rates,343.5,100,,,fee schedule,100% of NM fee schedule,137.4,40,,,percent of total billed charges,40% of total billed charges,137.4,40,,,percent of total billed charges,40% of total billed charges,309.15,90,,,percent of total billed charges,90% of total billed charges,261.06,76,,,percent of total billed charges,76% of total billed charges,137.4,40,,,percent of total billed charges,40% of total billed charges,291.98,85,,,percent of total billed charges,85% of total billed charges,343.5,100,,,fee schedule,100% of CO APG rate,274.8,80,,,percent of total billed charges,80% of total billed charges,133.28,38.8,,,percent of total billed charges,38.8% of total billed charges,291.98,85,,,percent of total billed charges,85% of total billed charges,343.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,133.28,343.5,
PROFYLE/M PLATE T 90DG NRW 6H,46050975,CDM,278,RC,,,OUTPATIENT,,,481.1,384.88,,360.83,75,,,percent of total billed charges,75% of total billed charges,192.44,40,,,percent of total billed charges,40% of total billed charges,381.03,79.2,,,percent of total billed charges,79.2% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,481.1,100,,,fee schedule,100% of CO APG rates,457.05,95,,,percent of total billed charges,95% of total billed charges,384.88,80,,,percent of total billed charges,80% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,432.99,90,,,percent of total billed charges,90% of total billed charges,481.1,100,,,fee schedule,100% of CO APG rates,481.1,100,,,fee schedule,100% of CO APG rates,481.1,100,,,fee schedule,100% of NM fee schedule,192.44,40,,,percent of total billed charges,40% of total billed charges,192.44,40,,,percent of total billed charges,40% of total billed charges,432.99,90,,,percent of total billed charges,90% of total billed charges,365.64,76,,,percent of total billed charges,76% of total billed charges,192.44,40,,,percent of total billed charges,40% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,481.1,100,,,fee schedule,100% of CO APG rate,384.88,80,,,percent of total billed charges,80% of total billed charges,186.67,38.8,,,percent of total billed charges,38.8% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,481.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,186.67,481.1,
PROFYLE/M PLATE T 90DG REG 7H,46050976,CDM,278,RC,,,OUTPATIENT,,,530.5,424.4,,397.88,75,,,percent of total billed charges,75% of total billed charges,212.2,40,,,percent of total billed charges,40% of total billed charges,420.16,79.2,,,percent of total billed charges,79.2% of total billed charges,450.93,85,,,percent of total billed charges,85% of total billed charges,530.5,100,,,fee schedule,100% of CO APG rates,503.98,95,,,percent of total billed charges,95% of total billed charges,424.4,80,,,percent of total billed charges,80% of total billed charges,450.93,85,,,percent of total billed charges,85% of total billed charges,477.45,90,,,percent of total billed charges,90% of total billed charges,530.5,100,,,fee schedule,100% of CO APG rates,530.5,100,,,fee schedule,100% of CO APG rates,530.5,100,,,fee schedule,100% of NM fee schedule,212.2,40,,,percent of total billed charges,40% of total billed charges,212.2,40,,,percent of total billed charges,40% of total billed charges,477.45,90,,,percent of total billed charges,90% of total billed charges,403.18,76,,,percent of total billed charges,76% of total billed charges,212.2,40,,,percent of total billed charges,40% of total billed charges,450.93,85,,,percent of total billed charges,85% of total billed charges,530.5,100,,,fee schedule,100% of CO APG rate,424.4,80,,,percent of total billed charges,80% of total billed charges,205.83,38.8,,,percent of total billed charges,38.8% of total billed charges,450.93,85,,,percent of total billed charges,85% of total billed charges,530.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,205.83,530.5,
PROFYLE/M PLATE Y NRW 7H,46050977,CDM,278,RC,,,OUTPATIENT,,,607.1,485.68,,455.33,75,,,percent of total billed charges,75% of total billed charges,242.84,40,,,percent of total billed charges,40% of total billed charges,480.82,79.2,,,percent of total billed charges,79.2% of total billed charges,516.04,85,,,percent of total billed charges,85% of total billed charges,607.1,100,,,fee schedule,100% of CO APG rates,576.75,95,,,percent of total billed charges,95% of total billed charges,485.68,80,,,percent of total billed charges,80% of total billed charges,516.04,85,,,percent of total billed charges,85% of total billed charges,546.39,90,,,percent of total billed charges,90% of total billed charges,607.1,100,,,fee schedule,100% of CO APG rates,607.1,100,,,fee schedule,100% of CO APG rates,607.1,100,,,fee schedule,100% of NM fee schedule,242.84,40,,,percent of total billed charges,40% of total billed charges,242.84,40,,,percent of total billed charges,40% of total billed charges,546.39,90,,,percent of total billed charges,90% of total billed charges,461.4,76,,,percent of total billed charges,76% of total billed charges,242.84,40,,,percent of total billed charges,40% of total billed charges,516.04,85,,,percent of total billed charges,85% of total billed charges,607.1,100,,,fee schedule,100% of CO APG rate,485.68,80,,,percent of total billed charges,80% of total billed charges,235.55,38.8,,,percent of total billed charges,38.8% of total billed charges,516.04,85,,,percent of total billed charges,85% of total billed charges,607.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,235.55,607.1,
PROFYLE/M REPLANT PLATE 4X2H,46050978,CDM,278,RC,,,OUTPATIENT,,,993.7,794.96,,745.28,75,,,percent of total billed charges,75% of total billed charges,397.48,40,,,percent of total billed charges,40% of total billed charges,787.01,79.2,,,percent of total billed charges,79.2% of total billed charges,844.65,85,,,percent of total billed charges,85% of total billed charges,993.7,100,,,fee schedule,100% of CO APG rates,944.02,95,,,percent of total billed charges,95% of total billed charges,794.96,80,,,percent of total billed charges,80% of total billed charges,844.65,85,,,percent of total billed charges,85% of total billed charges,894.33,90,,,percent of total billed charges,90% of total billed charges,993.7,100,,,fee schedule,100% of CO APG rates,993.7,100,,,fee schedule,100% of CO APG rates,993.7,100,,,fee schedule,100% of NM fee schedule,397.48,40,,,percent of total billed charges,40% of total billed charges,397.48,40,,,percent of total billed charges,40% of total billed charges,894.33,90,,,percent of total billed charges,90% of total billed charges,755.21,76,,,percent of total billed charges,76% of total billed charges,397.48,40,,,percent of total billed charges,40% of total billed charges,844.65,85,,,percent of total billed charges,85% of total billed charges,993.7,100,,,fee schedule,100% of CO APG rate,794.96,80,,,percent of total billed charges,80% of total billed charges,385.56,38.8,,,percent of total billed charges,38.8% of total billed charges,844.65,85,,,percent of total billed charges,85% of total billed charges,993.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,385.56,993.7,
PROFYLE/M V Z-SHAPE 13H,46050979,CDM,278,RC,,,OUTPATIENT,,,672.3,537.84,,504.23,75,,,percent of total billed charges,75% of total billed charges,268.92,40,,,percent of total billed charges,40% of total billed charges,532.46,79.2,,,percent of total billed charges,79.2% of total billed charges,571.46,85,,,percent of total billed charges,85% of total billed charges,672.3,100,,,fee schedule,100% of CO APG rates,638.69,95,,,percent of total billed charges,95% of total billed charges,537.84,80,,,percent of total billed charges,80% of total billed charges,571.46,85,,,percent of total billed charges,85% of total billed charges,605.07,90,,,percent of total billed charges,90% of total billed charges,672.3,100,,,fee schedule,100% of CO APG rates,672.3,100,,,fee schedule,100% of CO APG rates,672.3,100,,,fee schedule,100% of NM fee schedule,268.92,40,,,percent of total billed charges,40% of total billed charges,268.92,40,,,percent of total billed charges,40% of total billed charges,605.07,90,,,percent of total billed charges,90% of total billed charges,510.95,76,,,percent of total billed charges,76% of total billed charges,268.92,40,,,percent of total billed charges,40% of total billed charges,571.46,85,,,percent of total billed charges,85% of total billed charges,672.3,100,,,fee schedule,100% of CO APG rate,537.84,80,,,percent of total billed charges,80% of total billed charges,260.85,38.8,,,percent of total billed charges,38.8% of total billed charges,571.46,85,,,percent of total billed charges,85% of total billed charges,672.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,260.85,672.3,
PROFYLE/S 3-D PLATE 2X2 HOLE,46050980,CDM,278,RC,,,OUTPATIENT,,,592.4,473.92,,444.3,75,,,percent of total billed charges,75% of total billed charges,236.96,40,,,percent of total billed charges,40% of total billed charges,469.18,79.2,,,percent of total billed charges,79.2% of total billed charges,503.54,85,,,percent of total billed charges,85% of total billed charges,592.4,100,,,fee schedule,100% of CO APG rates,562.78,95,,,percent of total billed charges,95% of total billed charges,473.92,80,,,percent of total billed charges,80% of total billed charges,503.54,85,,,percent of total billed charges,85% of total billed charges,533.16,90,,,percent of total billed charges,90% of total billed charges,592.4,100,,,fee schedule,100% of CO APG rates,592.4,100,,,fee schedule,100% of CO APG rates,592.4,100,,,fee schedule,100% of NM fee schedule,236.96,40,,,percent of total billed charges,40% of total billed charges,236.96,40,,,percent of total billed charges,40% of total billed charges,533.16,90,,,percent of total billed charges,90% of total billed charges,450.22,76,,,percent of total billed charges,76% of total billed charges,236.96,40,,,percent of total billed charges,40% of total billed charges,503.54,85,,,percent of total billed charges,85% of total billed charges,592.4,100,,,fee schedule,100% of CO APG rate,473.92,80,,,percent of total billed charges,80% of total billed charges,229.85,38.8,,,percent of total billed charges,38.8% of total billed charges,503.54,85,,,percent of total billed charges,85% of total billed charges,592.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,229.85,592.4,
PROFYLE/S 3D PLATE 2X2+2H,46050981,CDM,278,RC,,,OUTPATIENT,,,880.2,704.16,,660.15,75,,,percent of total billed charges,75% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,697.12,79.2,,,percent of total billed charges,79.2% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rates,836.19,95,,,percent of total billed charges,95% of total billed charges,704.16,80,,,percent of total billed charges,80% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,792.18,90,,,percent of total billed charges,90% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rates,880.2,100,,,fee schedule,100% of CO APG rates,880.2,100,,,fee schedule,100% of NM fee schedule,352.08,40,,,percent of total billed charges,40% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,792.18,90,,,percent of total billed charges,90% of total billed charges,668.95,76,,,percent of total billed charges,76% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rate,704.16,80,,,percent of total billed charges,80% of total billed charges,341.52,38.8,,,percent of total billed charges,38.8% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,341.52,880.2,
PROFYLE/S 3-D PLATE 3X2 HOLE,46050982,CDM,278,RC,,,OUTPATIENT,,,880.2,704.16,,660.15,75,,,percent of total billed charges,75% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,697.12,79.2,,,percent of total billed charges,79.2% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rates,836.19,95,,,percent of total billed charges,95% of total billed charges,704.16,80,,,percent of total billed charges,80% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,792.18,90,,,percent of total billed charges,90% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rates,880.2,100,,,fee schedule,100% of CO APG rates,880.2,100,,,fee schedule,100% of NM fee schedule,352.08,40,,,percent of total billed charges,40% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,792.18,90,,,percent of total billed charges,90% of total billed charges,668.95,76,,,percent of total billed charges,76% of total billed charges,352.08,40,,,percent of total billed charges,40% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of CO APG rate,704.16,80,,,percent of total billed charges,80% of total billed charges,341.52,38.8,,,percent of total billed charges,38.8% of total billed charges,748.17,85,,,percent of total billed charges,85% of total billed charges,880.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,341.52,880.2,
PROFYLE/S 3-D PLATE 4X2 HOLE,46050983,CDM,278,RC,,,OUTPATIENT,,,925.4,740.32,,694.05,75,,,percent of total billed charges,75% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,732.92,79.2,,,percent of total billed charges,79.2% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rates,879.13,95,,,percent of total billed charges,95% of total billed charges,740.32,80,,,percent of total billed charges,80% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,832.86,90,,,percent of total billed charges,90% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rates,925.4,100,,,fee schedule,100% of CO APG rates,925.4,100,,,fee schedule,100% of NM fee schedule,370.16,40,,,percent of total billed charges,40% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,832.86,90,,,percent of total billed charges,90% of total billed charges,703.3,76,,,percent of total billed charges,76% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rate,740.32,80,,,percent of total billed charges,80% of total billed charges,359.06,38.8,,,percent of total billed charges,38.8% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,359.06,925.4,
PROFYLE/S CONDYLAR PLATE 1 HOLE,46050984,CDM,278,RC,,,OUTPATIENT,,,563,450.4,,422.25,75,,,percent of total billed charges,75% of total billed charges,225.2,40,,,percent of total billed charges,40% of total billed charges,445.9,79.2,,,percent of total billed charges,79.2% of total billed charges,478.55,85,,,percent of total billed charges,85% of total billed charges,563,100,,,fee schedule,100% of CO APG rates,534.85,95,,,percent of total billed charges,95% of total billed charges,450.4,80,,,percent of total billed charges,80% of total billed charges,478.55,85,,,percent of total billed charges,85% of total billed charges,506.7,90,,,percent of total billed charges,90% of total billed charges,563,100,,,fee schedule,100% of CO APG rates,563,100,,,fee schedule,100% of CO APG rates,563,100,,,fee schedule,100% of NM fee schedule,225.2,40,,,percent of total billed charges,40% of total billed charges,225.2,40,,,percent of total billed charges,40% of total billed charges,506.7,90,,,percent of total billed charges,90% of total billed charges,427.88,76,,,percent of total billed charges,76% of total billed charges,225.2,40,,,percent of total billed charges,40% of total billed charges,478.55,85,,,percent of total billed charges,85% of total billed charges,563,100,,,fee schedule,100% of CO APG rate,450.4,80,,,percent of total billed charges,80% of total billed charges,218.44,38.8,,,percent of total billed charges,38.8% of total billed charges,478.55,85,,,percent of total billed charges,85% of total billed charges,563,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.44,563,
PROFYLE/S CONDYLAR PLATE BAR 5H LFT,46050985,CDM,278,RC,,,OUTPATIENT,,,543.1,434.48,,407.33,75,,,percent of total billed charges,75% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,430.14,79.2,,,percent of total billed charges,79.2% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rates,515.95,95,,,percent of total billed charges,95% of total billed charges,434.48,80,,,percent of total billed charges,80% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,488.79,90,,,percent of total billed charges,90% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rates,543.1,100,,,fee schedule,100% of CO APG rates,543.1,100,,,fee schedule,100% of NM fee schedule,217.24,40,,,percent of total billed charges,40% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,488.79,90,,,percent of total billed charges,90% of total billed charges,412.76,76,,,percent of total billed charges,76% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rate,434.48,80,,,percent of total billed charges,80% of total billed charges,210.72,38.8,,,percent of total billed charges,38.8% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,210.72,543.1,
PROFYLE/S CONDYLAR PLATE BAR 5H RT,46050986,CDM,278,RC,,,OUTPATIENT,,,543.1,434.48,,407.33,75,,,percent of total billed charges,75% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,430.14,79.2,,,percent of total billed charges,79.2% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rates,515.95,95,,,percent of total billed charges,95% of total billed charges,434.48,80,,,percent of total billed charges,80% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,488.79,90,,,percent of total billed charges,90% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rates,543.1,100,,,fee schedule,100% of CO APG rates,543.1,100,,,fee schedule,100% of NM fee schedule,217.24,40,,,percent of total billed charges,40% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,488.79,90,,,percent of total billed charges,90% of total billed charges,412.76,76,,,percent of total billed charges,76% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rate,434.48,80,,,percent of total billed charges,80% of total billed charges,210.72,38.8,,,percent of total billed charges,38.8% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,210.72,543.1,
PROFYLE/S PLATE L 90DG REG LT 6H,46050987,CDM,278,RC,,,OUTPATIENT,,,466.4,373.12,,349.8,75,,,percent of total billed charges,75% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,369.39,79.2,,,percent of total billed charges,79.2% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,443.08,95,,,percent of total billed charges,95% of total billed charges,373.12,80,,,percent of total billed charges,80% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of NM fee schedule,186.56,40,,,percent of total billed charges,40% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,354.46,76,,,percent of total billed charges,76% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rate,373.12,80,,,percent of total billed charges,80% of total billed charges,180.96,38.8,,,percent of total billed charges,38.8% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,180.96,466.4,
PROFYLE/S PLATE L 90DG REG RT 6H,46050988,CDM,278,RC,,,OUTPATIENT,,,466.4,373.12,,349.8,75,,,percent of total billed charges,75% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,369.39,79.2,,,percent of total billed charges,79.2% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,443.08,95,,,percent of total billed charges,95% of total billed charges,373.12,80,,,percent of total billed charges,80% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of NM fee schedule,186.56,40,,,percent of total billed charges,40% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,354.46,76,,,percent of total billed charges,76% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rate,373.12,80,,,percent of total billed charges,80% of total billed charges,180.96,38.8,,,percent of total billed charges,38.8% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,180.96,466.4,
PROFYLE/S PLATE MED STR 4HOLE,46050989,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,154.89,399.2,
PROFYLE/S PLATE STR 16HOLE,46050990,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
PROFYLE/S PLATE T 90DG NRW 6H,46050991,CDM,278,RC,,,OUTPATIENT,,,513.7,410.96,,385.28,75,,,percent of total billed charges,75% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,406.85,79.2,,,percent of total billed charges,79.2% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rates,488.02,95,,,percent of total billed charges,95% of total billed charges,410.96,80,,,percent of total billed charges,80% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,462.33,90,,,percent of total billed charges,90% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rates,513.7,100,,,fee schedule,100% of CO APG rates,513.7,100,,,fee schedule,100% of NM fee schedule,205.48,40,,,percent of total billed charges,40% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,462.33,90,,,percent of total billed charges,90% of total billed charges,390.41,76,,,percent of total billed charges,76% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rate,410.96,80,,,percent of total billed charges,80% of total billed charges,199.32,38.8,,,percent of total billed charges,38.8% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,199.32,513.7,
PROFYLE/S PLATE T 90DG REG 7H,46050992,CDM,278,RC,,,OUTPATIENT,,,513.7,410.96,,385.28,75,,,percent of total billed charges,75% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,406.85,79.2,,,percent of total billed charges,79.2% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rates,488.02,95,,,percent of total billed charges,95% of total billed charges,410.96,80,,,percent of total billed charges,80% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,462.33,90,,,percent of total billed charges,90% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rates,513.7,100,,,fee schedule,100% of CO APG rates,513.7,100,,,fee schedule,100% of NM fee schedule,205.48,40,,,percent of total billed charges,40% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,462.33,90,,,percent of total billed charges,90% of total billed charges,390.41,76,,,percent of total billed charges,76% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rate,410.96,80,,,percent of total billed charges,80% of total billed charges,199.32,38.8,,,percent of total billed charges,38.8% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,199.32,513.7,
PROFYLE/S PLATE Y-NRW 7H,46050993,CDM,278,RC,,,OUTPATIENT,,,563,450.4,,422.25,75,,,percent of total billed charges,75% of total billed charges,225.2,40,,,percent of total billed charges,40% of total billed charges,445.9,79.2,,,percent of total billed charges,79.2% of total billed charges,478.55,85,,,percent of total billed charges,85% of total billed charges,563,100,,,fee schedule,100% of CO APG rates,534.85,95,,,percent of total billed charges,95% of total billed charges,450.4,80,,,percent of total billed charges,80% of total billed charges,478.55,85,,,percent of total billed charges,85% of total billed charges,506.7,90,,,percent of total billed charges,90% of total billed charges,563,100,,,fee schedule,100% of CO APG rates,563,100,,,fee schedule,100% of CO APG rates,563,100,,,fee schedule,100% of NM fee schedule,225.2,40,,,percent of total billed charges,40% of total billed charges,225.2,40,,,percent of total billed charges,40% of total billed charges,506.7,90,,,percent of total billed charges,90% of total billed charges,427.88,76,,,percent of total billed charges,76% of total billed charges,225.2,40,,,percent of total billed charges,40% of total billed charges,478.55,85,,,percent of total billed charges,85% of total billed charges,563,100,,,fee schedule,100% of CO APG rate,450.4,80,,,percent of total billed charges,80% of total billed charges,218.44,38.8,,,percent of total billed charges,38.8% of total billed charges,478.55,85,,,percent of total billed charges,85% of total billed charges,563,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.44,563,
PROFYLE/S REPLANT PLT 4X2H,46050994,CDM,278,RC,,,OUTPATIENT,,,925.4,740.32,,694.05,75,,,percent of total billed charges,75% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,732.92,79.2,,,percent of total billed charges,79.2% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rates,879.13,95,,,percent of total billed charges,95% of total billed charges,740.32,80,,,percent of total billed charges,80% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,832.86,90,,,percent of total billed charges,90% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rates,925.4,100,,,fee schedule,100% of CO APG rates,925.4,100,,,fee schedule,100% of NM fee schedule,370.16,40,,,percent of total billed charges,40% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,832.86,90,,,percent of total billed charges,90% of total billed charges,703.3,76,,,percent of total billed charges,76% of total billed charges,370.16,40,,,percent of total billed charges,40% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of CO APG rate,740.32,80,,,percent of total billed charges,80% of total billed charges,359.06,38.8,,,percent of total billed charges,38.8% of total billed charges,786.59,85,,,percent of total billed charges,85% of total billed charges,925.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,359.06,925.4,
PROFYLE/S T PLATE 90DG 10H REG,46050995,CDM,278,RC,,,OUTPATIENT,,,543.1,434.48,,407.33,75,,,percent of total billed charges,75% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,430.14,79.2,,,percent of total billed charges,79.2% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rates,515.95,95,,,percent of total billed charges,95% of total billed charges,434.48,80,,,percent of total billed charges,80% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,488.79,90,,,percent of total billed charges,90% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rates,543.1,100,,,fee schedule,100% of CO APG rates,543.1,100,,,fee schedule,100% of NM fee schedule,217.24,40,,,percent of total billed charges,40% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,488.79,90,,,percent of total billed charges,90% of total billed charges,412.76,76,,,percent of total billed charges,76% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rate,434.48,80,,,percent of total billed charges,80% of total billed charges,210.72,38.8,,,percent of total billed charges,38.8% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,210.72,543.1,
PROFYLE/S Z PLATE 9 HOLE,46050996,CDM,278,RC,,,OUTPATIENT,,,672.3,537.84,,504.23,75,,,percent of total billed charges,75% of total billed charges,268.92,40,,,percent of total billed charges,40% of total billed charges,532.46,79.2,,,percent of total billed charges,79.2% of total billed charges,571.46,85,,,percent of total billed charges,85% of total billed charges,672.3,100,,,fee schedule,100% of CO APG rates,638.69,95,,,percent of total billed charges,95% of total billed charges,537.84,80,,,percent of total billed charges,80% of total billed charges,571.46,85,,,percent of total billed charges,85% of total billed charges,605.07,90,,,percent of total billed charges,90% of total billed charges,672.3,100,,,fee schedule,100% of CO APG rates,672.3,100,,,fee schedule,100% of CO APG rates,672.3,100,,,fee schedule,100% of NM fee schedule,268.92,40,,,percent of total billed charges,40% of total billed charges,268.92,40,,,percent of total billed charges,40% of total billed charges,605.07,90,,,percent of total billed charges,90% of total billed charges,510.95,76,,,percent of total billed charges,76% of total billed charges,268.92,40,,,percent of total billed charges,40% of total billed charges,571.46,85,,,percent of total billed charges,85% of total billed charges,672.3,100,,,fee schedule,100% of CO APG rate,537.84,80,,,percent of total billed charges,80% of total billed charges,260.85,38.8,,,percent of total billed charges,38.8% of total billed charges,571.46,85,,,percent of total billed charges,85% of total billed charges,672.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,260.85,672.3,
PROFYLE/XS 3-D PLATE 2X2 HOLE,46050997,CDM,278,RC,,,OUTPATIENT,,,575.6,460.48,,431.7,75,,,percent of total billed charges,75% of total billed charges,230.24,40,,,percent of total billed charges,40% of total billed charges,455.88,79.2,,,percent of total billed charges,79.2% of total billed charges,489.26,85,,,percent of total billed charges,85% of total billed charges,575.6,100,,,fee schedule,100% of CO APG rates,546.82,95,,,percent of total billed charges,95% of total billed charges,460.48,80,,,percent of total billed charges,80% of total billed charges,489.26,85,,,percent of total billed charges,85% of total billed charges,518.04,90,,,percent of total billed charges,90% of total billed charges,575.6,100,,,fee schedule,100% of CO APG rates,575.6,100,,,fee schedule,100% of CO APG rates,575.6,100,,,fee schedule,100% of NM fee schedule,230.24,40,,,percent of total billed charges,40% of total billed charges,230.24,40,,,percent of total billed charges,40% of total billed charges,518.04,90,,,percent of total billed charges,90% of total billed charges,437.46,76,,,percent of total billed charges,76% of total billed charges,230.24,40,,,percent of total billed charges,40% of total billed charges,489.26,85,,,percent of total billed charges,85% of total billed charges,575.6,100,,,fee schedule,100% of CO APG rate,460.48,80,,,percent of total billed charges,80% of total billed charges,223.33,38.8,,,percent of total billed charges,38.8% of total billed charges,489.26,85,,,percent of total billed charges,85% of total billed charges,575.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,223.33,575.6,
PROFYLE/XS 3D PLATE 2X2+2HOLE,46050998,CDM,278,RC,,,OUTPATIENT,,,864.5,691.6,,648.38,75,,,percent of total billed charges,75% of total billed charges,345.8,40,,,percent of total billed charges,40% of total billed charges,684.68,79.2,,,percent of total billed charges,79.2% of total billed charges,734.83,85,,,percent of total billed charges,85% of total billed charges,864.5,100,,,fee schedule,100% of CO APG rates,821.28,95,,,percent of total billed charges,95% of total billed charges,691.6,80,,,percent of total billed charges,80% of total billed charges,734.83,85,,,percent of total billed charges,85% of total billed charges,778.05,90,,,percent of total billed charges,90% of total billed charges,864.5,100,,,fee schedule,100% of CO APG rates,864.5,100,,,fee schedule,100% of CO APG rates,864.5,100,,,fee schedule,100% of NM fee schedule,345.8,40,,,percent of total billed charges,40% of total billed charges,345.8,40,,,percent of total billed charges,40% of total billed charges,778.05,90,,,percent of total billed charges,90% of total billed charges,657.02,76,,,percent of total billed charges,76% of total billed charges,345.8,40,,,percent of total billed charges,40% of total billed charges,734.83,85,,,percent of total billed charges,85% of total billed charges,864.5,100,,,fee schedule,100% of CO APG rate,691.6,80,,,percent of total billed charges,80% of total billed charges,335.43,38.8,,,percent of total billed charges,38.8% of total billed charges,734.83,85,,,percent of total billed charges,85% of total billed charges,864.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,335.43,864.5,
PROFYLE/XS 3-D PLATE 3X2 HOLE,46050999,CDM,278,RC,,,OUTPATIENT,,,864.5,691.6,,648.38,75,,,percent of total billed charges,75% of total billed charges,345.8,40,,,percent of total billed charges,40% of total billed charges,684.68,79.2,,,percent of total billed charges,79.2% of total billed charges,734.83,85,,,percent of total billed charges,85% of total billed charges,864.5,100,,,fee schedule,100% of CO APG rates,821.28,95,,,percent of total billed charges,95% of total billed charges,691.6,80,,,percent of total billed charges,80% of total billed charges,734.83,85,,,percent of total billed charges,85% of total billed charges,778.05,90,,,percent of total billed charges,90% of total billed charges,864.5,100,,,fee schedule,100% of CO APG rates,864.5,100,,,fee schedule,100% of CO APG rates,864.5,100,,,fee schedule,100% of NM fee schedule,345.8,40,,,percent of total billed charges,40% of total billed charges,345.8,40,,,percent of total billed charges,40% of total billed charges,778.05,90,,,percent of total billed charges,90% of total billed charges,657.02,76,,,percent of total billed charges,76% of total billed charges,345.8,40,,,percent of total billed charges,40% of total billed charges,734.83,85,,,percent of total billed charges,85% of total billed charges,864.5,100,,,fee schedule,100% of CO APG rate,691.6,80,,,percent of total billed charges,80% of total billed charges,335.43,38.8,,,percent of total billed charges,38.8% of total billed charges,734.83,85,,,percent of total billed charges,85% of total billed charges,864.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,335.43,864.5,
PROFYLE/XS 3-D PLATE 4X2 HOLE,46051000,CDM,278,RC,,,OUTPATIENT,,,1041,832.8,,780.75,75,,,percent of total billed charges,75% of total billed charges,416.4,40,,,percent of total billed charges,40% of total billed charges,824.47,79.2,,,percent of total billed charges,79.2% of total billed charges,884.85,85,,,percent of total billed charges,85% of total billed charges,1041,100,,,fee schedule,100% of CO APG rates,988.95,95,,,percent of total billed charges,95% of total billed charges,832.8,80,,,percent of total billed charges,80% of total billed charges,884.85,85,,,percent of total billed charges,85% of total billed charges,936.9,90,,,percent of total billed charges,90% of total billed charges,1041,100,,,fee schedule,100% of CO APG rates,1041,100,,,fee schedule,100% of CO APG rates,1041,100,,,fee schedule,100% of NM fee schedule,416.4,40,,,percent of total billed charges,40% of total billed charges,416.4,40,,,percent of total billed charges,40% of total billed charges,936.9,90,,,percent of total billed charges,90% of total billed charges,791.16,76,,,percent of total billed charges,76% of total billed charges,416.4,40,,,percent of total billed charges,40% of total billed charges,884.85,85,,,percent of total billed charges,85% of total billed charges,1041,100,,,fee schedule,100% of CO APG rate,832.8,80,,,percent of total billed charges,80% of total billed charges,403.91,38.8,,,percent of total billed charges,38.8% of total billed charges,884.85,85,,,percent of total billed charges,85% of total billed charges,1041,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,403.91,1041,
PROFYLE/XS 90DEG PLATE 8 HOLE NA,46051001,CDM,278,RC,,,OUTPATIENT,,,543.1,434.48,,407.33,75,,,percent of total billed charges,75% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,430.14,79.2,,,percent of total billed charges,79.2% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rates,515.95,95,,,percent of total billed charges,95% of total billed charges,434.48,80,,,percent of total billed charges,80% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,488.79,90,,,percent of total billed charges,90% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rates,543.1,100,,,fee schedule,100% of CO APG rates,543.1,100,,,fee schedule,100% of NM fee schedule,217.24,40,,,percent of total billed charges,40% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,488.79,90,,,percent of total billed charges,90% of total billed charges,412.76,76,,,percent of total billed charges,76% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rate,434.48,80,,,percent of total billed charges,80% of total billed charges,210.72,38.8,,,percent of total billed charges,38.8% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,210.72,543.1,
PROFYLE/XS PLATE STGHT 16 HOLE,46051002,CDM,278,RC,,,OUTPATIENT,,,753.1,602.48,,564.83,75,,,percent of total billed charges,75% of total billed charges,301.24,40,,,percent of total billed charges,40% of total billed charges,596.46,79.2,,,percent of total billed charges,79.2% of total billed charges,640.14,85,,,percent of total billed charges,85% of total billed charges,753.1,100,,,fee schedule,100% of CO APG rates,715.45,95,,,percent of total billed charges,95% of total billed charges,602.48,80,,,percent of total billed charges,80% of total billed charges,640.14,85,,,percent of total billed charges,85% of total billed charges,677.79,90,,,percent of total billed charges,90% of total billed charges,753.1,100,,,fee schedule,100% of CO APG rates,753.1,100,,,fee schedule,100% of CO APG rates,753.1,100,,,fee schedule,100% of NM fee schedule,301.24,40,,,percent of total billed charges,40% of total billed charges,301.24,40,,,percent of total billed charges,40% of total billed charges,677.79,90,,,percent of total billed charges,90% of total billed charges,572.36,76,,,percent of total billed charges,76% of total billed charges,301.24,40,,,percent of total billed charges,40% of total billed charges,640.14,85,,,percent of total billed charges,85% of total billed charges,753.1,100,,,fee schedule,100% of CO APG rate,602.48,80,,,percent of total billed charges,80% of total billed charges,292.2,38.8,,,percent of total billed charges,38.8% of total billed charges,640.14,85,,,percent of total billed charges,85% of total billed charges,753.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,292.2,753.1,
PROFYLE/XS PLATE STGHT 4 HOLE,46051003,CDM,278,RC,,,OUTPATIENT,,,379.2,303.36,,284.4,75,,,percent of total billed charges,75% of total billed charges,151.68,40,,,percent of total billed charges,40% of total billed charges,300.33,79.2,,,percent of total billed charges,79.2% of total billed charges,322.32,85,,,percent of total billed charges,85% of total billed charges,379.2,100,,,fee schedule,100% of CO APG rates,360.24,95,,,percent of total billed charges,95% of total billed charges,303.36,80,,,percent of total billed charges,80% of total billed charges,322.32,85,,,percent of total billed charges,85% of total billed charges,341.28,90,,,percent of total billed charges,90% of total billed charges,379.2,100,,,fee schedule,100% of CO APG rates,379.2,100,,,fee schedule,100% of CO APG rates,379.2,100,,,fee schedule,100% of NM fee schedule,151.68,40,,,percent of total billed charges,40% of total billed charges,151.68,40,,,percent of total billed charges,40% of total billed charges,341.28,90,,,percent of total billed charges,90% of total billed charges,288.19,76,,,percent of total billed charges,76% of total billed charges,151.68,40,,,percent of total billed charges,40% of total billed charges,322.32,85,,,percent of total billed charges,85% of total billed charges,379.2,100,,,fee schedule,100% of CO APG rate,303.36,80,,,percent of total billed charges,80% of total billed charges,147.13,38.8,,,percent of total billed charges,38.8% of total billed charges,322.32,85,,,percent of total billed charges,85% of total billed charges,379.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,147.13,379.2,
PROFYLE/XS PLATE T 90DG NARROW,46051004,CDM,278,RC,,,OUTPATIENT,,,448.5,358.8,,336.38,75,,,percent of total billed charges,75% of total billed charges,179.4,40,,,percent of total billed charges,40% of total billed charges,355.21,79.2,,,percent of total billed charges,79.2% of total billed charges,381.23,85,,,percent of total billed charges,85% of total billed charges,448.5,100,,,fee schedule,100% of CO APG rates,426.08,95,,,percent of total billed charges,95% of total billed charges,358.8,80,,,percent of total billed charges,80% of total billed charges,381.23,85,,,percent of total billed charges,85% of total billed charges,403.65,90,,,percent of total billed charges,90% of total billed charges,448.5,100,,,fee schedule,100% of CO APG rates,448.5,100,,,fee schedule,100% of CO APG rates,448.5,100,,,fee schedule,100% of NM fee schedule,179.4,40,,,percent of total billed charges,40% of total billed charges,179.4,40,,,percent of total billed charges,40% of total billed charges,403.65,90,,,percent of total billed charges,90% of total billed charges,340.86,76,,,percent of total billed charges,76% of total billed charges,179.4,40,,,percent of total billed charges,40% of total billed charges,381.23,85,,,percent of total billed charges,85% of total billed charges,448.5,100,,,fee schedule,100% of CO APG rate,358.8,80,,,percent of total billed charges,80% of total billed charges,174.02,38.8,,,percent of total billed charges,38.8% of total billed charges,381.23,85,,,percent of total billed charges,85% of total billed charges,448.5,100,,,fee schedule,100% of APG fee schedule,897,200,,,percent of total billed charges,200% of total billed charges,174.02,897,
PROFYLE/XS PLATE T-BEVL NRW LT,46051005,CDM,278,RC,,,OUTPATIENT,,,513.7,410.96,,385.28,75,,,percent of total billed charges,75% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,406.85,79.2,,,percent of total billed charges,79.2% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rates,488.02,95,,,percent of total billed charges,95% of total billed charges,410.96,80,,,percent of total billed charges,80% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,462.33,90,,,percent of total billed charges,90% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rates,513.7,100,,,fee schedule,100% of CO APG rates,513.7,100,,,fee schedule,100% of NM fee schedule,205.48,40,,,percent of total billed charges,40% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,462.33,90,,,percent of total billed charges,90% of total billed charges,390.41,76,,,percent of total billed charges,76% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rate,410.96,80,,,percent of total billed charges,80% of total billed charges,199.32,38.8,,,percent of total billed charges,38.8% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,199.32,513.7,
PROFYLE/XS PLATE T-BEVL NRW RT,46051006,CDM,278,RC,,,OUTPATIENT,,,513.7,410.96,,385.28,75,,,percent of total billed charges,75% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,406.85,79.2,,,percent of total billed charges,79.2% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rates,488.02,95,,,percent of total billed charges,95% of total billed charges,410.96,80,,,percent of total billed charges,80% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,462.33,90,,,percent of total billed charges,90% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rates,513.7,100,,,fee schedule,100% of CO APG rates,513.7,100,,,fee schedule,100% of NM fee schedule,205.48,40,,,percent of total billed charges,40% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,462.33,90,,,percent of total billed charges,90% of total billed charges,390.41,76,,,percent of total billed charges,76% of total billed charges,205.48,40,,,percent of total billed charges,40% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of CO APG rate,410.96,80,,,percent of total billed charges,80% of total billed charges,199.32,38.8,,,percent of total billed charges,38.8% of total billed charges,436.65,85,,,percent of total billed charges,85% of total billed charges,513.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,199.32,513.7,
PROFYLE/XS PLATE Y-NRW 5 HOLE,46051007,CDM,278,RC,,,OUTPATIENT,,,481.1,384.88,,360.83,75,,,percent of total billed charges,75% of total billed charges,192.44,40,,,percent of total billed charges,40% of total billed charges,381.03,79.2,,,percent of total billed charges,79.2% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,481.1,100,,,fee schedule,100% of CO APG rates,457.05,95,,,percent of total billed charges,95% of total billed charges,384.88,80,,,percent of total billed charges,80% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,432.99,90,,,percent of total billed charges,90% of total billed charges,481.1,100,,,fee schedule,100% of CO APG rates,481.1,100,,,fee schedule,100% of CO APG rates,481.1,100,,,fee schedule,100% of NM fee schedule,192.44,40,,,percent of total billed charges,40% of total billed charges,192.44,40,,,percent of total billed charges,40% of total billed charges,432.99,90,,,percent of total billed charges,90% of total billed charges,365.64,76,,,percent of total billed charges,76% of total billed charges,192.44,40,,,percent of total billed charges,40% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,481.1,100,,,fee schedule,100% of CO APG rate,384.88,80,,,percent of total billed charges,80% of total billed charges,186.67,38.8,,,percent of total billed charges,38.8% of total billed charges,408.94,85,,,percent of total billed charges,85% of total billed charges,481.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,186.67,481.1,
PROFYLE/XS REPLANT PLATE 4X2H,46051008,CDM,278,RC,,,OUTPATIENT,,,976.9,781.52,,732.68,75,,,percent of total billed charges,75% of total billed charges,390.76,40,,,percent of total billed charges,40% of total billed charges,773.7,79.2,,,percent of total billed charges,79.2% of total billed charges,830.37,85,,,percent of total billed charges,85% of total billed charges,976.9,100,,,fee schedule,100% of CO APG rates,928.06,95,,,percent of total billed charges,95% of total billed charges,781.52,80,,,percent of total billed charges,80% of total billed charges,830.37,85,,,percent of total billed charges,85% of total billed charges,879.21,90,,,percent of total billed charges,90% of total billed charges,976.9,100,,,fee schedule,100% of CO APG rates,976.9,100,,,fee schedule,100% of CO APG rates,976.9,100,,,fee schedule,100% of NM fee schedule,390.76,40,,,percent of total billed charges,40% of total billed charges,390.76,40,,,percent of total billed charges,40% of total billed charges,879.21,90,,,percent of total billed charges,90% of total billed charges,742.44,76,,,percent of total billed charges,76% of total billed charges,390.76,40,,,percent of total billed charges,40% of total billed charges,830.37,85,,,percent of total billed charges,85% of total billed charges,976.9,100,,,fee schedule,100% of CO APG rate,781.52,80,,,percent of total billed charges,80% of total billed charges,379.04,38.8,,,percent of total billed charges,38.8% of total billed charges,830.37,85,,,percent of total billed charges,85% of total billed charges,976.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,379.04,976.9,
PROXIMAL LATERAL HUMERUS PLATE TS 3 HOLE / LEFT,46051009,CDM,278,RC,,,OUTPATIENT,,,2960,2368,,2220,75,,,percent of total billed charges,75% of total billed charges,1184,40,,,percent of total billed charges,40% of total billed charges,2344.32,79.2,,,percent of total billed charges,79.2% of total billed charges,2516,85,,,percent of total billed charges,85% of total billed charges,2960,100,,,fee schedule,100% of CO APG rates,2812,95,,,percent of total billed charges,95% of total billed charges,2368,80,,,percent of total billed charges,80% of total billed charges,2516,85,,,percent of total billed charges,85% of total billed charges,2664,90,,,percent of total billed charges,90% of total billed charges,2960,100,,,fee schedule,100% of CO APG rates,2960,100,,,fee schedule,100% of CO APG rates,2960,100,,,fee schedule,100% of NM fee schedule,1184,40,,,percent of total billed charges,40% of total billed charges,1184,40,,,percent of total billed charges,40% of total billed charges,2664,90,,,percent of total billed charges,90% of total billed charges,2249.6,76,,,percent of total billed charges,76% of total billed charges,1184,40,,,percent of total billed charges,40% of total billed charges,2516,85,,,percent of total billed charges,85% of total billed charges,2960,100,,,fee schedule,100% of CO APG rate,2368,80,,,percent of total billed charges,80% of total billed charges,1148.48,38.8,,,percent of total billed charges,38.8% of total billed charges,2516,85,,,percent of total billed charges,85% of total billed charges,2960,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1148.48,2960,
PROXIMAL LATERAL HUMERUS PLATE TS 3 HOLE / RIGHT,46051010,CDM,278,RC,,,OUTPATIENT,,,2987.3,2389.84,,2240.48,75,,,percent of total billed charges,75% of total billed charges,1194.92,40,,,percent of total billed charges,40% of total billed charges,2365.94,79.2,,,percent of total billed charges,79.2% of total billed charges,2539.21,85,,,percent of total billed charges,85% of total billed charges,2987.3,100,,,fee schedule,100% of CO APG rates,2837.94,95,,,percent of total billed charges,95% of total billed charges,2389.84,80,,,percent of total billed charges,80% of total billed charges,2539.21,85,,,percent of total billed charges,85% of total billed charges,2688.57,90,,,percent of total billed charges,90% of total billed charges,2987.3,100,,,fee schedule,100% of CO APG rates,2987.3,100,,,fee schedule,100% of CO APG rates,2987.3,100,,,fee schedule,100% of NM fee schedule,1194.92,40,,,percent of total billed charges,40% of total billed charges,1194.92,40,,,percent of total billed charges,40% of total billed charges,2688.57,90,,,percent of total billed charges,90% of total billed charges,2270.35,76,,,percent of total billed charges,76% of total billed charges,1194.92,40,,,percent of total billed charges,40% of total billed charges,2539.21,85,,,percent of total billed charges,85% of total billed charges,2987.3,100,,,fee schedule,100% of CO APG rate,2389.84,80,,,percent of total billed charges,80% of total billed charges,1159.07,38.8,,,percent of total billed charges,38.8% of total billed charges,2539.21,85,,,percent of total billed charges,85% of total billed charges,2987.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1159.07,2987.3,
RECTANGULAR COMPRESSION PLATE SIZE 1,46051011,CDM,278,RC,,,OUTPATIENT,,,1073.5,858.8,,805.13,75,,,percent of total billed charges,75% of total billed charges,429.4,40,,,percent of total billed charges,40% of total billed charges,850.21,79.2,,,percent of total billed charges,79.2% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,1073.5,100,,,fee schedule,100% of CO APG rates,1019.83,95,,,percent of total billed charges,95% of total billed charges,858.8,80,,,percent of total billed charges,80% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,966.15,90,,,percent of total billed charges,90% of total billed charges,1073.5,100,,,fee schedule,100% of CO APG rates,1073.5,100,,,fee schedule,100% of CO APG rates,1073.5,100,,,fee schedule,100% of NM fee schedule,429.4,40,,,percent of total billed charges,40% of total billed charges,429.4,40,,,percent of total billed charges,40% of total billed charges,966.15,90,,,percent of total billed charges,90% of total billed charges,815.86,76,,,percent of total billed charges,76% of total billed charges,429.4,40,,,percent of total billed charges,40% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,1073.5,100,,,fee schedule,100% of CO APG rate,858.8,80,,,percent of total billed charges,80% of total billed charges,416.52,38.8,,,percent of total billed charges,38.8% of total billed charges,912.48,85,,,percent of total billed charges,85% of total billed charges,1073.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,416.52,1073.5,
RECTANGULAR COMPRESSION PLATE SIZE 2,46051012,CDM,278,RC,,,OUTPATIENT,,,1182.8,946.24,,887.1,75,,,percent of total billed charges,75% of total billed charges,473.12,40,,,percent of total billed charges,40% of total billed charges,936.78,79.2,,,percent of total billed charges,79.2% of total billed charges,1005.38,85,,,percent of total billed charges,85% of total billed charges,1182.8,100,,,fee schedule,100% of CO APG rates,1123.66,95,,,percent of total billed charges,95% of total billed charges,946.24,80,,,percent of total billed charges,80% of total billed charges,1005.38,85,,,percent of total billed charges,85% of total billed charges,1064.52,90,,,percent of total billed charges,90% of total billed charges,1182.8,100,,,fee schedule,100% of CO APG rates,1182.8,100,,,fee schedule,100% of CO APG rates,1182.8,100,,,fee schedule,100% of NM fee schedule,473.12,40,,,percent of total billed charges,40% of total billed charges,473.12,40,,,percent of total billed charges,40% of total billed charges,1064.52,90,,,percent of total billed charges,90% of total billed charges,898.93,76,,,percent of total billed charges,76% of total billed charges,473.12,40,,,percent of total billed charges,40% of total billed charges,1005.38,85,,,percent of total billed charges,85% of total billed charges,1182.8,100,,,fee schedule,100% of CO APG rate,946.24,80,,,percent of total billed charges,80% of total billed charges,458.93,38.8,,,percent of total billed charges,38.8% of total billed charges,1005.38,85,,,percent of total billed charges,85% of total billed charges,1182.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,458.93,1182.8,
RECTANGULAR LOCKING PLATE SIZE 2,46051013,CDM,278,RC,,,OUTPATIENT,,,1092.4,873.92,,819.3,75,,,percent of total billed charges,75% of total billed charges,436.96,40,,,percent of total billed charges,40% of total billed charges,865.18,79.2,,,percent of total billed charges,79.2% of total billed charges,928.54,85,,,percent of total billed charges,85% of total billed charges,1092.4,100,,,fee schedule,100% of CO APG rates,1037.78,95,,,percent of total billed charges,95% of total billed charges,873.92,80,,,percent of total billed charges,80% of total billed charges,928.54,85,,,percent of total billed charges,85% of total billed charges,983.16,90,,,percent of total billed charges,90% of total billed charges,1092.4,100,,,fee schedule,100% of CO APG rates,1092.4,100,,,fee schedule,100% of CO APG rates,1092.4,100,,,fee schedule,100% of NM fee schedule,436.96,40,,,percent of total billed charges,40% of total billed charges,436.96,40,,,percent of total billed charges,40% of total billed charges,983.16,90,,,percent of total billed charges,90% of total billed charges,830.22,76,,,percent of total billed charges,76% of total billed charges,436.96,40,,,percent of total billed charges,40% of total billed charges,928.54,85,,,percent of total billed charges,85% of total billed charges,1092.4,100,,,fee schedule,100% of CO APG rate,873.92,80,,,percent of total billed charges,80% of total billed charges,423.85,38.8,,,percent of total billed charges,38.8% of total billed charges,928.54,85,,,percent of total billed charges,85% of total billed charges,1092.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,423.85,1092.4,
"S PROFYLE HAND T-PLATE,WIDE,8H",46051014,CDM,278,RC,,,OUTPATIENT,,,786.8,629.44,,590.1,75,,,percent of total billed charges,75% of total billed charges,314.72,40,,,percent of total billed charges,40% of total billed charges,623.15,79.2,,,percent of total billed charges,79.2% of total billed charges,668.78,85,,,percent of total billed charges,85% of total billed charges,786.8,100,,,fee schedule,100% of CO APG rates,747.46,95,,,percent of total billed charges,95% of total billed charges,629.44,80,,,percent of total billed charges,80% of total billed charges,668.78,85,,,percent of total billed charges,85% of total billed charges,708.12,90,,,percent of total billed charges,90% of total billed charges,786.8,100,,,fee schedule,100% of CO APG rates,786.8,100,,,fee schedule,100% of CO APG rates,786.8,100,,,fee schedule,100% of NM fee schedule,314.72,40,,,percent of total billed charges,40% of total billed charges,314.72,40,,,percent of total billed charges,40% of total billed charges,708.12,90,,,percent of total billed charges,90% of total billed charges,597.97,76,,,percent of total billed charges,76% of total billed charges,314.72,40,,,percent of total billed charges,40% of total billed charges,668.78,85,,,percent of total billed charges,85% of total billed charges,786.8,100,,,fee schedule,100% of CO APG rate,629.44,80,,,percent of total billed charges,80% of total billed charges,305.28,38.8,,,percent of total billed charges,38.8% of total billed charges,668.78,85,,,percent of total billed charges,85% of total billed charges,786.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,305.28,786.8,
SELF TAP CORTICAL SCREW 2.7X10MM,46051015,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 2.7X12MM,46051016,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 2.7X14MM,46051017,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 2.7X16MM,46051018,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 2.7X18MM,46051019,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 2.7X20MM,46051020,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 2.7X22MM,46051021,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 2.7X24MM,46051022,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 2.7X26MM,46051023,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 2.7X28MM,46051024,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 2.7X30MM,46051025,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 2.7X8MM,46051026,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X10MM,46051027,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X12MM,46051028,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X14MM,46051029,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X16MM,46051030,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X18MM,46051031,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X20MM,46051032,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X22MM,46051033,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X24MM,46051034,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X26MM,46051035,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X28MM,46051036,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X30MM,46051037,CDM,278,RC,,,OUTPATIENT,,,69.2,55.36,,51.9,75,,,percent of total billed charges,75% of total billed charges,27.68,40,,,percent of total billed charges,40% of total billed charges,54.81,79.2,,,percent of total billed charges,79.2% of total billed charges,58.82,85,,,percent of total billed charges,85% of total billed charges,69.2,100,,,fee schedule,100% of CO APG rates,65.74,95,,,percent of total billed charges,95% of total billed charges,55.36,80,,,percent of total billed charges,80% of total billed charges,58.82,85,,,percent of total billed charges,85% of total billed charges,62.28,90,,,percent of total billed charges,90% of total billed charges,69.2,100,,,fee schedule,100% of CO APG rates,69.2,100,,,fee schedule,100% of CO APG rates,69.2,100,,,fee schedule,100% of NM fee schedule,27.68,40,,,percent of total billed charges,40% of total billed charges,27.68,40,,,percent of total billed charges,40% of total billed charges,62.28,90,,,percent of total billed charges,90% of total billed charges,52.59,76,,,percent of total billed charges,76% of total billed charges,27.68,40,,,percent of total billed charges,40% of total billed charges,58.82,85,,,percent of total billed charges,85% of total billed charges,69.2,100,,,fee schedule,100% of CO APG rate,55.36,80,,,percent of total billed charges,80% of total billed charges,26.85,38.8,,,percent of total billed charges,38.8% of total billed charges,58.82,85,,,percent of total billed charges,85% of total billed charges,69.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.85,69.2,
SELF TAP CORTICAL SCREW 3.5X32MM,46051038,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X34MM,46051039,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X36MM,46051040,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X38MM,46051041,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X40MM,46051042,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X42MM,46051043,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X44MM,46051044,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X46MM,46051045,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X48MM,46051046,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X50MM,46051047,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X55MM,46051048,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X60MM,46051049,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
T-PLATE,46051050,CDM,278,RC,,,OUTPATIENT,,,866.6,693.28,,649.95,75,,,percent of total billed charges,75% of total billed charges,346.64,40,,,percent of total billed charges,40% of total billed charges,686.35,79.2,,,percent of total billed charges,79.2% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,866.6,100,,,fee schedule,100% of CO APG rates,823.27,95,,,percent of total billed charges,95% of total billed charges,693.28,80,,,percent of total billed charges,80% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,779.94,90,,,percent of total billed charges,90% of total billed charges,866.6,100,,,fee schedule,100% of CO APG rates,866.6,100,,,fee schedule,100% of CO APG rates,866.6,100,,,fee schedule,100% of NM fee schedule,346.64,40,,,percent of total billed charges,40% of total billed charges,346.64,40,,,percent of total billed charges,40% of total billed charges,779.94,90,,,percent of total billed charges,90% of total billed charges,658.62,76,,,percent of total billed charges,76% of total billed charges,346.64,40,,,percent of total billed charges,40% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,866.6,100,,,fee schedule,100% of CO APG rate,693.28,80,,,percent of total billed charges,80% of total billed charges,336.24,38.8,,,percent of total billed charges,38.8% of total billed charges,736.61,85,,,percent of total billed charges,85% of total billed charges,866.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,336.24,866.6,
TWIST DRILL 1.4MM DIA. AO,46051053,CDM,270,RC,,,OUTPATIENT,,,412.9,330.32,,309.68,75,,,percent of total billed charges,75% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,327.02,79.2,,,percent of total billed charges,79.2% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,412.9,100,,,fee schedule,100% of CO APG rates,392.26,95,,,percent of total billed charges,95% of total billed charges,330.32,80,,,percent of total billed charges,80% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,371.61,90,,,percent of total billed charges,90% of total billed charges,412.9,100,,,fee schedule,100% of CO APG rates,412.9,100,,,fee schedule,100% of CO APG rates,412.9,100,,,fee schedule,100% of NM fee schedule,165.16,40,,,percent of total billed charges,40% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,371.61,90,,,percent of total billed charges,90% of total billed charges,313.8,76,,,percent of total billed charges,76% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,412.9,100,,,fee schedule,100% of CO APG rate,330.32,80,,,percent of total billed charges,80% of total billed charges,160.21,38.8,,,percent of total billed charges,38.8% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,412.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,160.21,412.9,
TWIST DRILL 1.9MM DIA. AO,46051056,CDM,270,RC,,,OUTPATIENT,,,417.3,333.84,,312.98,75,,,percent of total billed charges,75% of total billed charges,166.92,40,,,percent of total billed charges,40% of total billed charges,330.5,79.2,,,percent of total billed charges,79.2% of total billed charges,354.71,85,,,percent of total billed charges,85% of total billed charges,417.3,100,,,fee schedule,100% of CO APG rates,396.44,95,,,percent of total billed charges,95% of total billed charges,333.84,80,,,percent of total billed charges,80% of total billed charges,354.71,85,,,percent of total billed charges,85% of total billed charges,375.57,90,,,percent of total billed charges,90% of total billed charges,417.3,100,,,fee schedule,100% of CO APG rates,417.3,100,,,fee schedule,100% of CO APG rates,417.3,100,,,fee schedule,100% of NM fee schedule,166.92,40,,,percent of total billed charges,40% of total billed charges,166.92,40,,,percent of total billed charges,40% of total billed charges,375.57,90,,,percent of total billed charges,90% of total billed charges,317.15,76,,,percent of total billed charges,76% of total billed charges,166.92,40,,,percent of total billed charges,40% of total billed charges,354.71,85,,,percent of total billed charges,85% of total billed charges,417.3,100,,,fee schedule,100% of CO APG rate,333.84,80,,,percent of total billed charges,80% of total billed charges,161.91,38.8,,,percent of total billed charges,38.8% of total billed charges,354.71,85,,,percent of total billed charges,85% of total billed charges,417.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,161.91,417.3,
TWIST DRILL 2.5MM DIA. AO,46051059,CDM,270,RC,,,OUTPATIENT,,,417.3,333.84,,312.98,75,,,percent of total billed charges,75% of total billed charges,166.92,40,,,percent of total billed charges,40% of total billed charges,330.5,79.2,,,percent of total billed charges,79.2% of total billed charges,354.71,85,,,percent of total billed charges,85% of total billed charges,417.3,100,,,fee schedule,100% of CO APG rates,396.44,95,,,percent of total billed charges,95% of total billed charges,333.84,80,,,percent of total billed charges,80% of total billed charges,354.71,85,,,percent of total billed charges,85% of total billed charges,375.57,90,,,percent of total billed charges,90% of total billed charges,417.3,100,,,fee schedule,100% of CO APG rates,417.3,100,,,fee schedule,100% of CO APG rates,417.3,100,,,fee schedule,100% of NM fee schedule,166.92,40,,,percent of total billed charges,40% of total billed charges,166.92,40,,,percent of total billed charges,40% of total billed charges,375.57,90,,,percent of total billed charges,90% of total billed charges,317.15,76,,,percent of total billed charges,76% of total billed charges,166.92,40,,,percent of total billed charges,40% of total billed charges,354.71,85,,,percent of total billed charges,85% of total billed charges,417.3,100,,,fee schedule,100% of CO APG rate,333.84,80,,,percent of total billed charges,80% of total billed charges,161.91,38.8,,,percent of total billed charges,38.8% of total billed charges,354.71,85,,,percent of total billed charges,85% of total billed charges,417.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,161.91,417.3,
WASHER FOR 1.2 MM BONE SCREWS,46051062,CDM,278,RC,,,OUTPATIENT,,,97.7,78.16,,73.28,75,,,percent of total billed charges,75% of total billed charges,39.08,40,,,percent of total billed charges,40% of total billed charges,77.38,79.2,,,percent of total billed charges,79.2% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,97.7,100,,,fee schedule,100% of CO APG rates,92.82,95,,,percent of total billed charges,95% of total billed charges,78.16,80,,,percent of total billed charges,80% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,87.93,90,,,percent of total billed charges,90% of total billed charges,97.7,100,,,fee schedule,100% of CO APG rates,97.7,100,,,fee schedule,100% of CO APG rates,97.7,100,,,fee schedule,100% of NM fee schedule,39.08,40,,,percent of total billed charges,40% of total billed charges,39.08,40,,,percent of total billed charges,40% of total billed charges,87.93,90,,,percent of total billed charges,90% of total billed charges,74.25,76,,,percent of total billed charges,76% of total billed charges,39.08,40,,,percent of total billed charges,40% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,97.7,100,,,fee schedule,100% of CO APG rate,78.16,80,,,percent of total billed charges,80% of total billed charges,37.91,38.8,,,percent of total billed charges,38.8% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,97.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,37.91,97.7,
WASHER FOR 1.7 MM BONE SCREWS,46051063,CDM,278,RC,,,OUTPATIENT,,,97.7,78.16,,73.28,75,,,percent of total billed charges,75% of total billed charges,39.08,40,,,percent of total billed charges,40% of total billed charges,77.38,79.2,,,percent of total billed charges,79.2% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,97.7,100,,,fee schedule,100% of CO APG rates,92.82,95,,,percent of total billed charges,95% of total billed charges,78.16,80,,,percent of total billed charges,80% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,87.93,90,,,percent of total billed charges,90% of total billed charges,97.7,100,,,fee schedule,100% of CO APG rates,97.7,100,,,fee schedule,100% of CO APG rates,97.7,100,,,fee schedule,100% of NM fee schedule,39.08,40,,,percent of total billed charges,40% of total billed charges,39.08,40,,,percent of total billed charges,40% of total billed charges,87.93,90,,,percent of total billed charges,90% of total billed charges,74.25,76,,,percent of total billed charges,76% of total billed charges,39.08,40,,,percent of total billed charges,40% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,97.7,100,,,fee schedule,100% of CO APG rate,78.16,80,,,percent of total billed charges,80% of total billed charges,37.91,38.8,,,percent of total billed charges,38.8% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,97.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,37.91,97.7,
WASHER FOR 2.3MM BONE SCREWS,46051064,CDM,278,RC,,,OUTPATIENT,,,97.7,78.16,,73.28,75,,,percent of total billed charges,75% of total billed charges,39.08,40,,,percent of total billed charges,40% of total billed charges,77.38,79.2,,,percent of total billed charges,79.2% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,97.7,100,,,fee schedule,100% of CO APG rates,92.82,95,,,percent of total billed charges,95% of total billed charges,78.16,80,,,percent of total billed charges,80% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,87.93,90,,,percent of total billed charges,90% of total billed charges,97.7,100,,,fee schedule,100% of CO APG rates,97.7,100,,,fee schedule,100% of CO APG rates,97.7,100,,,fee schedule,100% of NM fee schedule,39.08,40,,,percent of total billed charges,40% of total billed charges,39.08,40,,,percent of total billed charges,40% of total billed charges,87.93,90,,,percent of total billed charges,90% of total billed charges,74.25,76,,,percent of total billed charges,76% of total billed charges,39.08,40,,,percent of total billed charges,40% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,97.7,100,,,fee schedule,100% of CO APG rate,78.16,80,,,percent of total billed charges,80% of total billed charges,37.91,38.8,,,percent of total billed charges,38.8% of total billed charges,83.05,85,,,percent of total billed charges,85% of total billed charges,97.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,37.91,97.7,
WASHER FOR 2.7MM SCREW,46051065,CDM,278,RC,,,OUTPATIENT,,,327.7,262.16,,245.78,75,,,percent of total billed charges,75% of total billed charges,131.08,40,,,percent of total billed charges,40% of total billed charges,259.54,79.2,,,percent of total billed charges,79.2% of total billed charges,278.55,85,,,percent of total billed charges,85% of total billed charges,327.7,100,,,fee schedule,100% of CO APG rates,311.32,95,,,percent of total billed charges,95% of total billed charges,262.16,80,,,percent of total billed charges,80% of total billed charges,278.55,85,,,percent of total billed charges,85% of total billed charges,294.93,90,,,percent of total billed charges,90% of total billed charges,327.7,100,,,fee schedule,100% of CO APG rates,327.7,100,,,fee schedule,100% of CO APG rates,327.7,100,,,fee schedule,100% of NM fee schedule,131.08,40,,,percent of total billed charges,40% of total billed charges,131.08,40,,,percent of total billed charges,40% of total billed charges,294.93,90,,,percent of total billed charges,90% of total billed charges,249.05,76,,,percent of total billed charges,76% of total billed charges,131.08,40,,,percent of total billed charges,40% of total billed charges,278.55,85,,,percent of total billed charges,85% of total billed charges,327.7,100,,,fee schedule,100% of CO APG rate,262.16,80,,,percent of total billed charges,80% of total billed charges,127.15,38.8,,,percent of total billed charges,38.8% of total billed charges,278.55,85,,,percent of total billed charges,85% of total billed charges,327.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,127.15,327.7,
WASHER FOR 3.5MM SCREW,46051066,CDM,278,RC,,,OUTPATIENT,,,375,300,,281.25,75,,,percent of total billed charges,75% of total billed charges,150,40,,,percent of total billed charges,40% of total billed charges,297,79.2,,,percent of total billed charges,79.2% of total billed charges,318.75,85,,,percent of total billed charges,85% of total billed charges,375,100,,,fee schedule,100% of CO APG rates,356.25,95,,,percent of total billed charges,95% of total billed charges,300,80,,,percent of total billed charges,80% of total billed charges,318.75,85,,,percent of total billed charges,85% of total billed charges,337.5,90,,,percent of total billed charges,90% of total billed charges,375,100,,,fee schedule,100% of CO APG rates,375,100,,,fee schedule,100% of CO APG rates,375,100,,,fee schedule,100% of NM fee schedule,150,40,,,percent of total billed charges,40% of total billed charges,150,40,,,percent of total billed charges,40% of total billed charges,337.5,90,,,percent of total billed charges,90% of total billed charges,285,76,,,percent of total billed charges,76% of total billed charges,150,40,,,percent of total billed charges,40% of total billed charges,318.75,85,,,percent of total billed charges,85% of total billed charges,375,100,,,fee schedule,100% of CO APG rate,300,80,,,percent of total billed charges,80% of total billed charges,145.5,38.8,,,percent of total billed charges,38.8% of total billed charges,318.75,85,,,percent of total billed charges,85% of total billed charges,375,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,145.5,375,
VISCOAT .75,46050035,CDM,270,RC,,,OUTPATIENT,,,277.4,221.92,,208.05,75,,,percent of total billed charges,75% of total billed charges,110.96,40,,,percent of total billed charges,40% of total billed charges,219.7,79.2,,,percent of total billed charges,79.2% of total billed charges,235.79,85,,,percent of total billed charges,85% of total billed charges,277.4,100,,,fee schedule,100% of CO APG rates,263.53,95,,,percent of total billed charges,95% of total billed charges,221.92,80,,,percent of total billed charges,80% of total billed charges,235.79,85,,,percent of total billed charges,85% of total billed charges,249.66,90,,,percent of total billed charges,90% of total billed charges,277.4,100,,,fee schedule,100% of CO APG rates,277.4,100,,,fee schedule,100% of CO APG rates,277.4,100,,,fee schedule,100% of NM fee schedule,110.96,40,,,percent of total billed charges,40% of total billed charges,110.96,40,,,percent of total billed charges,40% of total billed charges,249.66,90,,,percent of total billed charges,90% of total billed charges,210.82,76,,,percent of total billed charges,76% of total billed charges,110.96,40,,,percent of total billed charges,40% of total billed charges,235.79,85,,,percent of total billed charges,85% of total billed charges,277.4,100,,,fee schedule,100% of CO APG rate,221.92,80,,,percent of total billed charges,80% of total billed charges,107.63,38.8,,,percent of total billed charges,38.8% of total billed charges,235.79,85,,,percent of total billed charges,85% of total billed charges,277.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,107.63,277.4,
"CHEST DRAIN SYSTEM ATRIUM, OASIS",31050054,CDM,270,RC,,,OUTPATIENT,,,148.5,118.8,,111.38,75,,,percent of total billed charges,75% of total billed charges,59.4,40,,,percent of total billed charges,40% of total billed charges,117.61,79.2,,,percent of total billed charges,79.2% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,148.5,100,,,fee schedule,100% of CO APG rates,141.08,95,,,percent of total billed charges,95% of total billed charges,118.8,80,,,percent of total billed charges,80% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,133.65,90,,,percent of total billed charges,90% of total billed charges,148.5,100,,,fee schedule,100% of CO APG rates,148.5,100,,,fee schedule,100% of CO APG rates,148.5,100,,,fee schedule,100% of NM fee schedule,59.4,40,,,percent of total billed charges,40% of total billed charges,59.4,40,,,percent of total billed charges,40% of total billed charges,133.65,90,,,percent of total billed charges,90% of total billed charges,112.86,76,,,percent of total billed charges,76% of total billed charges,59.4,40,,,percent of total billed charges,40% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,148.5,100,,,fee schedule,100% of CO APG rate,118.8,80,,,percent of total billed charges,80% of total billed charges,57.62,38.8,,,percent of total billed charges,38.8% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,148.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,57.62,148.5,
SPINAL TRAY W/BUPIV,46250105,CDM,270,RC,,,OUTPATIENT,,,81.9,65.52,,61.43,75,,,percent of total billed charges,75% of total billed charges,32.76,40,,,percent of total billed charges,40% of total billed charges,64.86,79.2,,,percent of total billed charges,79.2% of total billed charges,69.62,85,,,percent of total billed charges,85% of total billed charges,81.9,100,,,fee schedule,100% of CO APG rates,77.81,95,,,percent of total billed charges,95% of total billed charges,65.52,80,,,percent of total billed charges,80% of total billed charges,69.62,85,,,percent of total billed charges,85% of total billed charges,73.71,90,,,percent of total billed charges,90% of total billed charges,81.9,100,,,fee schedule,100% of CO APG rates,81.9,100,,,fee schedule,100% of CO APG rates,81.9,100,,,fee schedule,100% of NM fee schedule,32.76,40,,,percent of total billed charges,40% of total billed charges,32.76,40,,,percent of total billed charges,40% of total billed charges,73.71,90,,,percent of total billed charges,90% of total billed charges,62.24,76,,,percent of total billed charges,76% of total billed charges,32.76,40,,,percent of total billed charges,40% of total billed charges,69.62,85,,,percent of total billed charges,85% of total billed charges,81.9,100,,,fee schedule,100% of CO APG rate,65.52,80,,,percent of total billed charges,80% of total billed charges,31.78,38.8,,,percent of total billed charges,38.8% of total billed charges,69.62,85,,,percent of total billed charges,85% of total billed charges,81.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,31.78,81.9,
ALLIANCE II,46050118,CDM,270,RC,,,OUTPATIENT,,,142,113.6,,106.5,75,,,percent of total billed charges,75% of total billed charges,56.8,40,,,percent of total billed charges,40% of total billed charges,112.46,79.2,,,percent of total billed charges,79.2% of total billed charges,120.7,85,,,percent of total billed charges,85% of total billed charges,142,100,,,fee schedule,100% of CO APG rates,134.9,95,,,percent of total billed charges,95% of total billed charges,113.6,80,,,percent of total billed charges,80% of total billed charges,120.7,85,,,percent of total billed charges,85% of total billed charges,127.8,90,,,percent of total billed charges,90% of total billed charges,142,100,,,fee schedule,100% of CO APG rates,142,100,,,fee schedule,100% of CO APG rates,142,100,,,fee schedule,100% of NM fee schedule,56.8,40,,,percent of total billed charges,40% of total billed charges,56.8,40,,,percent of total billed charges,40% of total billed charges,127.8,90,,,percent of total billed charges,90% of total billed charges,107.92,76,,,percent of total billed charges,76% of total billed charges,56.8,40,,,percent of total billed charges,40% of total billed charges,120.7,85,,,percent of total billed charges,85% of total billed charges,142,100,,,fee schedule,100% of CO APG rate,113.6,80,,,percent of total billed charges,80% of total billed charges,55.1,38.8,,,percent of total billed charges,38.8% of total billed charges,120.7,85,,,percent of total billed charges,85% of total billed charges,142,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,55.1,142,
"RADIAL JAW 4, COLD, LARGE CAPACITY WITH NEEDLE, 2.8MM",50121,CDM,270,RC,,,OUTPATIENT,,,101.7,81.36,,76.28,75,,,percent of total billed charges,75% of total billed charges,40.68,40,,,percent of total billed charges,40% of total billed charges,80.55,79.2,,,percent of total billed charges,79.2% of total billed charges,86.45,85,,,percent of total billed charges,85% of total billed charges,101.7,100,,,fee schedule,100% of CO APG rates,96.62,95,,,percent of total billed charges,95% of total billed charges,81.36,80,,,percent of total billed charges,80% of total billed charges,86.45,85,,,percent of total billed charges,85% of total billed charges,91.53,90,,,percent of total billed charges,90% of total billed charges,101.7,100,,,fee schedule,100% of CO APG rates,101.7,100,,,fee schedule,100% of CO APG rates,101.7,100,,,fee schedule,100% of NM fee schedule,40.68,40,,,percent of total billed charges,40% of total billed charges,40.68,40,,,percent of total billed charges,40% of total billed charges,91.53,90,,,percent of total billed charges,90% of total billed charges,77.29,76,,,percent of total billed charges,76% of total billed charges,40.68,40,,,percent of total billed charges,40% of total billed charges,86.45,85,,,percent of total billed charges,85% of total billed charges,101.7,100,,,fee schedule,100% of CO APG rate,81.36,80,,,percent of total billed charges,80% of total billed charges,39.46,38.8,,,percent of total billed charges,38.8% of total billed charges,86.45,85,,,percent of total billed charges,85% of total billed charges,101.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,39.46,101.7,
INJECT GOLD PROBE,46050126,CDM,270,RC,,,OUTPATIENT,,,768,614.4,,576,75,,,percent of total billed charges,75% of total billed charges,307.2,40,,,percent of total billed charges,40% of total billed charges,608.26,79.2,,,percent of total billed charges,79.2% of total billed charges,652.8,85,,,percent of total billed charges,85% of total billed charges,768,100,,,fee schedule,100% of CO APG rates,729.6,95,,,percent of total billed charges,95% of total billed charges,614.4,80,,,percent of total billed charges,80% of total billed charges,652.8,85,,,percent of total billed charges,85% of total billed charges,691.2,90,,,percent of total billed charges,90% of total billed charges,768,100,,,fee schedule,100% of CO APG rates,768,100,,,fee schedule,100% of CO APG rates,768,100,,,fee schedule,100% of NM fee schedule,307.2,40,,,percent of total billed charges,40% of total billed charges,307.2,40,,,percent of total billed charges,40% of total billed charges,691.2,90,,,percent of total billed charges,90% of total billed charges,583.68,76,,,percent of total billed charges,76% of total billed charges,307.2,40,,,percent of total billed charges,40% of total billed charges,652.8,85,,,percent of total billed charges,85% of total billed charges,768,100,,,fee schedule,100% of CO APG rate,614.4,80,,,percent of total billed charges,80% of total billed charges,297.98,38.8,,,percent of total billed charges,38.8% of total billed charges,652.8,85,,,percent of total billed charges,85% of total billed charges,768,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,297.98,768,
CENTRAL LINE KITS 7 FR,31050135,CDM,270,RC,,,OUTPATIENT,,,540.8,432.64,,405.6,75,,,percent of total billed charges,75% of total billed charges,216.32,40,,,percent of total billed charges,40% of total billed charges,428.31,79.2,,,percent of total billed charges,79.2% of total billed charges,459.68,85,,,percent of total billed charges,85% of total billed charges,540.8,100,,,fee schedule,100% of CO APG rates,513.76,95,,,percent of total billed charges,95% of total billed charges,432.64,80,,,percent of total billed charges,80% of total billed charges,459.68,85,,,percent of total billed charges,85% of total billed charges,486.72,90,,,percent of total billed charges,90% of total billed charges,540.8,100,,,fee schedule,100% of CO APG rates,540.8,100,,,fee schedule,100% of CO APG rates,540.8,100,,,fee schedule,100% of NM fee schedule,216.32,40,,,percent of total billed charges,40% of total billed charges,216.32,40,,,percent of total billed charges,40% of total billed charges,486.72,90,,,percent of total billed charges,90% of total billed charges,411.01,76,,,percent of total billed charges,76% of total billed charges,216.32,40,,,percent of total billed charges,40% of total billed charges,459.68,85,,,percent of total billed charges,85% of total billed charges,540.8,100,,,fee schedule,100% of CO APG rate,432.64,80,,,percent of total billed charges,80% of total billed charges,209.83,38.8,,,percent of total billed charges,38.8% of total billed charges,459.68,85,,,percent of total billed charges,85% of total billed charges,540.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,209.83,540.8,
"ANTI-EMBOLISM STOCKING, KNEE SM REGULAR",52878,CDM,270,RC,,,OUTPATIENT,,,28.3,22.64,,21.23,75,,,percent of total billed charges,75% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,22.41,79.2,,,percent of total billed charges,79.2% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,28.3,100,,,fee schedule,100% of CO APG rates,26.89,95,,,percent of total billed charges,95% of total billed charges,22.64,80,,,percent of total billed charges,80% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,25.47,90,,,percent of total billed charges,90% of total billed charges,28.3,100,,,fee schedule,100% of CO APG rates,28.3,100,,,fee schedule,100% of CO APG rates,28.3,100,,,fee schedule,100% of NM fee schedule,11.32,40,,,percent of total billed charges,40% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,25.47,90,,,percent of total billed charges,90% of total billed charges,21.51,76,,,percent of total billed charges,76% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,28.3,100,,,fee schedule,100% of CO APG rate,22.64,80,,,percent of total billed charges,80% of total billed charges,10.98,38.8,,,percent of total billed charges,38.8% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,28.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,10.98,28.3,
"CENTRAL LINE INSERTION TRAY 7 FR, 20 CM",31050178,CDM,278,RC,,,OUTPATIENT,,,551.5,441.2,,413.63,75,,,percent of total billed charges,75% of total billed charges,220.6,40,,,percent of total billed charges,40% of total billed charges,436.79,79.2,,,percent of total billed charges,79.2% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,551.5,100,,,fee schedule,100% of CO APG rates,523.93,95,,,percent of total billed charges,95% of total billed charges,441.2,80,,,percent of total billed charges,80% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,496.35,90,,,percent of total billed charges,90% of total billed charges,551.5,100,,,fee schedule,100% of CO APG rates,551.5,100,,,fee schedule,100% of CO APG rates,551.5,100,,,fee schedule,100% of NM fee schedule,220.6,40,,,percent of total billed charges,40% of total billed charges,220.6,40,,,percent of total billed charges,40% of total billed charges,496.35,90,,,percent of total billed charges,90% of total billed charges,419.14,76,,,percent of total billed charges,76% of total billed charges,220.6,40,,,percent of total billed charges,40% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,551.5,100,,,fee schedule,100% of CO APG rate,441.2,80,,,percent of total billed charges,80% of total billed charges,213.98,38.8,,,percent of total billed charges,38.8% of total billed charges,468.78,85,,,percent of total billed charges,85% of total billed charges,551.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,213.98,551.5,
CENTRAL VENOUS TRAY,31050180,CDM,270,RC,,,OUTPATIENT,,,642.5,514,,481.88,75,,,percent of total billed charges,75% of total billed charges,257,40,,,percent of total billed charges,40% of total billed charges,508.86,79.2,,,percent of total billed charges,79.2% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,642.5,100,,,fee schedule,100% of CO APG rates,610.38,95,,,percent of total billed charges,95% of total billed charges,514,80,,,percent of total billed charges,80% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,578.25,90,,,percent of total billed charges,90% of total billed charges,642.5,100,,,fee schedule,100% of CO APG rates,642.5,100,,,fee schedule,100% of CO APG rates,642.5,100,,,fee schedule,100% of NM fee schedule,257,40,,,percent of total billed charges,40% of total billed charges,257,40,,,percent of total billed charges,40% of total billed charges,578.25,90,,,percent of total billed charges,90% of total billed charges,488.3,76,,,percent of total billed charges,76% of total billed charges,257,40,,,percent of total billed charges,40% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,642.5,100,,,fee schedule,100% of CO APG rate,514,80,,,percent of total billed charges,80% of total billed charges,249.29,38.8,,,percent of total billed charges,38.8% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,642.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,249.29,642.5,
CRICOTHYROTOMY TRAY,50181,CDM,270,RC,,,OUTPATIENT,,,1379.8,1103.84,,1034.85,75,,,percent of total billed charges,75% of total billed charges,551.92,40,,,percent of total billed charges,40% of total billed charges,1092.8,79.2,,,percent of total billed charges,79.2% of total billed charges,1172.83,85,,,percent of total billed charges,85% of total billed charges,1379.8,100,,,fee schedule,100% of CO APG rates,1310.81,95,,,percent of total billed charges,95% of total billed charges,1103.84,80,,,percent of total billed charges,80% of total billed charges,1172.83,85,,,percent of total billed charges,85% of total billed charges,1241.82,90,,,percent of total billed charges,90% of total billed charges,1379.8,100,,,fee schedule,100% of CO APG rates,1379.8,100,,,fee schedule,100% of CO APG rates,1379.8,100,,,fee schedule,100% of NM fee schedule,551.92,40,,,percent of total billed charges,40% of total billed charges,551.92,40,,,percent of total billed charges,40% of total billed charges,1241.82,90,,,percent of total billed charges,90% of total billed charges,1048.65,76,,,percent of total billed charges,76% of total billed charges,551.92,40,,,percent of total billed charges,40% of total billed charges,1172.83,85,,,percent of total billed charges,85% of total billed charges,1379.8,100,,,fee schedule,100% of CO APG rate,1103.84,80,,,percent of total billed charges,80% of total billed charges,535.36,38.8,,,percent of total billed charges,38.8% of total billed charges,1172.83,85,,,percent of total billed charges,85% of total billed charges,1379.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,535.36,1379.8,
"CENTRAL LINE INSERTION TRAY 8 FR, 20 CM",31050183,CDM,270,RC,,,OUTPATIENT,,,642.5,514,,481.88,75,,,percent of total billed charges,75% of total billed charges,257,40,,,percent of total billed charges,40% of total billed charges,508.86,79.2,,,percent of total billed charges,79.2% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,642.5,100,,,fee schedule,100% of CO APG rates,610.38,95,,,percent of total billed charges,95% of total billed charges,514,80,,,percent of total billed charges,80% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,578.25,90,,,percent of total billed charges,90% of total billed charges,642.5,100,,,fee schedule,100% of CO APG rates,642.5,100,,,fee schedule,100% of CO APG rates,642.5,100,,,fee schedule,100% of NM fee schedule,257,40,,,percent of total billed charges,40% of total billed charges,257,40,,,percent of total billed charges,40% of total billed charges,578.25,90,,,percent of total billed charges,90% of total billed charges,488.3,76,,,percent of total billed charges,76% of total billed charges,257,40,,,percent of total billed charges,40% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,642.5,100,,,fee schedule,100% of CO APG rate,514,80,,,percent of total billed charges,80% of total billed charges,249.29,38.8,,,percent of total billed charges,38.8% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,642.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,249.29,642.5,
NEEDLE CATH CENTESIS 5X19,50187,CDM,270,RC,,,OUTPATIENT,,,189,151.2,,141.75,75,,,percent of total billed charges,75% of total billed charges,75.6,40,,,percent of total billed charges,40% of total billed charges,149.69,79.2,,,percent of total billed charges,79.2% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,189,100,,,fee schedule,100% of CO APG rates,179.55,95,,,percent of total billed charges,95% of total billed charges,151.2,80,,,percent of total billed charges,80% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,170.1,90,,,percent of total billed charges,90% of total billed charges,189,100,,,fee schedule,100% of CO APG rates,189,100,,,fee schedule,100% of CO APG rates,189,100,,,fee schedule,100% of NM fee schedule,75.6,40,,,percent of total billed charges,40% of total billed charges,75.6,40,,,percent of total billed charges,40% of total billed charges,170.1,90,,,percent of total billed charges,90% of total billed charges,143.64,76,,,percent of total billed charges,76% of total billed charges,75.6,40,,,percent of total billed charges,40% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,189,100,,,fee schedule,100% of CO APG rate,151.2,80,,,percent of total billed charges,80% of total billed charges,73.33,38.8,,,percent of total billed charges,38.8% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,189,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,73.33,189,
LIGASURE CURVED SM LF1212A,46050194,CDM,270,RC,,,OUTPATIENT,,,1413.6,1130.88,,1060.2,75,,,percent of total billed charges,75% of total billed charges,565.44,40,,,percent of total billed charges,40% of total billed charges,1119.57,79.2,,,percent of total billed charges,79.2% of total billed charges,1201.56,85,,,percent of total billed charges,85% of total billed charges,1413.6,100,,,fee schedule,100% of CO APG rates,1342.92,95,,,percent of total billed charges,95% of total billed charges,1130.88,80,,,percent of total billed charges,80% of total billed charges,1201.56,85,,,percent of total billed charges,85% of total billed charges,1272.24,90,,,percent of total billed charges,90% of total billed charges,1413.6,100,,,fee schedule,100% of CO APG rates,1413.6,100,,,fee schedule,100% of CO APG rates,1413.6,100,,,fee schedule,100% of NM fee schedule,565.44,40,,,percent of total billed charges,40% of total billed charges,565.44,40,,,percent of total billed charges,40% of total billed charges,1272.24,90,,,percent of total billed charges,90% of total billed charges,1074.34,76,,,percent of total billed charges,76% of total billed charges,565.44,40,,,percent of total billed charges,40% of total billed charges,1201.56,85,,,percent of total billed charges,85% of total billed charges,1413.6,100,,,fee schedule,100% of CO APG rate,1130.88,80,,,percent of total billed charges,80% of total billed charges,548.48,38.8,,,percent of total billed charges,38.8% of total billed charges,1201.56,85,,,percent of total billed charges,85% of total billed charges,1413.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,548.48,1413.6,
LIGASURE LAP LF1537,46050195,CDM,270,RC,,,OUTPATIENT,,,1378.5,1102.8,,1033.88,75,,,percent of total billed charges,75% of total billed charges,551.4,40,,,percent of total billed charges,40% of total billed charges,1091.77,79.2,,,percent of total billed charges,79.2% of total billed charges,1171.73,85,,,percent of total billed charges,85% of total billed charges,1378.5,100,,,fee schedule,100% of CO APG rates,1309.58,95,,,percent of total billed charges,95% of total billed charges,1102.8,80,,,percent of total billed charges,80% of total billed charges,1171.73,85,,,percent of total billed charges,85% of total billed charges,1240.65,90,,,percent of total billed charges,90% of total billed charges,1378.5,100,,,fee schedule,100% of CO APG rates,1378.5,100,,,fee schedule,100% of CO APG rates,1378.5,100,,,fee schedule,100% of NM fee schedule,551.4,40,,,percent of total billed charges,40% of total billed charges,551.4,40,,,percent of total billed charges,40% of total billed charges,1240.65,90,,,percent of total billed charges,90% of total billed charges,1047.66,76,,,percent of total billed charges,76% of total billed charges,551.4,40,,,percent of total billed charges,40% of total billed charges,1171.73,85,,,percent of total billed charges,85% of total billed charges,1378.5,100,,,fee schedule,100% of CO APG rate,1102.8,80,,,percent of total billed charges,80% of total billed charges,534.86,38.8,,,percent of total billed charges,38.8% of total billed charges,1171.73,85,,,percent of total billed charges,85% of total billed charges,1378.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,534.86,1378.5,
LIGASURE OPEN,46050196,CDM,270,RC,,,OUTPATIENT,,,1750.1,1400.08,,1312.58,75,,,percent of total billed charges,75% of total billed charges,700.04,40,,,percent of total billed charges,40% of total billed charges,1386.08,79.2,,,percent of total billed charges,79.2% of total billed charges,1487.59,85,,,percent of total billed charges,85% of total billed charges,1750.1,100,,,fee schedule,100% of CO APG rates,1662.6,95,,,percent of total billed charges,95% of total billed charges,1400.08,80,,,percent of total billed charges,80% of total billed charges,1487.59,85,,,percent of total billed charges,85% of total billed charges,1575.09,90,,,percent of total billed charges,90% of total billed charges,1750.1,100,,,fee schedule,100% of CO APG rates,1750.1,100,,,fee schedule,100% of CO APG rates,1750.1,100,,,fee schedule,100% of NM fee schedule,700.04,40,,,percent of total billed charges,40% of total billed charges,700.04,40,,,percent of total billed charges,40% of total billed charges,1575.09,90,,,percent of total billed charges,90% of total billed charges,1330.08,76,,,percent of total billed charges,76% of total billed charges,700.04,40,,,percent of total billed charges,40% of total billed charges,1487.59,85,,,percent of total billed charges,85% of total billed charges,1750.1,100,,,fee schedule,100% of CO APG rate,1400.08,80,,,percent of total billed charges,80% of total billed charges,679.04,38.8,,,percent of total billed charges,38.8% of total billed charges,1487.59,85,,,percent of total billed charges,85% of total billed charges,1750.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,679.04,1750.1,
TRACH TUBE SHILEY SZ 8 CUFFED,31050199,CDM,270,RC,,,OUTPATIENT,,,377,301.6,,282.75,75,,,percent of total billed charges,75% of total billed charges,150.8,40,,,percent of total billed charges,40% of total billed charges,298.58,79.2,,,percent of total billed charges,79.2% of total billed charges,320.45,85,,,percent of total billed charges,85% of total billed charges,377,100,,,fee schedule,100% of CO APG rates,358.15,95,,,percent of total billed charges,95% of total billed charges,301.6,80,,,percent of total billed charges,80% of total billed charges,320.45,85,,,percent of total billed charges,85% of total billed charges,339.3,90,,,percent of total billed charges,90% of total billed charges,377,100,,,fee schedule,100% of CO APG rates,377,100,,,fee schedule,100% of CO APG rates,377,100,,,fee schedule,100% of NM fee schedule,150.8,40,,,percent of total billed charges,40% of total billed charges,150.8,40,,,percent of total billed charges,40% of total billed charges,339.3,90,,,percent of total billed charges,90% of total billed charges,286.52,76,,,percent of total billed charges,76% of total billed charges,150.8,40,,,percent of total billed charges,40% of total billed charges,320.45,85,,,percent of total billed charges,85% of total billed charges,377,100,,,fee schedule,100% of CO APG rate,301.6,80,,,percent of total billed charges,80% of total billed charges,146.28,38.8,,,percent of total billed charges,38.8% of total billed charges,320.45,85,,,percent of total billed charges,85% of total billed charges,377,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,146.28,377,
TRACH TUBE SHILEY SZ4,31050200,CDM,270,RC,,,OUTPATIENT,,,245.7,196.56,,184.28,75,,,percent of total billed charges,75% of total billed charges,98.28,40,,,percent of total billed charges,40% of total billed charges,194.59,79.2,,,percent of total billed charges,79.2% of total billed charges,208.85,85,,,percent of total billed charges,85% of total billed charges,245.7,100,,,fee schedule,100% of CO APG rates,233.42,95,,,percent of total billed charges,95% of total billed charges,196.56,80,,,percent of total billed charges,80% of total billed charges,208.85,85,,,percent of total billed charges,85% of total billed charges,221.13,90,,,percent of total billed charges,90% of total billed charges,245.7,100,,,fee schedule,100% of CO APG rates,245.7,100,,,fee schedule,100% of CO APG rates,245.7,100,,,fee schedule,100% of NM fee schedule,98.28,40,,,percent of total billed charges,40% of total billed charges,98.28,40,,,percent of total billed charges,40% of total billed charges,221.13,90,,,percent of total billed charges,90% of total billed charges,186.73,76,,,percent of total billed charges,76% of total billed charges,98.28,40,,,percent of total billed charges,40% of total billed charges,208.85,85,,,percent of total billed charges,85% of total billed charges,245.7,100,,,fee schedule,100% of CO APG rate,196.56,80,,,percent of total billed charges,80% of total billed charges,95.33,38.8,,,percent of total billed charges,38.8% of total billed charges,208.85,85,,,percent of total billed charges,85% of total billed charges,245.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.33,245.7,
TRACH TUBE SHILEY SZ6,31050201,CDM,270,RC,,,OUTPATIENT,,,245.7,196.56,,184.28,75,,,percent of total billed charges,75% of total billed charges,98.28,40,,,percent of total billed charges,40% of total billed charges,194.59,79.2,,,percent of total billed charges,79.2% of total billed charges,208.85,85,,,percent of total billed charges,85% of total billed charges,245.7,100,,,fee schedule,100% of CO APG rates,233.42,95,,,percent of total billed charges,95% of total billed charges,196.56,80,,,percent of total billed charges,80% of total billed charges,208.85,85,,,percent of total billed charges,85% of total billed charges,221.13,90,,,percent of total billed charges,90% of total billed charges,245.7,100,,,fee schedule,100% of CO APG rates,245.7,100,,,fee schedule,100% of CO APG rates,245.7,100,,,fee schedule,100% of NM fee schedule,98.28,40,,,percent of total billed charges,40% of total billed charges,98.28,40,,,percent of total billed charges,40% of total billed charges,221.13,90,,,percent of total billed charges,90% of total billed charges,186.73,76,,,percent of total billed charges,76% of total billed charges,98.28,40,,,percent of total billed charges,40% of total billed charges,208.85,85,,,percent of total billed charges,85% of total billed charges,245.7,100,,,fee schedule,100% of CO APG rate,196.56,80,,,percent of total billed charges,80% of total billed charges,95.33,38.8,,,percent of total billed charges,38.8% of total billed charges,208.85,85,,,percent of total billed charges,85% of total billed charges,245.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,95.33,245.7,
PNEUMONEEDLE INSUFFLATION 120MM  PN120,46050210,CDM,270,RC,,,OUTPATIENT,,,56.7,45.36,,42.53,75,,,percent of total billed charges,75% of total billed charges,22.68,40,,,percent of total billed charges,40% of total billed charges,44.91,79.2,,,percent of total billed charges,79.2% of total billed charges,48.2,85,,,percent of total billed charges,85% of total billed charges,56.7,100,,,fee schedule,100% of CO APG rates,53.87,95,,,percent of total billed charges,95% of total billed charges,45.36,80,,,percent of total billed charges,80% of total billed charges,48.2,85,,,percent of total billed charges,85% of total billed charges,51.03,90,,,percent of total billed charges,90% of total billed charges,56.7,100,,,fee schedule,100% of CO APG rates,56.7,100,,,fee schedule,100% of CO APG rates,56.7,100,,,fee schedule,100% of NM fee schedule,22.68,40,,,percent of total billed charges,40% of total billed charges,22.68,40,,,percent of total billed charges,40% of total billed charges,51.03,90,,,percent of total billed charges,90% of total billed charges,43.09,76,,,percent of total billed charges,76% of total billed charges,22.68,40,,,percent of total billed charges,40% of total billed charges,48.2,85,,,percent of total billed charges,85% of total billed charges,56.7,100,,,fee schedule,100% of CO APG rate,45.36,80,,,percent of total billed charges,80% of total billed charges,22,38.8,,,percent of total billed charges,38.8% of total billed charges,48.2,85,,,percent of total billed charges,85% of total billed charges,56.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,22,56.7,
SLEEVE SCD KNEE MED,50215,CDM,270,RC,,,OUTPATIENT,,,234.8,187.84,,176.1,75,,,percent of total billed charges,75% of total billed charges,93.92,40,,,percent of total billed charges,40% of total billed charges,185.96,79.2,,,percent of total billed charges,79.2% of total billed charges,199.58,85,,,percent of total billed charges,85% of total billed charges,234.8,100,,,fee schedule,100% of CO APG rates,223.06,95,,,percent of total billed charges,95% of total billed charges,187.84,80,,,percent of total billed charges,80% of total billed charges,199.58,85,,,percent of total billed charges,85% of total billed charges,211.32,90,,,percent of total billed charges,90% of total billed charges,234.8,100,,,fee schedule,100% of CO APG rates,234.8,100,,,fee schedule,100% of CO APG rates,234.8,100,,,fee schedule,100% of NM fee schedule,93.92,40,,,percent of total billed charges,40% of total billed charges,93.92,40,,,percent of total billed charges,40% of total billed charges,211.32,90,,,percent of total billed charges,90% of total billed charges,178.45,76,,,percent of total billed charges,76% of total billed charges,93.92,40,,,percent of total billed charges,40% of total billed charges,199.58,85,,,percent of total billed charges,85% of total billed charges,234.8,100,,,fee schedule,100% of CO APG rate,187.84,80,,,percent of total billed charges,80% of total billed charges,91.1,38.8,,,percent of total billed charges,38.8% of total billed charges,199.58,85,,,percent of total billed charges,85% of total billed charges,234.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,91.1,234.8,
STOCKING KNEE  MED REGULAR,52879,CDM,270,RC,,,OUTPATIENT,,,28.3,22.64,,21.23,75,,,percent of total billed charges,75% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,22.41,79.2,,,percent of total billed charges,79.2% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,28.3,100,,,fee schedule,100% of CO APG rates,26.89,95,,,percent of total billed charges,95% of total billed charges,22.64,80,,,percent of total billed charges,80% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,25.47,90,,,percent of total billed charges,90% of total billed charges,28.3,100,,,fee schedule,100% of CO APG rates,28.3,100,,,fee schedule,100% of CO APG rates,28.3,100,,,fee schedule,100% of NM fee schedule,11.32,40,,,percent of total billed charges,40% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,25.47,90,,,percent of total billed charges,90% of total billed charges,21.51,76,,,percent of total billed charges,76% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,28.3,100,,,fee schedule,100% of CO APG rate,22.64,80,,,percent of total billed charges,80% of total billed charges,10.98,38.8,,,percent of total billed charges,38.8% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,28.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,10.98,28.3,
"ANTI-EMBOLISM STOCKING, THIGH  MED SHORT",52872,CDM,270,RC,,,OUTPATIENT,,,29.4,23.52,,22.05,75,,,percent of total billed charges,75% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,23.28,79.2,,,percent of total billed charges,79.2% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rates,27.93,95,,,percent of total billed charges,95% of total billed charges,23.52,80,,,percent of total billed charges,80% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,26.46,90,,,percent of total billed charges,90% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rates,29.4,100,,,fee schedule,100% of CO APG rates,29.4,100,,,fee schedule,100% of NM fee schedule,11.76,40,,,percent of total billed charges,40% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,26.46,90,,,percent of total billed charges,90% of total billed charges,22.34,76,,,percent of total billed charges,76% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rate,23.52,80,,,percent of total billed charges,80% of total billed charges,11.41,38.8,,,percent of total billed charges,38.8% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,11.41,29.4,
INFINITY ID FLOW SENSOR ADULT,42250299,CDM,270,RC,,,OUTPATIENT,,,90.7,72.56,,68.03,75,,,percent of total billed charges,75% of total billed charges,36.28,40,,,percent of total billed charges,40% of total billed charges,71.83,79.2,,,percent of total billed charges,79.2% of total billed charges,77.1,85,,,percent of total billed charges,85% of total billed charges,90.7,100,,,fee schedule,100% of CO APG rates,86.17,95,,,percent of total billed charges,95% of total billed charges,72.56,80,,,percent of total billed charges,80% of total billed charges,77.1,85,,,percent of total billed charges,85% of total billed charges,81.63,90,,,percent of total billed charges,90% of total billed charges,90.7,100,,,fee schedule,100% of CO APG rates,90.7,100,,,fee schedule,100% of CO APG rates,90.7,100,,,fee schedule,100% of NM fee schedule,36.28,40,,,percent of total billed charges,40% of total billed charges,36.28,40,,,percent of total billed charges,40% of total billed charges,81.63,90,,,percent of total billed charges,90% of total billed charges,68.93,76,,,percent of total billed charges,76% of total billed charges,36.28,40,,,percent of total billed charges,40% of total billed charges,77.1,85,,,percent of total billed charges,85% of total billed charges,90.7,100,,,fee schedule,100% of CO APG rate,72.56,80,,,percent of total billed charges,80% of total billed charges,35.19,38.8,,,percent of total billed charges,38.8% of total billed charges,77.1,85,,,percent of total billed charges,85% of total billed charges,90.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.19,90.7,
INFINITY ID EXPIRATORY VALVE,42250300,CDM,270,RC,,,OUTPATIENT,,,75.4,60.32,,56.55,75,,,percent of total billed charges,75% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,59.72,79.2,,,percent of total billed charges,79.2% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,75.4,100,,,fee schedule,100% of CO APG rates,71.63,95,,,percent of total billed charges,95% of total billed charges,60.32,80,,,percent of total billed charges,80% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,75.4,100,,,fee schedule,100% of CO APG rates,75.4,100,,,fee schedule,100% of CO APG rates,75.4,100,,,fee schedule,100% of NM fee schedule,30.16,40,,,percent of total billed charges,40% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,57.3,76,,,percent of total billed charges,76% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,75.4,100,,,fee schedule,100% of CO APG rate,60.32,80,,,percent of total billed charges,80% of total billed charges,29.26,38.8,,,percent of total billed charges,38.8% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,75.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,29.26,75.4,
BREATHING HOSE,42250301,CDM,270,RC,,,OUTPATIENT,,,242.6,194.08,,181.95,75,,,percent of total billed charges,75% of total billed charges,97.04,40,,,percent of total billed charges,40% of total billed charges,192.14,79.2,,,percent of total billed charges,79.2% of total billed charges,206.21,85,,,percent of total billed charges,85% of total billed charges,242.6,100,,,fee schedule,100% of CO APG rates,230.47,95,,,percent of total billed charges,95% of total billed charges,194.08,80,,,percent of total billed charges,80% of total billed charges,206.21,85,,,percent of total billed charges,85% of total billed charges,218.34,90,,,percent of total billed charges,90% of total billed charges,242.6,100,,,fee schedule,100% of CO APG rates,242.6,100,,,fee schedule,100% of CO APG rates,242.6,100,,,fee schedule,100% of NM fee schedule,97.04,40,,,percent of total billed charges,40% of total billed charges,97.04,40,,,percent of total billed charges,40% of total billed charges,218.34,90,,,percent of total billed charges,90% of total billed charges,184.38,76,,,percent of total billed charges,76% of total billed charges,97.04,40,,,percent of total billed charges,40% of total billed charges,206.21,85,,,percent of total billed charges,85% of total billed charges,242.6,100,,,fee schedule,100% of CO APG rate,194.08,80,,,percent of total billed charges,80% of total billed charges,94.13,38.8,,,percent of total billed charges,38.8% of total billed charges,206.21,85,,,percent of total billed charges,85% of total billed charges,242.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,94.13,242.6,
NEONATAL FLOW SENSOR ISO15,42250302,CDM,270,RC,,,OUTPATIENT,,,424.8,339.84,,318.6,75,,,percent of total billed charges,75% of total billed charges,169.92,40,,,percent of total billed charges,40% of total billed charges,336.44,79.2,,,percent of total billed charges,79.2% of total billed charges,361.08,85,,,percent of total billed charges,85% of total billed charges,424.8,100,,,fee schedule,100% of CO APG rates,403.56,95,,,percent of total billed charges,95% of total billed charges,339.84,80,,,percent of total billed charges,80% of total billed charges,361.08,85,,,percent of total billed charges,85% of total billed charges,382.32,90,,,percent of total billed charges,90% of total billed charges,424.8,100,,,fee schedule,100% of CO APG rates,424.8,100,,,fee schedule,100% of CO APG rates,424.8,100,,,fee schedule,100% of NM fee schedule,169.92,40,,,percent of total billed charges,40% of total billed charges,169.92,40,,,percent of total billed charges,40% of total billed charges,382.32,90,,,percent of total billed charges,90% of total billed charges,322.85,76,,,percent of total billed charges,76% of total billed charges,169.92,40,,,percent of total billed charges,40% of total billed charges,361.08,85,,,percent of total billed charges,85% of total billed charges,424.8,100,,,fee schedule,100% of CO APG rate,339.84,80,,,percent of total billed charges,80% of total billed charges,164.82,38.8,,,percent of total billed charges,38.8% of total billed charges,361.08,85,,,percent of total billed charges,85% of total billed charges,424.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,164.82,424.8,
OXYGEN CANNULA OXYMIZER,50303,CDM,270,RC,,,OUTPATIENT,,,75.4,60.32,,56.55,75,,,percent of total billed charges,75% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,59.72,79.2,,,percent of total billed charges,79.2% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,75.4,100,,,fee schedule,100% of CO APG rates,71.63,95,,,percent of total billed charges,95% of total billed charges,60.32,80,,,percent of total billed charges,80% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,75.4,100,,,fee schedule,100% of CO APG rates,75.4,100,,,fee schedule,100% of CO APG rates,75.4,100,,,fee schedule,100% of NM fee schedule,30.16,40,,,percent of total billed charges,40% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,57.3,76,,,percent of total billed charges,76% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,75.4,100,,,fee schedule,100% of CO APG rate,60.32,80,,,percent of total billed charges,80% of total billed charges,29.26,38.8,,,percent of total billed charges,38.8% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,75.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,29.26,75.4,
SUTURE 4-0  VICRYL CTD FS-2 J392H,50354,CDM,270,RC,,,OUTPATIENT,,,8.8,7.04,,6.6,75,,,percent of total billed charges,75% of total billed charges,3.52,40,,,percent of total billed charges,40% of total billed charges,6.97,79.2,,,percent of total billed charges,79.2% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,8.8,100,,,fee schedule,100% of CO APG rates,8.36,95,,,percent of total billed charges,95% of total billed charges,7.04,80,,,percent of total billed charges,80% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,7.92,90,,,percent of total billed charges,90% of total billed charges,8.8,100,,,fee schedule,100% of CO APG rates,8.8,100,,,fee schedule,100% of CO APG rates,8.8,100,,,fee schedule,100% of NM fee schedule,3.52,40,,,percent of total billed charges,40% of total billed charges,3.52,40,,,percent of total billed charges,40% of total billed charges,7.92,90,,,percent of total billed charges,90% of total billed charges,6.69,76,,,percent of total billed charges,76% of total billed charges,3.52,40,,,percent of total billed charges,40% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,8.8,100,,,fee schedule,100% of CO APG rate,7.04,80,,,percent of total billed charges,80% of total billed charges,3.41,38.8,,,percent of total billed charges,38.8% of total billed charges,7.48,85,,,percent of total billed charges,85% of total billed charges,8.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.41,8.8,
SUTURE 5-0 ETHILON P-3 698G,50355,CDM,270,RC,,,OUTPATIENT,,,14.3,11.44,,10.73,75,,,percent of total billed charges,75% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,11.33,79.2,,,percent of total billed charges,79.2% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,13.59,95,,,percent of total billed charges,95% of total billed charges,11.44,80,,,percent of total billed charges,80% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of NM fee schedule,5.72,40,,,percent of total billed charges,40% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,10.87,76,,,percent of total billed charges,76% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rate,11.44,80,,,percent of total billed charges,80% of total billed charges,5.55,38.8,,,percent of total billed charges,38.8% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.55,14.3,
SUTURE 6-0 ETHILON P-1 697G,46050356,CDM,270,RC,,,OUTPATIENT,,,16.4,13.12,,12.3,75,,,percent of total billed charges,75% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,12.99,79.2,,,percent of total billed charges,79.2% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,15.58,95,,,percent of total billed charges,95% of total billed charges,13.12,80,,,percent of total billed charges,80% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of NM fee schedule,6.56,40,,,percent of total billed charges,40% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,12.46,76,,,percent of total billed charges,76% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rate,13.12,80,,,percent of total billed charges,80% of total billed charges,6.36,38.8,,,percent of total billed charges,38.8% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.36,16.4,
SUTURE 2-0 PROLENE FS 8685H,50357,CDM,270,RC,,,OUTPATIENT,,,9.9,7.92,,7.43,75,,,percent of total billed charges,75% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,7.84,79.2,,,percent of total billed charges,79.2% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rates,9.41,95,,,percent of total billed charges,95% of total billed charges,7.92,80,,,percent of total billed charges,80% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,8.91,90,,,percent of total billed charges,90% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rates,9.9,100,,,fee schedule,100% of CO APG rates,9.9,100,,,fee schedule,100% of NM fee schedule,3.96,40,,,percent of total billed charges,40% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,8.91,90,,,percent of total billed charges,90% of total billed charges,7.52,76,,,percent of total billed charges,76% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rate,7.92,80,,,percent of total billed charges,80% of total billed charges,3.84,38.8,,,percent of total billed charges,38.8% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.84,9.9,
DRAIN BLAKE 10FR RND,46050361,CDM,270,RC,,,OUTPATIENT,,,289.4,231.52,,217.05,75,,,percent of total billed charges,75% of total billed charges,115.76,40,,,percent of total billed charges,40% of total billed charges,229.2,79.2,,,percent of total billed charges,79.2% of total billed charges,245.99,85,,,percent of total billed charges,85% of total billed charges,289.4,100,,,fee schedule,100% of CO APG rates,274.93,95,,,percent of total billed charges,95% of total billed charges,231.52,80,,,percent of total billed charges,80% of total billed charges,245.99,85,,,percent of total billed charges,85% of total billed charges,260.46,90,,,percent of total billed charges,90% of total billed charges,289.4,100,,,fee schedule,100% of CO APG rates,289.4,100,,,fee schedule,100% of CO APG rates,289.4,100,,,fee schedule,100% of NM fee schedule,115.76,40,,,percent of total billed charges,40% of total billed charges,115.76,40,,,percent of total billed charges,40% of total billed charges,260.46,90,,,percent of total billed charges,90% of total billed charges,219.94,76,,,percent of total billed charges,76% of total billed charges,115.76,40,,,percent of total billed charges,40% of total billed charges,245.99,85,,,percent of total billed charges,85% of total billed charges,289.4,100,,,fee schedule,100% of CO APG rate,231.52,80,,,percent of total billed charges,80% of total billed charges,112.29,38.8,,,percent of total billed charges,38.8% of total billed charges,245.99,85,,,percent of total billed charges,85% of total billed charges,289.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,112.29,289.4,
DRAIN BLAKE 19FR RND FTD SIL,46050362,CDM,270,RC,,,OUTPATIENT,,,265.5,212.4,,199.13,75,,,percent of total billed charges,75% of total billed charges,106.2,40,,,percent of total billed charges,40% of total billed charges,210.28,79.2,,,percent of total billed charges,79.2% of total billed charges,225.68,85,,,percent of total billed charges,85% of total billed charges,265.5,100,,,fee schedule,100% of CO APG rates,252.23,95,,,percent of total billed charges,95% of total billed charges,212.4,80,,,percent of total billed charges,80% of total billed charges,225.68,85,,,percent of total billed charges,85% of total billed charges,238.95,90,,,percent of total billed charges,90% of total billed charges,265.5,100,,,fee schedule,100% of CO APG rates,265.5,100,,,fee schedule,100% of CO APG rates,265.5,100,,,fee schedule,100% of NM fee schedule,106.2,40,,,percent of total billed charges,40% of total billed charges,106.2,40,,,percent of total billed charges,40% of total billed charges,238.95,90,,,percent of total billed charges,90% of total billed charges,201.78,76,,,percent of total billed charges,76% of total billed charges,106.2,40,,,percent of total billed charges,40% of total billed charges,225.68,85,,,percent of total billed charges,85% of total billed charges,265.5,100,,,fee schedule,100% of CO APG rate,212.4,80,,,percent of total billed charges,80% of total billed charges,103.01,38.8,,,percent of total billed charges,38.8% of total billed charges,225.68,85,,,percent of total billed charges,85% of total billed charges,265.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.01,265.5,
DRAIN BLAKE 24FR RND FTD SIL,46050363,CDM,270,RC,,,OUTPATIENT,,,307.1,245.68,,230.33,75,,,percent of total billed charges,75% of total billed charges,122.84,40,,,percent of total billed charges,40% of total billed charges,243.22,79.2,,,percent of total billed charges,79.2% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,307.1,100,,,fee schedule,100% of CO APG rates,291.75,95,,,percent of total billed charges,95% of total billed charges,245.68,80,,,percent of total billed charges,80% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,276.39,90,,,percent of total billed charges,90% of total billed charges,307.1,100,,,fee schedule,100% of CO APG rates,307.1,100,,,fee schedule,100% of CO APG rates,307.1,100,,,fee schedule,100% of NM fee schedule,122.84,40,,,percent of total billed charges,40% of total billed charges,122.84,40,,,percent of total billed charges,40% of total billed charges,276.39,90,,,percent of total billed charges,90% of total billed charges,233.4,76,,,percent of total billed charges,76% of total billed charges,122.84,40,,,percent of total billed charges,40% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,307.1,100,,,fee schedule,100% of CO APG rate,245.68,80,,,percent of total billed charges,80% of total billed charges,119.15,38.8,,,percent of total billed charges,38.8% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,307.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,119.15,307.1,
DRAIN BLAKE 15FR R HUBLESS,46050364,CDM,270,RC,,,OUTPATIENT,,,289.4,231.52,,217.05,75,,,percent of total billed charges,75% of total billed charges,115.76,40,,,percent of total billed charges,40% of total billed charges,229.2,79.2,,,percent of total billed charges,79.2% of total billed charges,245.99,85,,,percent of total billed charges,85% of total billed charges,289.4,100,,,fee schedule,100% of CO APG rates,274.93,95,,,percent of total billed charges,95% of total billed charges,231.52,80,,,percent of total billed charges,80% of total billed charges,245.99,85,,,percent of total billed charges,85% of total billed charges,260.46,90,,,percent of total billed charges,90% of total billed charges,289.4,100,,,fee schedule,100% of CO APG rates,289.4,100,,,fee schedule,100% of CO APG rates,289.4,100,,,fee schedule,100% of NM fee schedule,115.76,40,,,percent of total billed charges,40% of total billed charges,115.76,40,,,percent of total billed charges,40% of total billed charges,260.46,90,,,percent of total billed charges,90% of total billed charges,219.94,76,,,percent of total billed charges,76% of total billed charges,115.76,40,,,percent of total billed charges,40% of total billed charges,245.99,85,,,percent of total billed charges,85% of total billed charges,289.4,100,,,fee schedule,100% of CO APG rate,231.52,80,,,percent of total billed charges,80% of total billed charges,112.29,38.8,,,percent of total billed charges,38.8% of total billed charges,245.99,85,,,percent of total billed charges,85% of total billed charges,289.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,112.29,289.4,
SUTURE  0- ETHILON L886T,50366,CDM,270,RC,,,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.04,13,
SUTURE 2-0 ETHILON FS 18'' 664H,50367,CDM,270,RC,,,OUTPATIENT,,,16.4,13.12,,12.3,75,,,percent of total billed charges,75% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,12.99,79.2,,,percent of total billed charges,79.2% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,15.58,95,,,percent of total billed charges,95% of total billed charges,13.12,80,,,percent of total billed charges,80% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of NM fee schedule,6.56,40,,,percent of total billed charges,40% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,12.46,76,,,percent of total billed charges,76% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rate,13.12,80,,,percent of total billed charges,80% of total billed charges,6.36,38.8,,,percent of total billed charges,38.8% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.36,16.4,
SUTURE 2-0 SILK  KS 623H,50368,CDM,270,RC,,,OUTPATIENT,,,6.5,5.2,,4.88,75,,,percent of total billed charges,75% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.15,79.2,,,percent of total billed charges,79.2% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.18,95,,,percent of total billed charges,95% of total billed charges,5.2,80,,,percent of total billed charges,80% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of NM fee schedule,2.6,40,,,percent of total billed charges,40% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,4.94,76,,,percent of total billed charges,76% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rate,5.2,80,,,percent of total billed charges,80% of total billed charges,2.52,38.8,,,percent of total billed charges,38.8% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.52,6.5,
SUTURE 3-0 MONOCRYL   PS-2 Y497G,50369,CDM,270,RC,,,OUTPATIENT,,,17.4,13.92,,13.05,75,,,percent of total billed charges,75% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,13.78,79.2,,,percent of total billed charges,79.2% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,16.53,95,,,percent of total billed charges,95% of total billed charges,13.92,80,,,percent of total billed charges,80% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of NM fee schedule,6.96,40,,,percent of total billed charges,40% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,13.22,76,,,percent of total billed charges,76% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rate,13.92,80,,,percent of total billed charges,80% of total billed charges,6.75,38.8,,,percent of total billed charges,38.8% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.75,17.4,
SUTURE 3-0 PROLENE 8684G,50370,CDM,270,RC,,,OUTPATIENT,,,12,9.6,,9,75,,,percent of total billed charges,75% of total billed charges,4.8,40,,,percent of total billed charges,40% of total billed charges,9.5,79.2,,,percent of total billed charges,79.2% of total billed charges,10.2,85,,,percent of total billed charges,85% of total billed charges,12,100,,,fee schedule,100% of CO APG rates,11.4,95,,,percent of total billed charges,95% of total billed charges,9.6,80,,,percent of total billed charges,80% of total billed charges,10.2,85,,,percent of total billed charges,85% of total billed charges,10.8,90,,,percent of total billed charges,90% of total billed charges,12,100,,,fee schedule,100% of CO APG rates,12,100,,,fee schedule,100% of CO APG rates,12,100,,,fee schedule,100% of NM fee schedule,4.8,40,,,percent of total billed charges,40% of total billed charges,4.8,40,,,percent of total billed charges,40% of total billed charges,10.8,90,,,percent of total billed charges,90% of total billed charges,9.12,76,,,percent of total billed charges,76% of total billed charges,4.8,40,,,percent of total billed charges,40% of total billed charges,10.2,85,,,percent of total billed charges,85% of total billed charges,12,100,,,fee schedule,100% of CO APG rate,9.6,80,,,percent of total billed charges,80% of total billed charges,4.66,38.8,,,percent of total billed charges,38.8% of total billed charges,10.2,85,,,percent of total billed charges,85% of total billed charges,12,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,4.66,12,
SUTURE 3-0 PROLENE SH 8522H,50371,CDM,270,RC,,,OUTPATIENT,,,18.5,14.8,,13.88,75,,,percent of total billed charges,75% of total billed charges,7.4,40,,,percent of total billed charges,40% of total billed charges,14.65,79.2,,,percent of total billed charges,79.2% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,18.5,100,,,fee schedule,100% of CO APG rates,17.58,95,,,percent of total billed charges,95% of total billed charges,14.8,80,,,percent of total billed charges,80% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,16.65,90,,,percent of total billed charges,90% of total billed charges,18.5,100,,,fee schedule,100% of CO APG rates,18.5,100,,,fee schedule,100% of CO APG rates,18.5,100,,,fee schedule,100% of NM fee schedule,7.4,40,,,percent of total billed charges,40% of total billed charges,7.4,40,,,percent of total billed charges,40% of total billed charges,16.65,90,,,percent of total billed charges,90% of total billed charges,14.06,76,,,percent of total billed charges,76% of total billed charges,7.4,40,,,percent of total billed charges,40% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,18.5,100,,,fee schedule,100% of CO APG rate,14.8,80,,,percent of total billed charges,80% of total billed charges,7.18,38.8,,,percent of total billed charges,38.8% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,18.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,7.18,18.5,
SUTURE 3-0 VICRYL CTD FS2 J423H,50372,CDM,270,RC,,,OUTPATIENT,,,18.5,14.8,,13.88,75,,,percent of total billed charges,75% of total billed charges,7.4,40,,,percent of total billed charges,40% of total billed charges,14.65,79.2,,,percent of total billed charges,79.2% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,18.5,100,,,fee schedule,100% of CO APG rates,17.58,95,,,percent of total billed charges,95% of total billed charges,14.8,80,,,percent of total billed charges,80% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,16.65,90,,,percent of total billed charges,90% of total billed charges,18.5,100,,,fee schedule,100% of CO APG rates,18.5,100,,,fee schedule,100% of CO APG rates,18.5,100,,,fee schedule,100% of NM fee schedule,7.4,40,,,percent of total billed charges,40% of total billed charges,7.4,40,,,percent of total billed charges,40% of total billed charges,16.65,90,,,percent of total billed charges,90% of total billed charges,14.06,76,,,percent of total billed charges,76% of total billed charges,7.4,40,,,percent of total billed charges,40% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,18.5,100,,,fee schedule,100% of CO APG rate,14.8,80,,,percent of total billed charges,80% of total billed charges,7.18,38.8,,,percent of total billed charges,38.8% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,18.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,7.18,18.5,
SUTURE 4-0 PROLENE FS1 8629H,50373,CDM,270,RC,,,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.04,13,
SUTURE 4-0 VICRYL UNDYED P-3 J494G,50374,CDM,270,RC,,,OUTPATIENT,,,34.8,27.84,,26.1,75,,,percent of total billed charges,75% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,27.56,79.2,,,percent of total billed charges,79.2% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rates,33.06,95,,,percent of total billed charges,95% of total billed charges,27.84,80,,,percent of total billed charges,80% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,31.32,90,,,percent of total billed charges,90% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rates,34.8,100,,,fee schedule,100% of CO APG rates,34.8,100,,,fee schedule,100% of NM fee schedule,13.92,40,,,percent of total billed charges,40% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,31.32,90,,,percent of total billed charges,90% of total billed charges,26.45,76,,,percent of total billed charges,76% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rate,27.84,80,,,percent of total billed charges,80% of total billed charges,13.5,38.8,,,percent of total billed charges,38.8% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,13.5,34.8,
SUTURE 5-0 MONOCRYL P-3 Y493G,50375,CDM,270,RC,,,OUTPATIENT,,,19.8,15.84,,14.85,75,,,percent of total billed charges,75% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,15.68,79.2,,,percent of total billed charges,79.2% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,19.8,100,,,fee schedule,100% of CO APG rates,18.81,95,,,percent of total billed charges,95% of total billed charges,15.84,80,,,percent of total billed charges,80% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,17.82,90,,,percent of total billed charges,90% of total billed charges,19.8,100,,,fee schedule,100% of CO APG rates,19.8,100,,,fee schedule,100% of CO APG rates,19.8,100,,,fee schedule,100% of NM fee schedule,7.92,40,,,percent of total billed charges,40% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,17.82,90,,,percent of total billed charges,90% of total billed charges,15.05,76,,,percent of total billed charges,76% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,19.8,100,,,fee schedule,100% of CO APG rate,15.84,80,,,percent of total billed charges,80% of total billed charges,7.68,38.8,,,percent of total billed charges,38.8% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,19.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,7.68,19.8,
SUTURE 5-0 PROLENE  FS-2 8661G,50376,CDM,270,RC,,,OUTPATIENT,,,21.8,17.44,,16.35,75,,,percent of total billed charges,75% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,17.27,79.2,,,percent of total billed charges,79.2% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rates,20.71,95,,,percent of total billed charges,95% of total billed charges,17.44,80,,,percent of total billed charges,80% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,19.62,90,,,percent of total billed charges,90% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rates,21.8,100,,,fee schedule,100% of CO APG rates,21.8,100,,,fee schedule,100% of NM fee schedule,8.72,40,,,percent of total billed charges,40% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,19.62,90,,,percent of total billed charges,90% of total billed charges,16.57,76,,,percent of total billed charges,76% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rate,17.44,80,,,percent of total billed charges,80% of total billed charges,8.46,38.8,,,percent of total billed charges,38.8% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.46,21.8,
SUTURE 5-0 VICRYL J493G,50378,CDM,270,RC,,,OUTPATIENT,,,16.4,13.12,,12.3,75,,,percent of total billed charges,75% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,12.99,79.2,,,percent of total billed charges,79.2% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,15.58,95,,,percent of total billed charges,95% of total billed charges,13.12,80,,,percent of total billed charges,80% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of NM fee schedule,6.56,40,,,percent of total billed charges,40% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,12.46,76,,,percent of total billed charges,76% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rate,13.12,80,,,percent of total billed charges,80% of total billed charges,6.36,38.8,,,percent of total billed charges,38.8% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.36,16.4,
SUTURE 6-0 PROLENE P3 8695G,50379,CDM,270,RC,,,OUTPATIENT,,,19.8,15.84,,14.85,75,,,percent of total billed charges,75% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,15.68,79.2,,,percent of total billed charges,79.2% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,19.8,100,,,fee schedule,100% of CO APG rates,18.81,95,,,percent of total billed charges,95% of total billed charges,15.84,80,,,percent of total billed charges,80% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,17.82,90,,,percent of total billed charges,90% of total billed charges,19.8,100,,,fee schedule,100% of CO APG rates,19.8,100,,,fee schedule,100% of CO APG rates,19.8,100,,,fee schedule,100% of NM fee schedule,7.92,40,,,percent of total billed charges,40% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,17.82,90,,,percent of total billed charges,90% of total billed charges,15.05,76,,,percent of total billed charges,76% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,19.8,100,,,fee schedule,100% of CO APG rate,15.84,80,,,percent of total billed charges,80% of total billed charges,7.68,38.8,,,percent of total billed charges,38.8% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,19.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,7.68,19.8,
SUTURE 0 ETHIBOND  MO-7 CX41D,50380,CDM,270,RC,,,OUTPATIENT,,,37.2,29.76,,27.9,75,,,percent of total billed charges,75% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,29.46,79.2,,,percent of total billed charges,79.2% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,37.2,100,,,fee schedule,100% of CO APG rates,35.34,95,,,percent of total billed charges,95% of total billed charges,29.76,80,,,percent of total billed charges,80% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,33.48,90,,,percent of total billed charges,90% of total billed charges,37.2,100,,,fee schedule,100% of CO APG rates,37.2,100,,,fee schedule,100% of CO APG rates,37.2,100,,,fee schedule,100% of NM fee schedule,14.88,40,,,percent of total billed charges,40% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,33.48,90,,,percent of total billed charges,90% of total billed charges,28.27,76,,,percent of total billed charges,76% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,37.2,100,,,fee schedule,100% of CO APG rate,29.76,80,,,percent of total billed charges,80% of total billed charges,14.43,38.8,,,percent of total billed charges,38.8% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,37.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,14.43,37.2,
SUTURE 0 PDS II CT Z358T,50381,CDM,270,RC,,,OUTPATIENT,,,10.9,8.72,,8.18,75,,,percent of total billed charges,75% of total billed charges,4.36,40,,,percent of total billed charges,40% of total billed charges,8.63,79.2,,,percent of total billed charges,79.2% of total billed charges,9.27,85,,,percent of total billed charges,85% of total billed charges,10.9,100,,,fee schedule,100% of CO APG rates,10.36,95,,,percent of total billed charges,95% of total billed charges,8.72,80,,,percent of total billed charges,80% of total billed charges,9.27,85,,,percent of total billed charges,85% of total billed charges,9.81,90,,,percent of total billed charges,90% of total billed charges,10.9,100,,,fee schedule,100% of CO APG rates,10.9,100,,,fee schedule,100% of CO APG rates,10.9,100,,,fee schedule,100% of NM fee schedule,4.36,40,,,percent of total billed charges,40% of total billed charges,4.36,40,,,percent of total billed charges,40% of total billed charges,9.81,90,,,percent of total billed charges,90% of total billed charges,8.28,76,,,percent of total billed charges,76% of total billed charges,4.36,40,,,percent of total billed charges,40% of total billed charges,9.27,85,,,percent of total billed charges,85% of total billed charges,10.9,100,,,fee schedule,100% of CO APG rate,8.72,80,,,percent of total billed charges,80% of total billed charges,4.23,38.8,,,percent of total billed charges,38.8% of total billed charges,9.27,85,,,percent of total billed charges,85% of total billed charges,10.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,4.23,10.9,
SUTURE 0 PROLENE CT 8434H,50383,CDM,270,RC,,,OUTPATIENT,,,9.9,7.92,,7.43,75,,,percent of total billed charges,75% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,7.84,79.2,,,percent of total billed charges,79.2% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rates,9.41,95,,,percent of total billed charges,95% of total billed charges,7.92,80,,,percent of total billed charges,80% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,8.91,90,,,percent of total billed charges,90% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rates,9.9,100,,,fee schedule,100% of CO APG rates,9.9,100,,,fee schedule,100% of NM fee schedule,3.96,40,,,percent of total billed charges,40% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,8.91,90,,,percent of total billed charges,90% of total billed charges,7.52,76,,,percent of total billed charges,76% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rate,7.92,80,,,percent of total billed charges,80% of total billed charges,3.84,38.8,,,percent of total billed charges,38.8% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.84,9.9,
SUTURE 0 VICRYL CTD CT-1 J346H,50386,CDM,270,RC,,,OUTPATIENT,,,6.5,5.2,,4.88,75,,,percent of total billed charges,75% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.15,79.2,,,percent of total billed charges,79.2% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.18,95,,,percent of total billed charges,95% of total billed charges,5.2,80,,,percent of total billed charges,80% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of NM fee schedule,2.6,40,,,percent of total billed charges,40% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,4.94,76,,,percent of total billed charges,76% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rate,5.2,80,,,percent of total billed charges,80% of total billed charges,2.52,38.8,,,percent of total billed charges,38.8% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.52,6.5,
SUTURE 1-0 ETHILON LR 489T,50388,CDM,270,RC,,,OUTPATIENT,,,14.3,11.44,,10.73,75,,,percent of total billed charges,75% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,11.33,79.2,,,percent of total billed charges,79.2% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,13.59,95,,,percent of total billed charges,95% of total billed charges,11.44,80,,,percent of total billed charges,80% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of NM fee schedule,5.72,40,,,percent of total billed charges,40% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,10.87,76,,,percent of total billed charges,76% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rate,11.44,80,,,percent of total billed charges,80% of total billed charges,5.55,38.8,,,percent of total billed charges,38.8% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.55,14.3,
SUTURE 10-0 PROLENE 1713G,50390,CDM,270,RC,,,OUTPATIENT,,,53.6,42.88,,40.2,75,,,percent of total billed charges,75% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,42.45,79.2,,,percent of total billed charges,79.2% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rates,50.92,95,,,percent of total billed charges,95% of total billed charges,42.88,80,,,percent of total billed charges,80% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,48.24,90,,,percent of total billed charges,90% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rates,53.6,100,,,fee schedule,100% of CO APG rates,53.6,100,,,fee schedule,100% of NM fee schedule,21.44,40,,,percent of total billed charges,40% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,48.24,90,,,percent of total billed charges,90% of total billed charges,40.74,76,,,percent of total billed charges,76% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rate,42.88,80,,,percent of total billed charges,80% of total billed charges,20.8,38.8,,,percent of total billed charges,38.8% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,20.8,53.6,
SUTURE 2-0 ETHIBOND MO-7 CX42D,50392,CDM,270,RC,,,OUTPATIENT,,,37.2,29.76,,27.9,75,,,percent of total billed charges,75% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,29.46,79.2,,,percent of total billed charges,79.2% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,37.2,100,,,fee schedule,100% of CO APG rates,35.34,95,,,percent of total billed charges,95% of total billed charges,29.76,80,,,percent of total billed charges,80% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,33.48,90,,,percent of total billed charges,90% of total billed charges,37.2,100,,,fee schedule,100% of CO APG rates,37.2,100,,,fee schedule,100% of CO APG rates,37.2,100,,,fee schedule,100% of NM fee schedule,14.88,40,,,percent of total billed charges,40% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,33.48,90,,,percent of total billed charges,90% of total billed charges,28.27,76,,,percent of total billed charges,76% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,37.2,100,,,fee schedule,100% of CO APG rate,29.76,80,,,percent of total billed charges,80% of total billed charges,14.43,38.8,,,percent of total billed charges,38.8% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,37.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,14.43,37.2,
SUTURE 2-0 PROLENE SH 8883H,50394,CDM,270,RC,,,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.04,13,
SUTURE 2-0 SILK A305H,50395,CDM,270,RC,,,OUTPATIENT,,,9.9,7.92,,7.43,75,,,percent of total billed charges,75% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,7.84,79.2,,,percent of total billed charges,79.2% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rates,9.41,95,,,percent of total billed charges,95% of total billed charges,7.92,80,,,percent of total billed charges,80% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,8.91,90,,,percent of total billed charges,90% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rates,9.9,100,,,fee schedule,100% of CO APG rates,9.9,100,,,fee schedule,100% of NM fee schedule,3.96,40,,,percent of total billed charges,40% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,8.91,90,,,percent of total billed charges,90% of total billed charges,7.52,76,,,percent of total billed charges,76% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rate,7.92,80,,,percent of total billed charges,80% of total billed charges,3.84,38.8,,,percent of total billed charges,38.8% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.84,9.9,
SUTURE 2-0 SILK PRE-CUT A185H,50397,CDM,270,RC,,,OUTPATIENT,,,6.5,5.2,,4.88,75,,,percent of total billed charges,75% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.15,79.2,,,percent of total billed charges,79.2% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.18,95,,,percent of total billed charges,95% of total billed charges,5.2,80,,,percent of total billed charges,80% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of NM fee schedule,2.6,40,,,percent of total billed charges,40% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,4.94,76,,,percent of total billed charges,76% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rate,5.2,80,,,percent of total billed charges,80% of total billed charges,2.52,38.8,,,percent of total billed charges,38.8% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.52,6.5,
SUTURE 2-0 SILK SH K833H,50398,CDM,270,RC,,,OUTPATIENT,,,5.5,4.4,,4.13,75,,,percent of total billed charges,75% of total billed charges,2.2,40,,,percent of total billed charges,40% of total billed charges,4.36,79.2,,,percent of total billed charges,79.2% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,5.5,100,,,fee schedule,100% of CO APG rates,5.23,95,,,percent of total billed charges,95% of total billed charges,4.4,80,,,percent of total billed charges,80% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,4.95,90,,,percent of total billed charges,90% of total billed charges,5.5,100,,,fee schedule,100% of CO APG rates,5.5,100,,,fee schedule,100% of CO APG rates,5.5,100,,,fee schedule,100% of NM fee schedule,2.2,40,,,percent of total billed charges,40% of total billed charges,2.2,40,,,percent of total billed charges,40% of total billed charges,4.95,90,,,percent of total billed charges,90% of total billed charges,4.18,76,,,percent of total billed charges,76% of total billed charges,2.2,40,,,percent of total billed charges,40% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,5.5,100,,,fee schedule,100% of CO APG rate,4.4,80,,,percent of total billed charges,80% of total billed charges,2.13,38.8,,,percent of total billed charges,38.8% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,5.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.13,5.5,
SUTURE 2-0 VICRYL CTD CT-1 J345H,50399,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.91,7.5,
SUTURE 2-0 VICRYL CTD UR-6 J602H,50400,CDM,270,RC,,,OUTPATIENT,,,16.4,13.12,,12.3,75,,,percent of total billed charges,75% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,12.99,79.2,,,percent of total billed charges,79.2% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,15.58,95,,,percent of total billed charges,95% of total billed charges,13.12,80,,,percent of total billed charges,80% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of NM fee schedule,6.56,40,,,percent of total billed charges,40% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,12.46,76,,,percent of total billed charges,76% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rate,13.12,80,,,percent of total billed charges,80% of total billed charges,6.36,38.8,,,percent of total billed charges,38.8% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.36,16.4,
SUTURE 3-0 GUT CHR SH G122H,50401,CDM,270,RC,,,OUTPATIENT,,,12,9.6,,9,75,,,percent of total billed charges,75% of total billed charges,4.8,40,,,percent of total billed charges,40% of total billed charges,9.5,79.2,,,percent of total billed charges,79.2% of total billed charges,10.2,85,,,percent of total billed charges,85% of total billed charges,12,100,,,fee schedule,100% of CO APG rates,11.4,95,,,percent of total billed charges,95% of total billed charges,9.6,80,,,percent of total billed charges,80% of total billed charges,10.2,85,,,percent of total billed charges,85% of total billed charges,10.8,90,,,percent of total billed charges,90% of total billed charges,12,100,,,fee schedule,100% of CO APG rates,12,100,,,fee schedule,100% of CO APG rates,12,100,,,fee schedule,100% of NM fee schedule,4.8,40,,,percent of total billed charges,40% of total billed charges,4.8,40,,,percent of total billed charges,40% of total billed charges,10.8,90,,,percent of total billed charges,90% of total billed charges,9.12,76,,,percent of total billed charges,76% of total billed charges,4.8,40,,,percent of total billed charges,40% of total billed charges,10.2,85,,,percent of total billed charges,85% of total billed charges,12,100,,,fee schedule,100% of CO APG rate,9.6,80,,,percent of total billed charges,80% of total billed charges,4.66,38.8,,,percent of total billed charges,38.8% of total billed charges,10.2,85,,,percent of total billed charges,85% of total billed charges,12,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,4.66,12,
SUTURE 3-0 PROLENE PS-2 8687H,50406,CDM,270,RC,,,OUTPATIENT,,,17.4,13.92,,13.05,75,,,percent of total billed charges,75% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,13.78,79.2,,,percent of total billed charges,79.2% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,16.53,95,,,percent of total billed charges,95% of total billed charges,13.92,80,,,percent of total billed charges,80% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of NM fee schedule,6.96,40,,,percent of total billed charges,40% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,13.22,76,,,percent of total billed charges,76% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rate,13.92,80,,,percent of total billed charges,80% of total billed charges,6.75,38.8,,,percent of total billed charges,38.8% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.75,17.4,
SUTURE 3-0 SILK A304H A304H,50407,CDM,270,RC,,,OUTPATIENT,,,10.9,8.72,,8.18,75,,,percent of total billed charges,75% of total billed charges,4.36,40,,,percent of total billed charges,40% of total billed charges,8.63,79.2,,,percent of total billed charges,79.2% of total billed charges,9.27,85,,,percent of total billed charges,85% of total billed charges,10.9,100,,,fee schedule,100% of CO APG rates,10.36,95,,,percent of total billed charges,95% of total billed charges,8.72,80,,,percent of total billed charges,80% of total billed charges,9.27,85,,,percent of total billed charges,85% of total billed charges,9.81,90,,,percent of total billed charges,90% of total billed charges,10.9,100,,,fee schedule,100% of CO APG rates,10.9,100,,,fee schedule,100% of CO APG rates,10.9,100,,,fee schedule,100% of NM fee schedule,4.36,40,,,percent of total billed charges,40% of total billed charges,4.36,40,,,percent of total billed charges,40% of total billed charges,9.81,90,,,percent of total billed charges,90% of total billed charges,8.28,76,,,percent of total billed charges,76% of total billed charges,4.36,40,,,percent of total billed charges,40% of total billed charges,9.27,85,,,percent of total billed charges,85% of total billed charges,10.9,100,,,fee schedule,100% of CO APG rate,8.72,80,,,percent of total billed charges,80% of total billed charges,4.23,38.8,,,percent of total billed charges,38.8% of total billed charges,9.27,85,,,percent of total billed charges,85% of total billed charges,10.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,4.23,10.9,
SUTURE 3-0 SILK PRE-CUT A184H,50409,CDM,270,RC,,,OUTPATIENT,,,6.5,5.2,,4.88,75,,,percent of total billed charges,75% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.15,79.2,,,percent of total billed charges,79.2% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.18,95,,,percent of total billed charges,95% of total billed charges,5.2,80,,,percent of total billed charges,80% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of NM fee schedule,2.6,40,,,percent of total billed charges,40% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,4.94,76,,,percent of total billed charges,76% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rate,5.2,80,,,percent of total billed charges,80% of total billed charges,2.52,38.8,,,percent of total billed charges,38.8% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.52,6.5,
SUTURE 3-0 SILK SH CO13D,50410,CDM,270,RC,,,OUTPATIENT,,,27.3,21.84,,20.48,75,,,percent of total billed charges,75% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,21.62,79.2,,,percent of total billed charges,79.2% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,27.3,100,,,fee schedule,100% of CO APG rates,25.94,95,,,percent of total billed charges,95% of total billed charges,21.84,80,,,percent of total billed charges,80% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,24.57,90,,,percent of total billed charges,90% of total billed charges,27.3,100,,,fee schedule,100% of CO APG rates,27.3,100,,,fee schedule,100% of CO APG rates,27.3,100,,,fee schedule,100% of NM fee schedule,10.92,40,,,percent of total billed charges,40% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,24.57,90,,,percent of total billed charges,90% of total billed charges,20.75,76,,,percent of total billed charges,76% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,27.3,100,,,fee schedule,100% of CO APG rate,21.84,80,,,percent of total billed charges,80% of total billed charges,10.59,38.8,,,percent of total billed charges,38.8% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,27.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,10.59,27.3,
SUTURE 3-0 VICRYL CTD CT1 J338H,50412,CDM,270,RC,,,OUTPATIENT,,,6.5,5.2,,4.88,75,,,percent of total billed charges,75% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.15,79.2,,,percent of total billed charges,79.2% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.18,95,,,percent of total billed charges,95% of total billed charges,5.2,80,,,percent of total billed charges,80% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of NM fee schedule,2.6,40,,,percent of total billed charges,40% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,4.94,76,,,percent of total billed charges,76% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rate,5.2,80,,,percent of total billed charges,80% of total billed charges,2.52,38.8,,,percent of total billed charges,38.8% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.52,6.5,
SUTURE 3-0 VICRYL CTD J644H,50413,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.91,7.5,
SUTURE 3-0 VICRYL SH J416H,50415,CDM,270,RC,,,OUTPATIENT,,,6.5,5.2,,4.88,75,,,percent of total billed charges,75% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.15,79.2,,,percent of total billed charges,79.2% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.18,95,,,percent of total billed charges,95% of total billed charges,5.2,80,,,percent of total billed charges,80% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of NM fee schedule,2.6,40,,,percent of total billed charges,40% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,4.94,76,,,percent of total billed charges,76% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rate,5.2,80,,,percent of total billed charges,80% of total billed charges,2.52,38.8,,,percent of total billed charges,38.8% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.52,6.5,
SUTURE 4-0 CHROMIC GUT P-3 1654G,50416,CDM,270,RC,,,OUTPATIENT,,,20.8,16.64,,15.6,75,,,percent of total billed charges,75% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,16.47,79.2,,,percent of total billed charges,79.2% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rates,19.76,95,,,percent of total billed charges,95% of total billed charges,16.64,80,,,percent of total billed charges,80% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rates,20.8,100,,,fee schedule,100% of CO APG rates,20.8,100,,,fee schedule,100% of NM fee schedule,8.32,40,,,percent of total billed charges,40% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,15.81,76,,,percent of total billed charges,76% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rate,16.64,80,,,percent of total billed charges,80% of total billed charges,8.07,38.8,,,percent of total billed charges,38.8% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.07,20.8,
SUTURE 4-0 ETHILON PS-2 1611G,50417,CDM,270,RC,,,OUTPATIENT,,,16.4,13.12,,12.3,75,,,percent of total billed charges,75% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,12.99,79.2,,,percent of total billed charges,79.2% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,15.58,95,,,percent of total billed charges,95% of total billed charges,13.12,80,,,percent of total billed charges,80% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of NM fee schedule,6.56,40,,,percent of total billed charges,40% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,12.46,76,,,percent of total billed charges,76% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rate,13.12,80,,,percent of total billed charges,80% of total billed charges,6.36,38.8,,,percent of total billed charges,38.8% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.36,16.4,
SUTURE 4-0 GUT CHR RB-1 U203H,50418,CDM,270,RC,,,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.04,13,
SUTURE 4-0 SILK PRE-CUT A183H,50423,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.91,7.5,
SUTURE 4-0 VICRYL CTD P-3 J464G,50425,CDM,270,RC,,,OUTPATIENT,,,16.4,13.12,,12.3,75,,,percent of total billed charges,75% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,12.99,79.2,,,percent of total billed charges,79.2% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,15.58,95,,,percent of total billed charges,95% of total billed charges,13.12,80,,,percent of total billed charges,80% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of NM fee schedule,6.56,40,,,percent of total billed charges,40% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,12.46,76,,,percent of total billed charges,76% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rate,13.12,80,,,percent of total billed charges,80% of total billed charges,6.36,38.8,,,percent of total billed charges,38.8% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.36,16.4,
SUTURE 4-0 VICRYL CTD PS-2 J496G,50427,CDM,270,RC,,,OUTPATIENT,,,15.3,12.24,,11.48,75,,,percent of total billed charges,75% of total billed charges,6.12,40,,,percent of total billed charges,40% of total billed charges,12.12,79.2,,,percent of total billed charges,79.2% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,15.3,100,,,fee schedule,100% of CO APG rates,14.54,95,,,percent of total billed charges,95% of total billed charges,12.24,80,,,percent of total billed charges,80% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,13.77,90,,,percent of total billed charges,90% of total billed charges,15.3,100,,,fee schedule,100% of CO APG rates,15.3,100,,,fee schedule,100% of CO APG rates,15.3,100,,,fee schedule,100% of NM fee schedule,6.12,40,,,percent of total billed charges,40% of total billed charges,6.12,40,,,percent of total billed charges,40% of total billed charges,13.77,90,,,percent of total billed charges,90% of total billed charges,11.63,76,,,percent of total billed charges,76% of total billed charges,6.12,40,,,percent of total billed charges,40% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,15.3,100,,,fee schedule,100% of CO APG rate,12.24,80,,,percent of total billed charges,80% of total billed charges,5.94,38.8,,,percent of total billed charges,38.8% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,15.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.94,15.3,
SUTURE 4-0 VICRYL CTD SH J315H,50428,CDM,270,RC,,,OUTPATIENT,,,6.5,5.2,,4.88,75,,,percent of total billed charges,75% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.15,79.2,,,percent of total billed charges,79.2% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.18,95,,,percent of total billed charges,95% of total billed charges,5.2,80,,,percent of total billed charges,80% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of NM fee schedule,2.6,40,,,percent of total billed charges,40% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,4.94,76,,,percent of total billed charges,76% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rate,5.2,80,,,percent of total billed charges,80% of total billed charges,2.52,38.8,,,percent of total billed charges,38.8% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.52,6.5,
SUTURE 4-0 VICRYL CTD SH J773D,50429,CDM,270,RC,,,OUTPATIENT,,,36.1,28.88,,27.08,75,,,percent of total billed charges,75% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,28.59,79.2,,,percent of total billed charges,79.2% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,36.1,100,,,fee schedule,100% of CO APG rates,34.3,95,,,percent of total billed charges,95% of total billed charges,28.88,80,,,percent of total billed charges,80% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,32.49,90,,,percent of total billed charges,90% of total billed charges,36.1,100,,,fee schedule,100% of CO APG rates,36.1,100,,,fee schedule,100% of CO APG rates,36.1,100,,,fee schedule,100% of NM fee schedule,14.44,40,,,percent of total billed charges,40% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,32.49,90,,,percent of total billed charges,90% of total billed charges,27.44,76,,,percent of total billed charges,76% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,36.1,100,,,fee schedule,100% of CO APG rate,28.88,80,,,percent of total billed charges,80% of total billed charges,14.01,38.8,,,percent of total billed charges,38.8% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,36.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,14.01,36.1,
SUTURE 5-0 CHROMIC GUT P-3 687G,50431,CDM,270,RC,,,OUTPATIENT,,,20.8,16.64,,15.6,75,,,percent of total billed charges,75% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,16.47,79.2,,,percent of total billed charges,79.2% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rates,19.76,95,,,percent of total billed charges,95% of total billed charges,16.64,80,,,percent of total billed charges,80% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rates,20.8,100,,,fee schedule,100% of CO APG rates,20.8,100,,,fee schedule,100% of NM fee schedule,8.32,40,,,percent of total billed charges,40% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,15.81,76,,,percent of total billed charges,76% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rate,16.64,80,,,percent of total billed charges,80% of total billed charges,8.07,38.8,,,percent of total billed charges,38.8% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.07,20.8,
SUTURE 5-0 GUT PLAIN  PC-1 1915G,50432,CDM,270,RC,,,OUTPATIENT,,,22.9,18.32,,17.18,75,,,percent of total billed charges,75% of total billed charges,9.16,40,,,percent of total billed charges,40% of total billed charges,18.14,79.2,,,percent of total billed charges,79.2% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,22.9,100,,,fee schedule,100% of CO APG rates,21.76,95,,,percent of total billed charges,95% of total billed charges,18.32,80,,,percent of total billed charges,80% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,20.61,90,,,percent of total billed charges,90% of total billed charges,22.9,100,,,fee schedule,100% of CO APG rates,22.9,100,,,fee schedule,100% of CO APG rates,22.9,100,,,fee schedule,100% of NM fee schedule,9.16,40,,,percent of total billed charges,40% of total billed charges,9.16,40,,,percent of total billed charges,40% of total billed charges,20.61,90,,,percent of total billed charges,90% of total billed charges,17.4,76,,,percent of total billed charges,76% of total billed charges,9.16,40,,,percent of total billed charges,40% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,22.9,100,,,fee schedule,100% of CO APG rate,18.32,80,,,percent of total billed charges,80% of total billed charges,8.89,38.8,,,percent of total billed charges,38.8% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,22.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.89,22.9,
SUTURE 5-0 NYLON  DS18 AC-0568D,50433,CDM,270,RC,,,OUTPATIENT,,,5.5,4.4,,4.13,75,,,percent of total billed charges,75% of total billed charges,2.2,40,,,percent of total billed charges,40% of total billed charges,4.36,79.2,,,percent of total billed charges,79.2% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,5.5,100,,,fee schedule,100% of CO APG rates,5.23,95,,,percent of total billed charges,95% of total billed charges,4.4,80,,,percent of total billed charges,80% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,4.95,90,,,percent of total billed charges,90% of total billed charges,5.5,100,,,fee schedule,100% of CO APG rates,5.5,100,,,fee schedule,100% of CO APG rates,5.5,100,,,fee schedule,100% of NM fee schedule,2.2,40,,,percent of total billed charges,40% of total billed charges,2.2,40,,,percent of total billed charges,40% of total billed charges,4.95,90,,,percent of total billed charges,90% of total billed charges,4.18,76,,,percent of total billed charges,76% of total billed charges,2.2,40,,,percent of total billed charges,40% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,5.5,100,,,fee schedule,100% of CO APG rate,4.4,80,,,percent of total billed charges,80% of total billed charges,2.13,38.8,,,percent of total billed charges,38.8% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,5.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.13,5.5,
SUTURE 5-0 PROLENE PS-2 8686G,50435,CDM,270,RC,,,OUTPATIENT,,,16.4,13.12,,12.3,75,,,percent of total billed charges,75% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,12.99,79.2,,,percent of total billed charges,79.2% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,15.58,95,,,percent of total billed charges,95% of total billed charges,13.12,80,,,percent of total billed charges,80% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of NM fee schedule,6.56,40,,,percent of total billed charges,40% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,12.46,76,,,percent of total billed charges,76% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rate,13.12,80,,,percent of total billed charges,80% of total billed charges,6.36,38.8,,,percent of total billed charges,38.8% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.36,16.4,
SUTURE 6-0 PLAIN GUT FAST ABS PC-1 1916G,50436,CDM,270,RC,,,OUTPATIENT,,,21.8,17.44,,16.35,75,,,percent of total billed charges,75% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,17.27,79.2,,,percent of total billed charges,79.2% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rates,20.71,95,,,percent of total billed charges,95% of total billed charges,17.44,80,,,percent of total billed charges,80% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,19.62,90,,,percent of total billed charges,90% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rates,21.8,100,,,fee schedule,100% of CO APG rates,21.8,100,,,fee schedule,100% of NM fee schedule,8.72,40,,,percent of total billed charges,40% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,19.62,90,,,percent of total billed charges,90% of total billed charges,16.57,76,,,percent of total billed charges,76% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rate,17.44,80,,,percent of total billed charges,80% of total billed charges,8.46,38.8,,,percent of total billed charges,38.8% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.46,21.8,
MARKER ENDOSCOPIC,46050440,CDM,270,RC,,,OUTPATIENT,,,166.1,132.88,,124.58,75,,,percent of total billed charges,75% of total billed charges,66.44,40,,,percent of total billed charges,40% of total billed charges,131.55,79.2,,,percent of total billed charges,79.2% of total billed charges,141.19,85,,,percent of total billed charges,85% of total billed charges,166.1,100,,,fee schedule,100% of CO APG rates,157.8,95,,,percent of total billed charges,95% of total billed charges,132.88,80,,,percent of total billed charges,80% of total billed charges,141.19,85,,,percent of total billed charges,85% of total billed charges,149.49,90,,,percent of total billed charges,90% of total billed charges,166.1,100,,,fee schedule,100% of CO APG rates,166.1,100,,,fee schedule,100% of CO APG rates,166.1,100,,,fee schedule,100% of NM fee schedule,66.44,40,,,percent of total billed charges,40% of total billed charges,66.44,40,,,percent of total billed charges,40% of total billed charges,149.49,90,,,percent of total billed charges,90% of total billed charges,126.24,76,,,percent of total billed charges,76% of total billed charges,66.44,40,,,percent of total billed charges,40% of total billed charges,141.19,85,,,percent of total billed charges,85% of total billed charges,166.1,100,,,fee schedule,100% of CO APG rate,132.88,80,,,percent of total billed charges,80% of total billed charges,64.45,38.8,,,percent of total billed charges,38.8% of total billed charges,141.19,85,,,percent of total billed charges,85% of total billed charges,166.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,64.45,166.1,
ELECTRODE BALL 5X5,46050442,CDM,270,RC,,,OUTPATIENT,,,67.6,54.08,,50.7,75,,,percent of total billed charges,75% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,53.54,79.2,,,percent of total billed charges,79.2% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rates,64.22,95,,,percent of total billed charges,95% of total billed charges,54.08,80,,,percent of total billed charges,80% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,60.84,90,,,percent of total billed charges,90% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rates,67.6,100,,,fee schedule,100% of CO APG rates,67.6,100,,,fee schedule,100% of NM fee schedule,27.04,40,,,percent of total billed charges,40% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,60.84,90,,,percent of total billed charges,90% of total billed charges,51.38,76,,,percent of total billed charges,76% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rate,54.08,80,,,percent of total billed charges,80% of total billed charges,26.23,38.8,,,percent of total billed charges,38.8% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.23,67.6,
ELECTRODE LOOP 20X13,46050443,CDM,270,RC,,,OUTPATIENT,,,67.6,54.08,,50.7,75,,,percent of total billed charges,75% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,53.54,79.2,,,percent of total billed charges,79.2% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rates,64.22,95,,,percent of total billed charges,95% of total billed charges,54.08,80,,,percent of total billed charges,80% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,60.84,90,,,percent of total billed charges,90% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rates,67.6,100,,,fee schedule,100% of CO APG rates,67.6,100,,,fee schedule,100% of NM fee schedule,27.04,40,,,percent of total billed charges,40% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,60.84,90,,,percent of total billed charges,90% of total billed charges,51.38,76,,,percent of total billed charges,76% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rate,54.08,80,,,percent of total billed charges,80% of total billed charges,26.23,38.8,,,percent of total billed charges,38.8% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.23,67.6,
ELECTRODE LOOP RADIUS,46050444,CDM,270,RC,,,OUTPATIENT,,,67.6,54.08,,50.7,75,,,percent of total billed charges,75% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,53.54,79.2,,,percent of total billed charges,79.2% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rates,64.22,95,,,percent of total billed charges,95% of total billed charges,54.08,80,,,percent of total billed charges,80% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,60.84,90,,,percent of total billed charges,90% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rates,67.6,100,,,fee schedule,100% of CO APG rates,67.6,100,,,fee schedule,100% of NM fee schedule,27.04,40,,,percent of total billed charges,40% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,60.84,90,,,percent of total billed charges,90% of total billed charges,51.38,76,,,percent of total billed charges,76% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rate,54.08,80,,,percent of total billed charges,80% of total billed charges,26.23,38.8,,,percent of total billed charges,38.8% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.23,67.6,
INFO VAC CANNISTER,50461,CDM,270,RC,,,OUTPATIENT,,,163.8,131.04,,122.85,75,,,percent of total billed charges,75% of total billed charges,65.52,40,,,percent of total billed charges,40% of total billed charges,129.73,79.2,,,percent of total billed charges,79.2% of total billed charges,139.23,85,,,percent of total billed charges,85% of total billed charges,163.8,100,,,fee schedule,100% of CO APG rates,155.61,95,,,percent of total billed charges,95% of total billed charges,131.04,80,,,percent of total billed charges,80% of total billed charges,139.23,85,,,percent of total billed charges,85% of total billed charges,147.42,90,,,percent of total billed charges,90% of total billed charges,163.8,100,,,fee schedule,100% of CO APG rates,163.8,100,,,fee schedule,100% of CO APG rates,163.8,100,,,fee schedule,100% of NM fee schedule,65.52,40,,,percent of total billed charges,40% of total billed charges,65.52,40,,,percent of total billed charges,40% of total billed charges,147.42,90,,,percent of total billed charges,90% of total billed charges,124.49,76,,,percent of total billed charges,76% of total billed charges,65.52,40,,,percent of total billed charges,40% of total billed charges,139.23,85,,,percent of total billed charges,85% of total billed charges,163.8,100,,,fee schedule,100% of CO APG rate,131.04,80,,,percent of total billed charges,80% of total billed charges,63.55,38.8,,,percent of total billed charges,38.8% of total billed charges,139.23,85,,,percent of total billed charges,85% of total billed charges,163.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,63.55,163.8,
INFO VAC MED GRANUFOAM,50462,CDM,270,RC,,,OUTPATIENT,,,393.4,314.72,,295.05,75,,,percent of total billed charges,75% of total billed charges,157.36,40,,,percent of total billed charges,40% of total billed charges,311.57,79.2,,,percent of total billed charges,79.2% of total billed charges,334.39,85,,,percent of total billed charges,85% of total billed charges,393.4,100,,,fee schedule,100% of CO APG rates,373.73,95,,,percent of total billed charges,95% of total billed charges,314.72,80,,,percent of total billed charges,80% of total billed charges,334.39,85,,,percent of total billed charges,85% of total billed charges,354.06,90,,,percent of total billed charges,90% of total billed charges,393.4,100,,,fee schedule,100% of CO APG rates,393.4,100,,,fee schedule,100% of CO APG rates,393.4,100,,,fee schedule,100% of NM fee schedule,157.36,40,,,percent of total billed charges,40% of total billed charges,157.36,40,,,percent of total billed charges,40% of total billed charges,354.06,90,,,percent of total billed charges,90% of total billed charges,298.98,76,,,percent of total billed charges,76% of total billed charges,157.36,40,,,percent of total billed charges,40% of total billed charges,334.39,85,,,percent of total billed charges,85% of total billed charges,393.4,100,,,fee schedule,100% of CO APG rate,314.72,80,,,percent of total billed charges,80% of total billed charges,152.64,38.8,,,percent of total billed charges,38.8% of total billed charges,334.39,85,,,percent of total billed charges,85% of total billed charges,393.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,152.64,393.4,
MORGAN LENS,31050483,CDM,270,RC,,,OUTPATIENT,,,155.2,124.16,,116.4,75,,,percent of total billed charges,75% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,122.92,79.2,,,percent of total billed charges,79.2% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rates,147.44,95,,,percent of total billed charges,95% of total billed charges,124.16,80,,,percent of total billed charges,80% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rates,155.2,100,,,fee schedule,100% of CO APG rates,155.2,100,,,fee schedule,100% of NM fee schedule,62.08,40,,,percent of total billed charges,40% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,117.95,76,,,percent of total billed charges,76% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rate,124.16,80,,,percent of total billed charges,80% of total billed charges,60.22,38.8,,,percent of total billed charges,38.8% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,60.22,155.2,
KUMAR CATHETER,46050484,CDM,270,RC,,,OUTPATIENT,,,147.4,117.92,,110.55,75,,,percent of total billed charges,75% of total billed charges,58.96,40,,,percent of total billed charges,40% of total billed charges,116.74,79.2,,,percent of total billed charges,79.2% of total billed charges,125.29,85,,,percent of total billed charges,85% of total billed charges,147.4,100,,,fee schedule,100% of CO APG rates,140.03,95,,,percent of total billed charges,95% of total billed charges,117.92,80,,,percent of total billed charges,80% of total billed charges,125.29,85,,,percent of total billed charges,85% of total billed charges,132.66,90,,,percent of total billed charges,90% of total billed charges,147.4,100,,,fee schedule,100% of CO APG rates,147.4,100,,,fee schedule,100% of CO APG rates,147.4,100,,,fee schedule,100% of NM fee schedule,58.96,40,,,percent of total billed charges,40% of total billed charges,58.96,40,,,percent of total billed charges,40% of total billed charges,132.66,90,,,percent of total billed charges,90% of total billed charges,112.02,76,,,percent of total billed charges,76% of total billed charges,58.96,40,,,percent of total billed charges,40% of total billed charges,125.29,85,,,percent of total billed charges,85% of total billed charges,147.4,100,,,fee schedule,100% of CO APG rate,117.92,80,,,percent of total billed charges,80% of total billed charges,57.19,38.8,,,percent of total billed charges,38.8% of total billed charges,125.29,85,,,percent of total billed charges,85% of total billed charges,147.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,57.19,147.4,
GELFOAM 100MM COMPRESS,46050489,CDM,270,RC,,,OUTPATIENT,,,133.4,106.72,,100.05,75,,,percent of total billed charges,75% of total billed charges,53.36,40,,,percent of total billed charges,40% of total billed charges,105.65,79.2,,,percent of total billed charges,79.2% of total billed charges,113.39,85,,,percent of total billed charges,85% of total billed charges,133.4,100,,,fee schedule,100% of CO APG rates,126.73,95,,,percent of total billed charges,95% of total billed charges,106.72,80,,,percent of total billed charges,80% of total billed charges,113.39,85,,,percent of total billed charges,85% of total billed charges,120.06,90,,,percent of total billed charges,90% of total billed charges,133.4,100,,,fee schedule,100% of CO APG rates,133.4,100,,,fee schedule,100% of CO APG rates,133.4,100,,,fee schedule,100% of NM fee schedule,53.36,40,,,percent of total billed charges,40% of total billed charges,53.36,40,,,percent of total billed charges,40% of total billed charges,120.06,90,,,percent of total billed charges,90% of total billed charges,101.38,76,,,percent of total billed charges,76% of total billed charges,53.36,40,,,percent of total billed charges,40% of total billed charges,113.39,85,,,percent of total billed charges,85% of total billed charges,133.4,100,,,fee schedule,100% of CO APG rate,106.72,80,,,percent of total billed charges,80% of total billed charges,51.76,38.8,,,percent of total billed charges,38.8% of total billed charges,113.39,85,,,percent of total billed charges,85% of total billed charges,133.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,51.76,133.4,
HIP/KNEE REACHER 26IN KIT,30050500,CDM,270,RC,,,OUTPATIENT,,,155.2,124.16,,116.4,75,,,percent of total billed charges,75% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,122.92,79.2,,,percent of total billed charges,79.2% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rates,147.44,95,,,percent of total billed charges,95% of total billed charges,124.16,80,,,percent of total billed charges,80% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rates,155.2,100,,,fee schedule,100% of CO APG rates,155.2,100,,,fee schedule,100% of NM fee schedule,62.08,40,,,percent of total billed charges,40% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,117.95,76,,,percent of total billed charges,76% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rate,124.16,80,,,percent of total billed charges,80% of total billed charges,60.22,38.8,,,percent of total billed charges,38.8% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,60.22,155.2,
SUTURE 4-0 NYLON DSM18 S1667G,50502,CDM,270,RC,,,OUTPATIENT,,,17.4,13.92,,13.05,75,,,percent of total billed charges,75% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,13.78,79.2,,,percent of total billed charges,79.2% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,16.53,95,,,percent of total billed charges,95% of total billed charges,13.92,80,,,percent of total billed charges,80% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of NM fee schedule,6.96,40,,,percent of total billed charges,40% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,13.22,76,,,percent of total billed charges,76% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rate,13.92,80,,,percent of total billed charges,80% of total billed charges,6.75,38.8,,,percent of total billed charges,38.8% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.75,17.4,
SUTURE 5-0 POLYPROPYLENE DSM13 S8698G,50503,CDM,270,RC,,,OUTPATIENT,,,17.4,13.92,,13.05,75,,,percent of total billed charges,75% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,13.78,79.2,,,percent of total billed charges,79.2% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,16.53,95,,,percent of total billed charges,95% of total billed charges,13.92,80,,,percent of total billed charges,80% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of NM fee schedule,6.96,40,,,percent of total billed charges,40% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,13.22,76,,,percent of total billed charges,76% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rate,13.92,80,,,percent of total billed charges,80% of total billed charges,6.75,38.8,,,percent of total billed charges,38.8% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.75,17.4,
ELECTRODE LOOP 10MMX10MM,46050508,CDM,270,RC,,,OUTPATIENT,,,59,47.2,,44.25,75,,,percent of total billed charges,75% of total billed charges,23.6,40,,,percent of total billed charges,40% of total billed charges,46.73,79.2,,,percent of total billed charges,79.2% of total billed charges,50.15,85,,,percent of total billed charges,85% of total billed charges,59,100,,,fee schedule,100% of CO APG rates,56.05,95,,,percent of total billed charges,95% of total billed charges,47.2,80,,,percent of total billed charges,80% of total billed charges,50.15,85,,,percent of total billed charges,85% of total billed charges,53.1,90,,,percent of total billed charges,90% of total billed charges,59,100,,,fee schedule,100% of CO APG rates,59,100,,,fee schedule,100% of CO APG rates,59,100,,,fee schedule,100% of NM fee schedule,23.6,40,,,percent of total billed charges,40% of total billed charges,23.6,40,,,percent of total billed charges,40% of total billed charges,53.1,90,,,percent of total billed charges,90% of total billed charges,44.84,76,,,percent of total billed charges,76% of total billed charges,23.6,40,,,percent of total billed charges,40% of total billed charges,50.15,85,,,percent of total billed charges,85% of total billed charges,59,100,,,fee schedule,100% of CO APG rate,47.2,80,,,percent of total billed charges,80% of total billed charges,22.89,38.8,,,percent of total billed charges,38.8% of total billed charges,50.15,85,,,percent of total billed charges,85% of total billed charges,59,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,22.89,59,
SUTURE 2-0 GUT CHR   C-14 SG637G,50555,CDM,270,RC,,,OUTPATIENT,,,72,57.6,,54,75,,,percent of total billed charges,75% of total billed charges,28.8,40,,,percent of total billed charges,40% of total billed charges,57.02,79.2,,,percent of total billed charges,79.2% of total billed charges,61.2,85,,,percent of total billed charges,85% of total billed charges,72,100,,,fee schedule,100% of CO APG rates,68.4,95,,,percent of total billed charges,95% of total billed charges,57.6,80,,,percent of total billed charges,80% of total billed charges,61.2,85,,,percent of total billed charges,85% of total billed charges,64.8,90,,,percent of total billed charges,90% of total billed charges,72,100,,,fee schedule,100% of CO APG rates,72,100,,,fee schedule,100% of CO APG rates,72,100,,,fee schedule,100% of NM fee schedule,28.8,40,,,percent of total billed charges,40% of total billed charges,28.8,40,,,percent of total billed charges,40% of total billed charges,64.8,90,,,percent of total billed charges,90% of total billed charges,54.72,76,,,percent of total billed charges,76% of total billed charges,28.8,40,,,percent of total billed charges,40% of total billed charges,61.2,85,,,percent of total billed charges,85% of total billed charges,72,100,,,fee schedule,100% of CO APG rate,57.6,80,,,percent of total billed charges,80% of total billed charges,27.94,38.8,,,percent of total billed charges,38.8% of total billed charges,61.2,85,,,percent of total billed charges,85% of total billed charges,72,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,27.94,72,
SUTURE 3-0 NYLON DS24 S663G,50556,CDM,270,RC,,,OUTPATIENT,,,6.5,5.2,,4.88,75,,,percent of total billed charges,75% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.15,79.2,,,percent of total billed charges,79.2% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.18,95,,,percent of total billed charges,95% of total billed charges,5.2,80,,,percent of total billed charges,80% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of NM fee schedule,2.6,40,,,percent of total billed charges,40% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,4.94,76,,,percent of total billed charges,76% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rate,5.2,80,,,percent of total billed charges,80% of total billed charges,2.52,38.8,,,percent of total billed charges,38.8% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.52,6.5,
SUTURE 4-0 NYLON  DS18 S662G,50557,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.91,7.5,
SUTURE 4-0 NYLON DSM13 S699G,50558,CDM,270,RC,,,OUTPATIENT,,,14.3,11.44,,10.73,75,,,percent of total billed charges,75% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,11.33,79.2,,,percent of total billed charges,79.2% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,13.59,95,,,percent of total billed charges,95% of total billed charges,11.44,80,,,percent of total billed charges,80% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of NM fee schedule,5.72,40,,,percent of total billed charges,40% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,10.87,76,,,percent of total billed charges,76% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rate,11.44,80,,,percent of total billed charges,80% of total billed charges,5.55,38.8,,,percent of total billed charges,38.8% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.55,14.3,
SUTURE 4-0 VICRYL PGA DSM13/P3 SJ494G,50559,CDM,270,RC,,,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.04,13,
SUTURE 5-0 NYLON DS18 S661G,50560,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.91,7.5,
SUTURE 5-0 NYLON DSM13 S698G,50561,CDM,270,RC,,,OUTPATIENT,,,14.3,11.44,,10.73,75,,,percent of total billed charges,75% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,11.33,79.2,,,percent of total billed charges,79.2% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,13.59,95,,,percent of total billed charges,95% of total billed charges,11.44,80,,,percent of total billed charges,80% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of NM fee schedule,5.72,40,,,percent of total billed charges,40% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,10.87,76,,,percent of total billed charges,76% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rate,11.44,80,,,percent of total billed charges,80% of total billed charges,5.55,38.8,,,percent of total billed charges,38.8% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.55,14.3,
SUTURE 6-0 NYLON DSM11 S697G,50562,CDM,270,RC,,,OUTPATIENT,,,14.3,11.44,,10.73,75,,,percent of total billed charges,75% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,11.33,79.2,,,percent of total billed charges,79.2% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,13.59,95,,,percent of total billed charges,95% of total billed charges,11.44,80,,,percent of total billed charges,80% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of NM fee schedule,5.72,40,,,percent of total billed charges,40% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,10.87,76,,,percent of total billed charges,76% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rate,11.44,80,,,percent of total billed charges,80% of total billed charges,5.55,38.8,,,percent of total billed charges,38.8% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.55,14.3,
SUTURE 2-0 SOFSILK  C15 SS685G,50563,CDM,270,RC,,,OUTPATIENT,,,15.3,12.24,,11.48,75,,,percent of total billed charges,75% of total billed charges,6.12,40,,,percent of total billed charges,40% of total billed charges,12.12,79.2,,,percent of total billed charges,79.2% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,15.3,100,,,fee schedule,100% of CO APG rates,14.54,95,,,percent of total billed charges,95% of total billed charges,12.24,80,,,percent of total billed charges,80% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,13.77,90,,,percent of total billed charges,90% of total billed charges,15.3,100,,,fee schedule,100% of CO APG rates,15.3,100,,,fee schedule,100% of CO APG rates,15.3,100,,,fee schedule,100% of NM fee schedule,6.12,40,,,percent of total billed charges,40% of total billed charges,6.12,40,,,percent of total billed charges,40% of total billed charges,13.77,90,,,percent of total billed charges,90% of total billed charges,11.63,76,,,percent of total billed charges,76% of total billed charges,6.12,40,,,percent of total billed charges,40% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,15.3,100,,,fee schedule,100% of CO APG rate,12.24,80,,,percent of total billed charges,80% of total billed charges,5.94,38.8,,,percent of total billed charges,38.8% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,15.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.94,15.3,
EZ PAP SYS W/MANOMETER MASK,50573,CDM,270,RC,,,OUTPATIENT,,,122.5,98,,91.88,75,,,percent of total billed charges,75% of total billed charges,49,40,,,percent of total billed charges,40% of total billed charges,97.02,79.2,,,percent of total billed charges,79.2% of total billed charges,104.13,85,,,percent of total billed charges,85% of total billed charges,122.5,100,,,fee schedule,100% of CO APG rates,116.38,95,,,percent of total billed charges,95% of total billed charges,98,80,,,percent of total billed charges,80% of total billed charges,104.13,85,,,percent of total billed charges,85% of total billed charges,110.25,90,,,percent of total billed charges,90% of total billed charges,122.5,100,,,fee schedule,100% of CO APG rates,122.5,100,,,fee schedule,100% of CO APG rates,122.5,100,,,fee schedule,100% of NM fee schedule,49,40,,,percent of total billed charges,40% of total billed charges,49,40,,,percent of total billed charges,40% of total billed charges,110.25,90,,,percent of total billed charges,90% of total billed charges,93.1,76,,,percent of total billed charges,76% of total billed charges,49,40,,,percent of total billed charges,40% of total billed charges,104.13,85,,,percent of total billed charges,85% of total billed charges,122.5,100,,,fee schedule,100% of CO APG rate,98,80,,,percent of total billed charges,80% of total billed charges,47.53,38.8,,,percent of total billed charges,38.8% of total billed charges,104.13,85,,,percent of total billed charges,85% of total billed charges,122.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,47.53,122.5,
EZ PAP SYS W/LG MASK,50574,CDM,270,RC,,,OUTPATIENT,,,95.2,76.16,,71.4,75,,,percent of total billed charges,75% of total billed charges,38.08,40,,,percent of total billed charges,40% of total billed charges,75.4,79.2,,,percent of total billed charges,79.2% of total billed charges,80.92,85,,,percent of total billed charges,85% of total billed charges,95.2,100,,,fee schedule,100% of CO APG rates,90.44,95,,,percent of total billed charges,95% of total billed charges,76.16,80,,,percent of total billed charges,80% of total billed charges,80.92,85,,,percent of total billed charges,85% of total billed charges,85.68,90,,,percent of total billed charges,90% of total billed charges,95.2,100,,,fee schedule,100% of CO APG rates,95.2,100,,,fee schedule,100% of CO APG rates,95.2,100,,,fee schedule,100% of NM fee schedule,38.08,40,,,percent of total billed charges,40% of total billed charges,38.08,40,,,percent of total billed charges,40% of total billed charges,85.68,90,,,percent of total billed charges,90% of total billed charges,72.35,76,,,percent of total billed charges,76% of total billed charges,38.08,40,,,percent of total billed charges,40% of total billed charges,80.92,85,,,percent of total billed charges,85% of total billed charges,95.2,100,,,fee schedule,100% of CO APG rate,76.16,80,,,percent of total billed charges,80% of total billed charges,36.94,38.8,,,percent of total billed charges,38.8% of total billed charges,80.92,85,,,percent of total billed charges,85% of total billed charges,95.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,36.94,95.2,
EZ PAP SYS W/MD MASK,50575,CDM,270,RC,,,OUTPATIENT,,,99.3,79.44,,74.48,75,,,percent of total billed charges,75% of total billed charges,39.72,40,,,percent of total billed charges,40% of total billed charges,78.65,79.2,,,percent of total billed charges,79.2% of total billed charges,84.41,85,,,percent of total billed charges,85% of total billed charges,99.3,100,,,fee schedule,100% of CO APG rates,94.34,95,,,percent of total billed charges,95% of total billed charges,79.44,80,,,percent of total billed charges,80% of total billed charges,84.41,85,,,percent of total billed charges,85% of total billed charges,89.37,90,,,percent of total billed charges,90% of total billed charges,99.3,100,,,fee schedule,100% of CO APG rates,99.3,100,,,fee schedule,100% of CO APG rates,99.3,100,,,fee schedule,100% of NM fee schedule,39.72,40,,,percent of total billed charges,40% of total billed charges,39.72,40,,,percent of total billed charges,40% of total billed charges,89.37,90,,,percent of total billed charges,90% of total billed charges,75.47,76,,,percent of total billed charges,76% of total billed charges,39.72,40,,,percent of total billed charges,40% of total billed charges,84.41,85,,,percent of total billed charges,85% of total billed charges,99.3,100,,,fee schedule,100% of CO APG rate,79.44,80,,,percent of total billed charges,80% of total billed charges,38.53,38.8,,,percent of total billed charges,38.8% of total billed charges,84.41,85,,,percent of total billed charges,85% of total billed charges,99.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,38.53,99.3,
EZ PAP SYS W/PED MASK,50576,CDM,270,RC,,,OUTPATIENT,,,95.2,76.16,,71.4,75,,,percent of total billed charges,75% of total billed charges,38.08,40,,,percent of total billed charges,40% of total billed charges,75.4,79.2,,,percent of total billed charges,79.2% of total billed charges,80.92,85,,,percent of total billed charges,85% of total billed charges,95.2,100,,,fee schedule,100% of CO APG rates,90.44,95,,,percent of total billed charges,95% of total billed charges,76.16,80,,,percent of total billed charges,80% of total billed charges,80.92,85,,,percent of total billed charges,85% of total billed charges,85.68,90,,,percent of total billed charges,90% of total billed charges,95.2,100,,,fee schedule,100% of CO APG rates,95.2,100,,,fee schedule,100% of CO APG rates,95.2,100,,,fee schedule,100% of NM fee schedule,38.08,40,,,percent of total billed charges,40% of total billed charges,38.08,40,,,percent of total billed charges,40% of total billed charges,85.68,90,,,percent of total billed charges,90% of total billed charges,72.35,76,,,percent of total billed charges,76% of total billed charges,38.08,40,,,percent of total billed charges,40% of total billed charges,80.92,85,,,percent of total billed charges,85% of total billed charges,95.2,100,,,fee schedule,100% of CO APG rate,76.16,80,,,percent of total billed charges,80% of total billed charges,36.94,38.8,,,percent of total billed charges,38.8% of total billed charges,80.92,85,,,percent of total billed charges,85% of total billed charges,95.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,36.94,95.2,
SUCTION IRRIGATOR,46050582,CDM,270,RC,,,OUTPATIENT,,,222.8,178.24,,167.1,75,,,percent of total billed charges,75% of total billed charges,89.12,40,,,percent of total billed charges,40% of total billed charges,176.46,79.2,,,percent of total billed charges,79.2% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,222.8,100,,,fee schedule,100% of CO APG rates,211.66,95,,,percent of total billed charges,95% of total billed charges,178.24,80,,,percent of total billed charges,80% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,200.52,90,,,percent of total billed charges,90% of total billed charges,222.8,100,,,fee schedule,100% of CO APG rates,222.8,100,,,fee schedule,100% of CO APG rates,222.8,100,,,fee schedule,100% of NM fee schedule,89.12,40,,,percent of total billed charges,40% of total billed charges,89.12,40,,,percent of total billed charges,40% of total billed charges,200.52,90,,,percent of total billed charges,90% of total billed charges,169.33,76,,,percent of total billed charges,76% of total billed charges,89.12,40,,,percent of total billed charges,40% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,222.8,100,,,fee schedule,100% of CO APG rate,178.24,80,,,percent of total billed charges,80% of total billed charges,86.45,38.8,,,percent of total billed charges,38.8% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,222.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,86.45,222.8,
CATH WORD BARTHOLIM GLAND 10/5  LTX,51082,CDM,270,RC,,,OUTPATIENT,,,120.1,96.08,,90.08,75,,,percent of total billed charges,75% of total billed charges,48.04,40,,,percent of total billed charges,40% of total billed charges,95.12,79.2,,,percent of total billed charges,79.2% of total billed charges,102.09,85,,,percent of total billed charges,85% of total billed charges,120.1,100,,,fee schedule,100% of CO APG rates,114.1,95,,,percent of total billed charges,95% of total billed charges,96.08,80,,,percent of total billed charges,80% of total billed charges,102.09,85,,,percent of total billed charges,85% of total billed charges,108.09,90,,,percent of total billed charges,90% of total billed charges,120.1,100,,,fee schedule,100% of CO APG rates,120.1,100,,,fee schedule,100% of CO APG rates,120.1,100,,,fee schedule,100% of NM fee schedule,48.04,40,,,percent of total billed charges,40% of total billed charges,48.04,40,,,percent of total billed charges,40% of total billed charges,108.09,90,,,percent of total billed charges,90% of total billed charges,91.28,76,,,percent of total billed charges,76% of total billed charges,48.04,40,,,percent of total billed charges,40% of total billed charges,102.09,85,,,percent of total billed charges,85% of total billed charges,120.1,100,,,fee schedule,100% of CO APG rate,96.08,80,,,percent of total billed charges,80% of total billed charges,46.6,38.8,,,percent of total billed charges,38.8% of total billed charges,102.09,85,,,percent of total billed charges,85% of total billed charges,120.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,46.6,120.1,
DISPOSABLE CPAP SYSTEM (LG ADULT),51107,CDM,270,RC,,,OUTPATIENT,,,251.2,200.96,,188.4,75,,,percent of total billed charges,75% of total billed charges,100.48,40,,,percent of total billed charges,40% of total billed charges,198.95,79.2,,,percent of total billed charges,79.2% of total billed charges,213.52,85,,,percent of total billed charges,85% of total billed charges,251.2,100,,,fee schedule,100% of CO APG rates,238.64,95,,,percent of total billed charges,95% of total billed charges,200.96,80,,,percent of total billed charges,80% of total billed charges,213.52,85,,,percent of total billed charges,85% of total billed charges,226.08,90,,,percent of total billed charges,90% of total billed charges,251.2,100,,,fee schedule,100% of CO APG rates,251.2,100,,,fee schedule,100% of CO APG rates,251.2,100,,,fee schedule,100% of NM fee schedule,100.48,40,,,percent of total billed charges,40% of total billed charges,100.48,40,,,percent of total billed charges,40% of total billed charges,226.08,90,,,percent of total billed charges,90% of total billed charges,190.91,76,,,percent of total billed charges,76% of total billed charges,100.48,40,,,percent of total billed charges,40% of total billed charges,213.52,85,,,percent of total billed charges,85% of total billed charges,251.2,100,,,fee schedule,100% of CO APG rate,200.96,80,,,percent of total billed charges,80% of total billed charges,97.47,38.8,,,percent of total billed charges,38.8% of total billed charges,213.52,85,,,percent of total billed charges,85% of total billed charges,251.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,97.47,251.2,
CARR LOCKE INJ NEEDLES,46051109,CDM,270,RC,,,OUTPATIENT,,,183.6,146.88,,137.7,75,,,percent of total billed charges,75% of total billed charges,73.44,40,,,percent of total billed charges,40% of total billed charges,145.41,79.2,,,percent of total billed charges,79.2% of total billed charges,156.06,85,,,percent of total billed charges,85% of total billed charges,183.6,100,,,fee schedule,100% of CO APG rates,174.42,95,,,percent of total billed charges,95% of total billed charges,146.88,80,,,percent of total billed charges,80% of total billed charges,156.06,85,,,percent of total billed charges,85% of total billed charges,165.24,90,,,percent of total billed charges,90% of total billed charges,183.6,100,,,fee schedule,100% of CO APG rates,183.6,100,,,fee schedule,100% of CO APG rates,183.6,100,,,fee schedule,100% of NM fee schedule,73.44,40,,,percent of total billed charges,40% of total billed charges,73.44,40,,,percent of total billed charges,40% of total billed charges,165.24,90,,,percent of total billed charges,90% of total billed charges,139.54,76,,,percent of total billed charges,76% of total billed charges,73.44,40,,,percent of total billed charges,40% of total billed charges,156.06,85,,,percent of total billed charges,85% of total billed charges,183.6,100,,,fee schedule,100% of CO APG rate,146.88,80,,,percent of total billed charges,80% of total billed charges,71.24,38.8,,,percent of total billed charges,38.8% of total billed charges,156.06,85,,,percent of total billed charges,85% of total billed charges,183.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,71.24,183.6,
ROTH NET FB STANDARD,46051110,CDM,270,RC,,,OUTPATIENT,,,340.9,272.72,,255.68,75,,,percent of total billed charges,75% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,269.99,79.2,,,percent of total billed charges,79.2% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,340.9,100,,,fee schedule,100% of CO APG rates,323.86,95,,,percent of total billed charges,95% of total billed charges,272.72,80,,,percent of total billed charges,80% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,306.81,90,,,percent of total billed charges,90% of total billed charges,340.9,100,,,fee schedule,100% of CO APG rates,340.9,100,,,fee schedule,100% of CO APG rates,340.9,100,,,fee schedule,100% of NM fee schedule,136.36,40,,,percent of total billed charges,40% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,306.81,90,,,percent of total billed charges,90% of total billed charges,259.08,76,,,percent of total billed charges,76% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,340.9,100,,,fee schedule,100% of CO APG rate,272.72,80,,,percent of total billed charges,80% of total billed charges,132.27,38.8,,,percent of total billed charges,38.8% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,340.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,132.27,340.9,
EZ IO NEEDLE SETS - ADULT,51112,CDM,270,RC,,,OUTPATIENT,,,527.5,422,,395.63,75,,,percent of total billed charges,75% of total billed charges,211,40,,,percent of total billed charges,40% of total billed charges,417.78,79.2,,,percent of total billed charges,79.2% of total billed charges,448.38,85,,,percent of total billed charges,85% of total billed charges,527.5,100,,,fee schedule,100% of CO APG rates,501.13,95,,,percent of total billed charges,95% of total billed charges,422,80,,,percent of total billed charges,80% of total billed charges,448.38,85,,,percent of total billed charges,85% of total billed charges,474.75,90,,,percent of total billed charges,90% of total billed charges,527.5,100,,,fee schedule,100% of CO APG rates,527.5,100,,,fee schedule,100% of CO APG rates,527.5,100,,,fee schedule,100% of NM fee schedule,211,40,,,percent of total billed charges,40% of total billed charges,211,40,,,percent of total billed charges,40% of total billed charges,474.75,90,,,percent of total billed charges,90% of total billed charges,400.9,76,,,percent of total billed charges,76% of total billed charges,211,40,,,percent of total billed charges,40% of total billed charges,448.38,85,,,percent of total billed charges,85% of total billed charges,527.5,100,,,fee schedule,100% of CO APG rate,422,80,,,percent of total billed charges,80% of total billed charges,204.67,38.8,,,percent of total billed charges,38.8% of total billed charges,448.38,85,,,percent of total billed charges,85% of total billed charges,527.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,204.67,527.5,
EZ IO NEEDLE SETS - LG ADULT,51113,CDM,270,RC,,,OUTPATIENT,,,561.6,449.28,,421.2,75,,,percent of total billed charges,75% of total billed charges,224.64,40,,,percent of total billed charges,40% of total billed charges,444.79,79.2,,,percent of total billed charges,79.2% of total billed charges,477.36,85,,,percent of total billed charges,85% of total billed charges,561.6,100,,,fee schedule,100% of CO APG rates,533.52,95,,,percent of total billed charges,95% of total billed charges,449.28,80,,,percent of total billed charges,80% of total billed charges,477.36,85,,,percent of total billed charges,85% of total billed charges,505.44,90,,,percent of total billed charges,90% of total billed charges,561.6,100,,,fee schedule,100% of CO APG rates,561.6,100,,,fee schedule,100% of CO APG rates,561.6,100,,,fee schedule,100% of NM fee schedule,224.64,40,,,percent of total billed charges,40% of total billed charges,224.64,40,,,percent of total billed charges,40% of total billed charges,505.44,90,,,percent of total billed charges,90% of total billed charges,426.82,76,,,percent of total billed charges,76% of total billed charges,224.64,40,,,percent of total billed charges,40% of total billed charges,477.36,85,,,percent of total billed charges,85% of total billed charges,561.6,100,,,fee schedule,100% of CO APG rate,449.28,80,,,percent of total billed charges,80% of total billed charges,217.9,38.8,,,percent of total billed charges,38.8% of total billed charges,477.36,85,,,percent of total billed charges,85% of total billed charges,561.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,217.9,561.6,
EZ IO NEEDLE SETS - PEDI,51114,CDM,270,RC,,,OUTPATIENT,,,527.5,422,,395.63,75,,,percent of total billed charges,75% of total billed charges,211,40,,,percent of total billed charges,40% of total billed charges,417.78,79.2,,,percent of total billed charges,79.2% of total billed charges,448.38,85,,,percent of total billed charges,85% of total billed charges,527.5,100,,,fee schedule,100% of CO APG rates,501.13,95,,,percent of total billed charges,95% of total billed charges,422,80,,,percent of total billed charges,80% of total billed charges,448.38,85,,,percent of total billed charges,85% of total billed charges,474.75,90,,,percent of total billed charges,90% of total billed charges,527.5,100,,,fee schedule,100% of CO APG rates,527.5,100,,,fee schedule,100% of CO APG rates,527.5,100,,,fee schedule,100% of NM fee schedule,211,40,,,percent of total billed charges,40% of total billed charges,211,40,,,percent of total billed charges,40% of total billed charges,474.75,90,,,percent of total billed charges,90% of total billed charges,400.9,76,,,percent of total billed charges,76% of total billed charges,211,40,,,percent of total billed charges,40% of total billed charges,448.38,85,,,percent of total billed charges,85% of total billed charges,527.5,100,,,fee schedule,100% of CO APG rate,422,80,,,percent of total billed charges,80% of total billed charges,204.67,38.8,,,percent of total billed charges,38.8% of total billed charges,448.38,85,,,percent of total billed charges,85% of total billed charges,527.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,204.67,527.5,
EZ IO EZ-STABILIZER,51115,CDM,270,RC,,,OUTPATIENT,,,78.8,63.04,,59.1,75,,,percent of total billed charges,75% of total billed charges,31.52,40,,,percent of total billed charges,40% of total billed charges,62.41,79.2,,,percent of total billed charges,79.2% of total billed charges,66.98,85,,,percent of total billed charges,85% of total billed charges,78.8,100,,,fee schedule,100% of CO APG rates,74.86,95,,,percent of total billed charges,95% of total billed charges,63.04,80,,,percent of total billed charges,80% of total billed charges,66.98,85,,,percent of total billed charges,85% of total billed charges,70.92,90,,,percent of total billed charges,90% of total billed charges,78.8,100,,,fee schedule,100% of CO APG rates,78.8,100,,,fee schedule,100% of CO APG rates,78.8,100,,,fee schedule,100% of NM fee schedule,31.52,40,,,percent of total billed charges,40% of total billed charges,31.52,40,,,percent of total billed charges,40% of total billed charges,70.92,90,,,percent of total billed charges,90% of total billed charges,59.89,76,,,percent of total billed charges,76% of total billed charges,31.52,40,,,percent of total billed charges,40% of total billed charges,66.98,85,,,percent of total billed charges,85% of total billed charges,78.8,100,,,fee schedule,100% of CO APG rate,63.04,80,,,percent of total billed charges,80% of total billed charges,30.57,38.8,,,percent of total billed charges,38.8% of total billed charges,66.98,85,,,percent of total billed charges,85% of total billed charges,78.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,30.57,78.8,
SUTURE 0 VICRYL CTD CT-1 J740D,51117,CDM,270,RC,,,OUTPATIENT,,,34.8,27.84,,26.1,75,,,percent of total billed charges,75% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,27.56,79.2,,,percent of total billed charges,79.2% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rates,33.06,95,,,percent of total billed charges,95% of total billed charges,27.84,80,,,percent of total billed charges,80% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,31.32,90,,,percent of total billed charges,90% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rates,34.8,100,,,fee schedule,100% of CO APG rates,34.8,100,,,fee schedule,100% of NM fee schedule,13.92,40,,,percent of total billed charges,40% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,31.32,90,,,percent of total billed charges,90% of total billed charges,26.45,76,,,percent of total billed charges,76% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rate,27.84,80,,,percent of total billed charges,80% of total billed charges,13.5,38.8,,,percent of total billed charges,38.8% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,13.5,34.8,
DILATOR ESOPH BALLOON 10X8,46051120,CDM,270,RC,,,OUTPATIENT,,,350.7,280.56,,263.03,75,,,percent of total billed charges,75% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,277.75,79.2,,,percent of total billed charges,79.2% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rates,333.17,95,,,percent of total billed charges,95% of total billed charges,280.56,80,,,percent of total billed charges,80% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,315.63,90,,,percent of total billed charges,90% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rates,350.7,100,,,fee schedule,100% of CO APG rates,350.7,100,,,fee schedule,100% of NM fee schedule,140.28,40,,,percent of total billed charges,40% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,315.63,90,,,percent of total billed charges,90% of total billed charges,266.53,76,,,percent of total billed charges,76% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rate,280.56,80,,,percent of total billed charges,80% of total billed charges,136.07,38.8,,,percent of total billed charges,38.8% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,136.07,350.7,
DILATOR ESOPH BALLOON 12X8,46051121,CDM,270,RC,,,OUTPATIENT,,,350.7,280.56,,263.03,75,,,percent of total billed charges,75% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,277.75,79.2,,,percent of total billed charges,79.2% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rates,333.17,95,,,percent of total billed charges,95% of total billed charges,280.56,80,,,percent of total billed charges,80% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,315.63,90,,,percent of total billed charges,90% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rates,350.7,100,,,fee schedule,100% of CO APG rates,350.7,100,,,fee schedule,100% of NM fee schedule,140.28,40,,,percent of total billed charges,40% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,315.63,90,,,percent of total billed charges,90% of total billed charges,266.53,76,,,percent of total billed charges,76% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rate,280.56,80,,,percent of total billed charges,80% of total billed charges,136.07,38.8,,,percent of total billed charges,38.8% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,136.07,350.7,
DILATOR ESOPH BALLOON 15X8,46051122,CDM,270,RC,,,OUTPATIENT,,,350.7,280.56,,263.03,75,,,percent of total billed charges,75% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,277.75,79.2,,,percent of total billed charges,79.2% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rates,333.17,95,,,percent of total billed charges,95% of total billed charges,280.56,80,,,percent of total billed charges,80% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,315.63,90,,,percent of total billed charges,90% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rates,350.7,100,,,fee schedule,100% of CO APG rates,350.7,100,,,fee schedule,100% of NM fee schedule,140.28,40,,,percent of total billed charges,40% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,315.63,90,,,percent of total billed charges,90% of total billed charges,266.53,76,,,percent of total billed charges,76% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rate,280.56,80,,,percent of total billed charges,80% of total billed charges,136.07,38.8,,,percent of total billed charges,38.8% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,136.07,350.7,
SUTURE 4-0 PROLENE FS-2 8683G,51125,CDM,270,RC,,,OUTPATIENT,,,9.9,7.92,,7.43,75,,,percent of total billed charges,75% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,7.84,79.2,,,percent of total billed charges,79.2% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rates,9.41,95,,,percent of total billed charges,95% of total billed charges,7.92,80,,,percent of total billed charges,80% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,8.91,90,,,percent of total billed charges,90% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rates,9.9,100,,,fee schedule,100% of CO APG rates,9.9,100,,,fee schedule,100% of NM fee schedule,3.96,40,,,percent of total billed charges,40% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,8.91,90,,,percent of total billed charges,90% of total billed charges,7.52,76,,,percent of total billed charges,76% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rate,7.92,80,,,percent of total billed charges,80% of total billed charges,3.84,38.8,,,percent of total billed charges,38.8% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.84,9.9,
ANAL FISTUAL PLUG SET 0.6X9.5,46051127,CDM,270,RC,,,OUTPATIENT,,,2352,1881.6,,1764,75,,,percent of total billed charges,75% of total billed charges,940.8,40,,,percent of total billed charges,40% of total billed charges,1862.78,79.2,,,percent of total billed charges,79.2% of total billed charges,1999.2,85,,,percent of total billed charges,85% of total billed charges,2352,100,,,fee schedule,100% of CO APG rates,2234.4,95,,,percent of total billed charges,95% of total billed charges,1881.6,80,,,percent of total billed charges,80% of total billed charges,1999.2,85,,,percent of total billed charges,85% of total billed charges,2116.8,90,,,percent of total billed charges,90% of total billed charges,2352,100,,,fee schedule,100% of CO APG rates,2352,100,,,fee schedule,100% of CO APG rates,2352,100,,,fee schedule,100% of NM fee schedule,940.8,40,,,percent of total billed charges,40% of total billed charges,940.8,40,,,percent of total billed charges,40% of total billed charges,2116.8,90,,,percent of total billed charges,90% of total billed charges,1787.52,76,,,percent of total billed charges,76% of total billed charges,940.8,40,,,percent of total billed charges,40% of total billed charges,1999.2,85,,,percent of total billed charges,85% of total billed charges,2352,100,,,fee schedule,100% of CO APG rate,1881.6,80,,,percent of total billed charges,80% of total billed charges,912.58,38.8,,,percent of total billed charges,38.8% of total billed charges,1999.2,85,,,percent of total billed charges,85% of total billed charges,2352,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,912.58,2352,
ANAL FISTUAL PLUG SET 0.4,46051128,CDM,270,RC,,,OUTPATIENT,,,2283.1,1826.48,,1712.33,75,,,percent of total billed charges,75% of total billed charges,913.24,40,,,percent of total billed charges,40% of total billed charges,1808.22,79.2,,,percent of total billed charges,79.2% of total billed charges,1940.64,85,,,percent of total billed charges,85% of total billed charges,2283.1,100,,,fee schedule,100% of CO APG rates,2168.95,95,,,percent of total billed charges,95% of total billed charges,1826.48,80,,,percent of total billed charges,80% of total billed charges,1940.64,85,,,percent of total billed charges,85% of total billed charges,2054.79,90,,,percent of total billed charges,90% of total billed charges,2283.1,100,,,fee schedule,100% of CO APG rates,2283.1,100,,,fee schedule,100% of CO APG rates,2283.1,100,,,fee schedule,100% of NM fee schedule,913.24,40,,,percent of total billed charges,40% of total billed charges,913.24,40,,,percent of total billed charges,40% of total billed charges,2054.79,90,,,percent of total billed charges,90% of total billed charges,1735.16,76,,,percent of total billed charges,76% of total billed charges,913.24,40,,,percent of total billed charges,40% of total billed charges,1940.64,85,,,percent of total billed charges,85% of total billed charges,2283.1,100,,,fee schedule,100% of CO APG rate,1826.48,80,,,percent of total billed charges,80% of total billed charges,885.84,38.8,,,percent of total billed charges,38.8% of total billed charges,1940.64,85,,,percent of total billed charges,85% of total billed charges,2283.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,885.84,2283.1,
EZ PAP SYS W/MANOMETER,51130,CDM,270,RC,,,OUTPATIENT,,,569.1,455.28,,426.83,75,,,percent of total billed charges,75% of total billed charges,227.64,40,,,percent of total billed charges,40% of total billed charges,450.73,79.2,,,percent of total billed charges,79.2% of total billed charges,483.74,85,,,percent of total billed charges,85% of total billed charges,569.1,100,,,fee schedule,100% of CO APG rates,540.65,95,,,percent of total billed charges,95% of total billed charges,455.28,80,,,percent of total billed charges,80% of total billed charges,483.74,85,,,percent of total billed charges,85% of total billed charges,512.19,90,,,percent of total billed charges,90% of total billed charges,569.1,100,,,fee schedule,100% of CO APG rates,569.1,100,,,fee schedule,100% of CO APG rates,569.1,100,,,fee schedule,100% of NM fee schedule,227.64,40,,,percent of total billed charges,40% of total billed charges,227.64,40,,,percent of total billed charges,40% of total billed charges,512.19,90,,,percent of total billed charges,90% of total billed charges,432.52,76,,,percent of total billed charges,76% of total billed charges,227.64,40,,,percent of total billed charges,40% of total billed charges,483.74,85,,,percent of total billed charges,85% of total billed charges,569.1,100,,,fee schedule,100% of CO APG rate,455.28,80,,,percent of total billed charges,80% of total billed charges,220.81,38.8,,,percent of total billed charges,38.8% of total billed charges,483.74,85,,,percent of total billed charges,85% of total billed charges,569.1,100,,,fee schedule,100% of APG fee schedule,1138.2,200,,,percent of total billed charges,200% of total billed charges,220.81,1138.2,
PERFIX LIGHT PLUG  SM,46050055,CDM,278,RC,,,OUTPATIENT,,,526.3,421.04,,394.73,75,,,percent of total billed charges,75% of total billed charges,210.52,40,,,percent of total billed charges,40% of total billed charges,416.83,79.2,,,percent of total billed charges,79.2% of total billed charges,447.36,85,,,percent of total billed charges,85% of total billed charges,526.3,100,,,fee schedule,100% of CO APG rates,499.99,95,,,percent of total billed charges,95% of total billed charges,421.04,80,,,percent of total billed charges,80% of total billed charges,447.36,85,,,percent of total billed charges,85% of total billed charges,473.67,90,,,percent of total billed charges,90% of total billed charges,526.3,100,,,fee schedule,100% of CO APG rates,526.3,100,,,fee schedule,100% of CO APG rates,526.3,100,,,fee schedule,100% of NM fee schedule,210.52,40,,,percent of total billed charges,40% of total billed charges,210.52,40,,,percent of total billed charges,40% of total billed charges,473.67,90,,,percent of total billed charges,90% of total billed charges,399.99,76,,,percent of total billed charges,76% of total billed charges,210.52,40,,,percent of total billed charges,40% of total billed charges,447.36,85,,,percent of total billed charges,85% of total billed charges,526.3,100,,,fee schedule,100% of CO APG rate,421.04,80,,,percent of total billed charges,80% of total billed charges,204.2,38.8,,,percent of total billed charges,38.8% of total billed charges,447.36,85,,,percent of total billed charges,85% of total billed charges,526.3,100,,,fee schedule,100% of APG fee schedule,1052.6,200,,,percent of total billed charges,200% of total billed charges,204.2,1052.6,
BARD VENTRALEX ST LARGE CIRECLE Diameter: 8.0cm/3.2,46050057,CDM,278,RC,,,OUTPATIENT,,,1615.5,1292.4,,1211.63,75,,,percent of total billed charges,75% of total billed charges,646.2,40,,,percent of total billed charges,40% of total billed charges,1279.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1373.18,85,,,percent of total billed charges,85% of total billed charges,1615.5,100,,,fee schedule,100% of CO APG rates,1534.73,95,,,percent of total billed charges,95% of total billed charges,1292.4,80,,,percent of total billed charges,80% of total billed charges,1373.18,85,,,percent of total billed charges,85% of total billed charges,1453.95,90,,,percent of total billed charges,90% of total billed charges,1615.5,100,,,fee schedule,100% of CO APG rates,1615.5,100,,,fee schedule,100% of CO APG rates,1615.5,100,,,fee schedule,100% of NM fee schedule,646.2,40,,,percent of total billed charges,40% of total billed charges,646.2,40,,,percent of total billed charges,40% of total billed charges,1453.95,90,,,percent of total billed charges,90% of total billed charges,1227.78,76,,,percent of total billed charges,76% of total billed charges,646.2,40,,,percent of total billed charges,40% of total billed charges,1373.18,85,,,percent of total billed charges,85% of total billed charges,1615.5,100,,,fee schedule,100% of CO APG rate,1292.4,80,,,percent of total billed charges,80% of total billed charges,626.81,38.8,,,percent of total billed charges,38.8% of total billed charges,1373.18,85,,,percent of total billed charges,85% of total billed charges,1615.5,100,,,fee schedule,100% of APG fee schedule,3231,200,,,percent of total billed charges,200% of total billed charges,626.81,3231,
BARD VENTRALEX ST MEDIUM CIRCLE  Diameter: 6.4cm/2.5,46050058,CDM,278,RC,,,OUTPATIENT,,,1427.5,1142,,1070.63,75,,,percent of total billed charges,75% of total billed charges,571,40,,,percent of total billed charges,40% of total billed charges,1130.58,79.2,,,percent of total billed charges,79.2% of total billed charges,1213.38,85,,,percent of total billed charges,85% of total billed charges,1427.5,100,,,fee schedule,100% of CO APG rates,1356.13,95,,,percent of total billed charges,95% of total billed charges,1142,80,,,percent of total billed charges,80% of total billed charges,1213.38,85,,,percent of total billed charges,85% of total billed charges,1284.75,90,,,percent of total billed charges,90% of total billed charges,1427.5,100,,,fee schedule,100% of CO APG rates,1427.5,100,,,fee schedule,100% of CO APG rates,1427.5,100,,,fee schedule,100% of NM fee schedule,571,40,,,percent of total billed charges,40% of total billed charges,571,40,,,percent of total billed charges,40% of total billed charges,1284.75,90,,,percent of total billed charges,90% of total billed charges,1084.9,76,,,percent of total billed charges,76% of total billed charges,571,40,,,percent of total billed charges,40% of total billed charges,1213.38,85,,,percent of total billed charges,85% of total billed charges,1427.5,100,,,fee schedule,100% of CO APG rate,1142,80,,,percent of total billed charges,80% of total billed charges,553.87,38.8,,,percent of total billed charges,38.8% of total billed charges,1213.38,85,,,percent of total billed charges,85% of total billed charges,1427.5,100,,,fee schedule,100% of APG fee schedule,2855,200,,,percent of total billed charges,200% of total billed charges,553.87,2855,
HERNIA PATCH SM,46050059,CDM,278,RC,,,OUTPATIENT,,,1197.5,958,,898.13,75,,,percent of total billed charges,75% of total billed charges,479,40,,,percent of total billed charges,40% of total billed charges,948.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1017.88,85,,,percent of total billed charges,85% of total billed charges,1197.5,100,,,fee schedule,100% of CO APG rates,1137.63,95,,,percent of total billed charges,95% of total billed charges,958,80,,,percent of total billed charges,80% of total billed charges,1017.88,85,,,percent of total billed charges,85% of total billed charges,1077.75,90,,,percent of total billed charges,90% of total billed charges,1197.5,100,,,fee schedule,100% of CO APG rates,1197.5,100,,,fee schedule,100% of CO APG rates,1197.5,100,,,fee schedule,100% of NM fee schedule,479,40,,,percent of total billed charges,40% of total billed charges,479,40,,,percent of total billed charges,40% of total billed charges,1077.75,90,,,percent of total billed charges,90% of total billed charges,910.1,76,,,percent of total billed charges,76% of total billed charges,479,40,,,percent of total billed charges,40% of total billed charges,1017.88,85,,,percent of total billed charges,85% of total billed charges,1197.5,100,,,fee schedule,100% of CO APG rate,958,80,,,percent of total billed charges,80% of total billed charges,464.63,38.8,,,percent of total billed charges,38.8% of total billed charges,1017.88,85,,,percent of total billed charges,85% of total billed charges,1197.5,100,,,fee schedule,100% of APG fee schedule,2395,200,,,percent of total billed charges,200% of total billed charges,464.63,2395,
"SORBAFIX ABSORABLE FIXATION SYSTEM  5MM LAP, 15 count",46050060,CDM,270,RC,,,OUTPATIENT,,,1458.3,1166.64,,1093.73,75,,,percent of total billed charges,75% of total billed charges,583.32,40,,,percent of total billed charges,40% of total billed charges,1154.97,79.2,,,percent of total billed charges,79.2% of total billed charges,1239.56,85,,,percent of total billed charges,85% of total billed charges,1458.3,100,,,fee schedule,100% of CO APG rates,1385.39,95,,,percent of total billed charges,95% of total billed charges,1166.64,80,,,percent of total billed charges,80% of total billed charges,1239.56,85,,,percent of total billed charges,85% of total billed charges,1312.47,90,,,percent of total billed charges,90% of total billed charges,1458.3,100,,,fee schedule,100% of CO APG rates,1458.3,100,,,fee schedule,100% of CO APG rates,1458.3,100,,,fee schedule,100% of NM fee schedule,583.32,40,,,percent of total billed charges,40% of total billed charges,583.32,40,,,percent of total billed charges,40% of total billed charges,1312.47,90,,,percent of total billed charges,90% of total billed charges,1108.31,76,,,percent of total billed charges,76% of total billed charges,583.32,40,,,percent of total billed charges,40% of total billed charges,1239.56,85,,,percent of total billed charges,85% of total billed charges,1458.3,100,,,fee schedule,100% of CO APG rate,1166.64,80,,,percent of total billed charges,80% of total billed charges,565.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1239.56,85,,,percent of total billed charges,85% of total billed charges,1458.3,100,,,fee schedule,100% of APG fee schedule,2916.6,200,,,percent of total billed charges,200% of total billed charges,565.82,2916.6,
PERFIX LIGHT PLUG  LG,46050061,CDM,278,RC,,,OUTPATIENT,,,543.1,434.48,,407.33,75,,,percent of total billed charges,75% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,430.14,79.2,,,percent of total billed charges,79.2% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rates,515.95,95,,,percent of total billed charges,95% of total billed charges,434.48,80,,,percent of total billed charges,80% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,488.79,90,,,percent of total billed charges,90% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rates,543.1,100,,,fee schedule,100% of CO APG rates,543.1,100,,,fee schedule,100% of NM fee schedule,217.24,40,,,percent of total billed charges,40% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,488.79,90,,,percent of total billed charges,90% of total billed charges,412.76,76,,,percent of total billed charges,76% of total billed charges,217.24,40,,,percent of total billed charges,40% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of CO APG rate,434.48,80,,,percent of total billed charges,80% of total billed charges,210.72,38.8,,,percent of total billed charges,38.8% of total billed charges,461.64,85,,,percent of total billed charges,85% of total billed charges,543.1,100,,,fee schedule,100% of APG fee schedule,1086.2,200,,,percent of total billed charges,200% of total billed charges,210.72,1086.2,
HERNIA VENT PATCH 13.8CMX17.8CM,46050063,CDM,278,RC,,,OUTPATIENT,,,2163.8,1731.04,,1622.85,75,,,percent of total billed charges,75% of total billed charges,865.52,40,,,percent of total billed charges,40% of total billed charges,1713.73,79.2,,,percent of total billed charges,79.2% of total billed charges,1839.23,85,,,percent of total billed charges,85% of total billed charges,2163.8,100,,,fee schedule,100% of CO APG rates,2055.61,95,,,percent of total billed charges,95% of total billed charges,1731.04,80,,,percent of total billed charges,80% of total billed charges,1839.23,85,,,percent of total billed charges,85% of total billed charges,1947.42,90,,,percent of total billed charges,90% of total billed charges,2163.8,100,,,fee schedule,100% of CO APG rates,2163.8,100,,,fee schedule,100% of CO APG rates,2163.8,100,,,fee schedule,100% of NM fee schedule,865.52,40,,,percent of total billed charges,40% of total billed charges,865.52,40,,,percent of total billed charges,40% of total billed charges,1947.42,90,,,percent of total billed charges,90% of total billed charges,1644.49,76,,,percent of total billed charges,76% of total billed charges,865.52,40,,,percent of total billed charges,40% of total billed charges,1839.23,85,,,percent of total billed charges,85% of total billed charges,2163.8,100,,,fee schedule,100% of CO APG rate,1731.04,80,,,percent of total billed charges,80% of total billed charges,839.55,38.8,,,percent of total billed charges,38.8% of total billed charges,1839.23,85,,,percent of total billed charges,85% of total billed charges,2163.8,100,,,fee schedule,100% of APG fee schedule,4327.6,200,,,percent of total billed charges,200% of total billed charges,839.55,4327.6,
HERNIA VENTRIO PATCH 11CMX14CM,46050067,CDM,278,RC,,,OUTPATIENT,,,2137.6,1710.08,,1603.2,75,,,percent of total billed charges,75% of total billed charges,855.04,40,,,percent of total billed charges,40% of total billed charges,1692.98,79.2,,,percent of total billed charges,79.2% of total billed charges,1816.96,85,,,percent of total billed charges,85% of total billed charges,2137.6,100,,,fee schedule,100% of CO APG rates,2030.72,95,,,percent of total billed charges,95% of total billed charges,1710.08,80,,,percent of total billed charges,80% of total billed charges,1816.96,85,,,percent of total billed charges,85% of total billed charges,1923.84,90,,,percent of total billed charges,90% of total billed charges,2137.6,100,,,fee schedule,100% of CO APG rates,2137.6,100,,,fee schedule,100% of CO APG rates,2137.6,100,,,fee schedule,100% of NM fee schedule,855.04,40,,,percent of total billed charges,40% of total billed charges,855.04,40,,,percent of total billed charges,40% of total billed charges,1923.84,90,,,percent of total billed charges,90% of total billed charges,1624.58,76,,,percent of total billed charges,76% of total billed charges,855.04,40,,,percent of total billed charges,40% of total billed charges,1816.96,85,,,percent of total billed charges,85% of total billed charges,2137.6,100,,,fee schedule,100% of CO APG rate,1710.08,80,,,percent of total billed charges,80% of total billed charges,829.39,38.8,,,percent of total billed charges,38.8% of total billed charges,1816.96,85,,,percent of total billed charges,85% of total billed charges,2137.6,100,,,fee schedule,100% of APG fee schedule,4275.2,200,,,percent of total billed charges,200% of total billed charges,829.39,4275.2,
POWERPORT ISP 8FR,46050069,CDM,270,RC,,,OUTPATIENT,,,950.3,760.24,,712.73,75,,,percent of total billed charges,75% of total billed charges,380.12,40,,,percent of total billed charges,40% of total billed charges,752.64,79.2,,,percent of total billed charges,79.2% of total billed charges,807.76,85,,,percent of total billed charges,85% of total billed charges,950.3,100,,,fee schedule,100% of CO APG rates,902.79,95,,,percent of total billed charges,95% of total billed charges,760.24,80,,,percent of total billed charges,80% of total billed charges,807.76,85,,,percent of total billed charges,85% of total billed charges,855.27,90,,,percent of total billed charges,90% of total billed charges,950.3,100,,,fee schedule,100% of CO APG rates,950.3,100,,,fee schedule,100% of CO APG rates,950.3,100,,,fee schedule,100% of NM fee schedule,380.12,40,,,percent of total billed charges,40% of total billed charges,380.12,40,,,percent of total billed charges,40% of total billed charges,855.27,90,,,percent of total billed charges,90% of total billed charges,722.23,76,,,percent of total billed charges,76% of total billed charges,380.12,40,,,percent of total billed charges,40% of total billed charges,807.76,85,,,percent of total billed charges,85% of total billed charges,950.3,100,,,fee schedule,100% of CO APG rate,760.24,80,,,percent of total billed charges,80% of total billed charges,368.72,38.8,,,percent of total billed charges,38.8% of total billed charges,807.76,85,,,percent of total billed charges,85% of total billed charges,950.3,100,,,fee schedule,100% of APG fee schedule,1900.6,200,,,percent of total billed charges,200% of total billed charges,368.72,1900.6,
CONTOUR CURVED CUTTER STAPELER BLUE CS40B,46050307,CDM,270,RC,,,OUTPATIENT,,,1474.7,1179.76,,1106.03,75,,,percent of total billed charges,75% of total billed charges,589.88,40,,,percent of total billed charges,40% of total billed charges,1167.96,79.2,,,percent of total billed charges,79.2% of total billed charges,1253.5,85,,,percent of total billed charges,85% of total billed charges,1474.7,100,,,fee schedule,100% of CO APG rates,1400.97,95,,,percent of total billed charges,95% of total billed charges,1179.76,80,,,percent of total billed charges,80% of total billed charges,1253.5,85,,,percent of total billed charges,85% of total billed charges,1327.23,90,,,percent of total billed charges,90% of total billed charges,1474.7,100,,,fee schedule,100% of CO APG rates,1474.7,100,,,fee schedule,100% of CO APG rates,1474.7,100,,,fee schedule,100% of NM fee schedule,589.88,40,,,percent of total billed charges,40% of total billed charges,589.88,40,,,percent of total billed charges,40% of total billed charges,1327.23,90,,,percent of total billed charges,90% of total billed charges,1120.77,76,,,percent of total billed charges,76% of total billed charges,589.88,40,,,percent of total billed charges,40% of total billed charges,1253.5,85,,,percent of total billed charges,85% of total billed charges,1474.7,100,,,fee schedule,100% of CO APG rate,1179.76,80,,,percent of total billed charges,80% of total billed charges,572.18,38.8,,,percent of total billed charges,38.8% of total billed charges,1253.5,85,,,percent of total billed charges,85% of total billed charges,1474.7,100,,,fee schedule,100% of APG fee schedule,2949.4,200,,,percent of total billed charges,200% of total billed charges,572.18,2949.4,
ENDO 10MM CLIP APPLIER LAP ER320,46050312,CDM,270,RC,,,OUTPATIENT,,,328.9,263.12,,246.68,75,,,percent of total billed charges,75% of total billed charges,131.56,40,,,percent of total billed charges,40% of total billed charges,260.49,79.2,,,percent of total billed charges,79.2% of total billed charges,279.57,85,,,percent of total billed charges,85% of total billed charges,328.9,100,,,fee schedule,100% of CO APG rates,312.46,95,,,percent of total billed charges,95% of total billed charges,263.12,80,,,percent of total billed charges,80% of total billed charges,279.57,85,,,percent of total billed charges,85% of total billed charges,296.01,90,,,percent of total billed charges,90% of total billed charges,328.9,100,,,fee schedule,100% of CO APG rates,328.9,100,,,fee schedule,100% of CO APG rates,328.9,100,,,fee schedule,100% of NM fee schedule,131.56,40,,,percent of total billed charges,40% of total billed charges,131.56,40,,,percent of total billed charges,40% of total billed charges,296.01,90,,,percent of total billed charges,90% of total billed charges,249.96,76,,,percent of total billed charges,76% of total billed charges,131.56,40,,,percent of total billed charges,40% of total billed charges,279.57,85,,,percent of total billed charges,85% of total billed charges,328.9,100,,,fee schedule,100% of CO APG rate,263.12,80,,,percent of total billed charges,80% of total billed charges,127.61,38.8,,,percent of total billed charges,38.8% of total billed charges,279.57,85,,,percent of total billed charges,85% of total billed charges,328.9,100,,,fee schedule,100% of APG fee schedule,657.8,200,,,percent of total billed charges,200% of total billed charges,127.61,657.8,
ENDO 5MM CLIP APPLIER LAP EL5ML,46050313,CDM,270,RC,,,OUTPATIENT,,,575.6,460.48,,431.7,75,,,percent of total billed charges,75% of total billed charges,230.24,40,,,percent of total billed charges,40% of total billed charges,455.88,79.2,,,percent of total billed charges,79.2% of total billed charges,489.26,85,,,percent of total billed charges,85% of total billed charges,575.6,100,,,fee schedule,100% of CO APG rates,546.82,95,,,percent of total billed charges,95% of total billed charges,460.48,80,,,percent of total billed charges,80% of total billed charges,489.26,85,,,percent of total billed charges,85% of total billed charges,518.04,90,,,percent of total billed charges,90% of total billed charges,575.6,100,,,fee schedule,100% of CO APG rates,575.6,100,,,fee schedule,100% of CO APG rates,575.6,100,,,fee schedule,100% of NM fee schedule,230.24,40,,,percent of total billed charges,40% of total billed charges,230.24,40,,,percent of total billed charges,40% of total billed charges,518.04,90,,,percent of total billed charges,90% of total billed charges,437.46,76,,,percent of total billed charges,76% of total billed charges,230.24,40,,,percent of total billed charges,40% of total billed charges,489.26,85,,,percent of total billed charges,85% of total billed charges,575.6,100,,,fee schedule,100% of CO APG rate,460.48,80,,,percent of total billed charges,80% of total billed charges,223.33,38.8,,,percent of total billed charges,38.8% of total billed charges,489.26,85,,,percent of total billed charges,85% of total billed charges,575.6,100,,,fee schedule,100% of APG fee schedule,1151.2,200,,,percent of total billed charges,200% of total billed charges,223.33,1151.2,
ENDO LIN CUT RELOAD RED 6R45B,46050314,CDM,270,RC,,,OUTPATIENT,,,501.5,401.2,,376.13,75,,,percent of total billed charges,75% of total billed charges,200.6,40,,,percent of total billed charges,40% of total billed charges,397.19,79.2,,,percent of total billed charges,79.2% of total billed charges,426.28,85,,,percent of total billed charges,85% of total billed charges,501.5,100,,,fee schedule,100% of CO APG rates,476.43,95,,,percent of total billed charges,95% of total billed charges,401.2,80,,,percent of total billed charges,80% of total billed charges,426.28,85,,,percent of total billed charges,85% of total billed charges,451.35,90,,,percent of total billed charges,90% of total billed charges,501.5,100,,,fee schedule,100% of CO APG rates,501.5,100,,,fee schedule,100% of CO APG rates,501.5,100,,,fee schedule,100% of NM fee schedule,200.6,40,,,percent of total billed charges,40% of total billed charges,200.6,40,,,percent of total billed charges,40% of total billed charges,451.35,90,,,percent of total billed charges,90% of total billed charges,381.14,76,,,percent of total billed charges,76% of total billed charges,200.6,40,,,percent of total billed charges,40% of total billed charges,426.28,85,,,percent of total billed charges,85% of total billed charges,501.5,100,,,fee schedule,100% of CO APG rate,401.2,80,,,percent of total billed charges,80% of total billed charges,194.58,38.8,,,percent of total billed charges,38.8% of total billed charges,426.28,85,,,percent of total billed charges,85% of total billed charges,501.5,100,,,fee schedule,100% of APG fee schedule,1003,200,,,percent of total billed charges,200% of total billed charges,194.58,1003,
ENDO LIN CUT RELOAD WHITE TR45W,46050315,CDM,270,RC,,,OUTPATIENT,,,501.5,401.2,,376.13,75,,,percent of total billed charges,75% of total billed charges,200.6,40,,,percent of total billed charges,40% of total billed charges,397.19,79.2,,,percent of total billed charges,79.2% of total billed charges,426.28,85,,,percent of total billed charges,85% of total billed charges,501.5,100,,,fee schedule,100% of CO APG rates,476.43,95,,,percent of total billed charges,95% of total billed charges,401.2,80,,,percent of total billed charges,80% of total billed charges,426.28,85,,,percent of total billed charges,85% of total billed charges,451.35,90,,,percent of total billed charges,90% of total billed charges,501.5,100,,,fee schedule,100% of CO APG rates,501.5,100,,,fee schedule,100% of CO APG rates,501.5,100,,,fee schedule,100% of NM fee schedule,200.6,40,,,percent of total billed charges,40% of total billed charges,200.6,40,,,percent of total billed charges,40% of total billed charges,451.35,90,,,percent of total billed charges,90% of total billed charges,381.14,76,,,percent of total billed charges,76% of total billed charges,200.6,40,,,percent of total billed charges,40% of total billed charges,426.28,85,,,percent of total billed charges,85% of total billed charges,501.5,100,,,fee schedule,100% of CO APG rate,401.2,80,,,percent of total billed charges,80% of total billed charges,194.58,38.8,,,percent of total billed charges,38.8% of total billed charges,426.28,85,,,percent of total billed charges,85% of total billed charges,501.5,100,,,fee schedule,100% of APG fee schedule,1003,200,,,percent of total billed charges,200% of total billed charges,194.58,1003,
ENDO LINEAR CUTTER 45MM FLEX ATS45,46050317,CDM,270,RC,,,OUTPATIENT,,,1001.8,801.44,,751.35,75,,,percent of total billed charges,75% of total billed charges,400.72,40,,,percent of total billed charges,40% of total billed charges,793.43,79.2,,,percent of total billed charges,79.2% of total billed charges,851.53,85,,,percent of total billed charges,85% of total billed charges,1001.8,100,,,fee schedule,100% of CO APG rates,951.71,95,,,percent of total billed charges,95% of total billed charges,801.44,80,,,percent of total billed charges,80% of total billed charges,851.53,85,,,percent of total billed charges,85% of total billed charges,901.62,90,,,percent of total billed charges,90% of total billed charges,1001.8,100,,,fee schedule,100% of CO APG rates,1001.8,100,,,fee schedule,100% of CO APG rates,1001.8,100,,,fee schedule,100% of NM fee schedule,400.72,40,,,percent of total billed charges,40% of total billed charges,400.72,40,,,percent of total billed charges,40% of total billed charges,901.62,90,,,percent of total billed charges,90% of total billed charges,761.37,76,,,percent of total billed charges,76% of total billed charges,400.72,40,,,percent of total billed charges,40% of total billed charges,851.53,85,,,percent of total billed charges,85% of total billed charges,1001.8,100,,,fee schedule,100% of CO APG rate,801.44,80,,,percent of total billed charges,80% of total billed charges,388.7,38.8,,,percent of total billed charges,38.8% of total billed charges,851.53,85,,,percent of total billed charges,85% of total billed charges,1001.8,100,,,fee schedule,100% of APG fee schedule,2003.6,200,,,percent of total billed charges,200% of total billed charges,388.7,2003.6,
ENDOPATH BLUNT TIP DISSECTOR BTD05,46050318,CDM,270,RC,,,OUTPATIENT,,,76.4,61.12,,57.3,75,,,percent of total billed charges,75% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,60.51,79.2,,,percent of total billed charges,79.2% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,76.4,100,,,fee schedule,100% of CO APG rates,72.58,95,,,percent of total billed charges,95% of total billed charges,61.12,80,,,percent of total billed charges,80% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,76.4,100,,,fee schedule,100% of CO APG rates,76.4,100,,,fee schedule,100% of CO APG rates,76.4,100,,,fee schedule,100% of NM fee schedule,30.56,40,,,percent of total billed charges,40% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,58.06,76,,,percent of total billed charges,76% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,76.4,100,,,fee schedule,100% of CO APG rate,61.12,80,,,percent of total billed charges,80% of total billed charges,29.64,38.8,,,percent of total billed charges,38.8% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,76.4,100,,,fee schedule,100% of APG fee schedule,152.8,200,,,percent of total billed charges,200% of total billed charges,29.64,152.8,
ENDOPOUCH RETRIEVER SPEC BAG,46050319,CDM,270,RC,,,OUTPATIENT,,,192.1,153.68,,144.08,75,,,percent of total billed charges,75% of total billed charges,76.84,40,,,percent of total billed charges,40% of total billed charges,152.14,79.2,,,percent of total billed charges,79.2% of total billed charges,163.29,85,,,percent of total billed charges,85% of total billed charges,192.1,100,,,fee schedule,100% of CO APG rates,182.5,95,,,percent of total billed charges,95% of total billed charges,153.68,80,,,percent of total billed charges,80% of total billed charges,163.29,85,,,percent of total billed charges,85% of total billed charges,172.89,90,,,percent of total billed charges,90% of total billed charges,192.1,100,,,fee schedule,100% of CO APG rates,192.1,100,,,fee schedule,100% of CO APG rates,192.1,100,,,fee schedule,100% of NM fee schedule,76.84,40,,,percent of total billed charges,40% of total billed charges,76.84,40,,,percent of total billed charges,40% of total billed charges,172.89,90,,,percent of total billed charges,90% of total billed charges,146,76,,,percent of total billed charges,76% of total billed charges,76.84,40,,,percent of total billed charges,40% of total billed charges,163.29,85,,,percent of total billed charges,85% of total billed charges,192.1,100,,,fee schedule,100% of CO APG rate,153.68,80,,,percent of total billed charges,80% of total billed charges,74.53,38.8,,,percent of total billed charges,38.8% of total billed charges,163.29,85,,,percent of total billed charges,85% of total billed charges,192.1,100,,,fee schedule,100% of APG fee schedule,384.2,200,,,percent of total billed charges,200% of total billed charges,74.53,384.2,
LIGACLIP MCA MED SHORT APPLIER MSM20,46050320,CDM,270,RC,,,OUTPATIENT,,,231.7,185.36,,173.78,75,,,percent of total billed charges,75% of total billed charges,92.68,40,,,percent of total billed charges,40% of total billed charges,183.51,79.2,,,percent of total billed charges,79.2% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,231.7,100,,,fee schedule,100% of CO APG rates,220.12,95,,,percent of total billed charges,95% of total billed charges,185.36,80,,,percent of total billed charges,80% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,208.53,90,,,percent of total billed charges,90% of total billed charges,231.7,100,,,fee schedule,100% of CO APG rates,231.7,100,,,fee schedule,100% of CO APG rates,231.7,100,,,fee schedule,100% of NM fee schedule,92.68,40,,,percent of total billed charges,40% of total billed charges,92.68,40,,,percent of total billed charges,40% of total billed charges,208.53,90,,,percent of total billed charges,90% of total billed charges,176.09,76,,,percent of total billed charges,76% of total billed charges,92.68,40,,,percent of total billed charges,40% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,231.7,100,,,fee schedule,100% of CO APG rate,185.36,80,,,percent of total billed charges,80% of total billed charges,89.9,38.8,,,percent of total billed charges,38.8% of total billed charges,196.95,85,,,percent of total billed charges,85% of total billed charges,231.7,100,,,fee schedule,100% of APG fee schedule,463.4,200,,,percent of total billed charges,200% of total billed charges,89.9,463.4,
LIGACLIP MCA SMALL APPLIER MCS20,46050321,CDM,270,RC,,,OUTPATIENT,,,210.9,168.72,,158.18,75,,,percent of total billed charges,75% of total billed charges,84.36,40,,,percent of total billed charges,40% of total billed charges,167.03,79.2,,,percent of total billed charges,79.2% of total billed charges,179.27,85,,,percent of total billed charges,85% of total billed charges,210.9,100,,,fee schedule,100% of CO APG rates,200.36,95,,,percent of total billed charges,95% of total billed charges,168.72,80,,,percent of total billed charges,80% of total billed charges,179.27,85,,,percent of total billed charges,85% of total billed charges,189.81,90,,,percent of total billed charges,90% of total billed charges,210.9,100,,,fee schedule,100% of CO APG rates,210.9,100,,,fee schedule,100% of CO APG rates,210.9,100,,,fee schedule,100% of NM fee schedule,84.36,40,,,percent of total billed charges,40% of total billed charges,84.36,40,,,percent of total billed charges,40% of total billed charges,189.81,90,,,percent of total billed charges,90% of total billed charges,160.28,76,,,percent of total billed charges,76% of total billed charges,84.36,40,,,percent of total billed charges,40% of total billed charges,179.27,85,,,percent of total billed charges,85% of total billed charges,210.9,100,,,fee schedule,100% of CO APG rate,168.72,80,,,percent of total billed charges,80% of total billed charges,81.83,38.8,,,percent of total billed charges,38.8% of total billed charges,179.27,85,,,percent of total billed charges,85% of total billed charges,210.9,100,,,fee schedule,100% of APG fee schedule,421.8,200,,,percent of total billed charges,200% of total billed charges,81.83,421.8,
PROXIMATE 25MM CDH25A,46050322,CDM,270,RC,,,OUTPATIENT,,,1068.3,854.64,,801.23,75,,,percent of total billed charges,75% of total billed charges,427.32,40,,,percent of total billed charges,40% of total billed charges,846.09,79.2,,,percent of total billed charges,79.2% of total billed charges,908.06,85,,,percent of total billed charges,85% of total billed charges,1068.3,100,,,fee schedule,100% of CO APG rates,1014.89,95,,,percent of total billed charges,95% of total billed charges,854.64,80,,,percent of total billed charges,80% of total billed charges,908.06,85,,,percent of total billed charges,85% of total billed charges,961.47,90,,,percent of total billed charges,90% of total billed charges,1068.3,100,,,fee schedule,100% of CO APG rates,1068.3,100,,,fee schedule,100% of CO APG rates,1068.3,100,,,fee schedule,100% of NM fee schedule,427.32,40,,,percent of total billed charges,40% of total billed charges,427.32,40,,,percent of total billed charges,40% of total billed charges,961.47,90,,,percent of total billed charges,90% of total billed charges,811.91,76,,,percent of total billed charges,76% of total billed charges,427.32,40,,,percent of total billed charges,40% of total billed charges,908.06,85,,,percent of total billed charges,85% of total billed charges,1068.3,100,,,fee schedule,100% of CO APG rate,854.64,80,,,percent of total billed charges,80% of total billed charges,414.5,38.8,,,percent of total billed charges,38.8% of total billed charges,908.06,85,,,percent of total billed charges,85% of total billed charges,1068.3,100,,,fee schedule,100% of APG fee schedule,2136.6,200,,,percent of total billed charges,200% of total billed charges,414.5,2136.6,
PROXIMATE 29MM CDH29A,46050324,CDM,270,RC,,,OUTPATIENT,,,931.8,745.44,,698.85,75,,,percent of total billed charges,75% of total billed charges,372.72,40,,,percent of total billed charges,40% of total billed charges,737.99,79.2,,,percent of total billed charges,79.2% of total billed charges,792.03,85,,,percent of total billed charges,85% of total billed charges,931.8,100,,,fee schedule,100% of CO APG rates,885.21,95,,,percent of total billed charges,95% of total billed charges,745.44,80,,,percent of total billed charges,80% of total billed charges,792.03,85,,,percent of total billed charges,85% of total billed charges,838.62,90,,,percent of total billed charges,90% of total billed charges,931.8,100,,,fee schedule,100% of CO APG rates,931.8,100,,,fee schedule,100% of CO APG rates,931.8,100,,,fee schedule,100% of NM fee schedule,372.72,40,,,percent of total billed charges,40% of total billed charges,372.72,40,,,percent of total billed charges,40% of total billed charges,838.62,90,,,percent of total billed charges,90% of total billed charges,708.17,76,,,percent of total billed charges,76% of total billed charges,372.72,40,,,percent of total billed charges,40% of total billed charges,792.03,85,,,percent of total billed charges,85% of total billed charges,931.8,100,,,fee schedule,100% of CO APG rate,745.44,80,,,percent of total billed charges,80% of total billed charges,361.54,38.8,,,percent of total billed charges,38.8% of total billed charges,792.03,85,,,percent of total billed charges,85% of total billed charges,931.8,100,,,fee schedule,100% of APG fee schedule,1863.6,200,,,percent of total billed charges,200% of total billed charges,361.54,1863.6,
PROXIMATE 33MM CDH33A,46050326,CDM,270,RC,,,OUTPATIENT,,,931.8,745.44,,698.85,75,,,percent of total billed charges,75% of total billed charges,372.72,40,,,percent of total billed charges,40% of total billed charges,737.99,79.2,,,percent of total billed charges,79.2% of total billed charges,792.03,85,,,percent of total billed charges,85% of total billed charges,931.8,100,,,fee schedule,100% of CO APG rates,885.21,95,,,percent of total billed charges,95% of total billed charges,745.44,80,,,percent of total billed charges,80% of total billed charges,792.03,85,,,percent of total billed charges,85% of total billed charges,838.62,90,,,percent of total billed charges,90% of total billed charges,931.8,100,,,fee schedule,100% of CO APG rates,931.8,100,,,fee schedule,100% of CO APG rates,931.8,100,,,fee schedule,100% of NM fee schedule,372.72,40,,,percent of total billed charges,40% of total billed charges,372.72,40,,,percent of total billed charges,40% of total billed charges,838.62,90,,,percent of total billed charges,90% of total billed charges,708.17,76,,,percent of total billed charges,76% of total billed charges,372.72,40,,,percent of total billed charges,40% of total billed charges,792.03,85,,,percent of total billed charges,85% of total billed charges,931.8,100,,,fee schedule,100% of CO APG rate,745.44,80,,,percent of total billed charges,80% of total billed charges,361.54,38.8,,,percent of total billed charges,38.8% of total billed charges,792.03,85,,,percent of total billed charges,85% of total billed charges,931.8,100,,,fee schedule,100% of APG fee schedule,1863.6,200,,,percent of total billed charges,200% of total billed charges,361.54,1863.6,
PROXIMATE 55MM LINEAR CUTTER TLC55,46050328,CDM,270,RC,,,OUTPATIENT,,,356.2,284.96,,267.15,75,,,percent of total billed charges,75% of total billed charges,142.48,40,,,percent of total billed charges,40% of total billed charges,282.11,79.2,,,percent of total billed charges,79.2% of total billed charges,302.77,85,,,percent of total billed charges,85% of total billed charges,356.2,100,,,fee schedule,100% of CO APG rates,338.39,95,,,percent of total billed charges,95% of total billed charges,284.96,80,,,percent of total billed charges,80% of total billed charges,302.77,85,,,percent of total billed charges,85% of total billed charges,320.58,90,,,percent of total billed charges,90% of total billed charges,356.2,100,,,fee schedule,100% of CO APG rates,356.2,100,,,fee schedule,100% of CO APG rates,356.2,100,,,fee schedule,100% of NM fee schedule,142.48,40,,,percent of total billed charges,40% of total billed charges,142.48,40,,,percent of total billed charges,40% of total billed charges,320.58,90,,,percent of total billed charges,90% of total billed charges,270.71,76,,,percent of total billed charges,76% of total billed charges,142.48,40,,,percent of total billed charges,40% of total billed charges,302.77,85,,,percent of total billed charges,85% of total billed charges,356.2,100,,,fee schedule,100% of CO APG rate,284.96,80,,,percent of total billed charges,80% of total billed charges,138.21,38.8,,,percent of total billed charges,38.8% of total billed charges,302.77,85,,,percent of total billed charges,85% of total billed charges,356.2,100,,,fee schedule,100% of APG fee schedule,712.4,200,,,percent of total billed charges,200% of total billed charges,138.21,712.4,
PROXIMATE 75MM LINEAR CUTTER TLC75,46050329,CDM,270,RC,,,OUTPATIENT,,,530.9,424.72,,398.18,75,,,percent of total billed charges,75% of total billed charges,212.36,40,,,percent of total billed charges,40% of total billed charges,420.47,79.2,,,percent of total billed charges,79.2% of total billed charges,451.27,85,,,percent of total billed charges,85% of total billed charges,530.9,100,,,fee schedule,100% of CO APG rates,504.36,95,,,percent of total billed charges,95% of total billed charges,424.72,80,,,percent of total billed charges,80% of total billed charges,451.27,85,,,percent of total billed charges,85% of total billed charges,477.81,90,,,percent of total billed charges,90% of total billed charges,530.9,100,,,fee schedule,100% of CO APG rates,530.9,100,,,fee schedule,100% of CO APG rates,530.9,100,,,fee schedule,100% of NM fee schedule,212.36,40,,,percent of total billed charges,40% of total billed charges,212.36,40,,,percent of total billed charges,40% of total billed charges,477.81,90,,,percent of total billed charges,90% of total billed charges,403.48,76,,,percent of total billed charges,76% of total billed charges,212.36,40,,,percent of total billed charges,40% of total billed charges,451.27,85,,,percent of total billed charges,85% of total billed charges,530.9,100,,,fee schedule,100% of CO APG rate,424.72,80,,,percent of total billed charges,80% of total billed charges,205.99,38.8,,,percent of total billed charges,38.8% of total billed charges,451.27,85,,,percent of total billed charges,85% of total billed charges,530.9,100,,,fee schedule,100% of APG fee schedule,1061.8,200,,,percent of total billed charges,200% of total billed charges,205.99,1061.8,
PROXIMATE CUTTER RELOAD UNIT TCR55,46050330,CDM,270,RC,,,OUTPATIENT,,,222.8,178.24,,167.1,75,,,percent of total billed charges,75% of total billed charges,89.12,40,,,percent of total billed charges,40% of total billed charges,176.46,79.2,,,percent of total billed charges,79.2% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,222.8,100,,,fee schedule,100% of CO APG rates,211.66,95,,,percent of total billed charges,95% of total billed charges,178.24,80,,,percent of total billed charges,80% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,200.52,90,,,percent of total billed charges,90% of total billed charges,222.8,100,,,fee schedule,100% of CO APG rates,222.8,100,,,fee schedule,100% of CO APG rates,222.8,100,,,fee schedule,100% of NM fee schedule,89.12,40,,,percent of total billed charges,40% of total billed charges,89.12,40,,,percent of total billed charges,40% of total billed charges,200.52,90,,,percent of total billed charges,90% of total billed charges,169.33,76,,,percent of total billed charges,76% of total billed charges,89.12,40,,,percent of total billed charges,40% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,222.8,100,,,fee schedule,100% of CO APG rate,178.24,80,,,percent of total billed charges,80% of total billed charges,86.45,38.8,,,percent of total billed charges,38.8% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,222.8,100,,,fee schedule,100% of APG fee schedule,445.6,200,,,percent of total billed charges,200% of total billed charges,86.45,445.6,
PROXIMATE CUTTER RELOAD UNIT TCR75,46050331,CDM,270,RC,,,OUTPATIENT,,,305.8,244.64,,229.35,75,,,percent of total billed charges,75% of total billed charges,122.32,40,,,percent of total billed charges,40% of total billed charges,242.19,79.2,,,percent of total billed charges,79.2% of total billed charges,259.93,85,,,percent of total billed charges,85% of total billed charges,305.8,100,,,fee schedule,100% of CO APG rates,290.51,95,,,percent of total billed charges,95% of total billed charges,244.64,80,,,percent of total billed charges,80% of total billed charges,259.93,85,,,percent of total billed charges,85% of total billed charges,275.22,90,,,percent of total billed charges,90% of total billed charges,305.8,100,,,fee schedule,100% of CO APG rates,305.8,100,,,fee schedule,100% of CO APG rates,305.8,100,,,fee schedule,100% of NM fee schedule,122.32,40,,,percent of total billed charges,40% of total billed charges,122.32,40,,,percent of total billed charges,40% of total billed charges,275.22,90,,,percent of total billed charges,90% of total billed charges,232.41,76,,,percent of total billed charges,76% of total billed charges,122.32,40,,,percent of total billed charges,40% of total billed charges,259.93,85,,,percent of total billed charges,85% of total billed charges,305.8,100,,,fee schedule,100% of CO APG rate,244.64,80,,,percent of total billed charges,80% of total billed charges,118.65,38.8,,,percent of total billed charges,38.8% of total billed charges,259.93,85,,,percent of total billed charges,85% of total billed charges,305.8,100,,,fee schedule,100% of APG fee schedule,611.6,200,,,percent of total billed charges,200% of total billed charges,118.65,611.6,
PROXIMATE LINEAR CUTTER THICK TCT75,46050334,CDM,270,RC,,,OUTPATIENT,,,579,463.2,,434.25,75,,,percent of total billed charges,75% of total billed charges,231.6,40,,,percent of total billed charges,40% of total billed charges,458.57,79.2,,,percent of total billed charges,79.2% of total billed charges,492.15,85,,,percent of total billed charges,85% of total billed charges,579,100,,,fee schedule,100% of CO APG rates,550.05,95,,,percent of total billed charges,95% of total billed charges,463.2,80,,,percent of total billed charges,80% of total billed charges,492.15,85,,,percent of total billed charges,85% of total billed charges,521.1,90,,,percent of total billed charges,90% of total billed charges,579,100,,,fee schedule,100% of CO APG rates,579,100,,,fee schedule,100% of CO APG rates,579,100,,,fee schedule,100% of NM fee schedule,231.6,40,,,percent of total billed charges,40% of total billed charges,231.6,40,,,percent of total billed charges,40% of total billed charges,521.1,90,,,percent of total billed charges,90% of total billed charges,440.04,76,,,percent of total billed charges,76% of total billed charges,231.6,40,,,percent of total billed charges,40% of total billed charges,492.15,85,,,percent of total billed charges,85% of total billed charges,579,100,,,fee schedule,100% of CO APG rate,463.2,80,,,percent of total billed charges,80% of total billed charges,224.65,38.8,,,percent of total billed charges,38.8% of total billed charges,492.15,85,,,percent of total billed charges,85% of total billed charges,579,100,,,fee schedule,100% of APG fee schedule,1158,200,,,percent of total billed charges,200% of total billed charges,224.65,1158,
PROXIMATE RELOAD THICK TISSUE TRT75,46050336,CDM,270,RC,,,OUTPATIENT,,,305.8,244.64,,229.35,75,,,percent of total billed charges,75% of total billed charges,122.32,40,,,percent of total billed charges,40% of total billed charges,242.19,79.2,,,percent of total billed charges,79.2% of total billed charges,259.93,85,,,percent of total billed charges,85% of total billed charges,305.8,100,,,fee schedule,100% of CO APG rates,290.51,95,,,percent of total billed charges,95% of total billed charges,244.64,80,,,percent of total billed charges,80% of total billed charges,259.93,85,,,percent of total billed charges,85% of total billed charges,275.22,90,,,percent of total billed charges,90% of total billed charges,305.8,100,,,fee schedule,100% of CO APG rates,305.8,100,,,fee schedule,100% of CO APG rates,305.8,100,,,fee schedule,100% of NM fee schedule,122.32,40,,,percent of total billed charges,40% of total billed charges,122.32,40,,,percent of total billed charges,40% of total billed charges,275.22,90,,,percent of total billed charges,90% of total billed charges,232.41,76,,,percent of total billed charges,76% of total billed charges,122.32,40,,,percent of total billed charges,40% of total billed charges,259.93,85,,,percent of total billed charges,85% of total billed charges,305.8,100,,,fee schedule,100% of CO APG rate,244.64,80,,,percent of total billed charges,80% of total billed charges,118.65,38.8,,,percent of total billed charges,38.8% of total billed charges,259.93,85,,,percent of total billed charges,85% of total billed charges,305.8,100,,,fee schedule,100% of APG fee schedule,611.6,200,,,percent of total billed charges,200% of total billed charges,118.65,611.6,
PROXIMATE RELOAD UNIT 30MM TR30,46050337,CDM,270,RC,,,OUTPATIENT,,,192.1,153.68,,144.08,75,,,percent of total billed charges,75% of total billed charges,76.84,40,,,percent of total billed charges,40% of total billed charges,152.14,79.2,,,percent of total billed charges,79.2% of total billed charges,163.29,85,,,percent of total billed charges,85% of total billed charges,192.1,100,,,fee schedule,100% of CO APG rates,182.5,95,,,percent of total billed charges,95% of total billed charges,153.68,80,,,percent of total billed charges,80% of total billed charges,163.29,85,,,percent of total billed charges,85% of total billed charges,172.89,90,,,percent of total billed charges,90% of total billed charges,192.1,100,,,fee schedule,100% of CO APG rates,192.1,100,,,fee schedule,100% of CO APG rates,192.1,100,,,fee schedule,100% of NM fee schedule,76.84,40,,,percent of total billed charges,40% of total billed charges,76.84,40,,,percent of total billed charges,40% of total billed charges,172.89,90,,,percent of total billed charges,90% of total billed charges,146,76,,,percent of total billed charges,76% of total billed charges,76.84,40,,,percent of total billed charges,40% of total billed charges,163.29,85,,,percent of total billed charges,85% of total billed charges,192.1,100,,,fee schedule,100% of CO APG rate,153.68,80,,,percent of total billed charges,80% of total billed charges,74.53,38.8,,,percent of total billed charges,38.8% of total billed charges,163.29,85,,,percent of total billed charges,85% of total billed charges,192.1,100,,,fee schedule,100% of APG fee schedule,384.2,200,,,percent of total billed charges,200% of total billed charges,74.53,384.2,
PROXIMATE RL TITANIUM STAPLER   30MM TL30,46050341,CDM,270,RC,,,OUTPATIENT,,,350.7,280.56,,263.03,75,,,percent of total billed charges,75% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,277.75,79.2,,,percent of total billed charges,79.2% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rates,333.17,95,,,percent of total billed charges,95% of total billed charges,280.56,80,,,percent of total billed charges,80% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,315.63,90,,,percent of total billed charges,90% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rates,350.7,100,,,fee schedule,100% of CO APG rates,350.7,100,,,fee schedule,100% of NM fee schedule,140.28,40,,,percent of total billed charges,40% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,315.63,90,,,percent of total billed charges,90% of total billed charges,266.53,76,,,percent of total billed charges,76% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rate,280.56,80,,,percent of total billed charges,80% of total billed charges,136.07,38.8,,,percent of total billed charges,38.8% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of APG fee schedule,701.4,200,,,percent of total billed charges,200% of total billed charges,136.07,701.4,
PROXIMATE RL TITANIUM STAPLER   90MM TL90,46050342,CDM,270,RC,,,OUTPATIENT,,,811.7,649.36,,608.78,75,,,percent of total billed charges,75% of total billed charges,324.68,40,,,percent of total billed charges,40% of total billed charges,642.87,79.2,,,percent of total billed charges,79.2% of total billed charges,689.95,85,,,percent of total billed charges,85% of total billed charges,811.7,100,,,fee schedule,100% of CO APG rates,771.12,95,,,percent of total billed charges,95% of total billed charges,649.36,80,,,percent of total billed charges,80% of total billed charges,689.95,85,,,percent of total billed charges,85% of total billed charges,730.53,90,,,percent of total billed charges,90% of total billed charges,811.7,100,,,fee schedule,100% of CO APG rates,811.7,100,,,fee schedule,100% of CO APG rates,811.7,100,,,fee schedule,100% of NM fee schedule,324.68,40,,,percent of total billed charges,40% of total billed charges,324.68,40,,,percent of total billed charges,40% of total billed charges,730.53,90,,,percent of total billed charges,90% of total billed charges,616.89,76,,,percent of total billed charges,76% of total billed charges,324.68,40,,,percent of total billed charges,40% of total billed charges,689.95,85,,,percent of total billed charges,85% of total billed charges,811.7,100,,,fee schedule,100% of CO APG rate,649.36,80,,,percent of total billed charges,80% of total billed charges,314.94,38.8,,,percent of total billed charges,38.8% of total billed charges,689.95,85,,,percent of total billed charges,85% of total billed charges,811.7,100,,,fee schedule,100% of APG fee schedule,1623.4,200,,,percent of total billed charges,200% of total billed charges,314.94,1623.4,
RELOAD CURVED CUTTER STAPLER CR40B,46050344,CDM,270,RC,,,OUTPATIENT,,,830.2,664.16,,622.65,75,,,percent of total billed charges,75% of total billed charges,332.08,40,,,percent of total billed charges,40% of total billed charges,657.52,79.2,,,percent of total billed charges,79.2% of total billed charges,705.67,85,,,percent of total billed charges,85% of total billed charges,830.2,100,,,fee schedule,100% of CO APG rates,788.69,95,,,percent of total billed charges,95% of total billed charges,664.16,80,,,percent of total billed charges,80% of total billed charges,705.67,85,,,percent of total billed charges,85% of total billed charges,747.18,90,,,percent of total billed charges,90% of total billed charges,830.2,100,,,fee schedule,100% of CO APG rates,830.2,100,,,fee schedule,100% of CO APG rates,830.2,100,,,fee schedule,100% of NM fee schedule,332.08,40,,,percent of total billed charges,40% of total billed charges,332.08,40,,,percent of total billed charges,40% of total billed charges,747.18,90,,,percent of total billed charges,90% of total billed charges,630.95,76,,,percent of total billed charges,76% of total billed charges,332.08,40,,,percent of total billed charges,40% of total billed charges,705.67,85,,,percent of total billed charges,85% of total billed charges,830.2,100,,,fee schedule,100% of CO APG rate,664.16,80,,,percent of total billed charges,80% of total billed charges,322.12,38.8,,,percent of total billed charges,38.8% of total billed charges,705.67,85,,,percent of total billed charges,85% of total billed charges,830.2,100,,,fee schedule,100% of APG fee schedule,1660.4,200,,,percent of total billed charges,200% of total billed charges,322.12,1660.4,
XCEL BLADELESS TROCAR 12MM B12LT,46050348,CDM,270,RC,,,OUTPATIENT,,,100.6,80.48,,75.45,75,,,percent of total billed charges,75% of total billed charges,40.24,40,,,percent of total billed charges,40% of total billed charges,79.68,79.2,,,percent of total billed charges,79.2% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,100.6,100,,,fee schedule,100% of CO APG rates,95.57,95,,,percent of total billed charges,95% of total billed charges,80.48,80,,,percent of total billed charges,80% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,90.54,90,,,percent of total billed charges,90% of total billed charges,100.6,100,,,fee schedule,100% of CO APG rates,100.6,100,,,fee schedule,100% of CO APG rates,100.6,100,,,fee schedule,100% of NM fee schedule,40.24,40,,,percent of total billed charges,40% of total billed charges,40.24,40,,,percent of total billed charges,40% of total billed charges,90.54,90,,,percent of total billed charges,90% of total billed charges,76.46,76,,,percent of total billed charges,76% of total billed charges,40.24,40,,,percent of total billed charges,40% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,100.6,100,,,fee schedule,100% of CO APG rate,80.48,80,,,percent of total billed charges,80% of total billed charges,39.03,38.8,,,percent of total billed charges,38.8% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,100.6,100,,,fee schedule,100% of APG fee schedule,201.2,200,,,percent of total billed charges,200% of total billed charges,39.03,201.2,
XCEL BLADELESS TROCAR 5MM B5LT,46050349,CDM,270,RC,,,OUTPATIENT,,,115.7,92.56,,86.78,75,,,percent of total billed charges,75% of total billed charges,46.28,40,,,percent of total billed charges,40% of total billed charges,91.63,79.2,,,percent of total billed charges,79.2% of total billed charges,98.35,85,,,percent of total billed charges,85% of total billed charges,115.7,100,,,fee schedule,100% of CO APG rates,109.92,95,,,percent of total billed charges,95% of total billed charges,92.56,80,,,percent of total billed charges,80% of total billed charges,98.35,85,,,percent of total billed charges,85% of total billed charges,104.13,90,,,percent of total billed charges,90% of total billed charges,115.7,100,,,fee schedule,100% of CO APG rates,115.7,100,,,fee schedule,100% of CO APG rates,115.7,100,,,fee schedule,100% of NM fee schedule,46.28,40,,,percent of total billed charges,40% of total billed charges,46.28,40,,,percent of total billed charges,40% of total billed charges,104.13,90,,,percent of total billed charges,90% of total billed charges,87.93,76,,,percent of total billed charges,76% of total billed charges,46.28,40,,,percent of total billed charges,40% of total billed charges,98.35,85,,,percent of total billed charges,85% of total billed charges,115.7,100,,,fee schedule,100% of CO APG rate,92.56,80,,,percent of total billed charges,80% of total billed charges,44.89,38.8,,,percent of total billed charges,38.8% of total billed charges,98.35,85,,,percent of total billed charges,85% of total billed charges,115.7,100,,,fee schedule,100% of APG fee schedule,231.4,200,,,percent of total billed charges,200% of total billed charges,44.89,231.4,
XCEL BLUNT TIP TROCAR H12LP,46050350,CDM,270,RC,,,OUTPATIENT,,,146.4,117.12,,109.8,75,,,percent of total billed charges,75% of total billed charges,58.56,40,,,percent of total billed charges,40% of total billed charges,115.95,79.2,,,percent of total billed charges,79.2% of total billed charges,124.44,85,,,percent of total billed charges,85% of total billed charges,146.4,100,,,fee schedule,100% of CO APG rates,139.08,95,,,percent of total billed charges,95% of total billed charges,117.12,80,,,percent of total billed charges,80% of total billed charges,124.44,85,,,percent of total billed charges,85% of total billed charges,131.76,90,,,percent of total billed charges,90% of total billed charges,146.4,100,,,fee schedule,100% of CO APG rates,146.4,100,,,fee schedule,100% of CO APG rates,146.4,100,,,fee schedule,100% of NM fee schedule,58.56,40,,,percent of total billed charges,40% of total billed charges,58.56,40,,,percent of total billed charges,40% of total billed charges,131.76,90,,,percent of total billed charges,90% of total billed charges,111.26,76,,,percent of total billed charges,76% of total billed charges,58.56,40,,,percent of total billed charges,40% of total billed charges,124.44,85,,,percent of total billed charges,85% of total billed charges,146.4,100,,,fee schedule,100% of CO APG rate,117.12,80,,,percent of total billed charges,80% of total billed charges,56.8,38.8,,,percent of total billed charges,38.8% of total billed charges,124.44,85,,,percent of total billed charges,85% of total billed charges,146.4,100,,,fee schedule,100% of APG fee schedule,292.8,200,,,percent of total billed charges,200% of total billed charges,56.8,292.8,
XCEL UNIV STABILITY SLEEVE 5MM CB5LT,46050353,CDM,270,RC,,,OUTPATIENT,,,69.9,55.92,,52.43,75,,,percent of total billed charges,75% of total billed charges,27.96,40,,,percent of total billed charges,40% of total billed charges,55.36,79.2,,,percent of total billed charges,79.2% of total billed charges,59.42,85,,,percent of total billed charges,85% of total billed charges,69.9,100,,,fee schedule,100% of CO APG rates,66.41,95,,,percent of total billed charges,95% of total billed charges,55.92,80,,,percent of total billed charges,80% of total billed charges,59.42,85,,,percent of total billed charges,85% of total billed charges,62.91,90,,,percent of total billed charges,90% of total billed charges,69.9,100,,,fee schedule,100% of CO APG rates,69.9,100,,,fee schedule,100% of CO APG rates,69.9,100,,,fee schedule,100% of NM fee schedule,27.96,40,,,percent of total billed charges,40% of total billed charges,27.96,40,,,percent of total billed charges,40% of total billed charges,62.91,90,,,percent of total billed charges,90% of total billed charges,53.12,76,,,percent of total billed charges,76% of total billed charges,27.96,40,,,percent of total billed charges,40% of total billed charges,59.42,85,,,percent of total billed charges,85% of total billed charges,69.9,100,,,fee schedule,100% of CO APG rate,55.92,80,,,percent of total billed charges,80% of total billed charges,27.12,38.8,,,percent of total billed charges,38.8% of total billed charges,59.42,85,,,percent of total billed charges,85% of total billed charges,69.9,100,,,fee schedule,100% of APG fee schedule,139.8,200,,,percent of total billed charges,200% of total billed charges,27.12,139.8,
O ENDOLOOP LIG W/PDSII EZ10G,46050358,CDM,270,RC,,,OUTPATIENT,,,197.6,158.08,,148.2,75,,,percent of total billed charges,75% of total billed charges,79.04,40,,,percent of total billed charges,40% of total billed charges,156.5,79.2,,,percent of total billed charges,79.2% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,197.6,100,,,fee schedule,100% of CO APG rates,187.72,95,,,percent of total billed charges,95% of total billed charges,158.08,80,,,percent of total billed charges,80% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,177.84,90,,,percent of total billed charges,90% of total billed charges,197.6,100,,,fee schedule,100% of CO APG rates,197.6,100,,,fee schedule,100% of CO APG rates,197.6,100,,,fee schedule,100% of NM fee schedule,79.04,40,,,percent of total billed charges,40% of total billed charges,79.04,40,,,percent of total billed charges,40% of total billed charges,177.84,90,,,percent of total billed charges,90% of total billed charges,150.18,76,,,percent of total billed charges,76% of total billed charges,79.04,40,,,percent of total billed charges,40% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,197.6,100,,,fee schedule,100% of CO APG rate,158.08,80,,,percent of total billed charges,80% of total billed charges,76.67,38.8,,,percent of total billed charges,38.8% of total billed charges,167.96,85,,,percent of total billed charges,85% of total billed charges,197.6,100,,,fee schedule,100% of APG fee schedule,395.2,200,,,percent of total billed charges,200% of total billed charges,76.67,395.2,
SURGICEL 4X8,46050359,CDM,270,RC,,,OUTPATIENT,,,422.8,338.24,,317.1,75,,,percent of total billed charges,75% of total billed charges,169.12,40,,,percent of total billed charges,40% of total billed charges,334.86,79.2,,,percent of total billed charges,79.2% of total billed charges,359.38,85,,,percent of total billed charges,85% of total billed charges,422.8,100,,,fee schedule,100% of CO APG rates,401.66,95,,,percent of total billed charges,95% of total billed charges,338.24,80,,,percent of total billed charges,80% of total billed charges,359.38,85,,,percent of total billed charges,85% of total billed charges,380.52,90,,,percent of total billed charges,90% of total billed charges,422.8,100,,,fee schedule,100% of CO APG rates,422.8,100,,,fee schedule,100% of CO APG rates,422.8,100,,,fee schedule,100% of NM fee schedule,169.12,40,,,percent of total billed charges,40% of total billed charges,169.12,40,,,percent of total billed charges,40% of total billed charges,380.52,90,,,percent of total billed charges,90% of total billed charges,321.33,76,,,percent of total billed charges,76% of total billed charges,169.12,40,,,percent of total billed charges,40% of total billed charges,359.38,85,,,percent of total billed charges,85% of total billed charges,422.8,100,,,fee schedule,100% of CO APG rate,338.24,80,,,percent of total billed charges,80% of total billed charges,164.05,38.8,,,percent of total billed charges,38.8% of total billed charges,359.38,85,,,percent of total billed charges,85% of total billed charges,422.8,100,,,fee schedule,100% of APG fee schedule,845.6,200,,,percent of total billed charges,200% of total billed charges,164.05,845.6,
URGENT PC LEAD SETS,42151108,CDM,270,RC,,,OUTPATIENT,,,249.1,199.28,,186.83,75,,,percent of total billed charges,75% of total billed charges,99.64,40,,,percent of total billed charges,40% of total billed charges,197.29,79.2,,,percent of total billed charges,79.2% of total billed charges,211.74,85,,,percent of total billed charges,85% of total billed charges,249.1,100,,,fee schedule,100% of CO APG rates,236.65,95,,,percent of total billed charges,95% of total billed charges,199.28,80,,,percent of total billed charges,80% of total billed charges,211.74,85,,,percent of total billed charges,85% of total billed charges,224.19,90,,,percent of total billed charges,90% of total billed charges,249.1,100,,,fee schedule,100% of CO APG rates,249.1,100,,,fee schedule,100% of CO APG rates,249.1,100,,,fee schedule,100% of NM fee schedule,99.64,40,,,percent of total billed charges,40% of total billed charges,99.64,40,,,percent of total billed charges,40% of total billed charges,224.19,90,,,percent of total billed charges,90% of total billed charges,189.32,76,,,percent of total billed charges,76% of total billed charges,99.64,40,,,percent of total billed charges,40% of total billed charges,211.74,85,,,percent of total billed charges,85% of total billed charges,249.1,100,,,fee schedule,100% of CO APG rate,199.28,80,,,percent of total billed charges,80% of total billed charges,96.65,38.8,,,percent of total billed charges,38.8% of total billed charges,211.74,85,,,percent of total billed charges,85% of total billed charges,249.1,100,,,fee schedule,100% of APG fee schedule,498.2,200,,,percent of total billed charges,200% of total billed charges,96.65,498.2,
SURGICEL 2X3,31051131,CDM,270,RC,,,OUTPATIENT,,,270.9,216.72,,203.18,75,,,percent of total billed charges,75% of total billed charges,108.36,40,,,percent of total billed charges,40% of total billed charges,214.55,79.2,,,percent of total billed charges,79.2% of total billed charges,230.27,85,,,percent of total billed charges,85% of total billed charges,270.9,100,,,fee schedule,100% of CO APG rates,257.36,95,,,percent of total billed charges,95% of total billed charges,216.72,80,,,percent of total billed charges,80% of total billed charges,230.27,85,,,percent of total billed charges,85% of total billed charges,243.81,90,,,percent of total billed charges,90% of total billed charges,270.9,100,,,fee schedule,100% of CO APG rates,270.9,100,,,fee schedule,100% of CO APG rates,270.9,100,,,fee schedule,100% of NM fee schedule,108.36,40,,,percent of total billed charges,40% of total billed charges,108.36,40,,,percent of total billed charges,40% of total billed charges,243.81,90,,,percent of total billed charges,90% of total billed charges,205.88,76,,,percent of total billed charges,76% of total billed charges,108.36,40,,,percent of total billed charges,40% of total billed charges,230.27,85,,,percent of total billed charges,85% of total billed charges,270.9,100,,,fee schedule,100% of CO APG rate,216.72,80,,,percent of total billed charges,80% of total billed charges,105.11,38.8,,,percent of total billed charges,38.8% of total billed charges,230.27,85,,,percent of total billed charges,85% of total billed charges,270.9,100,,,fee schedule,100% of APG fee schedule,541.8,200,,,percent of total billed charges,200% of total billed charges,105.11,541.8,
MN60AC+ 06.0,460ECON0002,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,939,200,,,percent of total billed charges,200% of total billed charges,182.17,939,
TRAUMA PELVIC DEVICE,31051124,CDM,270,RC,,,OUTPATIENT,,,360.6,288.48,,270.45,75,,,percent of total billed charges,75% of total billed charges,144.24,40,,,percent of total billed charges,40% of total billed charges,285.6,79.2,,,percent of total billed charges,79.2% of total billed charges,306.51,85,,,percent of total billed charges,85% of total billed charges,360.6,100,,,fee schedule,100% of CO APG rates,342.57,95,,,percent of total billed charges,95% of total billed charges,288.48,80,,,percent of total billed charges,80% of total billed charges,306.51,85,,,percent of total billed charges,85% of total billed charges,324.54,90,,,percent of total billed charges,90% of total billed charges,360.6,100,,,fee schedule,100% of CO APG rates,360.6,100,,,fee schedule,100% of CO APG rates,360.6,100,,,fee schedule,100% of NM fee schedule,144.24,40,,,percent of total billed charges,40% of total billed charges,144.24,40,,,percent of total billed charges,40% of total billed charges,324.54,90,,,percent of total billed charges,90% of total billed charges,274.06,76,,,percent of total billed charges,76% of total billed charges,144.24,40,,,percent of total billed charges,40% of total billed charges,306.51,85,,,percent of total billed charges,85% of total billed charges,360.6,100,,,fee schedule,100% of CO APG rate,288.48,80,,,percent of total billed charges,80% of total billed charges,139.91,38.8,,,percent of total billed charges,38.8% of total billed charges,306.51,85,,,percent of total billed charges,85% of total billed charges,360.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,139.91,360.6,
"SYRINGE DUAL HEAD 200ML, CT",41152465,CDM,270,RC,,,OUTPATIENT,,,58,46.4,,43.5,75,,,percent of total billed charges,75% of total billed charges,23.2,40,,,percent of total billed charges,40% of total billed charges,45.94,79.2,,,percent of total billed charges,79.2% of total billed charges,49.3,85,,,percent of total billed charges,85% of total billed charges,58,100,,,fee schedule,100% of CO APG rates,55.1,95,,,percent of total billed charges,95% of total billed charges,46.4,80,,,percent of total billed charges,80% of total billed charges,49.3,85,,,percent of total billed charges,85% of total billed charges,52.2,90,,,percent of total billed charges,90% of total billed charges,58,100,,,fee schedule,100% of CO APG rates,58,100,,,fee schedule,100% of CO APG rates,58,100,,,fee schedule,100% of NM fee schedule,23.2,40,,,percent of total billed charges,40% of total billed charges,23.2,40,,,percent of total billed charges,40% of total billed charges,52.2,90,,,percent of total billed charges,90% of total billed charges,44.08,76,,,percent of total billed charges,76% of total billed charges,23.2,40,,,percent of total billed charges,40% of total billed charges,49.3,85,,,percent of total billed charges,85% of total billed charges,58,100,,,fee schedule,100% of CO APG rate,46.4,80,,,percent of total billed charges,80% of total billed charges,22.5,38.8,,,percent of total billed charges,38.8% of total billed charges,49.3,85,,,percent of total billed charges,85% of total billed charges,58,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,22.5,58,
Immunoassay for analyte other than infectious agent antibody,40064085,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,278.3,222.64,,208.73,75,,,percent of total billed charges,75% of total billed charges,111.32,40,,,percent of total billed charges,40% of total billed charges,220.41,79.2,,,percent of total billed charges,79.2% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,264.39,95,,,percent of total billed charges,95% of total billed charges,222.64,80,,,percent of total billed charges,80% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,250.47,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,111.32,40,,,percent of total billed charges,40% of total billed charges,111.32,40,,,percent of total billed charges,40% of total billed charges,250.47,90,,,percent of total billed charges,90% of total billed charges,211.51,76,,,percent of total billed charges,76% of total billed charges,111.32,40,,,percent of total billed charges,40% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,222.64,80,,,percent of total billed charges,80% of total billed charges,107.98,38.8,,,percent of total billed charges,38.8% of total billed charges,236.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,264.39,
"Buprenorphine, Urine LC",40080307,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,111.4,89.12,,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,105.83,
C4+C3 LC,40086160,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,125.4,100.32,,94.05,75,,,percent of total billed charges,75% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,99.32,79.2,,,percent of total billed charges,79.2% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,119.13,95,,,percent of total billed charges,95% of total billed charges,100.32,80,,,percent of total billed charges,80% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.16,40,,,percent of total billed charges,40% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,95.3,76,,,percent of total billed charges,76% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,100.32,80,,,percent of total billed charges,80% of total billed charges,48.66,38.8,,,percent of total billed charges,38.8% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,119.13,
"Cadmium Std Profile, Blood/Ur LC",40082300,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,103.9,83.12,,77.93,75,,,percent of total billed charges,75% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,82.29,79.2,,,percent of total billed charges,79.2% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,98.71,95,,,percent of total billed charges,95% of total billed charges,83.12,80,,,percent of total billed charges,80% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,41.56,40,,,percent of total billed charges,40% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,78.96,76,,,percent of total billed charges,76% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,83.12,80,,,percent of total billed charges,80% of total billed charges,40.31,38.8,,,percent of total billed charges,38.8% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,98.71,
"Catecholamine+VMA, 24-Hr Urine LC",40084585,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,68.9,55.12,,51.68,75,,,percent of total billed charges,75% of total billed charges,27.56,40,,,percent of total billed charges,40% of total billed charges,54.57,79.2,,,percent of total billed charges,79.2% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,65.46,95,,,percent of total billed charges,95% of total billed charges,55.12,80,,,percent of total billed charges,80% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,62.01,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,27.56,40,,,percent of total billed charges,40% of total billed charges,27.56,40,,,percent of total billed charges,40% of total billed charges,62.01,90,,,percent of total billed charges,90% of total billed charges,52.36,76,,,percent of total billed charges,76% of total billed charges,27.56,40,,,percent of total billed charges,40% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,55.12,80,,,percent of total billed charges,80% of total billed charges,26.73,38.8,,,percent of total billed charges,38.8% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,65.46,
"82784 Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, ea",40065118,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,100,80,,75,75,,,percent of total billed charges,75% of total billed charges,40,40,,,percent of total billed charges,40% of total billed charges,79.2,79.2,,,percent of total billed charges,79.2% of total billed charges,85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,95,95,,,percent of total billed charges,95% of total billed charges,80,80,,,percent of total billed charges,80% of total billed charges,85,85,,,percent of total billed charges,85% of total billed charges,90,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,40,40,,,percent of total billed charges,40% of total billed charges,40,40,,,percent of total billed charges,40% of total billed charges,90,90,,,percent of total billed charges,90% of total billed charges,76,76,,,percent of total billed charges,76% of total billed charges,40,40,,,percent of total billed charges,40% of total billed charges,85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,80,80,,,percent of total billed charges,80% of total billed charges,38.8,38.8,,,percent of total billed charges,38.8% of total billed charges,85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,95,
"Chromium, Plasma LC",40082495,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.6,58.88,,55.2,75,,,percent of total billed charges,75% of total billed charges,29.44,40,,,percent of total billed charges,40% of total billed charges,58.29,79.2,,,percent of total billed charges,79.2% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.92,95,,,percent of total billed charges,95% of total billed charges,58.88,80,,,percent of total billed charges,80% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,66.24,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.44,40,,,percent of total billed charges,40% of total billed charges,29.44,40,,,percent of total billed charges,40% of total billed charges,66.24,90,,,percent of total billed charges,90% of total billed charges,55.94,76,,,percent of total billed charges,76% of total billed charges,29.44,40,,,percent of total billed charges,40% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.88,80,,,percent of total billed charges,80% of total billed charges,28.56,38.8,,,percent of total billed charges,38.8% of total billed charges,62.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.92,
CMV Abs IgG/IgM LC,40086644,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,118,94.4,,88.5,75,,,percent of total billed charges,75% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,93.46,79.2,,,percent of total billed charges,79.2% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,112.1,95,,,percent of total billed charges,95% of total billed charges,94.4,80,,,percent of total billed charges,80% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,47.2,40,,,percent of total billed charges,40% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,89.68,76,,,percent of total billed charges,76% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,94.4,80,,,percent of total billed charges,80% of total billed charges,45.78,38.8,,,percent of total billed charges,38.8% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,112.1,
"Cobalt, Plasma LC",40083018,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,142.2,113.76,,106.65,75,,,percent of total billed charges,75% of total billed charges,56.88,40,,,percent of total billed charges,40% of total billed charges,112.62,79.2,,,percent of total billed charges,79.2% of total billed charges,120.87,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,135.09,95,,,percent of total billed charges,95% of total billed charges,113.76,80,,,percent of total billed charges,80% of total billed charges,120.87,85,,,percent of total billed charges,85% of total billed charges,127.98,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,56.88,40,,,percent of total billed charges,40% of total billed charges,56.88,40,,,percent of total billed charges,40% of total billed charges,127.98,90,,,percent of total billed charges,90% of total billed charges,108.07,76,,,percent of total billed charges,76% of total billed charges,56.88,40,,,percent of total billed charges,40% of total billed charges,120.87,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,113.76,80,,,percent of total billed charges,80% of total billed charges,55.17,38.8,,,percent of total billed charges,38.8% of total billed charges,120.87,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,135.09,
Coccidioides immitis Abs LC,40086635,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,116.9,93.52,,87.68,75,,,percent of total billed charges,75% of total billed charges,46.76,40,,,percent of total billed charges,40% of total billed charges,92.58,79.2,,,percent of total billed charges,79.2% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,111.06,95,,,percent of total billed charges,95% of total billed charges,93.52,80,,,percent of total billed charges,80% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,105.21,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,46.76,40,,,percent of total billed charges,40% of total billed charges,46.76,40,,,percent of total billed charges,40% of total billed charges,105.21,90,,,percent of total billed charges,90% of total billed charges,88.84,76,,,percent of total billed charges,76% of total billed charges,46.76,40,,,percent of total billed charges,40% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,93.52,80,,,percent of total billed charges,80% of total billed charges,45.36,38.8,,,percent of total billed charges,38.8% of total billed charges,99.37,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,111.06,
Comprehensive Thyroglobulin LC,40084432,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,243.7,194.96,,182.78,75,,,percent of total billed charges,75% of total billed charges,97.48,40,,,percent of total billed charges,40% of total billed charges,193.01,79.2,,,percent of total billed charges,79.2% of total billed charges,207.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,231.52,95,,,percent of total billed charges,95% of total billed charges,194.96,80,,,percent of total billed charges,80% of total billed charges,207.15,85,,,percent of total billed charges,85% of total billed charges,219.33,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,97.48,40,,,percent of total billed charges,40% of total billed charges,97.48,40,,,percent of total billed charges,40% of total billed charges,219.33,90,,,percent of total billed charges,90% of total billed charges,185.21,76,,,percent of total billed charges,76% of total billed charges,97.48,40,,,percent of total billed charges,40% of total billed charges,207.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,194.96,80,,,percent of total billed charges,80% of total billed charges,94.56,38.8,,,percent of total billed charges,38.8% of total billed charges,207.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,231.52,
"Cryptococcus Antibodies, Quant LC",40086641,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,110.4,88.32,,82.8,75,,,percent of total billed charges,75% of total billed charges,44.16,40,,,percent of total billed charges,40% of total billed charges,87.44,79.2,,,percent of total billed charges,79.2% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,104.88,95,,,percent of total billed charges,95% of total billed charges,88.32,80,,,percent of total billed charges,80% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,44.16,40,,,percent of total billed charges,40% of total billed charges,44.16,40,,,percent of total billed charges,40% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,83.9,76,,,percent of total billed charges,76% of total billed charges,44.16,40,,,percent of total billed charges,40% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,88.32,80,,,percent of total billed charges,80% of total billed charges,42.84,38.8,,,percent of total billed charges,38.8% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,104.88,
"C-Telopeptide, Serum LC",40082523,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,223.1,178.48,,167.33,75,,,percent of total billed charges,75% of total billed charges,89.24,40,,,percent of total billed charges,40% of total billed charges,176.7,79.2,,,percent of total billed charges,79.2% of total billed charges,189.64,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,211.95,95,,,percent of total billed charges,95% of total billed charges,178.48,80,,,percent of total billed charges,80% of total billed charges,189.64,85,,,percent of total billed charges,85% of total billed charges,200.79,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,89.24,40,,,percent of total billed charges,40% of total billed charges,89.24,40,,,percent of total billed charges,40% of total billed charges,200.79,90,,,percent of total billed charges,90% of total billed charges,169.56,76,,,percent of total billed charges,76% of total billed charges,89.24,40,,,percent of total billed charges,40% of total billed charges,189.64,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,178.48,80,,,percent of total billed charges,80% of total billed charges,86.56,38.8,,,percent of total billed charges,38.8% of total billed charges,189.64,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,211.95,
"Cyclospora Smear, Stool LC",4008715,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,30.3,24.24,,22.73,75,,,percent of total billed charges,75% of total billed charges,12.12,40,,,percent of total billed charges,40% of total billed charges,24,79.2,,,percent of total billed charges,79.2% of total billed charges,25.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,28.79,95,,,percent of total billed charges,95% of total billed charges,24.24,80,,,percent of total billed charges,80% of total billed charges,25.76,85,,,percent of total billed charges,85% of total billed charges,27.27,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,12.12,40,,,percent of total billed charges,40% of total billed charges,12.12,40,,,percent of total billed charges,40% of total billed charges,27.27,90,,,percent of total billed charges,90% of total billed charges,23.03,76,,,percent of total billed charges,76% of total billed charges,12.12,40,,,percent of total billed charges,40% of total billed charges,25.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,24.24,80,,,percent of total billed charges,80% of total billed charges,11.76,38.8,,,percent of total billed charges,38.8% of total billed charges,25.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,33.1,
Dihydrotestosterone LC,40080327,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,149.4,119.52,,112.05,75,,,percent of total billed charges,75% of total billed charges,59.76,40,,,percent of total billed charges,40% of total billed charges,118.32,79.2,,,percent of total billed charges,79.2% of total billed charges,126.99,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,141.93,95,,,percent of total billed charges,95% of total billed charges,119.52,80,,,percent of total billed charges,80% of total billed charges,126.99,85,,,percent of total billed charges,85% of total billed charges,134.46,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,59.76,40,,,percent of total billed charges,40% of total billed charges,59.76,40,,,percent of total billed charges,40% of total billed charges,134.46,90,,,percent of total billed charges,90% of total billed charges,113.54,76,,,percent of total billed charges,76% of total billed charges,59.76,40,,,percent of total billed charges,40% of total billed charges,126.99,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,119.52,80,,,percent of total billed charges,80% of total billed charges,57.97,38.8,,,percent of total billed charges,38.8% of total billed charges,126.99,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,141.93,
Echinococcus Antibody LC,40086682,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,164.5,131.6,,123.38,75,,,percent of total billed charges,75% of total billed charges,65.8,40,,,percent of total billed charges,40% of total billed charges,130.28,79.2,,,percent of total billed charges,79.2% of total billed charges,139.83,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,156.28,95,,,percent of total billed charges,95% of total billed charges,131.6,80,,,percent of total billed charges,80% of total billed charges,139.83,85,,,percent of total billed charges,85% of total billed charges,148.05,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,65.8,40,,,percent of total billed charges,40% of total billed charges,65.8,40,,,percent of total billed charges,40% of total billed charges,148.05,90,,,percent of total billed charges,90% of total billed charges,125.02,76,,,percent of total billed charges,76% of total billed charges,65.8,40,,,percent of total billed charges,40% of total billed charges,139.83,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,131.6,80,,,percent of total billed charges,80% of total billed charges,63.83,38.8,,,percent of total billed charges,38.8% of total billed charges,139.83,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,156.28,
"Eosinophil, Urine LC",40089050,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,60.42,
"Epstein-Barr DNA Quant, PCR LC",40087799,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,363.6,290.88,,272.7,75,,,percent of total billed charges,75% of total billed charges,145.44,40,,,percent of total billed charges,40% of total billed charges,287.97,79.2,,,percent of total billed charges,79.2% of total billed charges,309.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,345.42,95,,,percent of total billed charges,95% of total billed charges,290.88,80,,,percent of total billed charges,80% of total billed charges,309.06,85,,,percent of total billed charges,85% of total billed charges,327.24,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,145.44,40,,,percent of total billed charges,40% of total billed charges,145.44,40,,,percent of total billed charges,40% of total billed charges,327.24,90,,,percent of total billed charges,90% of total billed charges,276.34,76,,,percent of total billed charges,76% of total billed charges,145.44,40,,,percent of total billed charges,40% of total billed charges,309.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,290.88,80,,,percent of total billed charges,80% of total billed charges,141.08,38.8,,,percent of total billed charges,38.8% of total billed charges,309.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,345.42,
"Estrone, Serum LC",40082679,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,164.5,131.6,,123.38,75,,,percent of total billed charges,75% of total billed charges,65.8,40,,,percent of total billed charges,40% of total billed charges,130.28,79.2,,,percent of total billed charges,79.2% of total billed charges,139.83,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,156.28,95,,,percent of total billed charges,95% of total billed charges,131.6,80,,,percent of total billed charges,80% of total billed charges,139.83,85,,,percent of total billed charges,85% of total billed charges,148.05,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,65.8,40,,,percent of total billed charges,40% of total billed charges,65.8,40,,,percent of total billed charges,40% of total billed charges,148.05,90,,,percent of total billed charges,90% of total billed charges,125.02,76,,,percent of total billed charges,76% of total billed charges,65.8,40,,,percent of total billed charges,40% of total billed charges,139.83,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,131.6,80,,,percent of total billed charges,80% of total billed charges,63.83,38.8,,,percent of total billed charges,38.8% of total billed charges,139.83,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,156.28,
F091-IgE Mango LC,40002741,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,49.7,39.76,,37.28,75,,,percent of total billed charges,75% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,39.36,79.2,,,percent of total billed charges,79.2% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,47.22,95,,,percent of total billed charges,95% of total billed charges,39.76,80,,,percent of total billed charges,80% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,19.88,40,,,percent of total billed charges,40% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,37.77,76,,,percent of total billed charges,76% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,39.76,80,,,percent of total billed charges,80% of total billed charges,19.28,38.8,,,percent of total billed charges,38.8% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,47.22,
F203-IgE Pistachio Nut LC,40002486,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,49.7,39.76,,37.28,75,,,percent of total billed charges,75% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,39.36,79.2,,,percent of total billed charges,79.2% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,47.22,95,,,percent of total billed charges,95% of total billed charges,39.76,80,,,percent of total billed charges,80% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,19.88,40,,,percent of total billed charges,40% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,37.77,76,,,percent of total billed charges,76% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,39.76,80,,,percent of total billed charges,80% of total billed charges,19.28,38.8,,,percent of total billed charges,38.8% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,47.22,
"F256-IgE Walnut, Food LC",40002530,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,49.7,39.76,,37.28,75,,,percent of total billed charges,75% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,39.36,79.2,,,percent of total billed charges,79.2% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,47.22,95,,,percent of total billed charges,95% of total billed charges,39.76,80,,,percent of total billed charges,80% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,19.88,40,,,percent of total billed charges,40% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,37.77,76,,,percent of total billed charges,76% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,39.76,80,,,percent of total billed charges,80% of total billed charges,19.28,38.8,,,percent of total billed charges,38.8% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,47.22,
F293-IgE Papaya Food LC,40002828,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,49.7,39.76,,37.28,75,,,percent of total billed charges,75% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,39.36,79.2,,,percent of total billed charges,79.2% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,47.22,95,,,percent of total billed charges,95% of total billed charges,39.76,80,,,percent of total billed charges,80% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,19.88,40,,,percent of total billed charges,40% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,37.77,76,,,percent of total billed charges,76% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,39.76,80,,,percent of total billed charges,80% of total billed charges,19.28,38.8,,,percent of total billed charges,38.8% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,47.22,
Fibrinogen Activity LC,40085384,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,26.2,20.96,,19.65,75,,,percent of total billed charges,75% of total billed charges,10.48,40,,,percent of total billed charges,40% of total billed charges,20.75,79.2,,,percent of total billed charges,79.2% of total billed charges,22.27,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,24.89,95,,,percent of total billed charges,95% of total billed charges,20.96,80,,,percent of total billed charges,80% of total billed charges,22.27,85,,,percent of total billed charges,85% of total billed charges,23.58,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,10.48,40,,,percent of total billed charges,40% of total billed charges,10.48,40,,,percent of total billed charges,40% of total billed charges,23.58,90,,,percent of total billed charges,90% of total billed charges,19.91,76,,,percent of total billed charges,76% of total billed charges,10.48,40,,,percent of total billed charges,40% of total billed charges,22.27,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,20.96,80,,,percent of total billed charges,80% of total billed charges,10.17,38.8,,,percent of total billed charges,38.8% of total billed charges,22.27,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,24.89,
"Nephelometry, each analyte not elsewhere specified",40083883,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,113,90.4,,84.75,75,,,percent of total billed charges,75% of total billed charges,45.2,40,,,percent of total billed charges,40% of total billed charges,89.5,79.2,,,percent of total billed charges,79.2% of total billed charges,96.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,107.35,95,,,percent of total billed charges,95% of total billed charges,90.4,80,,,percent of total billed charges,80% of total billed charges,96.05,85,,,percent of total billed charges,85% of total billed charges,101.7,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,45.2,40,,,percent of total billed charges,40% of total billed charges,45.2,40,,,percent of total billed charges,40% of total billed charges,101.7,90,,,percent of total billed charges,90% of total billed charges,85.88,76,,,percent of total billed charges,76% of total billed charges,45.2,40,,,percent of total billed charges,40% of total billed charges,96.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,90.4,80,,,percent of total billed charges,80% of total billed charges,43.84,38.8,,,percent of total billed charges,38.8% of total billed charges,96.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,107.35,
"Gastrin, Serum (8 Specimens) LC",40082941,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,140.3,112.24,,105.23,75,,,percent of total billed charges,75% of total billed charges,56.12,40,,,percent of total billed charges,40% of total billed charges,111.12,79.2,,,percent of total billed charges,79.2% of total billed charges,119.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,133.29,95,,,percent of total billed charges,95% of total billed charges,112.24,80,,,percent of total billed charges,80% of total billed charges,119.26,85,,,percent of total billed charges,85% of total billed charges,126.27,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,56.12,40,,,percent of total billed charges,40% of total billed charges,56.12,40,,,percent of total billed charges,40% of total billed charges,126.27,90,,,percent of total billed charges,90% of total billed charges,106.63,76,,,percent of total billed charges,76% of total billed charges,56.12,40,,,percent of total billed charges,40% of total billed charges,119.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,112.24,80,,,percent of total billed charges,80% of total billed charges,54.44,38.8,,,percent of total billed charges,38.8% of total billed charges,119.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,133.29,
"Virus, not elsewhere specified.",40086790,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,142.8,114.24,,107.1,75,,,percent of total billed charges,75% of total billed charges,57.12,40,,,percent of total billed charges,40% of total billed charges,113.1,79.2,,,percent of total billed charges,79.2% of total billed charges,121.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,135.66,95,,,percent of total billed charges,95% of total billed charges,114.24,80,,,percent of total billed charges,80% of total billed charges,121.38,85,,,percent of total billed charges,85% of total billed charges,128.52,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,57.12,40,,,percent of total billed charges,40% of total billed charges,57.12,40,,,percent of total billed charges,40% of total billed charges,128.52,90,,,percent of total billed charges,90% of total billed charges,108.53,76,,,percent of total billed charges,76% of total billed charges,57.12,40,,,percent of total billed charges,40% of total billed charges,121.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,114.24,80,,,percent of total billed charges,80% of total billed charges,55.41,38.8,,,percent of total billed charges,38.8% of total billed charges,121.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,135.66,
"HBV RT PCR, Quant (Graph) LC",40087517,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,212.1,169.68,,159.08,75,,,percent of total billed charges,75% of total billed charges,84.84,40,,,percent of total billed charges,40% of total billed charges,167.98,79.2,,,percent of total billed charges,79.2% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,201.5,95,,,percent of total billed charges,95% of total billed charges,169.68,80,,,percent of total billed charges,80% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,84.84,40,,,percent of total billed charges,40% of total billed charges,84.84,40,,,percent of total billed charges,40% of total billed charges,190.89,90,,,percent of total billed charges,90% of total billed charges,161.2,76,,,percent of total billed charges,76% of total billed charges,84.84,40,,,percent of total billed charges,40% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,169.68,80,,,percent of total billed charges,80% of total billed charges,82.29,38.8,,,percent of total billed charges,38.8% of total billed charges,180.29,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,201.5,
"Hep B Core Ab, IgM LC",40086705,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,26.6,21.28,,19.95,75,,,percent of total billed charges,75% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,21.07,79.2,,,percent of total billed charges,79.2% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,25.27,95,,,percent of total billed charges,95% of total billed charges,21.28,80,,,percent of total billed charges,80% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,23.94,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,10.64,40,,,percent of total billed charges,40% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,23.94,90,,,percent of total billed charges,90% of total billed charges,20.22,76,,,percent of total billed charges,76% of total billed charges,10.64,40,,,percent of total billed charges,40% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,21.28,80,,,percent of total billed charges,80% of total billed charges,10.32,38.8,,,percent of total billed charges,38.8% of total billed charges,22.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,25.27,
Hepatitis B Surf Ab Quant LC,40086317,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,46,36.8,,34.5,75,,,percent of total billed charges,75% of total billed charges,18.4,40,,,percent of total billed charges,40% of total billed charges,36.43,79.2,,,percent of total billed charges,79.2% of total billed charges,39.1,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,43.7,95,,,percent of total billed charges,95% of total billed charges,36.8,80,,,percent of total billed charges,80% of total billed charges,39.1,85,,,percent of total billed charges,85% of total billed charges,41.4,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,18.4,40,,,percent of total billed charges,40% of total billed charges,18.4,40,,,percent of total billed charges,40% of total billed charges,41.4,90,,,percent of total billed charges,90% of total billed charges,34.96,76,,,percent of total billed charges,76% of total billed charges,18.4,40,,,percent of total billed charges,40% of total billed charges,39.1,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,36.8,80,,,percent of total billed charges,80% of total billed charges,17.85,38.8,,,percent of total billed charges,38.8% of total billed charges,39.1,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,43.7,
"Histamine Determination, Blood LC",40081315,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,202.4,161.92,,151.8,75,,,percent of total billed charges,75% of total billed charges,80.96,40,,,percent of total billed charges,40% of total billed charges,160.3,79.2,,,percent of total billed charges,79.2% of total billed charges,172.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,192.28,95,,,percent of total billed charges,95% of total billed charges,161.92,80,,,percent of total billed charges,80% of total billed charges,172.04,85,,,percent of total billed charges,85% of total billed charges,182.16,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,80.96,40,,,percent of total billed charges,40% of total billed charges,80.96,40,,,percent of total billed charges,40% of total billed charges,182.16,90,,,percent of total billed charges,90% of total billed charges,153.82,76,,,percent of total billed charges,76% of total billed charges,80.96,40,,,percent of total billed charges,40% of total billed charges,172.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,161.92,80,,,percent of total billed charges,80% of total billed charges,78.53,38.8,,,percent of total billed charges,38.8% of total billed charges,172.04,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,192.28,
Human Epididymis Protein 4 LC,40086305,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,392.5,314,,294.38,75,,,percent of total billed charges,75% of total billed charges,157,40,,,percent of total billed charges,40% of total billed charges,310.86,79.2,,,percent of total billed charges,79.2% of total billed charges,333.63,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,372.88,95,,,percent of total billed charges,95% of total billed charges,314,80,,,percent of total billed charges,80% of total billed charges,333.63,85,,,percent of total billed charges,85% of total billed charges,353.25,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,157,40,,,percent of total billed charges,40% of total billed charges,157,40,,,percent of total billed charges,40% of total billed charges,353.25,90,,,percent of total billed charges,90% of total billed charges,298.3,76,,,percent of total billed charges,76% of total billed charges,157,40,,,percent of total billed charges,40% of total billed charges,333.63,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,314,80,,,percent of total billed charges,80% of total billed charges,152.29,38.8,,,percent of total billed charges,38.8% of total billed charges,333.63,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,372.88,
Hymenoptera Profile LC,40086003,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,49.1,39.28,,36.83,75,,,percent of total billed charges,75% of total billed charges,19.64,40,,,percent of total billed charges,40% of total billed charges,38.89,79.2,,,percent of total billed charges,79.2% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,46.65,95,,,percent of total billed charges,95% of total billed charges,39.28,80,,,percent of total billed charges,80% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,44.19,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,19.64,40,,,percent of total billed charges,40% of total billed charges,19.64,40,,,percent of total billed charges,40% of total billed charges,44.19,90,,,percent of total billed charges,90% of total billed charges,37.32,76,,,percent of total billed charges,76% of total billed charges,19.64,40,,,percent of total billed charges,40% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,39.28,80,,,percent of total billed charges,80% of total billed charges,19.05,38.8,,,percent of total billed charges,38.8% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,46.65,
IA-2 Autoantibodies LC,40041531,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,131.2,104.96,,98.4,75,,,percent of total billed charges,75% of total billed charges,52.48,40,,,percent of total billed charges,40% of total billed charges,103.91,79.2,,,percent of total billed charges,79.2% of total billed charges,111.52,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,124.64,95,,,percent of total billed charges,95% of total billed charges,104.96,80,,,percent of total billed charges,80% of total billed charges,111.52,85,,,percent of total billed charges,85% of total billed charges,118.08,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,52.48,40,,,percent of total billed charges,40% of total billed charges,52.48,40,,,percent of total billed charges,40% of total billed charges,118.08,90,,,percent of total billed charges,90% of total billed charges,99.71,76,,,percent of total billed charges,76% of total billed charges,52.48,40,,,percent of total billed charges,40% of total billed charges,111.52,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,104.96,80,,,percent of total billed charges,80% of total billed charges,50.91,38.8,,,percent of total billed charges,38.8% of total billed charges,111.52,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,124.64,
IBD Expanded Panel LC,40086671,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,381.1,304.88,,285.83,75,,,percent of total billed charges,75% of total billed charges,152.44,40,,,percent of total billed charges,40% of total billed charges,301.83,79.2,,,percent of total billed charges,79.2% of total billed charges,323.94,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,362.05,95,,,percent of total billed charges,95% of total billed charges,304.88,80,,,percent of total billed charges,80% of total billed charges,323.94,85,,,percent of total billed charges,85% of total billed charges,342.99,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,152.44,40,,,percent of total billed charges,40% of total billed charges,152.44,40,,,percent of total billed charges,40% of total billed charges,342.99,90,,,percent of total billed charges,90% of total billed charges,289.64,76,,,percent of total billed charges,76% of total billed charges,152.44,40,,,percent of total billed charges,40% of total billed charges,323.94,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,304.88,80,,,percent of total billed charges,80% of total billed charges,147.87,38.8,,,percent of total billed charges,38.8% of total billed charges,323.94,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,362.05,
"IFE and PE, Random Urine LC",40084156,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,41.7,33.36,,31.28,75,,,percent of total billed charges,75% of total billed charges,16.68,40,,,percent of total billed charges,40% of total billed charges,33.03,79.2,,,percent of total billed charges,79.2% of total billed charges,35.45,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,39.62,95,,,percent of total billed charges,95% of total billed charges,33.36,80,,,percent of total billed charges,80% of total billed charges,35.45,85,,,percent of total billed charges,85% of total billed charges,37.53,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,16.68,40,,,percent of total billed charges,40% of total billed charges,16.68,40,,,percent of total billed charges,40% of total billed charges,37.53,90,,,percent of total billed charges,90% of total billed charges,31.69,76,,,percent of total billed charges,76% of total billed charges,16.68,40,,,percent of total billed charges,40% of total billed charges,35.45,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,33.36,80,,,percent of total billed charges,80% of total billed charges,16.18,38.8,,,percent of total billed charges,38.8% of total billed charges,35.45,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,39.62,
IgE Food Allergy Panel LC,40086003,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,49.7,39.76,,37.28,75,,,percent of total billed charges,75% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,39.36,79.2,,,percent of total billed charges,79.2% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,47.22,95,,,percent of total billed charges,95% of total billed charges,39.76,80,,,percent of total billed charges,80% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,19.88,40,,,percent of total billed charges,40% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,37.77,76,,,percent of total billed charges,76% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,39.76,80,,,percent of total billed charges,80% of total billed charges,19.28,38.8,,,percent of total billed charges,38.8% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,47.22,
IL28B Polymorphism Genotype LC,40081400,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,581.1,464.88,,435.83,75,,,percent of total billed charges,75% of total billed charges,232.44,40,,,percent of total billed charges,40% of total billed charges,460.23,79.2,,,percent of total billed charges,79.2% of total billed charges,493.94,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,552.05,95,,,percent of total billed charges,95% of total billed charges,464.88,80,,,percent of total billed charges,80% of total billed charges,493.94,85,,,percent of total billed charges,85% of total billed charges,522.99,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,232.44,40,,,percent of total billed charges,40% of total billed charges,232.44,40,,,percent of total billed charges,40% of total billed charges,522.99,90,,,percent of total billed charges,90% of total billed charges,441.64,76,,,percent of total billed charges,76% of total billed charges,232.44,40,,,percent of total billed charges,40% of total billed charges,493.94,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,464.88,80,,,percent of total billed charges,80% of total billed charges,225.47,38.8,,,percent of total billed charges,38.8% of total billed charges,493.94,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,552.05,
"Influenza A and B, RT PCR LC",40087502,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,348.5,278.8,,261.38,75,,,percent of total billed charges,75% of total billed charges,139.4,40,,,percent of total billed charges,40% of total billed charges,276.01,79.2,,,percent of total billed charges,79.2% of total billed charges,296.23,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,331.08,95,,,percent of total billed charges,95% of total billed charges,278.8,80,,,percent of total billed charges,80% of total billed charges,296.23,85,,,percent of total billed charges,85% of total billed charges,313.65,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,139.4,40,,,percent of total billed charges,40% of total billed charges,139.4,40,,,percent of total billed charges,40% of total billed charges,313.65,90,,,percent of total billed charges,90% of total billed charges,264.86,76,,,percent of total billed charges,76% of total billed charges,139.4,40,,,percent of total billed charges,40% of total billed charges,296.23,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,278.8,80,,,percent of total billed charges,80% of total billed charges,135.22,38.8,,,percent of total billed charges,38.8% of total billed charges,296.23,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,331.08,
"Iodine, Serum or Plasma LC",40083789,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,106.4,85.12,,79.8,75,,,percent of total billed charges,75% of total billed charges,42.56,40,,,percent of total billed charges,40% of total billed charges,84.27,79.2,,,percent of total billed charges,79.2% of total billed charges,90.44,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,101.08,95,,,percent of total billed charges,95% of total billed charges,85.12,80,,,percent of total billed charges,80% of total billed charges,90.44,85,,,percent of total billed charges,85% of total billed charges,95.76,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,42.56,40,,,percent of total billed charges,40% of total billed charges,42.56,40,,,percent of total billed charges,40% of total billed charges,95.76,90,,,percent of total billed charges,90% of total billed charges,80.86,76,,,percent of total billed charges,76% of total billed charges,42.56,40,,,percent of total billed charges,40% of total billed charges,90.44,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,85.12,80,,,percent of total billed charges,80% of total billed charges,41.28,38.8,,,percent of total billed charges,38.8% of total billed charges,90.44,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,101.08,
Lipid Panel LC,40003756,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,22,17.6,,16.5,75,,,percent of total billed charges,75% of total billed charges,8.8,40,,,percent of total billed charges,40% of total billed charges,17.42,79.2,,,percent of total billed charges,79.2% of total billed charges,18.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,20.9,95,,,percent of total billed charges,95% of total billed charges,17.6,80,,,percent of total billed charges,80% of total billed charges,18.7,85,,,percent of total billed charges,85% of total billed charges,19.8,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,8.8,40,,,percent of total billed charges,40% of total billed charges,8.8,40,,,percent of total billed charges,40% of total billed charges,19.8,90,,,percent of total billed charges,90% of total billed charges,16.72,76,,,percent of total billed charges,76% of total billed charges,8.8,40,,,percent of total billed charges,40% of total billed charges,18.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,17.6,80,,,percent of total billed charges,80% of total billed charges,8.54,38.8,,,percent of total billed charges,38.8% of total billed charges,18.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,20.9,
"Lithium (Eskalith(R)), Serum LC",40007708,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,22.1,17.68,,16.58,75,,,percent of total billed charges,75% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,17.5,79.2,,,percent of total billed charges,79.2% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,21,95,,,percent of total billed charges,95% of total billed charges,17.68,80,,,percent of total billed charges,80% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,19.89,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,8.84,40,,,percent of total billed charges,40% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,19.89,90,,,percent of total billed charges,90% of total billed charges,16.8,76,,,percent of total billed charges,76% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,17.68,80,,,percent of total billed charges,80% of total billed charges,8.57,38.8,,,percent of total billed charges,38.8% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,21,
Lower Respiratory Culture LC,40087070,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,16.2,12.96,,12.15,75,,,percent of total billed charges,75% of total billed charges,6.48,40,,,percent of total billed charges,40% of total billed charges,12.83,79.2,,,percent of total billed charges,79.2% of total billed charges,13.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,15.39,95,,,percent of total billed charges,95% of total billed charges,12.96,80,,,percent of total billed charges,80% of total billed charges,13.77,85,,,percent of total billed charges,85% of total billed charges,14.58,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,6.48,40,,,percent of total billed charges,40% of total billed charges,6.48,40,,,percent of total billed charges,40% of total billed charges,14.58,90,,,percent of total billed charges,90% of total billed charges,12.31,76,,,percent of total billed charges,76% of total billed charges,6.48,40,,,percent of total billed charges,40% of total billed charges,13.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,12.96,80,,,percent of total billed charges,80% of total billed charges,6.29,38.8,,,percent of total billed charges,38.8% of total billed charges,13.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,6.29,33.1,
Lp-PLA2 LC,40083698,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,184.9,147.92,,138.68,75,,,percent of total billed charges,75% of total billed charges,73.96,40,,,percent of total billed charges,40% of total billed charges,146.44,79.2,,,percent of total billed charges,79.2% of total billed charges,157.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,175.66,95,,,percent of total billed charges,95% of total billed charges,147.92,80,,,percent of total billed charges,80% of total billed charges,157.17,85,,,percent of total billed charges,85% of total billed charges,166.41,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,73.96,40,,,percent of total billed charges,40% of total billed charges,73.96,40,,,percent of total billed charges,40% of total billed charges,166.41,90,,,percent of total billed charges,90% of total billed charges,140.52,76,,,percent of total billed charges,76% of total billed charges,73.96,40,,,percent of total billed charges,40% of total billed charges,157.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,147.92,80,,,percent of total billed charges,80% of total billed charges,71.74,38.8,,,percent of total billed charges,38.8% of total billed charges,157.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,175.66,
Antibody; Borrelia burgdorferi (Lyme disease),40086618,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,166.8,133.44,,125.1,75,,,percent of total billed charges,75% of total billed charges,66.72,40,,,percent of total billed charges,40% of total billed charges,132.11,79.2,,,percent of total billed charges,79.2% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,158.46,95,,,percent of total billed charges,95% of total billed charges,133.44,80,,,percent of total billed charges,80% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,150.12,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,66.72,40,,,percent of total billed charges,40% of total billed charges,66.72,40,,,percent of total billed charges,40% of total billed charges,150.12,90,,,percent of total billed charges,90% of total billed charges,126.77,76,,,percent of total billed charges,76% of total billed charges,66.72,40,,,percent of total billed charges,40% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,133.44,80,,,percent of total billed charges,80% of total billed charges,64.72,38.8,,,percent of total billed charges,38.8% of total billed charges,141.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,158.46,
"Lysozyme, Serum LC",40080713,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,36.1,28.88,,27.08,75,,,percent of total billed charges,75% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,28.59,79.2,,,percent of total billed charges,79.2% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,34.3,95,,,percent of total billed charges,95% of total billed charges,28.88,80,,,percent of total billed charges,80% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,32.49,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,14.44,40,,,percent of total billed charges,40% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,32.49,90,,,percent of total billed charges,90% of total billed charges,27.44,76,,,percent of total billed charges,76% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,28.88,80,,,percent of total billed charges,80% of total billed charges,14.01,38.8,,,percent of total billed charges,38.8% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,34.3,
"Metanephrines, Frac., Pl. Free LC",40083835,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,36.4,29.12,,27.3,75,,,percent of total billed charges,75% of total billed charges,14.56,40,,,percent of total billed charges,40% of total billed charges,28.83,79.2,,,percent of total billed charges,79.2% of total billed charges,30.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,34.58,95,,,percent of total billed charges,95% of total billed charges,29.12,80,,,percent of total billed charges,80% of total billed charges,30.94,85,,,percent of total billed charges,85% of total billed charges,32.76,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,14.56,40,,,percent of total billed charges,40% of total billed charges,14.56,40,,,percent of total billed charges,40% of total billed charges,32.76,90,,,percent of total billed charges,90% of total billed charges,27.66,76,,,percent of total billed charges,76% of total billed charges,14.56,40,,,percent of total billed charges,40% of total billed charges,30.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,29.12,80,,,percent of total billed charges,80% of total billed charges,14.12,38.8,,,percent of total billed charges,38.8% of total billed charges,30.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,34.58,
Myasthenia Gravis Panel I LC,40083519,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,1181.6,945.28,,886.2,75,,,percent of total billed charges,75% of total billed charges,472.64,40,,,percent of total billed charges,40% of total billed charges,935.83,79.2,,,percent of total billed charges,79.2% of total billed charges,1004.36,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,1122.52,95,,,percent of total billed charges,95% of total billed charges,945.28,80,,,percent of total billed charges,80% of total billed charges,1004.36,85,,,percent of total billed charges,85% of total billed charges,1063.44,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,472.64,40,,,percent of total billed charges,40% of total billed charges,472.64,40,,,percent of total billed charges,40% of total billed charges,1063.44,90,,,percent of total billed charges,90% of total billed charges,898.02,76,,,percent of total billed charges,76% of total billed charges,472.64,40,,,percent of total billed charges,40% of total billed charges,1004.36,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,945.28,80,,,percent of total billed charges,80% of total billed charges,458.46,38.8,,,percent of total billed charges,38.8% of total billed charges,1004.36,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,1122.52,
Myasthenia Gravis Panel W/Rflx LC,40086255,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,137.1,109.68,,102.83,75,,,percent of total billed charges,75% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,108.58,79.2,,,percent of total billed charges,79.2% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,130.25,95,,,percent of total billed charges,95% of total billed charges,109.68,80,,,percent of total billed charges,80% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,123.39,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,54.84,40,,,percent of total billed charges,40% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,123.39,90,,,percent of total billed charges,90% of total billed charges,104.2,76,,,percent of total billed charges,76% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,109.68,80,,,percent of total billed charges,80% of total billed charges,53.19,38.8,,,percent of total billed charges,38.8% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,130.25,
"Mycoplasma pneumoniae, IgM Ab LC",40086738,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,40.3,32.24,,30.23,75,,,percent of total billed charges,75% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,31.92,79.2,,,percent of total billed charges,79.2% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,38.29,95,,,percent of total billed charges,95% of total billed charges,32.24,80,,,percent of total billed charges,80% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,16.12,40,,,percent of total billed charges,40% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,30.63,76,,,percent of total billed charges,76% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,32.24,80,,,percent of total billed charges,80% of total billed charges,15.64,38.8,,,percent of total billed charges,38.8% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,38.29,
"Myoglobin, Serum LC",40083874,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,58.5,46.8,,43.88,75,,,percent of total billed charges,75% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,46.33,79.2,,,percent of total billed charges,79.2% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,55.58,95,,,percent of total billed charges,95% of total billed charges,46.8,80,,,percent of total billed charges,80% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,23.4,40,,,percent of total billed charges,40% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,52.65,90,,,percent of total billed charges,90% of total billed charges,44.46,76,,,percent of total billed charges,76% of total billed charges,23.4,40,,,percent of total billed charges,40% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,46.8,80,,,percent of total billed charges,80% of total billed charges,22.7,38.8,,,percent of total billed charges,38.8% of total billed charges,49.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,55.58,
NMO IgG Autoantibodies LC,40004210,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,976.9,781.52,,732.68,75,,,percent of total billed charges,75% of total billed charges,390.76,40,,,percent of total billed charges,40% of total billed charges,773.7,79.2,,,percent of total billed charges,79.2% of total billed charges,830.37,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,928.06,95,,,percent of total billed charges,95% of total billed charges,781.52,80,,,percent of total billed charges,80% of total billed charges,830.37,85,,,percent of total billed charges,85% of total billed charges,879.21,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,390.76,40,,,percent of total billed charges,40% of total billed charges,390.76,40,,,percent of total billed charges,40% of total billed charges,879.21,90,,,percent of total billed charges,90% of total billed charges,742.44,76,,,percent of total billed charges,76% of total billed charges,390.76,40,,,percent of total billed charges,40% of total billed charges,830.37,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,781.52,80,,,percent of total billed charges,80% of total billed charges,379.04,38.8,,,percent of total billed charges,38.8% of total billed charges,830.37,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,928.06,
NMR LipoProfile LC,40080061,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,85.1,68.08,,63.83,75,,,percent of total billed charges,75% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,67.4,79.2,,,percent of total billed charges,79.2% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,80.85,95,,,percent of total billed charges,95% of total billed charges,68.08,80,,,percent of total billed charges,80% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,34.04,40,,,percent of total billed charges,40% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,64.68,76,,,percent of total billed charges,76% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,68.08,80,,,percent of total billed charges,80% of total billed charges,33.02,38.8,,,percent of total billed charges,38.8% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,80.85,
"O+P Exam, Formalin Only LC",40087177,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,20.1,16.08,,15.08,75,,,percent of total billed charges,75% of total billed charges,8.04,40,,,percent of total billed charges,40% of total billed charges,15.92,79.2,,,percent of total billed charges,79.2% of total billed charges,17.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,19.1,95,,,percent of total billed charges,95% of total billed charges,16.08,80,,,percent of total billed charges,80% of total billed charges,17.09,85,,,percent of total billed charges,85% of total billed charges,18.09,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,8.04,40,,,percent of total billed charges,40% of total billed charges,8.04,40,,,percent of total billed charges,40% of total billed charges,18.09,90,,,percent of total billed charges,90% of total billed charges,15.28,76,,,percent of total billed charges,76% of total billed charges,8.04,40,,,percent of total billed charges,40% of total billed charges,17.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,16.08,80,,,percent of total billed charges,80% of total billed charges,7.8,38.8,,,percent of total billed charges,38.8% of total billed charges,17.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,7.8,33.1,
"Parasite Exam, Blood LC",40008185,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,30.3,24.24,,22.73,75,,,percent of total billed charges,75% of total billed charges,12.12,40,,,percent of total billed charges,40% of total billed charges,24,79.2,,,percent of total billed charges,79.2% of total billed charges,25.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,28.79,95,,,percent of total billed charges,95% of total billed charges,24.24,80,,,percent of total billed charges,80% of total billed charges,25.76,85,,,percent of total billed charges,85% of total billed charges,27.27,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,12.12,40,,,percent of total billed charges,40% of total billed charges,12.12,40,,,percent of total billed charges,40% of total billed charges,27.27,90,,,percent of total billed charges,90% of total billed charges,23.03,76,,,percent of total billed charges,76% of total billed charges,12.12,40,,,percent of total billed charges,40% of total billed charges,25.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,24.24,80,,,percent of total billed charges,80% of total billed charges,11.76,38.8,,,percent of total billed charges,38.8% of total billed charges,25.76,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,33.1,
"Phenobarbital, Serum LC",40080184,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,38.7,30.96,,29.03,75,,,percent of total billed charges,75% of total billed charges,15.48,40,,,percent of total billed charges,40% of total billed charges,30.65,79.2,,,percent of total billed charges,79.2% of total billed charges,32.9,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,36.77,95,,,percent of total billed charges,95% of total billed charges,30.96,80,,,percent of total billed charges,80% of total billed charges,32.9,85,,,percent of total billed charges,85% of total billed charges,34.83,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,15.48,40,,,percent of total billed charges,40% of total billed charges,15.48,40,,,percent of total billed charges,40% of total billed charges,34.83,90,,,percent of total billed charges,90% of total billed charges,29.41,76,,,percent of total billed charges,76% of total billed charges,15.48,40,,,percent of total billed charges,40% of total billed charges,32.9,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,30.96,80,,,percent of total billed charges,80% of total billed charges,15.02,38.8,,,percent of total billed charges,38.8% of total billed charges,32.9,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,36.77,
"Phospholipids, Serum LC",40084311,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,32.4,25.92,,24.3,75,,,percent of total billed charges,75% of total billed charges,12.96,40,,,percent of total billed charges,40% of total billed charges,25.66,79.2,,,percent of total billed charges,79.2% of total billed charges,27.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,30.78,95,,,percent of total billed charges,95% of total billed charges,25.92,80,,,percent of total billed charges,80% of total billed charges,27.54,85,,,percent of total billed charges,85% of total billed charges,29.16,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,12.96,40,,,percent of total billed charges,40% of total billed charges,12.96,40,,,percent of total billed charges,40% of total billed charges,29.16,90,,,percent of total billed charges,90% of total billed charges,24.62,76,,,percent of total billed charges,76% of total billed charges,12.96,40,,,percent of total billed charges,40% of total billed charges,27.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,25.92,80,,,percent of total billed charges,80% of total billed charges,12.57,38.8,,,percent of total billed charges,38.8% of total billed charges,27.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,30.78,
PM-SCL Antibodies LC,40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,125.4,100.32,,94.05,75,,,percent of total billed charges,75% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,99.32,79.2,,,percent of total billed charges,79.2% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,119.13,95,,,percent of total billed charges,95% of total billed charges,100.32,80,,,percent of total billed charges,80% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.16,40,,,percent of total billed charges,40% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,95.3,76,,,percent of total billed charges,76% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,100.32,80,,,percent of total billed charges,80% of total billed charges,48.66,38.8,,,percent of total billed charges,38.8% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,119.13,
"Porphobilinogen, Qn, 24-Hr Ur LC",40084110,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,127.4,101.92,,95.55,75,,,percent of total billed charges,75% of total billed charges,50.96,40,,,percent of total billed charges,40% of total billed charges,100.9,79.2,,,percent of total billed charges,79.2% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,121.03,95,,,percent of total billed charges,95% of total billed charges,101.92,80,,,percent of total billed charges,80% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,114.66,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,50.96,40,,,percent of total billed charges,40% of total billed charges,50.96,40,,,percent of total billed charges,40% of total billed charges,114.66,90,,,percent of total billed charges,90% of total billed charges,96.82,76,,,percent of total billed charges,76% of total billed charges,50.96,40,,,percent of total billed charges,40% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,101.92,80,,,percent of total billed charges,80% of total billed charges,49.43,38.8,,,percent of total billed charges,38.8% of total billed charges,108.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,121.03,
Prealbumin LC,40084134,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,27.8,22.24,,20.85,75,,,percent of total billed charges,75% of total billed charges,11.12,40,,,percent of total billed charges,40% of total billed charges,22.02,79.2,,,percent of total billed charges,79.2% of total billed charges,23.63,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,26.41,95,,,percent of total billed charges,95% of total billed charges,22.24,80,,,percent of total billed charges,80% of total billed charges,23.63,85,,,percent of total billed charges,85% of total billed charges,25.02,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,11.12,40,,,percent of total billed charges,40% of total billed charges,11.12,40,,,percent of total billed charges,40% of total billed charges,25.02,90,,,percent of total billed charges,90% of total billed charges,21.13,76,,,percent of total billed charges,76% of total billed charges,11.12,40,,,percent of total billed charges,40% of total billed charges,23.63,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,22.24,80,,,percent of total billed charges,80% of total billed charges,10.79,38.8,,,percent of total billed charges,38.8% of total billed charges,23.63,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,26.41,
"Pregnenolone, MS LC",40084140,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,116,92.8,,87,75,,,percent of total billed charges,75% of total billed charges,46.4,40,,,percent of total billed charges,40% of total billed charges,91.87,79.2,,,percent of total billed charges,79.2% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,110.2,95,,,percent of total billed charges,95% of total billed charges,92.8,80,,,percent of total billed charges,80% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,46.4,40,,,percent of total billed charges,40% of total billed charges,46.4,40,,,percent of total billed charges,40% of total billed charges,104.4,90,,,percent of total billed charges,90% of total billed charges,88.16,76,,,percent of total billed charges,76% of total billed charges,46.4,40,,,percent of total billed charges,40% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,92.8,80,,,percent of total billed charges,80% of total billed charges,45.01,38.8,,,percent of total billed charges,38.8% of total billed charges,98.6,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,110.2,
Proinsulin LC,40084206,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,51.1,40.88,,38.33,75,,,percent of total billed charges,75% of total billed charges,20.44,40,,,percent of total billed charges,40% of total billed charges,40.47,79.2,,,percent of total billed charges,79.2% of total billed charges,43.44,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,48.55,95,,,percent of total billed charges,95% of total billed charges,40.88,80,,,percent of total billed charges,80% of total billed charges,43.44,85,,,percent of total billed charges,85% of total billed charges,45.99,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,20.44,40,,,percent of total billed charges,40% of total billed charges,20.44,40,,,percent of total billed charges,40% of total billed charges,45.99,90,,,percent of total billed charges,90% of total billed charges,38.84,76,,,percent of total billed charges,76% of total billed charges,20.44,40,,,percent of total billed charges,40% of total billed charges,43.44,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,40.88,80,,,percent of total billed charges,80% of total billed charges,19.83,38.8,,,percent of total billed charges,38.8% of total billed charges,43.44,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,48.55,
"Prostatic Acid Phos, Serum LC",40084066,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,39.8,31.84,,29.85,75,,,percent of total billed charges,75% of total billed charges,15.92,40,,,percent of total billed charges,40% of total billed charges,31.52,79.2,,,percent of total billed charges,79.2% of total billed charges,33.83,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,37.81,95,,,percent of total billed charges,95% of total billed charges,31.84,80,,,percent of total billed charges,80% of total billed charges,33.83,85,,,percent of total billed charges,85% of total billed charges,35.82,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,15.92,40,,,percent of total billed charges,40% of total billed charges,15.92,40,,,percent of total billed charges,40% of total billed charges,35.82,90,,,percent of total billed charges,90% of total billed charges,30.25,76,,,percent of total billed charges,76% of total billed charges,15.92,40,,,percent of total billed charges,40% of total billed charges,33.83,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,31.84,80,,,percent of total billed charges,80% of total billed charges,15.44,38.8,,,percent of total billed charges,38.8% of total billed charges,33.83,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,37.81,
Protein C Deficiency Profile LC,40085302,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,142.9,114.32,,107.18,75,,,percent of total billed charges,75% of total billed charges,57.16,40,,,percent of total billed charges,40% of total billed charges,113.18,79.2,,,percent of total billed charges,79.2% of total billed charges,121.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,135.76,95,,,percent of total billed charges,95% of total billed charges,114.32,80,,,percent of total billed charges,80% of total billed charges,121.47,85,,,percent of total billed charges,85% of total billed charges,128.61,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,57.16,40,,,percent of total billed charges,40% of total billed charges,57.16,40,,,percent of total billed charges,40% of total billed charges,128.61,90,,,percent of total billed charges,90% of total billed charges,108.6,76,,,percent of total billed charges,76% of total billed charges,57.16,40,,,percent of total billed charges,40% of total billed charges,121.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,114.32,80,,,percent of total billed charges,80% of total billed charges,55.45,38.8,,,percent of total billed charges,38.8% of total billed charges,121.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,135.76,
"PSA, Complexed LC",40084152,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,109.6,87.68,,82.2,75,,,percent of total billed charges,75% of total billed charges,43.84,40,,,percent of total billed charges,40% of total billed charges,86.8,79.2,,,percent of total billed charges,79.2% of total billed charges,93.16,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,104.12,95,,,percent of total billed charges,95% of total billed charges,87.68,80,,,percent of total billed charges,80% of total billed charges,93.16,85,,,percent of total billed charges,85% of total billed charges,98.64,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,43.84,40,,,percent of total billed charges,40% of total billed charges,43.84,40,,,percent of total billed charges,40% of total billed charges,98.64,90,,,percent of total billed charges,90% of total billed charges,83.3,76,,,percent of total billed charges,76% of total billed charges,43.84,40,,,percent of total billed charges,40% of total billed charges,93.16,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,87.68,80,,,percent of total billed charges,80% of total billed charges,42.52,38.8,,,percent of total billed charges,38.8% of total billed charges,93.16,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,104.12,
PT Mixing Study LC,40085610,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,69.83,
"Rubeola Antibodies, IgM LC",40086765,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,33.5,26.8,,25.13,75,,,percent of total billed charges,75% of total billed charges,13.4,40,,,percent of total billed charges,40% of total billed charges,26.53,79.2,,,percent of total billed charges,79.2% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,31.83,95,,,percent of total billed charges,95% of total billed charges,26.8,80,,,percent of total billed charges,80% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,30.15,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,13.4,40,,,percent of total billed charges,40% of total billed charges,13.4,40,,,percent of total billed charges,40% of total billed charges,30.15,90,,,percent of total billed charges,90% of total billed charges,25.46,76,,,percent of total billed charges,76% of total billed charges,13.4,40,,,percent of total billed charges,40% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,26.8,80,,,percent of total billed charges,80% of total billed charges,13,38.8,,,percent of total billed charges,38.8% of total billed charges,28.48,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,31.83,
"Salivary Cortisol X3, Timed LC",40082533,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,69.7,55.76,,52.28,75,,,percent of total billed charges,75% of total billed charges,27.88,40,,,percent of total billed charges,40% of total billed charges,55.2,79.2,,,percent of total billed charges,79.2% of total billed charges,59.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,66.22,95,,,percent of total billed charges,95% of total billed charges,55.76,80,,,percent of total billed charges,80% of total billed charges,59.25,85,,,percent of total billed charges,85% of total billed charges,62.73,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,27.88,40,,,percent of total billed charges,40% of total billed charges,27.88,40,,,percent of total billed charges,40% of total billed charges,62.73,90,,,percent of total billed charges,90% of total billed charges,52.97,76,,,percent of total billed charges,76% of total billed charges,27.88,40,,,percent of total billed charges,40% of total billed charges,59.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,55.76,80,,,percent of total billed charges,80% of total billed charges,27.04,38.8,,,percent of total billed charges,38.8% of total billed charges,59.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,66.22,
"Serotonin, Serum LC",40084260,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,52.9,42.32,,39.68,75,,,percent of total billed charges,75% of total billed charges,21.16,40,,,percent of total billed charges,40% of total billed charges,41.9,79.2,,,percent of total billed charges,79.2% of total billed charges,44.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,50.26,95,,,percent of total billed charges,95% of total billed charges,42.32,80,,,percent of total billed charges,80% of total billed charges,44.97,85,,,percent of total billed charges,85% of total billed charges,47.61,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,21.16,40,,,percent of total billed charges,40% of total billed charges,21.16,40,,,percent of total billed charges,40% of total billed charges,47.61,90,,,percent of total billed charges,90% of total billed charges,40.2,76,,,percent of total billed charges,76% of total billed charges,21.16,40,,,percent of total billed charges,40% of total billed charges,44.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,42.32,80,,,percent of total billed charges,80% of total billed charges,20.53,38.8,,,percent of total billed charges,38.8% of total billed charges,44.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,50.26,
Smith Antibodies LC,40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,125.4,100.32,,94.05,75,,,percent of total billed charges,75% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,99.32,79.2,,,percent of total billed charges,79.2% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,119.13,95,,,percent of total billed charges,95% of total billed charges,100.32,80,,,percent of total billed charges,80% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.16,40,,,percent of total billed charges,40% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,112.86,90,,,percent of total billed charges,90% of total billed charges,95.3,76,,,percent of total billed charges,76% of total billed charges,50.16,40,,,percent of total billed charges,40% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,100.32,80,,,percent of total billed charges,80% of total billed charges,48.66,38.8,,,percent of total billed charges,38.8% of total billed charges,106.59,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,119.13,
Tetanus Toxoid IgE LC,40086003,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,49.7,39.76,,37.28,75,,,percent of total billed charges,75% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,39.36,79.2,,,percent of total billed charges,79.2% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,47.22,95,,,percent of total billed charges,95% of total billed charges,39.76,80,,,percent of total billed charges,80% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,19.88,40,,,percent of total billed charges,40% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,37.77,76,,,percent of total billed charges,76% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,39.76,80,,,percent of total billed charges,80% of total billed charges,19.28,38.8,,,percent of total billed charges,38.8% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,47.22,
Thyroglobulin Reflex Profile LC,40086800,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,99.4,79.52,,74.55,75,,,percent of total billed charges,75% of total billed charges,39.76,40,,,percent of total billed charges,40% of total billed charges,78.72,79.2,,,percent of total billed charges,79.2% of total billed charges,84.49,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,94.43,95,,,percent of total billed charges,95% of total billed charges,79.52,80,,,percent of total billed charges,80% of total billed charges,84.49,85,,,percent of total billed charges,85% of total billed charges,89.46,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,39.76,40,,,percent of total billed charges,40% of total billed charges,39.76,40,,,percent of total billed charges,40% of total billed charges,89.46,90,,,percent of total billed charges,90% of total billed charges,75.54,76,,,percent of total billed charges,76% of total billed charges,39.76,40,,,percent of total billed charges,40% of total billed charges,84.49,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,79.52,80,,,percent of total billed charges,80% of total billed charges,38.57,38.8,,,percent of total billed charges,38.8% of total billed charges,84.49,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,94.43,
Thyroid Stim Immunoglobulin LC,40084445,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,122.1,97.68,,91.58,75,,,percent of total billed charges,75% of total billed charges,48.84,40,,,percent of total billed charges,40% of total billed charges,96.7,79.2,,,percent of total billed charges,79.2% of total billed charges,103.79,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,116,95,,,percent of total billed charges,95% of total billed charges,97.68,80,,,percent of total billed charges,80% of total billed charges,103.79,85,,,percent of total billed charges,85% of total billed charges,109.89,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,48.84,40,,,percent of total billed charges,40% of total billed charges,48.84,40,,,percent of total billed charges,40% of total billed charges,109.89,90,,,percent of total billed charges,90% of total billed charges,92.8,76,,,percent of total billed charges,76% of total billed charges,48.84,40,,,percent of total billed charges,40% of total billed charges,103.79,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,97.68,80,,,percent of total billed charges,80% of total billed charges,47.37,38.8,,,percent of total billed charges,38.8% of total billed charges,103.79,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,116,
Thyroxine (T4) LC,40084436,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,20.8,16.64,,15.6,75,,,percent of total billed charges,75% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,16.47,79.2,,,percent of total billed charges,79.2% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,19.76,95,,,percent of total billed charges,95% of total billed charges,16.64,80,,,percent of total billed charges,80% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,8.32,40,,,percent of total billed charges,40% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,15.81,76,,,percent of total billed charges,76% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,16.64,80,,,percent of total billed charges,80% of total billed charges,8.07,38.8,,,percent of total billed charges,38.8% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,19.76,
"Vancomycin Trough, Serum LC",40080202,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,38.3,30.64,,28.73,75,,,percent of total billed charges,75% of total billed charges,15.32,40,,,percent of total billed charges,40% of total billed charges,30.33,79.2,,,percent of total billed charges,79.2% of total billed charges,32.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,36.39,95,,,percent of total billed charges,95% of total billed charges,30.64,80,,,percent of total billed charges,80% of total billed charges,32.56,85,,,percent of total billed charges,85% of total billed charges,34.47,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,15.32,40,,,percent of total billed charges,40% of total billed charges,15.32,40,,,percent of total billed charges,40% of total billed charges,34.47,90,,,percent of total billed charges,90% of total billed charges,29.11,76,,,percent of total billed charges,76% of total billed charges,15.32,40,,,percent of total billed charges,40% of total billed charges,32.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,30.64,80,,,percent of total billed charges,80% of total billed charges,14.86,38.8,,,percent of total billed charges,38.8% of total billed charges,32.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,36.39,
Varicella-Zoster Virus Culture LC,40087252,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,60.8,48.64,,45.6,75,,,percent of total billed charges,75% of total billed charges,24.32,40,,,percent of total billed charges,40% of total billed charges,48.15,79.2,,,percent of total billed charges,79.2% of total billed charges,51.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,57.76,95,,,percent of total billed charges,95% of total billed charges,48.64,80,,,percent of total billed charges,80% of total billed charges,51.68,85,,,percent of total billed charges,85% of total billed charges,54.72,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,24.32,40,,,percent of total billed charges,40% of total billed charges,24.32,40,,,percent of total billed charges,40% of total billed charges,54.72,90,,,percent of total billed charges,90% of total billed charges,46.21,76,,,percent of total billed charges,76% of total billed charges,24.32,40,,,percent of total billed charges,40% of total billed charges,51.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,48.64,80,,,percent of total billed charges,80% of total billed charges,23.59,38.8,,,percent of total billed charges,38.8% of total billed charges,51.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,57.76,
"VEGF, Plasma LC",40083520,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,353.9,283.12,,265.43,75,,,percent of total billed charges,75% of total billed charges,141.56,40,,,percent of total billed charges,40% of total billed charges,280.29,79.2,,,percent of total billed charges,79.2% of total billed charges,300.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,336.21,95,,,percent of total billed charges,95% of total billed charges,283.12,80,,,percent of total billed charges,80% of total billed charges,300.82,85,,,percent of total billed charges,85% of total billed charges,318.51,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,141.56,40,,,percent of total billed charges,40% of total billed charges,141.56,40,,,percent of total billed charges,40% of total billed charges,318.51,90,,,percent of total billed charges,90% of total billed charges,268.96,76,,,percent of total billed charges,76% of total billed charges,141.56,40,,,percent of total billed charges,40% of total billed charges,300.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,283.12,80,,,percent of total billed charges,80% of total billed charges,137.31,38.8,,,percent of total billed charges,38.8% of total billed charges,300.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,336.21,
Vitamin C LC,40082180,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,41.14,
"Vitamin D 25-Hydroxy, D2 + D3 LC",40082606,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,270.6,216.48,,202.95,75,,,percent of total billed charges,75% of total billed charges,108.24,40,,,percent of total billed charges,40% of total billed charges,214.32,79.2,,,percent of total billed charges,79.2% of total billed charges,230.01,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,257.07,95,,,percent of total billed charges,95% of total billed charges,216.48,80,,,percent of total billed charges,80% of total billed charges,230.01,85,,,percent of total billed charges,85% of total billed charges,243.54,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,108.24,40,,,percent of total billed charges,40% of total billed charges,108.24,40,,,percent of total billed charges,40% of total billed charges,243.54,90,,,percent of total billed charges,90% of total billed charges,205.66,76,,,percent of total billed charges,76% of total billed charges,108.24,40,,,percent of total billed charges,40% of total billed charges,230.01,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,216.48,80,,,percent of total billed charges,80% of total billed charges,104.99,38.8,,,percent of total billed charges,38.8% of total billed charges,230.01,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,257.07,
"White Blood Cells (WBC), Stool LC",40008656,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,65.8,52.64,,49.35,75,,,percent of total billed charges,75% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,52.11,79.2,,,percent of total billed charges,79.2% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,62.51,95,,,percent of total billed charges,95% of total billed charges,52.64,80,,,percent of total billed charges,80% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,26.32,40,,,percent of total billed charges,40% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,50.01,76,,,percent of total billed charges,76% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,52.64,80,,,percent of total billed charges,80% of total billed charges,25.53,38.8,,,percent of total billed charges,38.8% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,62.51,
"Yeast Only, Culture LC",40087101,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,218.6,174.88,,163.95,75,,,percent of total billed charges,75% of total billed charges,87.44,40,,,percent of total billed charges,40% of total billed charges,173.13,79.2,,,percent of total billed charges,79.2% of total billed charges,185.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,207.67,95,,,percent of total billed charges,95% of total billed charges,174.88,80,,,percent of total billed charges,80% of total billed charges,185.81,85,,,percent of total billed charges,85% of total billed charges,196.74,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,87.44,40,,,percent of total billed charges,40% of total billed charges,87.44,40,,,percent of total billed charges,40% of total billed charges,196.74,90,,,percent of total billed charges,90% of total billed charges,166.14,76,,,percent of total billed charges,76% of total billed charges,87.44,40,,,percent of total billed charges,40% of total billed charges,185.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,174.88,80,,,percent of total billed charges,80% of total billed charges,84.82,38.8,,,percent of total billed charges,38.8% of total billed charges,185.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,207.67,
Inhibin B LC,40083520,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,207.9,166.32,,155.93,75,,,percent of total billed charges,75% of total billed charges,83.16,40,,,percent of total billed charges,40% of total billed charges,164.66,79.2,,,percent of total billed charges,79.2% of total billed charges,176.72,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,197.51,95,,,percent of total billed charges,95% of total billed charges,166.32,80,,,percent of total billed charges,80% of total billed charges,176.72,85,,,percent of total billed charges,85% of total billed charges,187.11,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,83.16,40,,,percent of total billed charges,40% of total billed charges,83.16,40,,,percent of total billed charges,40% of total billed charges,187.11,90,,,percent of total billed charges,90% of total billed charges,158,76,,,percent of total billed charges,76% of total billed charges,83.16,40,,,percent of total billed charges,40% of total billed charges,176.72,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,166.32,80,,,percent of total billed charges,80% of total billed charges,80.67,38.8,,,percent of total billed charges,38.8% of total billed charges,176.72,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,197.51,
Manual Differential 6,40085007,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,35,28,,26.25,75,,,percent of total billed charges,75% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,27.72,79.2,,,percent of total billed charges,79.2% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,33.25,95,,,percent of total billed charges,95% of total billed charges,28,80,,,percent of total billed charges,80% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,14,40,,,percent of total billed charges,40% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,31.5,90,,,percent of total billed charges,90% of total billed charges,26.6,76,,,percent of total billed charges,76% of total billed charges,14,40,,,percent of total billed charges,40% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,28,80,,,percent of total billed charges,80% of total billed charges,13.58,38.8,,,percent of total billed charges,38.8% of total billed charges,29.75,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,33.25,
96375 OBS ADDL SEQ IV PUSH NEW CHARGE,30996375,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,108.9,87.12,,81.68,75,,,percent of total billed charges,75% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,86.25,79.2,,,percent of total billed charges,79.2% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,103.46,95,,,percent of total billed charges,95% of total billed charges,87.12,80,,,percent of total billed charges,80% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,98.01,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,108.9,100,,,fee schedule,100% of NM APC rate,43.56,40,,,percent of total billed charges,40% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,98.01,90,,,percent of total billed charges,90% of total billed charges,82.76,76,,,percent of total billed charges,76% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,87.12,80,,,percent of total billed charges,80% of total billed charges,42.25,38.8,,,percent of total billed charges,38.8% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,42.25,108.9,
43262 ENDO CHOLANGIOPANCREATOGR CHARGE,30043262,CDM,750,RC,43262,HCPCS,OUTPATIENT,,,4869.3,3895.44,,3651.98,75,,,percent of total billed charges,75% of total billed charges,1947.72,40,,,percent of total billed charges,40% of total billed charges,3050,79.2,,,percent of total billed charges,79.2% of total billed charges,4138.91,85,,,percent of total billed charges,85% of total billed charges,3363.41,100,,,fee schedule,100% of CO APG rates,4625.84,95,,,percent of total billed charges,95% of total billed charges,3895.44,80,,,percent of total billed charges,80% of total billed charges,4138.91,85,,,percent of total billed charges,85% of total billed charges,4382.37,90,,,percent of total billed charges,90% of total billed charges,3363.41,100,,,fee schedule,100% of CO APG rates,3363.41,100,,,fee schedule,100% of CO APG rates,3260.69,100,,,fee schedule,100% of NM APC rate,1947.72,40,,,percent of total billed charges,40% of total billed charges,1947.72,40,,,percent of total billed charges,40% of total billed charges,4382.37,90,,,percent of total billed charges,90% of total billed charges,3700.67,76,,,percent of total billed charges,76% of total billed charges,1947.72,40,,,percent of total billed charges,40% of total billed charges,4138.91,85,,,percent of total billed charges,85% of total billed charges,3363.41,100,,,fee schedule,100% of CO APG rate,3895.44,80,,,percent of total billed charges,80% of total billed charges,1889.29,38.8,,,percent of total billed charges,38.8% of total billed charges,4138.91,85,,,percent of total billed charges,85% of total billed charges,3363.41,100,,,fee schedule,100% of APG fee schedule,710.96,200,,,fee schedule,200% of CMS fee schedule,710.96,4625.84,
43264 ENDO CHOLANGIOPANCREATOGR CHARGE,30043264,CDM,750,RC,43262,HCPCS,OUTPATIENT,,,4569.9,3655.92,,3427.43,75,,,percent of total billed charges,75% of total billed charges,1827.96,40,,,percent of total billed charges,40% of total billed charges,3050,79.2,,,percent of total billed charges,79.2% of total billed charges,3884.42,85,,,percent of total billed charges,85% of total billed charges,3363.41,100,,,fee schedule,100% of CO APG rates,4341.41,95,,,percent of total billed charges,95% of total billed charges,3655.92,80,,,percent of total billed charges,80% of total billed charges,3884.42,85,,,percent of total billed charges,85% of total billed charges,4112.91,90,,,percent of total billed charges,90% of total billed charges,3363.41,100,,,fee schedule,100% of CO APG rates,3363.41,100,,,fee schedule,100% of CO APG rates,3260.69,100,,,fee schedule,100% of NM APC rate,1827.96,40,,,percent of total billed charges,40% of total billed charges,1827.96,40,,,percent of total billed charges,40% of total billed charges,4112.91,90,,,percent of total billed charges,90% of total billed charges,3473.12,76,,,percent of total billed charges,76% of total billed charges,1827.96,40,,,percent of total billed charges,40% of total billed charges,3884.42,85,,,percent of total billed charges,85% of total billed charges,3363.41,100,,,fee schedule,100% of CO APG rate,3655.92,80,,,percent of total billed charges,80% of total billed charges,1773.12,38.8,,,percent of total billed charges,38.8% of total billed charges,3884.42,85,,,percent of total billed charges,85% of total billed charges,3363.41,100,,,fee schedule,100% of APG fee schedule,710.96,200,,,fee schedule,200% of CMS fee schedule,710.96,4341.41,
"93041 RHYTHM ECG,1-3LEADS TRACI CHARGE",42893041,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,196.6,157.28,,147.45,75,,,percent of total billed charges,75% of total billed charges,78.64,40,,,percent of total billed charges,40% of total billed charges,155.71,79.2,,,percent of total billed charges,79.2% of total billed charges,167.11,85,,,percent of total billed charges,85% of total billed charges,196.6,100,,,fee schedule,100% of CO APG rates,186.77,95,,,percent of total billed charges,95% of total billed charges,157.28,80,,,percent of total billed charges,80% of total billed charges,167.11,85,,,percent of total billed charges,85% of total billed charges,176.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,78.64,40,,,percent of total billed charges,40% of total billed charges,78.64,40,,,percent of total billed charges,40% of total billed charges,176.94,90,,,percent of total billed charges,90% of total billed charges,149.42,76,,,percent of total billed charges,76% of total billed charges,78.64,40,,,percent of total billed charges,40% of total billed charges,167.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,157.28,80,,,percent of total billed charges,80% of total billed charges,76.28,38.8,,,percent of total billed charges,38.8% of total billed charges,167.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,76.28,217.66,
95851 RANGE OF MOTION MEASUREME CHARGE,42595851,CDM,920,RC,95851,HCPCS,OUTPATIENT,,,233.9,187.12,,175.43,75,,,percent of total billed charges,75% of total billed charges,93.56,40,,,percent of total billed charges,40% of total billed charges,185.25,79.2,,,percent of total billed charges,79.2% of total billed charges,198.82,85,,,percent of total billed charges,85% of total billed charges,233.9,100,,,fee schedule,100% of CO APG rates,222.21,95,,,percent of total billed charges,95% of total billed charges,187.12,80,,,percent of total billed charges,80% of total billed charges,198.82,85,,,percent of total billed charges,85% of total billed charges,210.51,90,,,percent of total billed charges,90% of total billed charges,233.9,100,,,fee schedule,100% of CO APG rates,233.9,100,,,fee schedule,100% of CO APG rates,80.65,100,,,fee schedule,100% of NM fee schedule,93.56,40,,,percent of total billed charges,40% of total billed charges,93.56,40,,,percent of total billed charges,40% of total billed charges,210.51,90,,,percent of total billed charges,90% of total billed charges,177.76,76,,,percent of total billed charges,76% of total billed charges,93.56,40,,,percent of total billed charges,40% of total billed charges,198.82,85,,,percent of total billed charges,85% of total billed charges,233.9,100,,,fee schedule,100% of CO APG rate,187.12,80,,,percent of total billed charges,80% of total billed charges,90.75,38.8,,,percent of total billed charges,38.8% of total billed charges,198.82,85,,,percent of total billed charges,85% of total billed charges,233.9,100,,,fee schedule,100% of APG fee schedule,15.7,200,,,fee schedule,200% of CMS fee schedule,15.7,233.9,
11740 Evacuation Of Subungual Hematoma,31011740,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,214.2,171.36,,160.65,75,,,percent of total billed charges,75% of total billed charges,85.68,40,,,percent of total billed charges,40% of total billed charges,169.65,79.2,,,percent of total billed charges,79.2% of total billed charges,182.07,85,,,percent of total billed charges,85% of total billed charges,214.2,100,,,fee schedule,100% of CO APG rates,203.49,95,,,percent of total billed charges,95% of total billed charges,171.36,80,,,percent of total billed charges,80% of total billed charges,182.07,85,,,percent of total billed charges,85% of total billed charges,192.78,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,85.68,40,,,percent of total billed charges,40% of total billed charges,85.68,40,,,percent of total billed charges,40% of total billed charges,192.78,90,,,percent of total billed charges,90% of total billed charges,162.79,76,,,percent of total billed charges,76% of total billed charges,85.68,40,,,percent of total billed charges,40% of total billed charges,182.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,171.36,80,,,percent of total billed charges,80% of total billed charges,83.11,38.8,,,percent of total billed charges,38.8% of total billed charges,182.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,83.11,217.66,
11760 Repair Nail Bed,31011760,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1775.3,1420.24,,1331.48,75,,,percent of total billed charges,75% of total billed charges,710.12,40,,,percent of total billed charges,40% of total billed charges,1406.04,79.2,,,percent of total billed charges,79.2% of total billed charges,1509.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1686.54,95,,,percent of total billed charges,95% of total billed charges,1420.24,80,,,percent of total billed charges,80% of total billed charges,1509.01,85,,,percent of total billed charges,85% of total billed charges,1597.77,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,710.12,40,,,percent of total billed charges,40% of total billed charges,710.12,40,,,percent of total billed charges,40% of total billed charges,1597.77,90,,,percent of total billed charges,90% of total billed charges,1349.23,76,,,percent of total billed charges,76% of total billed charges,710.12,40,,,percent of total billed charges,40% of total billed charges,1509.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1420.24,80,,,percent of total billed charges,80% of total billed charges,688.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1509.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1686.54,
11765 Wedge Excision Of Skin Of Nail Fold,31011765,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1084.7,867.76,,813.53,75,,,percent of total billed charges,75% of total billed charges,433.88,40,,,percent of total billed charges,40% of total billed charges,859.08,79.2,,,percent of total billed charges,79.2% of total billed charges,922,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1030.47,95,,,percent of total billed charges,95% of total billed charges,867.76,80,,,percent of total billed charges,80% of total billed charges,922,85,,,percent of total billed charges,85% of total billed charges,976.23,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,433.88,40,,,percent of total billed charges,40% of total billed charges,433.88,40,,,percent of total billed charges,40% of total billed charges,976.23,90,,,percent of total billed charges,90% of total billed charges,824.37,76,,,percent of total billed charges,76% of total billed charges,433.88,40,,,percent of total billed charges,40% of total billed charges,922,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,867.76,80,,,percent of total billed charges,80% of total billed charges,420.86,38.8,,,percent of total billed charges,38.8% of total billed charges,922,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1030.47,
"Repair, Intermediate, Wounds Of Scalp, Axillae, Trunk And/Or",46012031,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1147.1,917.68,,860.33,75,,,percent of total billed charges,75% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,908.5,79.2,,,percent of total billed charges,79.2% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1089.75,95,,,percent of total billed charges,95% of total billed charges,917.68,80,,,percent of total billed charges,80% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,458.84,40,,,percent of total billed charges,40% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,871.8,76,,,percent of total billed charges,76% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,917.68,80,,,percent of total billed charges,80% of total billed charges,445.07,38.8,,,percent of total billed charges,38.8% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1089.75,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012034,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1147.1,917.68,,860.33,75,,,percent of total billed charges,75% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,908.5,79.2,,,percent of total billed charges,79.2% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1089.75,95,,,percent of total billed charges,95% of total billed charges,917.68,80,,,percent of total billed charges,80% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,458.84,40,,,percent of total billed charges,40% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,871.8,76,,,percent of total billed charges,76% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,917.68,80,,,percent of total billed charges,80% of total billed charges,445.07,38.8,,,percent of total billed charges,38.8% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1089.75,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012035,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1147.1,917.68,,860.33,75,,,percent of total billed charges,75% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,908.5,79.2,,,percent of total billed charges,79.2% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1089.75,95,,,percent of total billed charges,95% of total billed charges,917.68,80,,,percent of total billed charges,80% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,458.84,40,,,percent of total billed charges,40% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,871.8,76,,,percent of total billed charges,76% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,917.68,80,,,percent of total billed charges,80% of total billed charges,445.07,38.8,,,percent of total billed charges,38.8% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1089.75,
12051 LAYER CLO FACE 2.5/LESS,31012051,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,600.1,480.08,,450.08,75,,,percent of total billed charges,75% of total billed charges,240.04,40,,,percent of total billed charges,40% of total billed charges,475.28,79.2,,,percent of total billed charges,79.2% of total billed charges,510.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,570.1,95,,,percent of total billed charges,95% of total billed charges,480.08,80,,,percent of total billed charges,80% of total billed charges,510.09,85,,,percent of total billed charges,85% of total billed charges,540.09,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,240.04,40,,,percent of total billed charges,40% of total billed charges,240.04,40,,,percent of total billed charges,40% of total billed charges,540.09,90,,,percent of total billed charges,90% of total billed charges,456.08,76,,,percent of total billed charges,76% of total billed charges,240.04,40,,,percent of total billed charges,40% of total billed charges,510.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,480.08,80,,,percent of total billed charges,80% of total billed charges,232.84,38.8,,,percent of total billed charges,38.8% of total billed charges,510.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,570.1,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012052,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1147.1,917.68,,860.33,75,,,percent of total billed charges,75% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,908.5,79.2,,,percent of total billed charges,79.2% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1089.75,95,,,percent of total billed charges,95% of total billed charges,917.68,80,,,percent of total billed charges,80% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,458.84,40,,,percent of total billed charges,40% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,871.8,76,,,percent of total billed charges,76% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,917.68,80,,,percent of total billed charges,80% of total billed charges,445.07,38.8,,,percent of total billed charges,38.8% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1089.75,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012053,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1147.1,917.68,,860.33,75,,,percent of total billed charges,75% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,908.5,79.2,,,percent of total billed charges,79.2% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1089.75,95,,,percent of total billed charges,95% of total billed charges,917.68,80,,,percent of total billed charges,80% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,458.84,40,,,percent of total billed charges,40% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,871.8,76,,,percent of total billed charges,76% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,917.68,80,,,percent of total billed charges,80% of total billed charges,445.07,38.8,,,percent of total billed charges,38.8% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1089.75,
13121 - REPR CPX ARMS/LEGS2.6-7.5 CHARGE,46013121,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1521.5,1217.2,,1141.13,75,,,percent of total billed charges,75% of total billed charges,608.6,40,,,percent of total billed charges,40% of total billed charges,1205.03,79.2,,,percent of total billed charges,79.2% of total billed charges,1293.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1445.43,95,,,percent of total billed charges,95% of total billed charges,1217.2,80,,,percent of total billed charges,80% of total billed charges,1293.28,85,,,percent of total billed charges,85% of total billed charges,1369.35,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,608.6,40,,,percent of total billed charges,40% of total billed charges,608.6,40,,,percent of total billed charges,40% of total billed charges,1369.35,90,,,percent of total billed charges,90% of total billed charges,1156.34,76,,,percent of total billed charges,76% of total billed charges,608.6,40,,,percent of total billed charges,40% of total billed charges,1293.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1217.2,80,,,percent of total billed charges,80% of total billed charges,590.34,38.8,,,percent of total billed charges,38.8% of total billed charges,1293.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1445.43,
13122 - REP EA ADDTL 5 CM OR LES CHARGE,46013122,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,474.2,379.36,,355.65,75,,,percent of total billed charges,75% of total billed charges,189.68,40,,,percent of total billed charges,40% of total billed charges,375.57,79.2,,,percent of total billed charges,79.2% of total billed charges,403.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,450.49,95,,,percent of total billed charges,95% of total billed charges,379.36,80,,,percent of total billed charges,80% of total billed charges,403.07,85,,,percent of total billed charges,85% of total billed charges,426.78,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,189.68,40,,,percent of total billed charges,40% of total billed charges,189.68,40,,,percent of total billed charges,40% of total billed charges,426.78,90,,,percent of total billed charges,90% of total billed charges,360.39,76,,,percent of total billed charges,76% of total billed charges,189.68,40,,,percent of total billed charges,40% of total billed charges,403.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,379.36,80,,,percent of total billed charges,80% of total billed charges,183.99,38.8,,,percent of total billed charges,38.8% of total billed charges,403.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,450.49,
13131 - REP CPX FOREHD/CHIN 1.1-2 CHARGE,46013131,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1370.7,1096.56,,1028.03,75,,,percent of total billed charges,75% of total billed charges,548.28,40,,,percent of total billed charges,40% of total billed charges,1085.59,79.2,,,percent of total billed charges,79.2% of total billed charges,1165.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1302.17,95,,,percent of total billed charges,95% of total billed charges,1096.56,80,,,percent of total billed charges,80% of total billed charges,1165.1,85,,,percent of total billed charges,85% of total billed charges,1233.63,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,548.28,40,,,percent of total billed charges,40% of total billed charges,548.28,40,,,percent of total billed charges,40% of total billed charges,1233.63,90,,,percent of total billed charges,90% of total billed charges,1041.73,76,,,percent of total billed charges,76% of total billed charges,548.28,40,,,percent of total billed charges,40% of total billed charges,1165.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1096.56,80,,,percent of total billed charges,80% of total billed charges,531.83,38.8,,,percent of total billed charges,38.8% of total billed charges,1165.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1302.17,
13132 - REP CPX FOREHD/CHIN 2.6-7 CHARGE,46013132,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1626.6,1301.28,,1219.95,75,,,percent of total billed charges,75% of total billed charges,650.64,40,,,percent of total billed charges,40% of total billed charges,1288.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1382.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1545.27,95,,,percent of total billed charges,95% of total billed charges,1301.28,80,,,percent of total billed charges,80% of total billed charges,1382.61,85,,,percent of total billed charges,85% of total billed charges,1463.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,650.64,40,,,percent of total billed charges,40% of total billed charges,650.64,40,,,percent of total billed charges,40% of total billed charges,1463.94,90,,,percent of total billed charges,90% of total billed charges,1236.22,76,,,percent of total billed charges,76% of total billed charges,650.64,40,,,percent of total billed charges,40% of total billed charges,1382.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1301.28,80,,,percent of total billed charges,80% of total billed charges,631.12,38.8,,,percent of total billed charges,38.8% of total billed charges,1382.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1545.27,
13133 - ADDTL 5CM RPR CMPLX TO 13 CHARGE,46013133,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,627.1,501.68,,470.33,75,,,percent of total billed charges,75% of total billed charges,250.84,40,,,percent of total billed charges,40% of total billed charges,496.66,79.2,,,percent of total billed charges,79.2% of total billed charges,533.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,595.75,95,,,percent of total billed charges,95% of total billed charges,501.68,80,,,percent of total billed charges,80% of total billed charges,533.04,85,,,percent of total billed charges,85% of total billed charges,564.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,250.84,40,,,percent of total billed charges,40% of total billed charges,250.84,40,,,percent of total billed charges,40% of total billed charges,564.39,90,,,percent of total billed charges,90% of total billed charges,476.6,76,,,percent of total billed charges,76% of total billed charges,250.84,40,,,percent of total billed charges,40% of total billed charges,533.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,501.68,80,,,percent of total billed charges,80% of total billed charges,243.31,38.8,,,percent of total billed charges,38.8% of total billed charges,533.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,595.75,
"16000 Initial Treatment, First Degree Burn, When No More Tha",31016000,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,600.1,480.08,,450.08,75,,,percent of total billed charges,75% of total billed charges,240.04,40,,,percent of total billed charges,40% of total billed charges,475.28,79.2,,,percent of total billed charges,79.2% of total billed charges,510.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,570.1,95,,,percent of total billed charges,95% of total billed charges,480.08,80,,,percent of total billed charges,80% of total billed charges,510.09,85,,,percent of total billed charges,85% of total billed charges,540.09,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,240.04,40,,,percent of total billed charges,40% of total billed charges,240.04,40,,,percent of total billed charges,40% of total billed charges,540.09,90,,,percent of total billed charges,90% of total billed charges,456.08,76,,,percent of total billed charges,76% of total billed charges,240.04,40,,,percent of total billed charges,40% of total billed charges,510.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,480.08,80,,,percent of total billed charges,80% of total billed charges,232.84,38.8,,,percent of total billed charges,38.8% of total billed charges,510.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,570.1,
16025 DRESS/DEBRID P-THICK BURN M,31016025,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,566.8,453.44,,425.1,75,,,percent of total billed charges,75% of total billed charges,226.72,40,,,percent of total billed charges,40% of total billed charges,448.91,79.2,,,percent of total billed charges,79.2% of total billed charges,481.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,538.46,95,,,percent of total billed charges,95% of total billed charges,453.44,80,,,percent of total billed charges,80% of total billed charges,481.78,85,,,percent of total billed charges,85% of total billed charges,510.12,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,226.72,40,,,percent of total billed charges,40% of total billed charges,226.72,40,,,percent of total billed charges,40% of total billed charges,510.12,90,,,percent of total billed charges,90% of total billed charges,430.77,76,,,percent of total billed charges,76% of total billed charges,226.72,40,,,percent of total billed charges,40% of total billed charges,481.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,453.44,80,,,percent of total billed charges,80% of total billed charges,219.92,38.8,,,percent of total billed charges,38.8% of total billed charges,481.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,538.46,
16030 DRSS/DBRID P-THICK BURN L,31016030,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1084.7,867.76,,813.53,75,,,percent of total billed charges,75% of total billed charges,433.88,40,,,percent of total billed charges,40% of total billed charges,859.08,79.2,,,percent of total billed charges,79.2% of total billed charges,922,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1030.47,95,,,percent of total billed charges,95% of total billed charges,867.76,80,,,percent of total billed charges,80% of total billed charges,922,85,,,percent of total billed charges,85% of total billed charges,976.23,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,433.88,40,,,percent of total billed charges,40% of total billed charges,433.88,40,,,percent of total billed charges,40% of total billed charges,976.23,90,,,percent of total billed charges,90% of total billed charges,824.37,76,,,percent of total billed charges,76% of total billed charges,433.88,40,,,percent of total billed charges,40% of total billed charges,922,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,867.76,80,,,percent of total billed charges,80% of total billed charges,420.86,38.8,,,percent of total billed charges,38.8% of total billed charges,922,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1030.47,
"19020 Mastotomy With Exploration Or Drainage Of Abscess, Dee",46519020,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,5331,4264.8,,3998.25,75,,,percent of total billed charges,75% of total billed charges,2132.4,40,,,percent of total billed charges,40% of total billed charges,3050,79.2,,,percent of total billed charges,79.2% of total billed charges,4531.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,5064.45,95,,,percent of total billed charges,95% of total billed charges,4264.8,80,,,percent of total billed charges,80% of total billed charges,4531.35,85,,,percent of total billed charges,85% of total billed charges,4797.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,2132.4,40,,,percent of total billed charges,40% of total billed charges,2132.4,40,,,percent of total billed charges,40% of total billed charges,4797.9,90,,,percent of total billed charges,90% of total billed charges,4051.56,76,,,percent of total billed charges,76% of total billed charges,2132.4,40,,,percent of total billed charges,40% of total billed charges,4531.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,4264.8,80,,,percent of total billed charges,80% of total billed charges,2068.43,38.8,,,percent of total billed charges,38.8% of total billed charges,4531.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,5064.45,
21480 Closed Treatment Of Temporomandibular Dislocation; Ini,31021480,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
82010 - Bofall Dengue Fever Antibody,60000787,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,101.4,81.12,,76.05,75,,,percent of total billed charges,75% of total billed charges,40.56,40,,,percent of total billed charges,40% of total billed charges,80.31,79.2,,,percent of total billed charges,79.2% of total billed charges,86.19,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,96.33,95,,,percent of total billed charges,95% of total billed charges,81.12,80,,,percent of total billed charges,80% of total billed charges,86.19,85,,,percent of total billed charges,85% of total billed charges,91.26,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,40.56,40,,,percent of total billed charges,40% of total billed charges,40.56,40,,,percent of total billed charges,40% of total billed charges,91.26,90,,,percent of total billed charges,90% of total billed charges,77.06,76,,,percent of total billed charges,76% of total billed charges,40.56,40,,,percent of total billed charges,40% of total billed charges,86.19,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,81.12,80,,,percent of total billed charges,80% of total billed charges,39.34,38.8,,,percent of total billed charges,38.8% of total billed charges,86.19,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,96.33,
86692- Hepatitis Delta Antibody,60000785,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,146.5,117.2,,109.88,75,,,percent of total billed charges,75% of total billed charges,58.6,40,,,percent of total billed charges,40% of total billed charges,116.03,79.2,,,percent of total billed charges,79.2% of total billed charges,124.53,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,139.18,95,,,percent of total billed charges,95% of total billed charges,117.2,80,,,percent of total billed charges,80% of total billed charges,124.53,85,,,percent of total billed charges,85% of total billed charges,131.85,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,58.6,40,,,percent of total billed charges,40% of total billed charges,58.6,40,,,percent of total billed charges,40% of total billed charges,131.85,90,,,percent of total billed charges,90% of total billed charges,111.34,76,,,percent of total billed charges,76% of total billed charges,58.6,40,,,percent of total billed charges,40% of total billed charges,124.53,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,117.2,80,,,percent of total billed charges,80% of total billed charges,56.84,38.8,,,percent of total billed charges,38.8% of total billed charges,124.53,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,139.18,
UA Complete 1,40081001,CDM,307,RC,81002,HCPCS,OUTPATIENT,,,74.3,59.44,,55.73,75,,,percent of total billed charges,75% of total billed charges,29.72,40,,,percent of total billed charges,40% of total billed charges,58.85,79.2,,,percent of total billed charges,79.2% of total billed charges,63.16,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,70.59,95,,,percent of total billed charges,95% of total billed charges,59.44,80,,,percent of total billed charges,80% of total billed charges,63.16,85,,,percent of total billed charges,85% of total billed charges,66.87,90,,,percent of total billed charges,90% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,3.61,100,,,fee schedule,100% of CO APG rates,3.27,100,,,fee schedule,100% of NM fee schedule,29.72,40,,,percent of total billed charges,40% of total billed charges,29.72,40,,,percent of total billed charges,40% of total billed charges,66.87,90,,,percent of total billed charges,90% of total billed charges,56.47,76,,,percent of total billed charges,76% of total billed charges,29.72,40,,,percent of total billed charges,40% of total billed charges,63.16,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rate,59.44,80,,,percent of total billed charges,80% of total billed charges,28.83,38.8,,,percent of total billed charges,38.8% of total billed charges,63.16,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of APG fee schedule,6.96,200,,,fee schedule,200% of CMS fee schedule,3.27,70.59,
Omnipaque 300 mg/ mL,41130586,CDM,255,RC,,,OUTPATIENT,,,1.01,0.808,,0.76,75,,,percent of total billed charges,75% of total billed charges,0.4,40,,,percent of total billed charges,40% of total billed charges,0.8,79.2,,,percent of total billed charges,79.2% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,1.01,100,,,fee schedule,100% of CO APG rates,0.96,95,,,percent of total billed charges,95% of total billed charges,0.81,80,,,percent of total billed charges,80% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,0.91,90,,,percent of total billed charges,90% of total billed charges,1.01,100,,,fee schedule,100% of CO APG rates,1.01,100,,,fee schedule,100% of CO APG rates,1.01,100,,,fee schedule,100% of NM fee schedule,0.4,40,,,percent of total billed charges,40% of total billed charges,0.4,40,,,percent of total billed charges,40% of total billed charges,0.91,90,,,percent of total billed charges,90% of total billed charges,0.77,76,,,percent of total billed charges,76% of total billed charges,0.4,40,,,percent of total billed charges,40% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,1.01,100,,,fee schedule,100% of CO APG rate,0.81,80,,,percent of total billed charges,80% of total billed charges,0.39,38.8,,,percent of total billed charges,38.8% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,1.01,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,0.39,1.01,
Omnipaque 350 mg/ mL,41130586,CDM,255,RC,,,OUTPATIENT,,,1.01,0.808,,0.76,75,,,percent of total billed charges,75% of total billed charges,0.4,40,,,percent of total billed charges,40% of total billed charges,0.8,79.2,,,percent of total billed charges,79.2% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,1.01,100,,,fee schedule,100% of CO APG rates,0.96,95,,,percent of total billed charges,95% of total billed charges,0.81,80,,,percent of total billed charges,80% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,0.91,90,,,percent of total billed charges,90% of total billed charges,1.01,100,,,fee schedule,100% of CO APG rates,1.01,100,,,fee schedule,100% of CO APG rates,1.01,100,,,fee schedule,100% of NM fee schedule,0.4,40,,,percent of total billed charges,40% of total billed charges,0.4,40,,,percent of total billed charges,40% of total billed charges,0.91,90,,,percent of total billed charges,90% of total billed charges,0.77,76,,,percent of total billed charges,76% of total billed charges,0.4,40,,,percent of total billed charges,40% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,1.01,100,,,fee schedule,100% of CO APG rate,0.81,80,,,percent of total billed charges,80% of total billed charges,0.39,38.8,,,percent of total billed charges,38.8% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,1.01,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,0.39,1.01,
Omniscan,30587,CDM,255,RC,,,OUTPATIENT,,,12.6,10.08,,9.45,75,,,percent of total billed charges,75% of total billed charges,5.04,40,,,percent of total billed charges,40% of total billed charges,9.98,79.2,,,percent of total billed charges,79.2% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,12.6,100,,,fee schedule,100% of CO APG rates,11.97,95,,,percent of total billed charges,95% of total billed charges,10.08,80,,,percent of total billed charges,80% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,11.34,90,,,percent of total billed charges,90% of total billed charges,12.6,100,,,fee schedule,100% of CO APG rates,12.6,100,,,fee schedule,100% of CO APG rates,12.6,100,,,fee schedule,100% of NM fee schedule,5.04,40,,,percent of total billed charges,40% of total billed charges,5.04,40,,,percent of total billed charges,40% of total billed charges,11.34,90,,,percent of total billed charges,90% of total billed charges,9.58,76,,,percent of total billed charges,76% of total billed charges,5.04,40,,,percent of total billed charges,40% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,12.6,100,,,fee schedule,100% of CO APG rate,10.08,80,,,percent of total billed charges,80% of total billed charges,4.89,38.8,,,percent of total billed charges,38.8% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,12.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,4.89,12.6,
External Female Catheter,60001081,CDM,270,RC,,,OUTPATIENT,,,61.4,49.12,,46.05,75,,,percent of total billed charges,75% of total billed charges,24.56,40,,,percent of total billed charges,40% of total billed charges,48.63,79.2,,,percent of total billed charges,79.2% of total billed charges,52.19,85,,,percent of total billed charges,85% of total billed charges,61.4,100,,,fee schedule,100% of CO APG rates,58.33,95,,,percent of total billed charges,95% of total billed charges,49.12,80,,,percent of total billed charges,80% of total billed charges,52.19,85,,,percent of total billed charges,85% of total billed charges,55.26,90,,,percent of total billed charges,90% of total billed charges,61.4,100,,,fee schedule,100% of CO APG rates,61.4,100,,,fee schedule,100% of CO APG rates,61.4,100,,,fee schedule,100% of NM fee schedule,24.56,40,,,percent of total billed charges,40% of total billed charges,24.56,40,,,percent of total billed charges,40% of total billed charges,55.26,90,,,percent of total billed charges,90% of total billed charges,46.66,76,,,percent of total billed charges,76% of total billed charges,24.56,40,,,percent of total billed charges,40% of total billed charges,52.19,85,,,percent of total billed charges,85% of total billed charges,61.4,100,,,fee schedule,100% of CO APG rate,49.12,80,,,percent of total billed charges,80% of total billed charges,23.82,38.8,,,percent of total billed charges,38.8% of total billed charges,52.19,85,,,percent of total billed charges,85% of total billed charges,61.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,23.82,61.4,
Cryptosporidium EIA LC,40087328,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,118.9,95.12,,89.18,75,,,percent of total billed charges,75% of total billed charges,47.56,40,,,percent of total billed charges,40% of total billed charges,94.17,79.2,,,percent of total billed charges,79.2% of total billed charges,101.07,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,112.96,95,,,percent of total billed charges,95% of total billed charges,95.12,80,,,percent of total billed charges,80% of total billed charges,101.07,85,,,percent of total billed charges,85% of total billed charges,107.01,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,47.56,40,,,percent of total billed charges,40% of total billed charges,47.56,40,,,percent of total billed charges,40% of total billed charges,107.01,90,,,percent of total billed charges,90% of total billed charges,90.36,76,,,percent of total billed charges,76% of total billed charges,47.56,40,,,percent of total billed charges,40% of total billed charges,101.07,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,95.12,80,,,percent of total billed charges,80% of total billed charges,46.13,38.8,,,percent of total billed charges,38.8% of total billed charges,101.07,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,112.96,
"Mumps Ab, IgG LC",40058495,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,28.2,22.56,,21.15,75,,,percent of total billed charges,75% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,22.33,79.2,,,percent of total billed charges,79.2% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,26.79,95,,,percent of total billed charges,95% of total billed charges,22.56,80,,,percent of total billed charges,80% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,25.38,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,11.28,40,,,percent of total billed charges,40% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,25.38,90,,,percent of total billed charges,90% of total billed charges,21.43,76,,,percent of total billed charges,76% of total billed charges,11.28,40,,,percent of total billed charges,40% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,22.56,80,,,percent of total billed charges,80% of total billed charges,10.94,38.8,,,percent of total billed charges,38.8% of total billed charges,23.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,26.79,
AChR Binding Abs LC,40083519,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,87.2,69.76,,65.4,75,,,percent of total billed charges,75% of total billed charges,34.88,40,,,percent of total billed charges,40% of total billed charges,69.06,79.2,,,percent of total billed charges,79.2% of total billed charges,74.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,82.84,95,,,percent of total billed charges,95% of total billed charges,69.76,80,,,percent of total billed charges,80% of total billed charges,74.12,85,,,percent of total billed charges,85% of total billed charges,78.48,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,34.88,40,,,percent of total billed charges,40% of total billed charges,34.88,40,,,percent of total billed charges,40% of total billed charges,78.48,90,,,percent of total billed charges,90% of total billed charges,66.27,76,,,percent of total billed charges,76% of total billed charges,34.88,40,,,percent of total billed charges,40% of total billed charges,74.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,69.76,80,,,percent of total billed charges,80% of total billed charges,33.83,38.8,,,percent of total billed charges,38.8% of total billed charges,74.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,82.84,
20220 - BONE BIOPSY TROCAR/NEEDLE CHARGE,46020220,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,5702.3,4561.84,,4276.73,75,,,percent of total billed charges,75% of total billed charges,2280.92,40,,,percent of total billed charges,40% of total billed charges,3050,79.2,,,percent of total billed charges,79.2% of total billed charges,4846.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,5417.19,95,,,percent of total billed charges,95% of total billed charges,4561.84,80,,,percent of total billed charges,80% of total billed charges,4846.96,85,,,percent of total billed charges,85% of total billed charges,5132.07,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,2897.79,100,,,fee schedule,100% of NM APC rate,2280.92,40,,,percent of total billed charges,40% of total billed charges,2280.92,40,,,percent of total billed charges,40% of total billed charges,5132.07,90,,,percent of total billed charges,90% of total billed charges,4333.75,76,,,percent of total billed charges,76% of total billed charges,2280.92,40,,,percent of total billed charges,40% of total billed charges,4846.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,4561.84,80,,,percent of total billed charges,80% of total billed charges,2212.49,38.8,,,percent of total billed charges,38.8% of total billed charges,4846.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,5417.19,
20225 - BONE BIOPSY TROCAR/NDL DP CHARGE,46020225,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,4817.3,3853.84,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
32400 - NEEDLE BIOPSY CHEST LININ CHARGE,46032400,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,5701.3,4561.04,,4275.98,75,,,percent of total billed charges,75% of total billed charges,2280.52,40,,,percent of total billed charges,40% of total billed charges,3050,79.2,,,percent of total billed charges,79.2% of total billed charges,4846.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,5416.24,95,,,percent of total billed charges,95% of total billed charges,4561.04,80,,,percent of total billed charges,80% of total billed charges,4846.11,85,,,percent of total billed charges,85% of total billed charges,5131.17,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,2897.29,100,,,fee schedule,100% of NM APC rate,2280.52,40,,,percent of total billed charges,40% of total billed charges,2280.52,40,,,percent of total billed charges,40% of total billed charges,5131.17,90,,,percent of total billed charges,90% of total billed charges,4332.99,76,,,percent of total billed charges,76% of total billed charges,2280.52,40,,,percent of total billed charges,40% of total billed charges,4846.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,4561.04,80,,,percent of total billed charges,80% of total billed charges,2212.1,38.8,,,percent of total billed charges,38.8% of total billed charges,4846.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,5416.24,
32551 - INSERT CHEST TUBE CHARGE,46032551,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,735.3,588.24,,551.48,75,,,percent of total billed charges,75% of total billed charges,294.12,40,,,percent of total billed charges,40% of total billed charges,582.36,79.2,,,percent of total billed charges,79.2% of total billed charges,625.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,698.54,95,,,percent of total billed charges,95% of total billed charges,588.24,80,,,percent of total billed charges,80% of total billed charges,625.01,85,,,percent of total billed charges,85% of total billed charges,661.77,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,294.12,40,,,percent of total billed charges,40% of total billed charges,294.12,40,,,percent of total billed charges,40% of total billed charges,661.77,90,,,percent of total billed charges,90% of total billed charges,558.83,76,,,percent of total billed charges,76% of total billed charges,294.12,40,,,percent of total billed charges,40% of total billed charges,625.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,588.24,80,,,percent of total billed charges,80% of total billed charges,285.3,38.8,,,percent of total billed charges,38.8% of total billed charges,625.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,698.54,
36555 - CV CATHETER <5YRS CHARGE,46036555,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,525.2,420.16,,393.9,75,,,percent of total billed charges,75% of total billed charges,210.08,40,,,percent of total billed charges,40% of total billed charges,415.96,79.2,,,percent of total billed charges,79.2% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,498.94,95,,,percent of total billed charges,95% of total billed charges,420.16,80,,,percent of total billed charges,80% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,472.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,210.08,40,,,percent of total billed charges,40% of total billed charges,210.08,40,,,percent of total billed charges,40% of total billed charges,472.68,90,,,percent of total billed charges,90% of total billed charges,399.15,76,,,percent of total billed charges,76% of total billed charges,210.08,40,,,percent of total billed charges,40% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,420.16,80,,,percent of total billed charges,80% of total billed charges,203.78,38.8,,,percent of total billed charges,38.8% of total billed charges,446.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,498.94,
"47000 - BX LIVER, NEEDLE PERQ CHARGE",46047000,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,4860,3888,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
76998 - US GUIDE INTRAOP CHARGE,46076998,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,238.6,190.88,,178.95,75,,,percent of total billed charges,75% of total billed charges,95.44,40,,,percent of total billed charges,40% of total billed charges,188.97,79.2,,,percent of total billed charges,79.2% of total billed charges,202.81,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,226.67,95,,,percent of total billed charges,95% of total billed charges,190.88,80,,,percent of total billed charges,80% of total billed charges,202.81,85,,,percent of total billed charges,85% of total billed charges,214.74,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,95.44,40,,,percent of total billed charges,40% of total billed charges,95.44,40,,,percent of total billed charges,40% of total billed charges,214.74,90,,,percent of total billed charges,90% of total billed charges,181.34,76,,,percent of total billed charges,76% of total billed charges,95.44,40,,,percent of total billed charges,40% of total billed charges,202.81,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,190.88,80,,,percent of total billed charges,80% of total billed charges,92.58,38.8,,,percent of total billed charges,38.8% of total billed charges,202.81,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,92.58,246.44,
27301 - ID THIGH HEMATOMA CHARGE,46027301,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,2729,2183.2,,2046.75,75,,,percent of total billed charges,75% of total billed charges,1091.6,40,,,percent of total billed charges,40% of total billed charges,2161.37,79.2,,,percent of total billed charges,79.2% of total billed charges,2319.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2592.55,95,,,percent of total billed charges,95% of total billed charges,2183.2,80,,,percent of total billed charges,80% of total billed charges,2319.65,85,,,percent of total billed charges,85% of total billed charges,2456.1,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,1091.6,40,,,percent of total billed charges,40% of total billed charges,1091.6,40,,,percent of total billed charges,40% of total billed charges,2456.1,90,,,percent of total billed charges,90% of total billed charges,2074.04,76,,,percent of total billed charges,76% of total billed charges,1091.6,40,,,percent of total billed charges,40% of total billed charges,2319.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,2183.2,80,,,percent of total billed charges,80% of total billed charges,1058.85,38.8,,,percent of total billed charges,38.8% of total billed charges,2319.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,2592.55,
"13102 Repair, Complex, Trunk; Each Additional 5 Cm Or Less",46013102,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,430.6,344.48,,322.95,75,,,percent of total billed charges,75% of total billed charges,172.24,40,,,percent of total billed charges,40% of total billed charges,341.04,79.2,,,percent of total billed charges,79.2% of total billed charges,366.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,409.07,95,,,percent of total billed charges,95% of total billed charges,344.48,80,,,percent of total billed charges,80% of total billed charges,366.01,85,,,percent of total billed charges,85% of total billed charges,387.54,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,172.24,40,,,percent of total billed charges,40% of total billed charges,172.24,40,,,percent of total billed charges,40% of total billed charges,387.54,90,,,percent of total billed charges,90% of total billed charges,327.26,76,,,percent of total billed charges,76% of total billed charges,172.24,40,,,percent of total billed charges,40% of total billed charges,366.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,344.48,80,,,percent of total billed charges,80% of total billed charges,167.07,38.8,,,percent of total billed charges,38.8% of total billed charges,366.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,167.07,409.07,
77001 - FLUOROGUIDE FOR VEIN DEVI CHARGE,46077001,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,196.9,157.52,,147.68,75,,,percent of total billed charges,75% of total billed charges,78.76,40,,,percent of total billed charges,40% of total billed charges,155.94,79.2,,,percent of total billed charges,79.2% of total billed charges,167.37,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,187.06,95,,,percent of total billed charges,95% of total billed charges,157.52,80,,,percent of total billed charges,80% of total billed charges,167.37,85,,,percent of total billed charges,85% of total billed charges,177.21,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,78.76,40,,,percent of total billed charges,40% of total billed charges,78.76,40,,,percent of total billed charges,40% of total billed charges,177.21,90,,,percent of total billed charges,90% of total billed charges,149.64,76,,,percent of total billed charges,76% of total billed charges,78.76,40,,,percent of total billed charges,40% of total billed charges,167.37,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,157.52,80,,,percent of total billed charges,80% of total billed charges,76.4,38.8,,,percent of total billed charges,38.8% of total billed charges,167.37,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,76.4,187.06,
"Insertion of central venous catheter for infusion, patient",46036569,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2589.9,2071.92,,1942.43,75,,,percent of total billed charges,75% of total billed charges,1035.96,40,,,percent of total billed charges,40% of total billed charges,2051.2,79.2,,,percent of total billed charges,79.2% of total billed charges,2201.42,85,,,percent of total billed charges,85% of total billed charges,2589.9,100,,,fee schedule,100% of CO APG rates,2460.41,95,,,percent of total billed charges,95% of total billed charges,2071.92,80,,,percent of total billed charges,80% of total billed charges,2201.42,85,,,percent of total billed charges,85% of total billed charges,2330.91,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,1035.96,40,,,percent of total billed charges,40% of total billed charges,1035.96,40,,,percent of total billed charges,40% of total billed charges,2330.91,90,,,percent of total billed charges,90% of total billed charges,1968.32,76,,,percent of total billed charges,76% of total billed charges,1035.96,40,,,percent of total billed charges,40% of total billed charges,2201.42,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,2071.92,80,,,percent of total billed charges,80% of total billed charges,1004.88,38.8,,,percent of total billed charges,38.8% of total billed charges,2201.42,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
76937 - US GUIDE VASCULAR ACCESS CHARGE,46276937,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,568.9,455.12,,426.68,75,,,percent of total billed charges,75% of total billed charges,227.56,40,,,percent of total billed charges,40% of total billed charges,450.57,79.2,,,percent of total billed charges,79.2% of total billed charges,483.57,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,540.46,95,,,percent of total billed charges,95% of total billed charges,455.12,80,,,percent of total billed charges,80% of total billed charges,483.57,85,,,percent of total billed charges,85% of total billed charges,512.01,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,227.56,40,,,percent of total billed charges,40% of total billed charges,227.56,40,,,percent of total billed charges,40% of total billed charges,512.01,90,,,percent of total billed charges,90% of total billed charges,432.36,76,,,percent of total billed charges,76% of total billed charges,227.56,40,,,percent of total billed charges,40% of total billed charges,483.57,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,455.12,80,,,percent of total billed charges,80% of total billed charges,220.73,38.8,,,percent of total billed charges,38.8% of total billed charges,483.57,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,540.46,
36593 - DECLOT VASCULAR DEVICE CHARGE,46036593,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,257.9,206.32,,193.43,75,,,percent of total billed charges,75% of total billed charges,103.16,40,,,percent of total billed charges,40% of total billed charges,204.26,79.2,,,percent of total billed charges,79.2% of total billed charges,219.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,245.01,95,,,percent of total billed charges,95% of total billed charges,206.32,80,,,percent of total billed charges,80% of total billed charges,219.22,85,,,percent of total billed charges,85% of total billed charges,232.11,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,103.16,40,,,percent of total billed charges,40% of total billed charges,103.16,40,,,percent of total billed charges,40% of total billed charges,232.11,90,,,percent of total billed charges,90% of total billed charges,196,76,,,percent of total billed charges,76% of total billed charges,103.16,40,,,percent of total billed charges,40% of total billed charges,219.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,206.32,80,,,percent of total billed charges,80% of total billed charges,100.07,38.8,,,percent of total billed charges,38.8% of total billed charges,219.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,100.07,245.01,
10080 Incision And Drainage Of Pilonidal Cyst; Simple,46010080,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2245.4,1796.32,,1684.05,75,,,percent of total billed charges,75% of total billed charges,898.16,40,,,percent of total billed charges,40% of total billed charges,1778.36,79.2,,,percent of total billed charges,79.2% of total billed charges,1908.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2133.13,95,,,percent of total billed charges,95% of total billed charges,1796.32,80,,,percent of total billed charges,80% of total billed charges,1908.59,85,,,percent of total billed charges,85% of total billed charges,2020.86,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,898.16,40,,,percent of total billed charges,40% of total billed charges,898.16,40,,,percent of total billed charges,40% of total billed charges,2020.86,90,,,percent of total billed charges,90% of total billed charges,1706.5,76,,,percent of total billed charges,76% of total billed charges,898.16,40,,,percent of total billed charges,40% of total billed charges,1908.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1796.32,80,,,percent of total billed charges,80% of total billed charges,871.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1908.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2133.13,
PAIN PUMP CHARGE,46000017,CDM,360,RC,43215,HCPCS,OUTPATIENT,,,362.7,290.16,,272.03,75,,,percent of total billed charges,75% of total billed charges,145.08,40,,,percent of total billed charges,40% of total billed charges,287.26,79.2,,,percent of total billed charges,79.2% of total billed charges,308.3,85,,,percent of total billed charges,85% of total billed charges,362.7,100,,,fee schedule,100% of CO APG rates,344.57,95,,,percent of total billed charges,95% of total billed charges,290.16,80,,,percent of total billed charges,80% of total billed charges,308.3,85,,,percent of total billed charges,85% of total billed charges,326.43,90,,,percent of total billed charges,90% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rates,1260.54,100,,,fee schedule,100% of CO APG rates,362.7,100,,,fee schedule,100% of NM APC rate,145.08,40,,,percent of total billed charges,40% of total billed charges,145.08,40,,,percent of total billed charges,40% of total billed charges,326.43,90,,,percent of total billed charges,90% of total billed charges,275.65,76,,,percent of total billed charges,76% of total billed charges,145.08,40,,,percent of total billed charges,40% of total billed charges,308.3,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rate,290.16,80,,,percent of total billed charges,80% of total billed charges,140.73,38.8,,,percent of total billed charges,38.8% of total billed charges,308.3,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of APG fee schedule,281.54,200,,,fee schedule,200% of CMS fee schedule,140.73,1260.54,
"23330 Removal Of Foreign Body, Shoulder; Subcutaneous",31023330,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2112.2,1689.76,,1584.15,75,,,percent of total billed charges,75% of total billed charges,844.88,40,,,percent of total billed charges,40% of total billed charges,1672.86,79.2,,,percent of total billed charges,79.2% of total billed charges,1795.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2006.59,95,,,percent of total billed charges,95% of total billed charges,1689.76,80,,,percent of total billed charges,80% of total billed charges,1795.37,85,,,percent of total billed charges,85% of total billed charges,1900.98,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,844.88,40,,,percent of total billed charges,40% of total billed charges,844.88,40,,,percent of total billed charges,40% of total billed charges,1900.98,90,,,percent of total billed charges,90% of total billed charges,1605.27,76,,,percent of total billed charges,76% of total billed charges,844.88,40,,,percent of total billed charges,40% of total billed charges,1795.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1689.76,80,,,percent of total billed charges,80% of total billed charges,819.53,38.8,,,percent of total billed charges,38.8% of total billed charges,1795.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2006.59,
23350 Injection Procedure For Shoulder Arthrography Or Enhan,31023350,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,653.1,522.48,,489.83,75,,,percent of total billed charges,75% of total billed charges,261.24,40,,,percent of total billed charges,40% of total billed charges,517.26,79.2,,,percent of total billed charges,79.2% of total billed charges,555.14,85,,,percent of total billed charges,85% of total billed charges,653.1,100,,,fee schedule,100% of CO APG rates,620.45,95,,,percent of total billed charges,95% of total billed charges,522.48,80,,,percent of total billed charges,80% of total billed charges,555.14,85,,,percent of total billed charges,85% of total billed charges,587.79,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,653.1,100,,,fee schedule,100% of NM APC rate,261.24,40,,,percent of total billed charges,40% of total billed charges,261.24,40,,,percent of total billed charges,40% of total billed charges,587.79,90,,,percent of total billed charges,90% of total billed charges,496.36,76,,,percent of total billed charges,76% of total billed charges,261.24,40,,,percent of total billed charges,40% of total billed charges,555.14,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,522.48,80,,,percent of total billed charges,80% of total billed charges,253.4,38.8,,,percent of total billed charges,38.8% of total billed charges,555.14,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,253.4,2713.28,
23505 Closed Treatment Of Clavicular Fracture; With Manipula,31023505,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,5002.4,4001.92,,3751.8,75,,,percent of total billed charges,75% of total billed charges,2000.96,40,,,percent of total billed charges,40% of total billed charges,3961.9,79.2,,,percent of total billed charges,79.2% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4752.28,95,,,percent of total billed charges,95% of total billed charges,4001.92,80,,,percent of total billed charges,80% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,4502.16,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,2000.96,40,,,percent of total billed charges,40% of total billed charges,2000.96,40,,,percent of total billed charges,40% of total billed charges,4502.16,90,,,percent of total billed charges,90% of total billed charges,3801.82,76,,,percent of total billed charges,76% of total billed charges,2000.96,40,,,percent of total billed charges,40% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,4001.92,80,,,percent of total billed charges,80% of total billed charges,1940.93,38.8,,,percent of total billed charges,38.8% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4752.28,
23575 Closed Treatment Of Scapular Fracture; With Manipulati,31023575,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,5002.4,4001.92,,3751.8,75,,,percent of total billed charges,75% of total billed charges,2000.96,40,,,percent of total billed charges,40% of total billed charges,3961.9,79.2,,,percent of total billed charges,79.2% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4752.28,95,,,percent of total billed charges,95% of total billed charges,4001.92,80,,,percent of total billed charges,80% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,4502.16,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,2000.96,40,,,percent of total billed charges,40% of total billed charges,2000.96,40,,,percent of total billed charges,40% of total billed charges,4502.16,90,,,percent of total billed charges,90% of total billed charges,3801.82,76,,,percent of total billed charges,76% of total billed charges,2000.96,40,,,percent of total billed charges,40% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,4001.92,80,,,percent of total billed charges,80% of total billed charges,1940.93,38.8,,,percent of total billed charges,38.8% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4752.28,
23605 Closed Treatment Of Proximal Humeral Fracture; With Ma,31023605,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
"23650 Closed Treatment Of Shoulder Dislocation, With Manipul",31023650,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,828.9,663.12,,621.68,75,,,percent of total billed charges,75% of total billed charges,331.56,40,,,percent of total billed charges,40% of total billed charges,656.49,79.2,,,percent of total billed charges,79.2% of total billed charges,704.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,787.46,95,,,percent of total billed charges,95% of total billed charges,663.12,80,,,percent of total billed charges,80% of total billed charges,704.57,85,,,percent of total billed charges,85% of total billed charges,746.01,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,331.56,40,,,percent of total billed charges,40% of total billed charges,331.56,40,,,percent of total billed charges,40% of total billed charges,746.01,90,,,percent of total billed charges,90% of total billed charges,629.96,76,,,percent of total billed charges,76% of total billed charges,331.56,40,,,percent of total billed charges,40% of total billed charges,704.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,663.12,80,,,percent of total billed charges,80% of total billed charges,321.61,38.8,,,percent of total billed charges,38.8% of total billed charges,704.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,787.46,
"24200 Removal Of Foreign Body, Upper Arm Or Elbow Area; Subc",31024200,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4493.8,3595.04,,3370.35,75,,,percent of total billed charges,75% of total billed charges,1797.52,40,,,percent of total billed charges,40% of total billed charges,3559.09,79.2,,,percent of total billed charges,79.2% of total billed charges,3819.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4269.11,95,,,percent of total billed charges,95% of total billed charges,3595.04,80,,,percent of total billed charges,80% of total billed charges,3819.73,85,,,percent of total billed charges,85% of total billed charges,4044.42,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1797.52,40,,,percent of total billed charges,40% of total billed charges,1797.52,40,,,percent of total billed charges,40% of total billed charges,4044.42,90,,,percent of total billed charges,90% of total billed charges,3415.29,76,,,percent of total billed charges,76% of total billed charges,1797.52,40,,,percent of total billed charges,40% of total billed charges,3819.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3595.04,80,,,percent of total billed charges,80% of total billed charges,1743.59,38.8,,,percent of total billed charges,38.8% of total billed charges,3819.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4269.11,
24505 Closed Treatment Of Humeral Shaft Fracture; With Manip,31024505,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
24535 Closed Treatment Of Supracondylar Or Transcondylar Hum,31024535,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
24600 Treatment Of Closed Elbow Dislocation; Without Anesthe,31024600,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
24620 Closed Treatment Of Monteggia Type Of Fracture Disloca,31024620,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
"24640 Closed Treatment Of Radial Head Subluxation In Child,",31024640,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,828.9,663.12,,621.68,75,,,percent of total billed charges,75% of total billed charges,331.56,40,,,percent of total billed charges,40% of total billed charges,656.49,79.2,,,percent of total billed charges,79.2% of total billed charges,704.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,787.46,95,,,percent of total billed charges,95% of total billed charges,663.12,80,,,percent of total billed charges,80% of total billed charges,704.57,85,,,percent of total billed charges,85% of total billed charges,746.01,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,331.56,40,,,percent of total billed charges,40% of total billed charges,331.56,40,,,percent of total billed charges,40% of total billed charges,746.01,90,,,percent of total billed charges,90% of total billed charges,629.96,76,,,percent of total billed charges,76% of total billed charges,331.56,40,,,percent of total billed charges,40% of total billed charges,704.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,663.12,80,,,percent of total billed charges,80% of total billed charges,321.61,38.8,,,percent of total billed charges,38.8% of total billed charges,704.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,787.46,
"24670 Closed Treatment Of Ulnar Fracture, Proximal End",31024670,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2044.6,1635.68,,1533.45,75,,,percent of total billed charges,75% of total billed charges,817.84,40,,,percent of total billed charges,40% of total billed charges,1619.32,79.2,,,percent of total billed charges,79.2% of total billed charges,1737.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1942.37,95,,,percent of total billed charges,95% of total billed charges,1635.68,80,,,percent of total billed charges,80% of total billed charges,1737.91,85,,,percent of total billed charges,85% of total billed charges,1840.14,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,817.84,40,,,percent of total billed charges,40% of total billed charges,817.84,40,,,percent of total billed charges,40% of total billed charges,1840.14,90,,,percent of total billed charges,90% of total billed charges,1553.9,76,,,percent of total billed charges,76% of total billed charges,817.84,40,,,percent of total billed charges,40% of total billed charges,1737.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1635.68,80,,,percent of total billed charges,80% of total billed charges,793.3,38.8,,,percent of total billed charges,38.8% of total billed charges,1737.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1942.37,
Glucose Level 24 Hour Urine,40082945,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,82.7,66.16,,62.03,75,,,percent of total billed charges,75% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,65.5,79.2,,,percent of total billed charges,79.2% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,78.57,95,,,percent of total billed charges,95% of total billed charges,66.16,80,,,percent of total billed charges,80% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,74.43,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,33.08,40,,,percent of total billed charges,40% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,74.43,90,,,percent of total billed charges,90% of total billed charges,62.85,76,,,percent of total billed charges,76% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,66.16,80,,,percent of total billed charges,80% of total billed charges,32.09,38.8,,,percent of total billed charges,38.8% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,78.57,
Magnesium Level 24 Hour Urine,40083735,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,107.2,85.76,,80.4,75,,,percent of total billed charges,75% of total billed charges,42.88,40,,,percent of total billed charges,40% of total billed charges,84.9,79.2,,,percent of total billed charges,79.2% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,101.84,95,,,percent of total billed charges,95% of total billed charges,85.76,80,,,percent of total billed charges,80% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,96.48,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,42.88,40,,,percent of total billed charges,40% of total billed charges,42.88,40,,,percent of total billed charges,40% of total billed charges,96.48,90,,,percent of total billed charges,90% of total billed charges,81.47,76,,,percent of total billed charges,76% of total billed charges,42.88,40,,,percent of total billed charges,40% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,85.76,80,,,percent of total billed charges,80% of total billed charges,41.59,38.8,,,percent of total billed charges,38.8% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,101.84,
Phosphorus Level 24 Hour Urine,40084105,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,95.6,76.48,,71.7,75,,,percent of total billed charges,75% of total billed charges,38.24,40,,,percent of total billed charges,40% of total billed charges,75.72,79.2,,,percent of total billed charges,79.2% of total billed charges,81.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,90.82,95,,,percent of total billed charges,95% of total billed charges,76.48,80,,,percent of total billed charges,80% of total billed charges,81.26,85,,,percent of total billed charges,85% of total billed charges,86.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,38.24,40,,,percent of total billed charges,40% of total billed charges,38.24,40,,,percent of total billed charges,40% of total billed charges,86.04,90,,,percent of total billed charges,90% of total billed charges,72.66,76,,,percent of total billed charges,76% of total billed charges,38.24,40,,,percent of total billed charges,40% of total billed charges,81.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,76.48,80,,,percent of total billed charges,80% of total billed charges,37.09,38.8,,,percent of total billed charges,38.8% of total billed charges,81.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,90.82,
25530 Closed Treatment Of Ulnar Shaft Fracture; Without Mani,31025530,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
25535 Closed Treatment Of Ulnar Shaft Fracture; With Manipul,31025535,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
25624 CLSD TX WRIST FX W/MANIP,31025624,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
25635 CLO TX CARPAL W/ MANIP,31025635,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
25650 CD FX TX ULNAR STYLOID Charge,31025650,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
25680 CLOTX WRISTFX DIS W/MAN,31025680,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
25690 CLD TX W/ MANI LUNATE,31025690,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
26010 DRAINAGE FING ABSCESS SIM,31026010,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,556.4,445.12,,417.3,75,,,percent of total billed charges,75% of total billed charges,222.56,40,,,percent of total billed charges,40% of total billed charges,440.67,79.2,,,percent of total billed charges,79.2% of total billed charges,472.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,528.58,95,,,percent of total billed charges,95% of total billed charges,445.12,80,,,percent of total billed charges,80% of total billed charges,472.94,85,,,percent of total billed charges,85% of total billed charges,500.76,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,222.56,40,,,percent of total billed charges,40% of total billed charges,222.56,40,,,percent of total billed charges,40% of total billed charges,500.76,90,,,percent of total billed charges,90% of total billed charges,422.86,76,,,percent of total billed charges,76% of total billed charges,222.56,40,,,percent of total billed charges,40% of total billed charges,472.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,445.12,80,,,percent of total billed charges,80% of total billed charges,215.88,38.8,,,percent of total billed charges,38.8% of total billed charges,472.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,528.58,
"26011 DRNG FINGER ABSCESS, COMP",46026011,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4582.2,3665.76,,3436.65,75,,,percent of total billed charges,75% of total billed charges,1832.88,40,,,percent of total billed charges,40% of total billed charges,3629.1,79.2,,,percent of total billed charges,79.2% of total billed charges,3894.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4353.09,95,,,percent of total billed charges,95% of total billed charges,3665.76,80,,,percent of total billed charges,80% of total billed charges,3894.87,85,,,percent of total billed charges,85% of total billed charges,4123.98,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1832.88,40,,,percent of total billed charges,40% of total billed charges,1832.88,40,,,percent of total billed charges,40% of total billed charges,4123.98,90,,,percent of total billed charges,90% of total billed charges,3482.47,76,,,percent of total billed charges,76% of total billed charges,1832.88,40,,,percent of total billed charges,40% of total billed charges,3894.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3665.76,80,,,percent of total billed charges,80% of total billed charges,1777.89,38.8,,,percent of total billed charges,38.8% of total billed charges,3894.87,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4353.09,
"26418 RPAIR XT TENDON, FINGER",31026418,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,9035.5,7228.4,,6776.63,75,,,percent of total billed charges,75% of total billed charges,3614.2,40,,,percent of total billed charges,40% of total billed charges,7156.12,79.2,,,percent of total billed charges,79.2% of total billed charges,7680.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,8583.73,95,,,percent of total billed charges,95% of total billed charges,7228.4,80,,,percent of total billed charges,80% of total billed charges,7680.18,85,,,percent of total billed charges,85% of total billed charges,8131.95,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,4540.32,100,,,fee schedule,100% of NM APC rate,3614.2,40,,,percent of total billed charges,40% of total billed charges,3614.2,40,,,percent of total billed charges,40% of total billed charges,8131.95,90,,,percent of total billed charges,90% of total billed charges,6866.98,76,,,percent of total billed charges,76% of total billed charges,3614.2,40,,,percent of total billed charges,40% of total billed charges,7680.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,7228.4,80,,,percent of total billed charges,80% of total billed charges,3505.77,38.8,,,percent of total billed charges,38.8% of total billed charges,7680.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,215.49,8583.73,
NM Thyroid Uptake,41578012,CDM,340,RC,78315,HCPCS,OUTPATIENT,,,298,238.4,TC,223.5,75,,,percent of total billed charges,75% of total billed charges,119.2,40,,,percent of total billed charges,40% of total billed charges,236.02,79.2,,,percent of total billed charges,79.2% of total billed charges,253.3,85,,,percent of total billed charges,85% of total billed charges,298,100,,,fee schedule,100% of CO APG rates,283.1,95,,,percent of total billed charges,95% of total billed charges,238.4,80,,,percent of total billed charges,80% of total billed charges,253.3,85,,,percent of total billed charges,85% of total billed charges,268.2,90,,,percent of total billed charges,90% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rates,505.7,100,,,fee schedule,100% of CO APG rates,298,100,,,fee schedule,100% of NM APC rate,119.2,40,,,percent of total billed charges,40% of total billed charges,119.2,40,,,percent of total billed charges,40% of total billed charges,268.2,90,,,percent of total billed charges,90% of total billed charges,226.48,76,,,percent of total billed charges,76% of total billed charges,119.2,40,,,percent of total billed charges,40% of total billed charges,253.3,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rate,238.4,80,,,percent of total billed charges,80% of total billed charges,115.62,38.8,,,percent of total billed charges,38.8% of total billed charges,253.3,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of APG fee schedule,596,200,,,fee schedule,200% of CMS fee schedule,115.62,596,
Lactic Acid Venous,40083605,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,121.2,96.96,,90.9,75,,,percent of total billed charges,75% of total billed charges,48.48,40,,,percent of total billed charges,40% of total billed charges,95.99,79.2,,,percent of total billed charges,79.2% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,115.14,95,,,percent of total billed charges,95% of total billed charges,96.96,80,,,percent of total billed charges,80% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,109.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,48.48,40,,,percent of total billed charges,40% of total billed charges,48.48,40,,,percent of total billed charges,40% of total billed charges,109.08,90,,,percent of total billed charges,90% of total billed charges,92.11,76,,,percent of total billed charges,76% of total billed charges,48.48,40,,,percent of total billed charges,40% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,96.96,80,,,percent of total billed charges,80% of total billed charges,47.03,38.8,,,percent of total billed charges,38.8% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,115.14,
SLEEVE SCD KNEE LG,51148,CDM,270,RC,,,OUTPATIENT,,,312.5,250,,234.38,75,,,percent of total billed charges,75% of total billed charges,125,40,,,percent of total billed charges,40% of total billed charges,247.5,79.2,,,percent of total billed charges,79.2% of total billed charges,265.63,85,,,percent of total billed charges,85% of total billed charges,312.5,100,,,fee schedule,100% of CO APG rates,296.88,95,,,percent of total billed charges,95% of total billed charges,250,80,,,percent of total billed charges,80% of total billed charges,265.63,85,,,percent of total billed charges,85% of total billed charges,281.25,90,,,percent of total billed charges,90% of total billed charges,312.5,100,,,fee schedule,100% of CO APG rates,312.5,100,,,fee schedule,100% of CO APG rates,312.5,100,,,fee schedule,100% of NM fee schedule,125,40,,,percent of total billed charges,40% of total billed charges,125,40,,,percent of total billed charges,40% of total billed charges,281.25,90,,,percent of total billed charges,90% of total billed charges,237.5,76,,,percent of total billed charges,76% of total billed charges,125,40,,,percent of total billed charges,40% of total billed charges,265.63,85,,,percent of total billed charges,85% of total billed charges,312.5,100,,,fee schedule,100% of CO APG rate,250,80,,,percent of total billed charges,80% of total billed charges,121.25,38.8,,,percent of total billed charges,38.8% of total billed charges,265.63,85,,,percent of total billed charges,85% of total billed charges,312.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,121.25,312.5,
SUTURE 3-0 MONOCRYL PS-1  Y936H,51156,CDM,270,RC,,,OUTPATIENT,,,19.8,15.84,,14.85,75,,,percent of total billed charges,75% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,15.68,79.2,,,percent of total billed charges,79.2% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,19.8,100,,,fee schedule,100% of CO APG rates,18.81,95,,,percent of total billed charges,95% of total billed charges,15.84,80,,,percent of total billed charges,80% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,17.82,90,,,percent of total billed charges,90% of total billed charges,19.8,100,,,fee schedule,100% of CO APG rates,19.8,100,,,fee schedule,100% of CO APG rates,19.8,100,,,fee schedule,100% of NM fee schedule,7.92,40,,,percent of total billed charges,40% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,17.82,90,,,percent of total billed charges,90% of total billed charges,15.05,76,,,percent of total billed charges,76% of total billed charges,7.92,40,,,percent of total billed charges,40% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,19.8,100,,,fee schedule,100% of CO APG rate,15.84,80,,,percent of total billed charges,80% of total billed charges,7.68,38.8,,,percent of total billed charges,38.8% of total billed charges,16.83,85,,,percent of total billed charges,85% of total billed charges,19.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,7.68,19.8,
CAST FIBERGLASS LONG LEG- ED/ORTHO,30523,CDM,270,RC,,,OUTPATIENT,,,85.3,68.24,,63.98,75,,,percent of total billed charges,75% of total billed charges,34.12,40,,,percent of total billed charges,40% of total billed charges,67.56,79.2,,,percent of total billed charges,79.2% of total billed charges,72.51,85,,,percent of total billed charges,85% of total billed charges,85.3,100,,,fee schedule,100% of CO APG rates,81.04,95,,,percent of total billed charges,95% of total billed charges,68.24,80,,,percent of total billed charges,80% of total billed charges,72.51,85,,,percent of total billed charges,85% of total billed charges,76.77,90,,,percent of total billed charges,90% of total billed charges,85.3,100,,,fee schedule,100% of CO APG rates,85.3,100,,,fee schedule,100% of CO APG rates,85.3,100,,,fee schedule,100% of NM fee schedule,34.12,40,,,percent of total billed charges,40% of total billed charges,34.12,40,,,percent of total billed charges,40% of total billed charges,76.77,90,,,percent of total billed charges,90% of total billed charges,64.83,76,,,percent of total billed charges,76% of total billed charges,34.12,40,,,percent of total billed charges,40% of total billed charges,72.51,85,,,percent of total billed charges,85% of total billed charges,85.3,100,,,fee schedule,100% of CO APG rate,68.24,80,,,percent of total billed charges,80% of total billed charges,33.1,38.8,,,percent of total billed charges,38.8% of total billed charges,72.51,85,,,percent of total billed charges,85% of total billed charges,85.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,33.1,85.3,
SUTURE,30530,CDM,270,RC,,,OUTPATIENT,,,16.4,13.12,,12.3,75,,,percent of total billed charges,75% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,12.99,79.2,,,percent of total billed charges,79.2% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,15.58,95,,,percent of total billed charges,95% of total billed charges,13.12,80,,,percent of total billed charges,80% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of NM fee schedule,6.56,40,,,percent of total billed charges,40% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,12.46,76,,,percent of total billed charges,76% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rate,13.12,80,,,percent of total billed charges,80% of total billed charges,6.36,38.8,,,percent of total billed charges,38.8% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.36,16.4,
Bill Antigen Type Product,40586902,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,177,141.6,,132.75,75,,,percent of total billed charges,75% of total billed charges,70.8,40,,,percent of total billed charges,40% of total billed charges,140.18,79.2,,,percent of total billed charges,79.2% of total billed charges,150.45,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,168.15,95,,,percent of total billed charges,95% of total billed charges,141.6,80,,,percent of total billed charges,80% of total billed charges,150.45,85,,,percent of total billed charges,85% of total billed charges,159.3,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,70.8,40,,,percent of total billed charges,40% of total billed charges,70.8,40,,,percent of total billed charges,40% of total billed charges,159.3,90,,,percent of total billed charges,90% of total billed charges,134.52,76,,,percent of total billed charges,76% of total billed charges,70.8,40,,,percent of total billed charges,40% of total billed charges,150.45,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,141.6,80,,,percent of total billed charges,80% of total billed charges,68.68,38.8,,,percent of total billed charges,38.8% of total billed charges,150.45,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,168.15,
13151 CMPLX RPR E/N/E/L 1.1-2.5 CM,46013151,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1497.6,1198.08,,1123.2,75,,,percent of total billed charges,75% of total billed charges,599.04,40,,,percent of total billed charges,40% of total billed charges,1186.1,79.2,,,percent of total billed charges,79.2% of total billed charges,1272.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1422.72,95,,,percent of total billed charges,95% of total billed charges,1198.08,80,,,percent of total billed charges,80% of total billed charges,1272.96,85,,,percent of total billed charges,85% of total billed charges,1347.84,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,599.04,40,,,percent of total billed charges,40% of total billed charges,599.04,40,,,percent of total billed charges,40% of total billed charges,1347.84,90,,,percent of total billed charges,90% of total billed charges,1138.18,76,,,percent of total billed charges,76% of total billed charges,599.04,40,,,percent of total billed charges,40% of total billed charges,1272.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1198.08,80,,,percent of total billed charges,80% of total billed charges,581.07,38.8,,,percent of total billed charges,38.8% of total billed charges,1272.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1422.72,
13152 CMPLX RPR E/N/E/L 2.6-7.5 CM,46013152,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1698.3,1358.64,,1273.73,75,,,percent of total billed charges,75% of total billed charges,679.32,40,,,percent of total billed charges,40% of total billed charges,1345.05,79.2,,,percent of total billed charges,79.2% of total billed charges,1443.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1613.39,95,,,percent of total billed charges,95% of total billed charges,1358.64,80,,,percent of total billed charges,80% of total billed charges,1443.56,85,,,percent of total billed charges,85% of total billed charges,1528.47,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,679.32,40,,,percent of total billed charges,40% of total billed charges,679.32,40,,,percent of total billed charges,40% of total billed charges,1528.47,90,,,percent of total billed charges,90% of total billed charges,1290.71,76,,,percent of total billed charges,76% of total billed charges,679.32,40,,,percent of total billed charges,40% of total billed charges,1443.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1358.64,80,,,percent of total billed charges,80% of total billed charges,658.94,38.8,,,percent of total billed charges,38.8% of total billed charges,1443.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1613.39,
27096 - INJECT SACROILIAC JOINT CHARGE,46227096,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,682.1,545.68,,511.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,540.22,79.2,,,percent of total billed charges,79.2% of total billed charges,579.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,648,95,,,percent of total billed charges,95% of total billed charges,545.68,80,,,percent of total billed charges,80% of total billed charges,579.79,85,,,percent of total billed charges,85% of total billed charges,613.89,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,682.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,613.89,90,,,percent of total billed charges,90% of total billed charges,518.4,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,579.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,545.68,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,579.79,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
CDL Physical  UA,49100CDL,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,72.5,58,,54.38,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,57.42,79.2,,,percent of total billed charges,79.2% of total billed charges,61.63,85,,,percent of total billed charges,85% of total billed charges,72.5,100,,,fee schedule,100% of CO APG rates,68.88,95,,,percent of total billed charges,95% of total billed charges,58,80,,,percent of total billed charges,80% of total billed charges,61.63,85,,,percent of total billed charges,85% of total billed charges,65.25,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,72.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,65.25,90,,,percent of total billed charges,90% of total billed charges,55.1,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,61.63,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,58,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,61.63,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,527.2,100,,,case rate,pays based on per visit rate,54.38,527.2,
Venous Blood Gas 2,40082803,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.3,116.24,,108.98,75,,,percent of total billed charges,75% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,115.08,79.2,,,percent of total billed charges,79.2% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.04,95,,,percent of total billed charges,95% of total billed charges,116.24,80,,,percent of total billed charges,80% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,130.77,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.12,40,,,percent of total billed charges,40% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,130.77,90,,,percent of total billed charges,90% of total billed charges,110.43,76,,,percent of total billed charges,76% of total billed charges,58.12,40,,,percent of total billed charges,40% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.24,80,,,percent of total billed charges,80% of total billed charges,56.38,38.8,,,percent of total billed charges,38.8% of total billed charges,123.51,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.04,
Aph FFP ACDB Thawed,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Thyroid Stimulating Hormone with Reflex,60001034,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,136.9,109.52,,102.68,75,,,percent of total billed charges,75% of total billed charges,54.76,40,,,percent of total billed charges,40% of total billed charges,108.42,79.2,,,percent of total billed charges,79.2% of total billed charges,116.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,130.06,95,,,percent of total billed charges,95% of total billed charges,109.52,80,,,percent of total billed charges,80% of total billed charges,116.37,85,,,percent of total billed charges,85% of total billed charges,123.21,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,54.76,40,,,percent of total billed charges,40% of total billed charges,54.76,40,,,percent of total billed charges,40% of total billed charges,123.21,90,,,percent of total billed charges,90% of total billed charges,104.04,76,,,percent of total billed charges,76% of total billed charges,54.76,40,,,percent of total billed charges,40% of total billed charges,116.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,109.52,80,,,percent of total billed charges,80% of total billed charges,53.12,38.8,,,percent of total billed charges,38.8% of total billed charges,116.37,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,130.06,
Bill 37 Incubation,40586921,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,94.4,75.52,,70.8,75,,,percent of total billed charges,75% of total billed charges,37.76,40,,,percent of total billed charges,40% of total billed charges,74.76,79.2,,,percent of total billed charges,79.2% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,89.68,95,,,percent of total billed charges,95% of total billed charges,75.52,80,,,percent of total billed charges,80% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,84.96,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,37.76,40,,,percent of total billed charges,40% of total billed charges,37.76,40,,,percent of total billed charges,40% of total billed charges,84.96,90,,,percent of total billed charges,90% of total billed charges,71.74,76,,,percent of total billed charges,76% of total billed charges,37.76,40,,,percent of total billed charges,40% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,75.52,80,,,percent of total billed charges,80% of total billed charges,36.63,38.8,,,percent of total billed charges,38.8% of total billed charges,80.24,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,89.68,
Bill Antigen Type Patient Crossmatch,40586905,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,222.9,178.32,,167.18,75,,,percent of total billed charges,75% of total billed charges,89.16,40,,,percent of total billed charges,40% of total billed charges,176.54,79.2,,,percent of total billed charges,79.2% of total billed charges,189.47,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,211.76,95,,,percent of total billed charges,95% of total billed charges,178.32,80,,,percent of total billed charges,80% of total billed charges,189.47,85,,,percent of total billed charges,85% of total billed charges,200.61,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,89.16,40,,,percent of total billed charges,40% of total billed charges,89.16,40,,,percent of total billed charges,40% of total billed charges,200.61,90,,,percent of total billed charges,90% of total billed charges,169.4,76,,,percent of total billed charges,76% of total billed charges,89.16,40,,,percent of total billed charges,40% of total billed charges,189.47,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,178.32,80,,,percent of total billed charges,80% of total billed charges,86.49,38.8,,,percent of total billed charges,38.8% of total billed charges,189.47,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,211.76,
Bill Anitbody Screen Rist,40586978,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,280.1,224.08,,210.08,75,,,percent of total billed charges,75% of total billed charges,112.04,40,,,percent of total billed charges,40% of total billed charges,221.84,79.2,,,percent of total billed charges,79.2% of total billed charges,238.09,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,266.1,95,,,percent of total billed charges,95% of total billed charges,224.08,80,,,percent of total billed charges,80% of total billed charges,238.09,85,,,percent of total billed charges,85% of total billed charges,252.09,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,112.04,40,,,percent of total billed charges,40% of total billed charges,112.04,40,,,percent of total billed charges,40% of total billed charges,252.09,90,,,percent of total billed charges,90% of total billed charges,212.88,76,,,percent of total billed charges,76% of total billed charges,112.04,40,,,percent of total billed charges,40% of total billed charges,238.09,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,224.08,80,,,percent of total billed charges,80% of total billed charges,108.68,38.8,,,percent of total billed charges,38.8% of total billed charges,238.09,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,266.1,
Bill Crossmatch,40586920,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,305.5,244.4,,229.13,75,,,percent of total billed charges,75% of total billed charges,122.2,40,,,percent of total billed charges,40% of total billed charges,241.96,79.2,,,percent of total billed charges,79.2% of total billed charges,259.68,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,290.23,95,,,percent of total billed charges,95% of total billed charges,244.4,80,,,percent of total billed charges,80% of total billed charges,259.68,85,,,percent of total billed charges,85% of total billed charges,274.95,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,122.2,40,,,percent of total billed charges,40% of total billed charges,122.2,40,,,percent of total billed charges,40% of total billed charges,274.95,90,,,percent of total billed charges,90% of total billed charges,232.18,76,,,percent of total billed charges,76% of total billed charges,122.2,40,,,percent of total billed charges,40% of total billed charges,259.68,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,244.4,80,,,percent of total billed charges,80% of total billed charges,118.53,38.8,,,percent of total billed charges,38.8% of total billed charges,259.68,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,290.23,
Bill Cold Agg Screen,40586156,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,162.2,129.76,,121.65,75,,,percent of total billed charges,75% of total billed charges,64.88,40,,,percent of total billed charges,40% of total billed charges,128.46,79.2,,,percent of total billed charges,79.2% of total billed charges,137.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,154.09,95,,,percent of total billed charges,95% of total billed charges,129.76,80,,,percent of total billed charges,80% of total billed charges,137.87,85,,,percent of total billed charges,85% of total billed charges,145.98,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,64.88,40,,,percent of total billed charges,40% of total billed charges,64.88,40,,,percent of total billed charges,40% of total billed charges,145.98,90,,,percent of total billed charges,90% of total billed charges,123.27,76,,,percent of total billed charges,76% of total billed charges,64.88,40,,,percent of total billed charges,40% of total billed charges,137.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,129.76,80,,,percent of total billed charges,80% of total billed charges,62.93,38.8,,,percent of total billed charges,38.8% of total billed charges,137.87,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,154.09,
Bill Titration Studies,40586886,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,539.7,431.76,,404.78,75,,,percent of total billed charges,75% of total billed charges,215.88,40,,,percent of total billed charges,40% of total billed charges,427.44,79.2,,,percent of total billed charges,79.2% of total billed charges,458.75,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,512.72,95,,,percent of total billed charges,95% of total billed charges,431.76,80,,,percent of total billed charges,80% of total billed charges,458.75,85,,,percent of total billed charges,85% of total billed charges,485.73,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,215.88,40,,,percent of total billed charges,40% of total billed charges,215.88,40,,,percent of total billed charges,40% of total billed charges,485.73,90,,,percent of total billed charges,90% of total billed charges,410.17,76,,,percent of total billed charges,76% of total billed charges,215.88,40,,,percent of total billed charges,40% of total billed charges,458.75,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,431.76,80,,,percent of total billed charges,80% of total billed charges,209.4,38.8,,,percent of total billed charges,38.8% of total billed charges,458.75,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,512.72,
Bill Antigen Type RBC,40586905,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,190,152,,142.5,75,,,percent of total billed charges,75% of total billed charges,76,40,,,percent of total billed charges,40% of total billed charges,150.48,79.2,,,percent of total billed charges,79.2% of total billed charges,161.5,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,180.5,95,,,percent of total billed charges,95% of total billed charges,152,80,,,percent of total billed charges,80% of total billed charges,161.5,85,,,percent of total billed charges,85% of total billed charges,171,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,76,40,,,percent of total billed charges,40% of total billed charges,76,40,,,percent of total billed charges,40% of total billed charges,171,90,,,percent of total billed charges,90% of total billed charges,144.4,76,,,percent of total billed charges,76% of total billed charges,76,40,,,percent of total billed charges,40% of total billed charges,161.5,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,152,80,,,percent of total billed charges,80% of total billed charges,73.72,38.8,,,percent of total billed charges,38.8% of total billed charges,161.5,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,180.5,
Bill Blood Bank Draw Charge,40536415,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,5.04,33.06,
Bill Crossmatch Int/Report,40586077,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,187.8,150.24,,140.85,75,,,percent of total billed charges,75% of total billed charges,75.12,40,,,percent of total billed charges,40% of total billed charges,148.74,79.2,,,percent of total billed charges,79.2% of total billed charges,159.63,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,178.41,95,,,percent of total billed charges,95% of total billed charges,150.24,80,,,percent of total billed charges,80% of total billed charges,159.63,85,,,percent of total billed charges,85% of total billed charges,169.02,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,75.12,40,,,percent of total billed charges,40% of total billed charges,75.12,40,,,percent of total billed charges,40% of total billed charges,169.02,90,,,percent of total billed charges,90% of total billed charges,142.73,76,,,percent of total billed charges,76% of total billed charges,75.12,40,,,percent of total billed charges,40% of total billed charges,159.63,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,150.24,80,,,percent of total billed charges,80% of total billed charges,72.87,38.8,,,percent of total billed charges,38.8% of total billed charges,159.63,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,178.41,
26700 CLO TX KNUCKL SNGL W/MANI,31026700,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
26705 TREAT KNUCKLE DISLOCATION,31026705,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
26740 FX/Disloc Hand/Fingers,31026740,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
26742 TREAT FINGER FRACTURE EAC,31026742,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
26755 CLOTX DIST PH FX FING MAN,31026755,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
26770 CLSD REDUCTN DSLCTED FING,31026770,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
27502 CLSD TX FX FEM W/MANIP,31027502,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,5002.4,4001.92,,3751.8,75,,,percent of total billed charges,75% of total billed charges,2000.96,40,,,percent of total billed charges,40% of total billed charges,3961.9,79.2,,,percent of total billed charges,79.2% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4752.28,95,,,percent of total billed charges,95% of total billed charges,4001.92,80,,,percent of total billed charges,80% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,4502.16,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,2000.96,40,,,percent of total billed charges,40% of total billed charges,2000.96,40,,,percent of total billed charges,40% of total billed charges,4502.16,90,,,percent of total billed charges,90% of total billed charges,3801.82,76,,,percent of total billed charges,76% of total billed charges,2000.96,40,,,percent of total billed charges,40% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,4001.92,80,,,percent of total billed charges,80% of total billed charges,1940.93,38.8,,,percent of total billed charges,38.8% of total billed charges,4252.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4752.28,
"27530 Closed Treatment Of Tibial Fracture, Proximal (Plateau",46027530,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,793.5,634.8,,595.13,75,,,percent of total billed charges,75% of total billed charges,317.4,40,,,percent of total billed charges,40% of total billed charges,628.45,79.2,,,percent of total billed charges,79.2% of total billed charges,674.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,753.83,95,,,percent of total billed charges,95% of total billed charges,634.8,80,,,percent of total billed charges,80% of total billed charges,674.48,85,,,percent of total billed charges,85% of total billed charges,714.15,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,317.4,40,,,percent of total billed charges,40% of total billed charges,317.4,40,,,percent of total billed charges,40% of total billed charges,714.15,90,,,percent of total billed charges,90% of total billed charges,603.06,76,,,percent of total billed charges,76% of total billed charges,317.4,40,,,percent of total billed charges,40% of total billed charges,674.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,634.8,80,,,percent of total billed charges,80% of total billed charges,307.88,38.8,,,percent of total billed charges,38.8% of total billed charges,674.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,753.83,
27550 Closed Treatment Of Knee Dislocation; Without Anesthes,31027550,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,796.6,637.28,,597.45,75,,,percent of total billed charges,75% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,630.91,79.2,,,percent of total billed charges,79.2% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,756.77,95,,,percent of total billed charges,95% of total billed charges,637.28,80,,,percent of total billed charges,80% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,716.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,318.64,40,,,percent of total billed charges,40% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,716.94,90,,,percent of total billed charges,90% of total billed charges,605.42,76,,,percent of total billed charges,76% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,637.28,80,,,percent of total billed charges,80% of total billed charges,309.08,38.8,,,percent of total billed charges,38.8% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,756.77,
27560 Closed Treatment Of Patellar Dislocation; Without Anes,31027560,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
27752 - Closed treatment of tibial shaft fracture (with or w,46027752,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2284.9,1827.92,,1713.68,75,,,percent of total billed charges,75% of total billed charges,913.96,40,,,percent of total billed charges,40% of total billed charges,1809.64,79.2,,,percent of total billed charges,79.2% of total billed charges,1942.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2170.66,95,,,percent of total billed charges,95% of total billed charges,1827.92,80,,,percent of total billed charges,80% of total billed charges,1942.17,85,,,percent of total billed charges,85% of total billed charges,2056.41,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,913.96,40,,,percent of total billed charges,40% of total billed charges,913.96,40,,,percent of total billed charges,40% of total billed charges,2056.41,90,,,percent of total billed charges,90% of total billed charges,1736.52,76,,,percent of total billed charges,76% of total billed charges,913.96,40,,,percent of total billed charges,40% of total billed charges,1942.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1827.92,80,,,percent of total billed charges,80% of total billed charges,886.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1942.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2170.66,
27788 CLO TX DIST FIBFX W MAN,31027788,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
27818 CLD TX TRIMAL W/MANI,31027818,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
27824 CDTX DISTAL TIBIA FX,31027824,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
28190 REMOV FB FOOT  SUBCUTAN,31028190,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1958.3,1566.64,,1468.73,75,,,percent of total billed charges,75% of total billed charges,783.32,40,,,percent of total billed charges,40% of total billed charges,1550.97,79.2,,,percent of total billed charges,79.2% of total billed charges,1664.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1860.39,95,,,percent of total billed charges,95% of total billed charges,1566.64,80,,,percent of total billed charges,80% of total billed charges,1664.56,85,,,percent of total billed charges,85% of total billed charges,1762.47,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,783.32,40,,,percent of total billed charges,40% of total billed charges,783.32,40,,,percent of total billed charges,40% of total billed charges,1762.47,90,,,percent of total billed charges,90% of total billed charges,1488.31,76,,,percent of total billed charges,76% of total billed charges,783.32,40,,,percent of total billed charges,40% of total billed charges,1664.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1566.64,80,,,percent of total billed charges,80% of total billed charges,759.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1664.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1860.39,
28495 FX BIG TOE W/MANIP,31028495,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
28630 CLO TX METATARS JT DISL,31028630,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
29240 STRAPPING SHOULDER,31029240,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,202.8,162.24,,152.1,75,,,percent of total billed charges,75% of total billed charges,81.12,40,,,percent of total billed charges,40% of total billed charges,160.62,79.2,,,percent of total billed charges,79.2% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,202.8,100,,,fee schedule,100% of CO APG rates,192.66,95,,,percent of total billed charges,95% of total billed charges,162.24,80,,,percent of total billed charges,80% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,182.52,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,81.12,40,,,percent of total billed charges,40% of total billed charges,81.12,40,,,percent of total billed charges,40% of total billed charges,182.52,90,,,percent of total billed charges,90% of total billed charges,154.13,76,,,percent of total billed charges,76% of total billed charges,81.12,40,,,percent of total billed charges,40% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,162.24,80,,,percent of total billed charges,80% of total billed charges,78.69,38.8,,,percent of total billed charges,38.8% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,78.69,217.66,
29280  STRAPPING HAND/FINGER,31029280,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,105,84,,78.75,75,,,percent of total billed charges,75% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,83.16,79.2,,,percent of total billed charges,79.2% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,105,100,,,fee schedule,100% of CO APG rates,99.75,95,,,percent of total billed charges,95% of total billed charges,84,80,,,percent of total billed charges,80% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,105,100,,,fee schedule,100% of NM APC rate,42,40,,,percent of total billed charges,40% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,79.8,76,,,percent of total billed charges,76% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,84,80,,,percent of total billed charges,80% of total billed charges,40.74,38.8,,,percent of total billed charges,38.8% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,210,200,,,fee schedule,200% of CMS fee schedule,40.74,215.49,
29550 STRAPPING TOE,31029550,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,202.8,162.24,,152.1,75,,,percent of total billed charges,75% of total billed charges,81.12,40,,,percent of total billed charges,40% of total billed charges,160.62,79.2,,,percent of total billed charges,79.2% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,202.8,100,,,fee schedule,100% of CO APG rates,192.66,95,,,percent of total billed charges,95% of total billed charges,162.24,80,,,percent of total billed charges,80% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,182.52,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,81.12,40,,,percent of total billed charges,40% of total billed charges,81.12,40,,,percent of total billed charges,40% of total billed charges,182.52,90,,,percent of total billed charges,90% of total billed charges,154.13,76,,,percent of total billed charges,76% of total billed charges,81.12,40,,,percent of total billed charges,40% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,162.24,80,,,percent of total billed charges,80% of total billed charges,78.69,38.8,,,percent of total billed charges,38.8% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,78.69,217.66,
"29700 Removal Or Bivalving; Gauntlet, Boot Or Body Cast",31029700,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,879.8,703.84,,659.85,75,,,percent of total billed charges,75% of total billed charges,351.92,40,,,percent of total billed charges,40% of total billed charges,696.8,79.2,,,percent of total billed charges,79.2% of total billed charges,747.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,835.81,95,,,percent of total billed charges,95% of total billed charges,703.84,80,,,percent of total billed charges,80% of total billed charges,747.83,85,,,percent of total billed charges,85% of total billed charges,791.82,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,351.92,40,,,percent of total billed charges,40% of total billed charges,351.92,40,,,percent of total billed charges,40% of total billed charges,791.82,90,,,percent of total billed charges,90% of total billed charges,668.65,76,,,percent of total billed charges,76% of total billed charges,351.92,40,,,percent of total billed charges,40% of total billed charges,747.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,703.84,80,,,percent of total billed charges,80% of total billed charges,341.36,38.8,,,percent of total billed charges,38.8% of total billed charges,747.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,835.81,
29740 Wedging Of Cast,31029740,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,817.4,653.92,,613.05,75,,,percent of total billed charges,75% of total billed charges,326.96,40,,,percent of total billed charges,40% of total billed charges,647.38,79.2,,,percent of total billed charges,79.2% of total billed charges,694.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,776.53,95,,,percent of total billed charges,95% of total billed charges,653.92,80,,,percent of total billed charges,80% of total billed charges,694.79,85,,,percent of total billed charges,85% of total billed charges,735.66,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,326.96,40,,,percent of total billed charges,40% of total billed charges,326.96,40,,,percent of total billed charges,40% of total billed charges,735.66,90,,,percent of total billed charges,90% of total billed charges,621.22,76,,,percent of total billed charges,76% of total billed charges,326.96,40,,,percent of total billed charges,40% of total billed charges,694.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,653.92,80,,,percent of total billed charges,80% of total billed charges,317.15,38.8,,,percent of total billed charges,38.8% of total billed charges,694.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,776.53,
30300 REMOV FB INTRANASAL,31030300,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,370.2,296.16,,277.65,75,,,percent of total billed charges,75% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,293.2,79.2,,,percent of total billed charges,79.2% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,351.69,95,,,percent of total billed charges,95% of total billed charges,296.16,80,,,percent of total billed charges,80% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,148.08,40,,,percent of total billed charges,40% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,281.35,76,,,percent of total billed charges,76% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,296.16,80,,,percent of total billed charges,80% of total billed charges,143.64,38.8,,,percent of total billed charges,38.8% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,143.64,351.69,
31500 INTUBATION ENDOTRACHEAL,31031500,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,688.5,550.8,,516.38,75,,,percent of total billed charges,75% of total billed charges,275.4,40,,,percent of total billed charges,40% of total billed charges,545.29,79.2,,,percent of total billed charges,79.2% of total billed charges,585.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,654.08,95,,,percent of total billed charges,95% of total billed charges,550.8,80,,,percent of total billed charges,80% of total billed charges,585.23,85,,,percent of total billed charges,85% of total billed charges,619.65,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,275.4,40,,,percent of total billed charges,40% of total billed charges,275.4,40,,,percent of total billed charges,40% of total billed charges,619.65,90,,,percent of total billed charges,90% of total billed charges,523.26,76,,,percent of total billed charges,76% of total billed charges,275.4,40,,,percent of total billed charges,40% of total billed charges,585.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,550.8,80,,,percent of total billed charges,80% of total billed charges,267.14,38.8,,,percent of total billed charges,38.8% of total billed charges,585.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,654.08,
36406 VENIPUNCT BY PHYS <3,31036406,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,55.1,44.08,,41.33,75,,,percent of total billed charges,75% of total billed charges,22.04,40,,,percent of total billed charges,40% of total billed charges,43.64,79.2,,,percent of total billed charges,79.2% of total billed charges,46.84,85,,,percent of total billed charges,85% of total billed charges,55.1,100,,,fee schedule,100% of CO APG rates,52.35,95,,,percent of total billed charges,95% of total billed charges,44.08,80,,,percent of total billed charges,80% of total billed charges,46.84,85,,,percent of total billed charges,85% of total billed charges,49.59,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,55.1,100,,,fee schedule,100% of NM APC rate,22.04,40,,,percent of total billed charges,40% of total billed charges,22.04,40,,,percent of total billed charges,40% of total billed charges,49.59,90,,,percent of total billed charges,90% of total billed charges,41.88,76,,,percent of total billed charges,76% of total billed charges,22.04,40,,,percent of total billed charges,40% of total billed charges,46.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,44.08,80,,,percent of total billed charges,80% of total billed charges,21.38,38.8,,,percent of total billed charges,38.8% of total billed charges,46.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,110.2,200,,,fee schedule,200% of CMS fee schedule,21.38,215.49,
36420 CUTDOWN < 1 YR,31036420,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,202.8,162.24,,152.1,75,,,percent of total billed charges,75% of total billed charges,81.12,40,,,percent of total billed charges,40% of total billed charges,160.62,79.2,,,percent of total billed charges,79.2% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,202.8,100,,,fee schedule,100% of CO APG rates,192.66,95,,,percent of total billed charges,95% of total billed charges,162.24,80,,,percent of total billed charges,80% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,182.52,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,81.12,40,,,percent of total billed charges,40% of total billed charges,81.12,40,,,percent of total billed charges,40% of total billed charges,182.52,90,,,percent of total billed charges,90% of total billed charges,154.13,76,,,percent of total billed charges,76% of total billed charges,81.12,40,,,percent of total billed charges,40% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,162.24,80,,,percent of total billed charges,80% of total billed charges,78.69,38.8,,,percent of total billed charges,38.8% of total billed charges,172.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,78.69,217.66,
36591 SPECIMEN COLL VIA CATH,31036591,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,368.2,294.56,,276.15,75,,,percent of total billed charges,75% of total billed charges,147.28,40,,,percent of total billed charges,40% of total billed charges,291.61,79.2,,,percent of total billed charges,79.2% of total billed charges,312.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,349.79,95,,,percent of total billed charges,95% of total billed charges,294.56,80,,,percent of total billed charges,80% of total billed charges,312.97,85,,,percent of total billed charges,85% of total billed charges,331.38,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,147.28,40,,,percent of total billed charges,40% of total billed charges,147.28,40,,,percent of total billed charges,40% of total billed charges,331.38,90,,,percent of total billed charges,90% of total billed charges,279.83,76,,,percent of total billed charges,76% of total billed charges,147.28,40,,,percent of total billed charges,40% of total billed charges,312.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,294.56,80,,,percent of total billed charges,80% of total billed charges,142.86,38.8,,,percent of total billed charges,38.8% of total billed charges,312.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,142.86,349.79,
36600 ARTERIAL BLOOD DRAW,31036600,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,120.9,96.72,,90.68,75,,,percent of total billed charges,75% of total billed charges,48.36,40,,,percent of total billed charges,40% of total billed charges,95.75,79.2,,,percent of total billed charges,79.2% of total billed charges,102.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,114.86,95,,,percent of total billed charges,95% of total billed charges,96.72,80,,,percent of total billed charges,80% of total billed charges,102.77,85,,,percent of total billed charges,85% of total billed charges,108.81,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,48.36,40,,,percent of total billed charges,40% of total billed charges,48.36,40,,,percent of total billed charges,40% of total billed charges,108.81,90,,,percent of total billed charges,90% of total billed charges,91.88,76,,,percent of total billed charges,76% of total billed charges,48.36,40,,,percent of total billed charges,40% of total billed charges,102.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,96.72,80,,,percent of total billed charges,80% of total billed charges,46.91,38.8,,,percent of total billed charges,38.8% of total billed charges,102.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,114.86,
36680 PLCNEEDLE BONE INFUSION,31036680,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,976.6,781.28,,732.45,75,,,percent of total billed charges,75% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,773.47,79.2,,,percent of total billed charges,79.2% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,927.77,95,,,percent of total billed charges,95% of total billed charges,781.28,80,,,percent of total billed charges,80% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,878.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,390.64,40,,,percent of total billed charges,40% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,878.94,90,,,percent of total billed charges,90% of total billed charges,742.22,76,,,percent of total billed charges,76% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,781.28,80,,,percent of total billed charges,80% of total billed charges,378.92,38.8,,,percent of total billed charges,38.8% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,927.77,
40830 REPAIR MOUTH LACERATION,31040830,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,655.2,524.16,,491.4,75,,,percent of total billed charges,75% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,518.92,79.2,,,percent of total billed charges,79.2% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,622.44,95,,,percent of total billed charges,95% of total billed charges,524.16,80,,,percent of total billed charges,80% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,589.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,262.08,40,,,percent of total billed charges,40% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,589.68,90,,,percent of total billed charges,90% of total billed charges,497.95,76,,,percent of total billed charges,76% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,524.16,80,,,percent of total billed charges,80% of total billed charges,254.22,38.8,,,percent of total billed charges,38.8% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,622.44,
41250 REPAIR TONGUE LACERATN,31041250,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,976.6,781.28,,732.45,75,,,percent of total billed charges,75% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,773.47,79.2,,,percent of total billed charges,79.2% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,927.77,95,,,percent of total billed charges,95% of total billed charges,781.28,80,,,percent of total billed charges,80% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,878.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,390.64,40,,,percent of total billed charges,40% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,878.94,90,,,percent of total billed charges,90% of total billed charges,742.22,76,,,percent of total billed charges,76% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,781.28,80,,,percent of total billed charges,80% of total billed charges,378.92,38.8,,,percent of total billed charges,38.8% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,927.77,
41800 DRAINAGE OF GUM LESION,31041800,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,370.2,296.16,,277.65,75,,,percent of total billed charges,75% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,293.2,79.2,,,percent of total billed charges,79.2% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,351.69,95,,,percent of total billed charges,95% of total billed charges,296.16,80,,,percent of total billed charges,80% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,148.08,40,,,percent of total billed charges,40% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,281.35,76,,,percent of total billed charges,76% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,296.16,80,,,percent of total billed charges,80% of total billed charges,143.64,38.8,,,percent of total billed charges,38.8% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,143.64,351.69,
"42960 CONTROL HEMORRHAGE, ORAL",31042960,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,655.2,524.16,,491.4,75,,,percent of total billed charges,75% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,518.92,79.2,,,percent of total billed charges,79.2% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,622.44,95,,,percent of total billed charges,95% of total billed charges,524.16,80,,,percent of total billed charges,80% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,589.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,262.08,40,,,percent of total billed charges,40% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,589.68,90,,,percent of total billed charges,90% of total billed charges,497.95,76,,,percent of total billed charges,76% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,524.16,80,,,percent of total billed charges,80% of total billed charges,254.22,38.8,,,percent of total billed charges,38.8% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,622.44,
43753 Gastric Intubation  Aspi,31043753,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,861.1,688.88,,645.83,75,,,percent of total billed charges,75% of total billed charges,344.44,40,,,percent of total billed charges,40% of total billed charges,681.99,79.2,,,percent of total billed charges,79.2% of total billed charges,731.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,818.05,95,,,percent of total billed charges,95% of total billed charges,688.88,80,,,percent of total billed charges,80% of total billed charges,731.94,85,,,percent of total billed charges,85% of total billed charges,774.99,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,344.44,40,,,percent of total billed charges,40% of total billed charges,344.44,40,,,percent of total billed charges,40% of total billed charges,774.99,90,,,percent of total billed charges,90% of total billed charges,654.44,76,,,percent of total billed charges,76% of total billed charges,344.44,40,,,percent of total billed charges,40% of total billed charges,731.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,688.88,80,,,percent of total billed charges,80% of total billed charges,334.11,38.8,,,percent of total billed charges,38.8% of total billed charges,731.94,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,818.05,
46083 INCISION THROMB XT HEMORR,31046083,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,846.6,677.28,,634.95,75,,,percent of total billed charges,75% of total billed charges,338.64,40,,,percent of total billed charges,40% of total billed charges,670.51,79.2,,,percent of total billed charges,79.2% of total billed charges,719.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,804.27,95,,,percent of total billed charges,95% of total billed charges,677.28,80,,,percent of total billed charges,80% of total billed charges,719.61,85,,,percent of total billed charges,85% of total billed charges,761.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,338.64,40,,,percent of total billed charges,40% of total billed charges,338.64,40,,,percent of total billed charges,40% of total billed charges,761.94,90,,,percent of total billed charges,90% of total billed charges,643.42,76,,,percent of total billed charges,76% of total billed charges,338.64,40,,,percent of total billed charges,40% of total billed charges,719.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,677.28,80,,,percent of total billed charges,80% of total billed charges,328.48,38.8,,,percent of total billed charges,38.8% of total billed charges,719.61,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,804.27,
"51703 Cath Insertion, Complicat",31051703,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,470.1,376.08,,352.58,75,,,percent of total billed charges,75% of total billed charges,188.04,40,,,percent of total billed charges,40% of total billed charges,372.32,79.2,,,percent of total billed charges,79.2% of total billed charges,399.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,446.6,95,,,percent of total billed charges,95% of total billed charges,376.08,80,,,percent of total billed charges,80% of total billed charges,399.59,85,,,percent of total billed charges,85% of total billed charges,423.09,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,188.04,40,,,percent of total billed charges,40% of total billed charges,188.04,40,,,percent of total billed charges,40% of total billed charges,423.09,90,,,percent of total billed charges,90% of total billed charges,357.28,76,,,percent of total billed charges,76% of total billed charges,188.04,40,,,percent of total billed charges,40% of total billed charges,399.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,376.08,80,,,percent of total billed charges,80% of total billed charges,182.4,38.8,,,percent of total billed charges,38.8% of total billed charges,399.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,446.6,
54220 - Irrigation of corpora cavernosa for priapism,31054220,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,800.8,640.64,,600.6,75,,,percent of total billed charges,75% of total billed charges,320.32,40,,,percent of total billed charges,40% of total billed charges,634.23,79.2,,,percent of total billed charges,79.2% of total billed charges,680.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,760.76,95,,,percent of total billed charges,95% of total billed charges,640.64,80,,,percent of total billed charges,80% of total billed charges,680.68,85,,,percent of total billed charges,85% of total billed charges,720.72,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,320.32,40,,,percent of total billed charges,40% of total billed charges,320.32,40,,,percent of total billed charges,40% of total billed charges,720.72,90,,,percent of total billed charges,90% of total billed charges,608.61,76,,,percent of total billed charges,76% of total billed charges,320.32,40,,,percent of total billed charges,40% of total billed charges,680.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,640.64,80,,,percent of total billed charges,80% of total billed charges,310.71,38.8,,,percent of total billed charges,38.8% of total billed charges,680.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,760.76,
56420 DRAINAGE OF GLAND ABSCESS,31056420,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,564.7,451.76,,423.53,75,,,percent of total billed charges,75% of total billed charges,225.88,40,,,percent of total billed charges,40% of total billed charges,447.24,79.2,,,percent of total billed charges,79.2% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,536.47,95,,,percent of total billed charges,95% of total billed charges,451.76,80,,,percent of total billed charges,80% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,508.23,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,225.88,40,,,percent of total billed charges,40% of total billed charges,225.88,40,,,percent of total billed charges,40% of total billed charges,508.23,90,,,percent of total billed charges,90% of total billed charges,429.17,76,,,percent of total billed charges,76% of total billed charges,225.88,40,,,percent of total billed charges,40% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,451.76,80,,,percent of total billed charges,80% of total billed charges,219.1,38.8,,,percent of total billed charges,38.8% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,536.47,
59409 DELIVERY,31059409,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,7727.2,6181.76,,5795.4,75,,,percent of total billed charges,75% of total billed charges,3090.88,40,,,percent of total billed charges,40% of total billed charges,6119.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6568.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,7340.84,95,,,percent of total billed charges,95% of total billed charges,6181.76,80,,,percent of total billed charges,80% of total billed charges,6568.12,85,,,percent of total billed charges,85% of total billed charges,6954.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,3886.17,100,,,fee schedule,100% of NM APC rate,3090.88,40,,,percent of total billed charges,40% of total billed charges,3090.88,40,,,percent of total billed charges,40% of total billed charges,6954.48,90,,,percent of total billed charges,90% of total billed charges,5872.67,76,,,percent of total billed charges,76% of total billed charges,3090.88,40,,,percent of total billed charges,40% of total billed charges,6568.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,6181.76,80,,,percent of total billed charges,80% of total billed charges,2998.15,38.8,,,percent of total billed charges,38.8% of total billed charges,6568.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,215.49,7340.84,
59414 DELIVERY OF PLACENTA,31059414,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,7727.2,6181.76,,5795.4,75,,,percent of total billed charges,75% of total billed charges,3090.88,40,,,percent of total billed charges,40% of total billed charges,6119.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6568.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,7340.84,95,,,percent of total billed charges,95% of total billed charges,6181.76,80,,,percent of total billed charges,80% of total billed charges,6568.12,85,,,percent of total billed charges,85% of total billed charges,6954.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,3886.17,100,,,fee schedule,100% of NM APC rate,3090.88,40,,,percent of total billed charges,40% of total billed charges,3090.88,40,,,percent of total billed charges,40% of total billed charges,6954.48,90,,,percent of total billed charges,90% of total billed charges,5872.67,76,,,percent of total billed charges,76% of total billed charges,3090.88,40,,,percent of total billed charges,40% of total billed charges,6568.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,6181.76,80,,,percent of total billed charges,80% of total billed charges,2998.15,38.8,,,percent of total billed charges,38.8% of total billed charges,6568.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,215.49,7340.84,
65205 REM FB EYE CONJUNC SUPERF,31065205,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,370.2,296.16,,277.65,75,,,percent of total billed charges,75% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,293.2,79.2,,,percent of total billed charges,79.2% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,351.69,95,,,percent of total billed charges,95% of total billed charges,296.16,80,,,percent of total billed charges,80% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,148.08,40,,,percent of total billed charges,40% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,281.35,76,,,percent of total billed charges,76% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,296.16,80,,,percent of total billed charges,80% of total billed charges,143.64,38.8,,,percent of total billed charges,38.8% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,143.64,351.69,
65210 REM FB CONJ EMBEDDED LT,31065210,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,976.6,781.28,,732.45,75,,,percent of total billed charges,75% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,773.47,79.2,,,percent of total billed charges,79.2% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,927.77,95,,,percent of total billed charges,95% of total billed charges,781.28,80,,,percent of total billed charges,80% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,878.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,390.64,40,,,percent of total billed charges,40% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,878.94,90,,,percent of total billed charges,90% of total billed charges,742.22,76,,,percent of total billed charges,76% of total billed charges,390.64,40,,,percent of total billed charges,40% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,781.28,80,,,percent of total billed charges,80% of total billed charges,378.92,38.8,,,percent of total billed charges,38.8% of total billed charges,830.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,927.77,
65220 REM FB CORNEAL W/O SLIT LAMP,31065220,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,172.6,138.08,,129.45,75,,,percent of total billed charges,75% of total billed charges,69.04,40,,,percent of total billed charges,40% of total billed charges,136.7,79.2,,,percent of total billed charges,79.2% of total billed charges,146.71,85,,,percent of total billed charges,85% of total billed charges,172.6,100,,,fee schedule,100% of CO APG rates,163.97,95,,,percent of total billed charges,95% of total billed charges,138.08,80,,,percent of total billed charges,80% of total billed charges,146.71,85,,,percent of total billed charges,85% of total billed charges,155.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,172.6,100,,,fee schedule,100% of NM APC rate,69.04,40,,,percent of total billed charges,40% of total billed charges,69.04,40,,,percent of total billed charges,40% of total billed charges,155.34,90,,,percent of total billed charges,90% of total billed charges,131.18,76,,,percent of total billed charges,76% of total billed charges,69.04,40,,,percent of total billed charges,40% of total billed charges,146.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,138.08,80,,,percent of total billed charges,80% of total billed charges,66.97,38.8,,,percent of total billed charges,38.8% of total billed charges,146.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,66.97,217.66,
65222 REM FB CORNEAL W/SLIT LAM,31065222,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,370.2,296.16,,277.65,75,,,percent of total billed charges,75% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,293.2,79.2,,,percent of total billed charges,79.2% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,351.69,95,,,percent of total billed charges,95% of total billed charges,296.16,80,,,percent of total billed charges,80% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,148.08,40,,,percent of total billed charges,40% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,281.35,76,,,percent of total billed charges,76% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,296.16,80,,,percent of total billed charges,80% of total billed charges,143.64,38.8,,,percent of total billed charges,38.8% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,143.64,351.69,
92950 CARDIOPULMONARY RESUSCITA,31092950,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1173.1,938.48,,879.83,75,,,percent of total billed charges,75% of total billed charges,469.24,40,,,percent of total billed charges,40% of total billed charges,929.1,79.2,,,percent of total billed charges,79.2% of total billed charges,997.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1114.45,95,,,percent of total billed charges,95% of total billed charges,938.48,80,,,percent of total billed charges,80% of total billed charges,997.14,85,,,percent of total billed charges,85% of total billed charges,1055.79,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,469.24,40,,,percent of total billed charges,40% of total billed charges,469.24,40,,,percent of total billed charges,40% of total billed charges,1055.79,90,,,percent of total billed charges,90% of total billed charges,891.56,76,,,percent of total billed charges,76% of total billed charges,469.24,40,,,percent of total billed charges,40% of total billed charges,997.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,938.48,80,,,percent of total billed charges,80% of total billed charges,455.16,38.8,,,percent of total billed charges,38.8% of total billed charges,997.14,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1114.45,
"92960 Cardioversion, elective, electrical conversion of arrh",46092960,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1852.2,1481.76,,1389.15,75,,,percent of total billed charges,75% of total billed charges,740.88,40,,,percent of total billed charges,40% of total billed charges,1466.94,79.2,,,percent of total billed charges,79.2% of total billed charges,1574.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1759.59,95,,,percent of total billed charges,95% of total billed charges,1481.76,80,,,percent of total billed charges,80% of total billed charges,1574.37,85,,,percent of total billed charges,85% of total billed charges,1666.98,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,740.88,40,,,percent of total billed charges,40% of total billed charges,740.88,40,,,percent of total billed charges,40% of total billed charges,1666.98,90,,,percent of total billed charges,90% of total billed charges,1407.67,76,,,percent of total billed charges,76% of total billed charges,740.88,40,,,percent of total billed charges,40% of total billed charges,1574.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1481.76,80,,,percent of total billed charges,80% of total billed charges,718.65,38.8,,,percent of total billed charges,38.8% of total billed charges,1574.37,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1759.59,
96360 IV Therapy Hydration - First Hour ED,31096360,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,282.8,226.24,,212.1,75,,,percent of total billed charges,75% of total billed charges,113.12,40,,,percent of total billed charges,40% of total billed charges,223.98,79.2,,,percent of total billed charges,79.2% of total billed charges,240.38,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,268.66,95,,,percent of total billed charges,95% of total billed charges,226.24,80,,,percent of total billed charges,80% of total billed charges,240.38,85,,,percent of total billed charges,85% of total billed charges,254.52,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,113.12,40,,,percent of total billed charges,40% of total billed charges,113.12,40,,,percent of total billed charges,40% of total billed charges,254.52,90,,,percent of total billed charges,90% of total billed charges,214.93,76,,,percent of total billed charges,76% of total billed charges,113.12,40,,,percent of total billed charges,40% of total billed charges,240.38,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,226.24,80,,,percent of total billed charges,80% of total billed charges,109.73,38.8,,,percent of total billed charges,38.8% of total billed charges,240.38,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,268.66,
96361 ED INFU-HYDRA EA ADDL HR,31096361,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,120.5,96.4,,90.38,75,,,percent of total billed charges,75% of total billed charges,48.2,40,,,percent of total billed charges,40% of total billed charges,95.44,79.2,,,percent of total billed charges,79.2% of total billed charges,102.43,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,114.48,95,,,percent of total billed charges,95% of total billed charges,96.4,80,,,percent of total billed charges,80% of total billed charges,102.43,85,,,percent of total billed charges,85% of total billed charges,108.45,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,48.2,40,,,percent of total billed charges,40% of total billed charges,48.2,40,,,percent of total billed charges,40% of total billed charges,108.45,90,,,percent of total billed charges,90% of total billed charges,91.58,76,,,percent of total billed charges,76% of total billed charges,48.2,40,,,percent of total billed charges,40% of total billed charges,102.43,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,96.4,80,,,percent of total billed charges,80% of total billed charges,46.75,38.8,,,percent of total billed charges,38.8% of total billed charges,102.43,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,46.75,116.11,
96365 ED IV INF INIT UP TO 1 HR,31096365,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,305.9,244.72,,229.43,75,,,percent of total billed charges,75% of total billed charges,122.36,40,,,percent of total billed charges,40% of total billed charges,242.27,79.2,,,percent of total billed charges,79.2% of total billed charges,260.02,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,290.61,95,,,percent of total billed charges,95% of total billed charges,244.72,80,,,percent of total billed charges,80% of total billed charges,260.02,85,,,percent of total billed charges,85% of total billed charges,275.31,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,122.36,40,,,percent of total billed charges,40% of total billed charges,122.36,40,,,percent of total billed charges,40% of total billed charges,275.31,90,,,percent of total billed charges,90% of total billed charges,232.48,76,,,percent of total billed charges,76% of total billed charges,122.36,40,,,percent of total billed charges,40% of total billed charges,260.02,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,244.72,80,,,percent of total billed charges,80% of total billed charges,118.69,38.8,,,percent of total billed charges,38.8% of total billed charges,260.02,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,290.61,
96366 ED THERA-INF EA ADDL HR,31096366,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,83.2,66.56,,62.4,75,,,percent of total billed charges,75% of total billed charges,33.28,40,,,percent of total billed charges,40% of total billed charges,65.89,79.2,,,percent of total billed charges,79.2% of total billed charges,70.72,85,,,percent of total billed charges,85% of total billed charges,83.2,100,,,fee schedule,100% of CO APG rates,79.04,95,,,percent of total billed charges,95% of total billed charges,66.56,80,,,percent of total billed charges,80% of total billed charges,70.72,85,,,percent of total billed charges,85% of total billed charges,74.88,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,83.2,100,,,fee schedule,100% of NM APC rate,33.28,40,,,percent of total billed charges,40% of total billed charges,33.28,40,,,percent of total billed charges,40% of total billed charges,74.88,90,,,percent of total billed charges,90% of total billed charges,63.23,76,,,percent of total billed charges,76% of total billed charges,33.28,40,,,percent of total billed charges,40% of total billed charges,70.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,66.56,80,,,percent of total billed charges,80% of total billed charges,32.28,38.8,,,percent of total billed charges,38.8% of total billed charges,70.72,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,166.4,200,,,fee schedule,200% of CMS fee schedule,32.28,215.49,
96367 ED ADDL SEQ INF UP TO 1HR,31096367,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,223.6,178.88,,167.7,75,,,percent of total billed charges,75% of total billed charges,89.44,40,,,percent of total billed charges,40% of total billed charges,177.09,79.2,,,percent of total billed charges,79.2% of total billed charges,190.06,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,212.42,95,,,percent of total billed charges,95% of total billed charges,178.88,80,,,percent of total billed charges,80% of total billed charges,190.06,85,,,percent of total billed charges,85% of total billed charges,201.24,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,89.44,40,,,percent of total billed charges,40% of total billed charges,89.44,40,,,percent of total billed charges,40% of total billed charges,201.24,90,,,percent of total billed charges,90% of total billed charges,169.94,76,,,percent of total billed charges,76% of total billed charges,89.44,40,,,percent of total billed charges,40% of total billed charges,190.06,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,178.88,80,,,percent of total billed charges,80% of total billed charges,86.76,38.8,,,percent of total billed charges,38.8% of total billed charges,190.06,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,212.42,
96369 EDSQINF 2-IHR SET^+ESTAB,31096369,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,464.9,371.92,,348.68,75,,,percent of total billed charges,75% of total billed charges,185.96,40,,,percent of total billed charges,40% of total billed charges,368.2,79.2,,,percent of total billed charges,79.2% of total billed charges,395.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,441.66,95,,,percent of total billed charges,95% of total billed charges,371.92,80,,,percent of total billed charges,80% of total billed charges,395.17,85,,,percent of total billed charges,85% of total billed charges,418.41,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,185.96,40,,,percent of total billed charges,40% of total billed charges,185.96,40,,,percent of total billed charges,40% of total billed charges,418.41,90,,,percent of total billed charges,90% of total billed charges,353.32,76,,,percent of total billed charges,76% of total billed charges,185.96,40,,,percent of total billed charges,40% of total billed charges,395.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,371.92,80,,,percent of total billed charges,80% of total billed charges,180.38,38.8,,,percent of total billed charges,38.8% of total billed charges,395.17,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.38,441.66,
96370 ED SQ INF EA ADD'L HR,31096370,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,123.8,99.04,,92.85,75,,,percent of total billed charges,75% of total billed charges,49.52,40,,,percent of total billed charges,40% of total billed charges,98.05,79.2,,,percent of total billed charges,79.2% of total billed charges,105.23,85,,,percent of total billed charges,85% of total billed charges,123.8,100,,,fee schedule,100% of CO APG rates,117.61,95,,,percent of total billed charges,95% of total billed charges,99.04,80,,,percent of total billed charges,80% of total billed charges,105.23,85,,,percent of total billed charges,85% of total billed charges,111.42,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,123.8,100,,,fee schedule,100% of NM APC rate,49.52,40,,,percent of total billed charges,40% of total billed charges,49.52,40,,,percent of total billed charges,40% of total billed charges,111.42,90,,,percent of total billed charges,90% of total billed charges,94.09,76,,,percent of total billed charges,76% of total billed charges,49.52,40,,,percent of total billed charges,40% of total billed charges,105.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,99.04,80,,,percent of total billed charges,80% of total billed charges,48.03,38.8,,,percent of total billed charges,38.8% of total billed charges,105.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,48.03,217.66,
96374 ED IV PUSH SINGL OR INITI,31096374,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,265.3,212.24,,198.98,75,,,percent of total billed charges,75% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,210.12,79.2,,,percent of total billed charges,79.2% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,252.04,95,,,percent of total billed charges,95% of total billed charges,212.24,80,,,percent of total billed charges,80% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,106.12,40,,,percent of total billed charges,40% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,201.63,76,,,percent of total billed charges,76% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,212.24,80,,,percent of total billed charges,80% of total billed charges,102.94,38.8,,,percent of total billed charges,38.8% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,252.04,
96375 ED ADD' SEQ IV PUSH NEW S,31096375,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,108.9,87.12,,81.68,75,,,percent of total billed charges,75% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,86.25,79.2,,,percent of total billed charges,79.2% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,103.46,95,,,percent of total billed charges,95% of total billed charges,87.12,80,,,percent of total billed charges,80% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,98.01,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,108.9,100,,,fee schedule,100% of NM APC rate,43.56,40,,,percent of total billed charges,40% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,98.01,90,,,percent of total billed charges,90% of total billed charges,82.76,76,,,percent of total billed charges,76% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,87.12,80,,,percent of total billed charges,80% of total billed charges,42.25,38.8,,,percent of total billed charges,38.8% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,42.25,108.9,
96376 ED ADL SEQIV PUSH S/MED,31096376,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,108.9,87.12,,81.68,75,,,percent of total billed charges,75% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,86.25,79.2,,,percent of total billed charges,79.2% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,103.46,95,,,percent of total billed charges,95% of total billed charges,87.12,80,,,percent of total billed charges,80% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,98.01,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,108.9,100,,,fee schedule,100% of NM APC rate,43.56,40,,,percent of total billed charges,40% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,98.01,90,,,percent of total billed charges,90% of total billed charges,82.76,76,,,percent of total billed charges,76% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,87.12,80,,,percent of total billed charges,80% of total billed charges,42.25,38.8,,,percent of total billed charges,38.8% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,42.25,108.9,
A0425 Ground Mileage,49000003,CDM,540,RC,,,OUTPATIENT,,,2.94,2.352,,2.21,75,,,percent of total billed charges,75% of total billed charges,1.18,40,,,percent of total billed charges,40% of total billed charges,2.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2.5,85,,,percent of total billed charges,85% of total billed charges,2.94,100,,,fee schedule,100% of CO APG rates,2.79,95,,,percent of total billed charges,95% of total billed charges,2.5,80,,,percent of total billed charges,80% of total billed charges,2.5,85,,,percent of total billed charges,85% of total billed charges,2.65,90,,,percent of total billed charges,90% of total billed charges,2.94,100,,,fee schedule,100% of CO APG rates,2.94,100,,,fee schedule,100% of CO APG rates,2.94,100,,,fee schedule,100% of NM fee schedule,1.18,40,,,percent of total billed charges,40% of total billed charges,1.18,40,,,percent of total billed charges,40% of total billed charges,2.65,90,,,percent of total billed charges,90% of total billed charges,2.23,76,,,percent of total billed charges,76% of total billed charges,1.18,40,,,percent of total billed charges,40% of total billed charges,2.5,85,,,percent of total billed charges,85% of total billed charges,2.94,100,,,fee schedule,100% of CO APG rate,2.35,80,,,percent of total billed charges,80% of total billed charges,1.14,38.8,,,percent of total billed charges,38.8% of total billed charges,2.5,85,,,percent of total billed charges,85% of total billed charges,2.94,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1.14,2.94,
A0426 Ambulance ALS1,49000006,CDM,540,RC,,,OUTPATIENT,,,2037,1629.6,,1527.75,75,,,percent of total billed charges,75% of total billed charges,814.8,40,,,percent of total billed charges,40% of total billed charges,1613.3,79.2,,,percent of total billed charges,79.2% of total billed charges,1731.45,85,,,percent of total billed charges,85% of total billed charges,2037,100,,,fee schedule,100% of CO APG rates,1935.15,95,,,percent of total billed charges,95% of total billed charges,1731.45,80,,,percent of total billed charges,80% of total billed charges,1731.45,85,,,percent of total billed charges,85% of total billed charges,1833.3,90,,,percent of total billed charges,90% of total billed charges,2037,100,,,fee schedule,100% of CO APG rates,2037,100,,,fee schedule,100% of CO APG rates,2037,100,,,fee schedule,100% of NM fee schedule,814.8,40,,,percent of total billed charges,40% of total billed charges,814.8,40,,,percent of total billed charges,40% of total billed charges,1833.3,90,,,percent of total billed charges,90% of total billed charges,1548.12,76,,,percent of total billed charges,76% of total billed charges,814.8,40,,,percent of total billed charges,40% of total billed charges,1731.45,85,,,percent of total billed charges,85% of total billed charges,2037,100,,,fee schedule,100% of CO APG rate,1629.6,80,,,percent of total billed charges,80% of total billed charges,790.36,38.8,,,percent of total billed charges,38.8% of total billed charges,1731.45,85,,,percent of total billed charges,85% of total billed charges,2037,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,790.36,2037,
A0427 Ambulance Svc-ALS1 E,49000001,CDM,540,RC,,,OUTPATIENT,,,2037,1629.6,,1527.75,75,,,percent of total billed charges,75% of total billed charges,814.8,40,,,percent of total billed charges,40% of total billed charges,1613.3,79.2,,,percent of total billed charges,79.2% of total billed charges,1731.45,85,,,percent of total billed charges,85% of total billed charges,2037,100,,,fee schedule,100% of CO APG rates,1935.15,95,,,percent of total billed charges,95% of total billed charges,1731.45,80,,,percent of total billed charges,80% of total billed charges,1731.45,85,,,percent of total billed charges,85% of total billed charges,1833.3,90,,,percent of total billed charges,90% of total billed charges,2037,100,,,fee schedule,100% of CO APG rates,2037,100,,,fee schedule,100% of CO APG rates,2037,100,,,fee schedule,100% of NM fee schedule,814.8,40,,,percent of total billed charges,40% of total billed charges,814.8,40,,,percent of total billed charges,40% of total billed charges,1833.3,90,,,percent of total billed charges,90% of total billed charges,1548.12,76,,,percent of total billed charges,76% of total billed charges,814.8,40,,,percent of total billed charges,40% of total billed charges,1731.45,85,,,percent of total billed charges,85% of total billed charges,2037,100,,,fee schedule,100% of CO APG rate,1629.6,80,,,percent of total billed charges,80% of total billed charges,790.36,38.8,,,percent of total billed charges,38.8% of total billed charges,1731.45,85,,,percent of total billed charges,85% of total billed charges,2037,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,790.36,2037,
A0428 Ambulance Base Chg-BLS,49000004,CDM,540,RC,,,OUTPATIENT,,,1853,1482.4,,1389.75,75,,,percent of total billed charges,75% of total billed charges,741.2,40,,,percent of total billed charges,40% of total billed charges,1467.58,79.2,,,percent of total billed charges,79.2% of total billed charges,1575.05,85,,,percent of total billed charges,85% of total billed charges,1853,100,,,fee schedule,100% of CO APG rates,1760.35,95,,,percent of total billed charges,95% of total billed charges,1575.05,80,,,percent of total billed charges,80% of total billed charges,1575.05,85,,,percent of total billed charges,85% of total billed charges,1667.7,90,,,percent of total billed charges,90% of total billed charges,1853,100,,,fee schedule,100% of CO APG rates,1853,100,,,fee schedule,100% of CO APG rates,1853,100,,,fee schedule,100% of NM fee schedule,741.2,40,,,percent of total billed charges,40% of total billed charges,741.2,40,,,percent of total billed charges,40% of total billed charges,1667.7,90,,,percent of total billed charges,90% of total billed charges,1408.28,76,,,percent of total billed charges,76% of total billed charges,741.2,40,,,percent of total billed charges,40% of total billed charges,1575.05,85,,,percent of total billed charges,85% of total billed charges,1853,100,,,fee schedule,100% of CO APG rate,1482.4,80,,,percent of total billed charges,80% of total billed charges,718.96,38.8,,,percent of total billed charges,38.8% of total billed charges,1575.05,85,,,percent of total billed charges,85% of total billed charges,1853,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,718.96,1853,
A0429 Ambulance Base BLS Emerg,49000005,CDM,540,RC,,,OUTPATIENT,,,1927,1541.6,,1445.25,75,,,percent of total billed charges,75% of total billed charges,770.8,40,,,percent of total billed charges,40% of total billed charges,1526.18,79.2,,,percent of total billed charges,79.2% of total billed charges,1637.95,85,,,percent of total billed charges,85% of total billed charges,1927,100,,,fee schedule,100% of CO APG rates,1830.65,95,,,percent of total billed charges,95% of total billed charges,1637.95,80,,,percent of total billed charges,80% of total billed charges,1637.95,85,,,percent of total billed charges,85% of total billed charges,1734.3,90,,,percent of total billed charges,90% of total billed charges,1927,100,,,fee schedule,100% of CO APG rates,1927,100,,,fee schedule,100% of CO APG rates,1927,100,,,fee schedule,100% of NM fee schedule,770.8,40,,,percent of total billed charges,40% of total billed charges,770.8,40,,,percent of total billed charges,40% of total billed charges,1734.3,90,,,percent of total billed charges,90% of total billed charges,1464.52,76,,,percent of total billed charges,76% of total billed charges,770.8,40,,,percent of total billed charges,40% of total billed charges,1637.95,85,,,percent of total billed charges,85% of total billed charges,1927,100,,,fee schedule,100% of CO APG rate,1541.6,80,,,percent of total billed charges,80% of total billed charges,747.68,38.8,,,percent of total billed charges,38.8% of total billed charges,1637.95,85,,,percent of total billed charges,85% of total billed charges,1927,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,747.68,1927,
A0433 Ambulance Svc-ALS2,49000002,CDM,540,RC,,,OUTPATIENT,,,2445,1956,,1833.75,75,,,percent of total billed charges,75% of total billed charges,978,40,,,percent of total billed charges,40% of total billed charges,1936.44,79.2,,,percent of total billed charges,79.2% of total billed charges,2078.25,85,,,percent of total billed charges,85% of total billed charges,2445,100,,,fee schedule,100% of CO APG rates,2322.75,95,,,percent of total billed charges,95% of total billed charges,2078.25,80,,,percent of total billed charges,80% of total billed charges,2078.25,85,,,percent of total billed charges,85% of total billed charges,2200.5,90,,,percent of total billed charges,90% of total billed charges,2445,100,,,fee schedule,100% of CO APG rates,2445,100,,,fee schedule,100% of CO APG rates,2445,100,,,fee schedule,100% of NM fee schedule,978,40,,,percent of total billed charges,40% of total billed charges,978,40,,,percent of total billed charges,40% of total billed charges,2200.5,90,,,percent of total billed charges,90% of total billed charges,1858.2,76,,,percent of total billed charges,76% of total billed charges,978,40,,,percent of total billed charges,40% of total billed charges,2078.25,85,,,percent of total billed charges,85% of total billed charges,2445,100,,,fee schedule,100% of CO APG rate,1956,80,,,percent of total billed charges,80% of total billed charges,948.66,38.8,,,percent of total billed charges,38.8% of total billed charges,2078.25,85,,,percent of total billed charges,85% of total billed charges,2445,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,948.66,2445,
L.E. MEDICAL CLEARANCE SC PMHA,31000007,CDM,459,RC,,,OUTPATIENT,,,222.8,178.24,,167.1,75,,,percent of total billed charges,75% of total billed charges,89.12,40,,,percent of total billed charges,40% of total billed charges,176.46,79.2,,,percent of total billed charges,79.2% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,222.8,100,,,fee schedule,100% of CO APG rates,211.66,95,,,percent of total billed charges,95% of total billed charges,178.24,80,,,percent of total billed charges,80% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,200.52,90,,,percent of total billed charges,90% of total billed charges,222.8,100,,,fee schedule,100% of CO APG rates,222.8,100,,,fee schedule,100% of CO APG rates,222.8,100,,,fee schedule,100% of NM fee schedule,89.12,40,,,percent of total billed charges,40% of total billed charges,89.12,40,,,percent of total billed charges,40% of total billed charges,200.52,90,,,percent of total billed charges,90% of total billed charges,169.33,76,,,percent of total billed charges,76% of total billed charges,89.12,40,,,percent of total billed charges,40% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,222.8,100,,,fee schedule,100% of CO APG rate,178.24,80,,,percent of total billed charges,80% of total billed charges,86.45,38.8,,,percent of total billed charges,38.8% of total billed charges,189.38,85,,,percent of total billed charges,85% of total billed charges,222.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,86.45,222.8,
SAFE EXAM PMHA,31000008,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,658.7,526.96,,494.03,75,,,percent of total billed charges,75% of total billed charges,263.48,40,,,percent of total billed charges,40% of total billed charges,521.69,79.2,,,percent of total billed charges,79.2% of total billed charges,559.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,625.77,95,,,percent of total billed charges,95% of total billed charges,526.96,80,,,percent of total billed charges,80% of total billed charges,559.9,85,,,percent of total billed charges,85% of total billed charges,592.83,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,263.48,40,,,percent of total billed charges,40% of total billed charges,263.48,40,,,percent of total billed charges,40% of total billed charges,592.83,90,,,percent of total billed charges,90% of total billed charges,500.61,76,,,percent of total billed charges,76% of total billed charges,263.48,40,,,percent of total billed charges,40% of total billed charges,559.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,526.96,80,,,percent of total billed charges,80% of total billed charges,255.58,38.8,,,percent of total billed charges,38.8% of total billed charges,559.9,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,625.77,
"Culture, bacterial; aerobic isolate, additional methods requ",40087077,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,58.3,46.64,,43.73,75,,,percent of total billed charges,75% of total billed charges,23.32,40,,,percent of total billed charges,40% of total billed charges,46.17,79.2,,,percent of total billed charges,79.2% of total billed charges,49.56,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,55.39,95,,,percent of total billed charges,95% of total billed charges,46.64,80,,,percent of total billed charges,80% of total billed charges,49.56,85,,,percent of total billed charges,85% of total billed charges,52.47,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,23.32,40,,,percent of total billed charges,40% of total billed charges,23.32,40,,,percent of total billed charges,40% of total billed charges,52.47,90,,,percent of total billed charges,90% of total billed charges,44.31,76,,,percent of total billed charges,76% of total billed charges,23.32,40,,,percent of total billed charges,40% of total billed charges,49.56,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,46.64,80,,,percent of total billed charges,80% of total billed charges,22.62,38.8,,,percent of total billed charges,38.8% of total billed charges,49.56,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,55.39,
Speech Fluency Eval,42692521,CDM,444,RC,96105,HCPCS,OUTPATIENT,,,399.4,319.52,GN,299.55,75,,,percent of total billed charges,75% of total billed charges,159.76,40,,,percent of total billed charges,40% of total billed charges,316.32,79.2,,,percent of total billed charges,79.2% of total billed charges,339.49,85,,,percent of total billed charges,85% of total billed charges,399.4,100,,,fee schedule,100% of CO APG rates,379.43,95,,,percent of total billed charges,95% of total billed charges,319.52,80,,,percent of total billed charges,80% of total billed charges,339.49,85,,,percent of total billed charges,85% of total billed charges,359.46,90,,,percent of total billed charges,90% of total billed charges,763.08,100,,,fee schedule,100% of CO APG rates,763.08,100,,,fee schedule,100% of CO APG rates,58.84,100,,,fee schedule,100% of NM fee schedule,159.76,40,,,percent of total billed charges,40% of total billed charges,159.76,40,,,percent of total billed charges,40% of total billed charges,359.46,90,,,percent of total billed charges,90% of total billed charges,303.54,76,,,percent of total billed charges,76% of total billed charges,159.76,40,,,percent of total billed charges,40% of total billed charges,339.49,85,,,percent of total billed charges,85% of total billed charges,763.08,100,,,fee schedule,100% of CO APG rate,319.52,80,,,percent of total billed charges,80% of total billed charges,154.97,38.8,,,percent of total billed charges,38.8% of total billed charges,339.49,85,,,percent of total billed charges,85% of total billed charges,763.08,100,,,fee schedule,100% of APG fee schedule,199.32,200,,,fee schedule,200% of CMS fee schedule,58.84,763.08,
"92522 Evaluation of speech sound production (eg, articulatio",42692522,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,372.3,297.84,GN,279.23,75,,,percent of total billed charges,75% of total billed charges,148.92,40,,,percent of total billed charges,40% of total billed charges,294.86,79.2,,,percent of total billed charges,79.2% of total billed charges,316.46,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,353.69,95,,,percent of total billed charges,95% of total billed charges,297.84,80,,,percent of total billed charges,80% of total billed charges,316.46,85,,,percent of total billed charges,85% of total billed charges,335.07,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,148.92,40,,,percent of total billed charges,40% of total billed charges,148.92,40,,,percent of total billed charges,40% of total billed charges,335.07,90,,,percent of total billed charges,90% of total billed charges,282.95,76,,,percent of total billed charges,76% of total billed charges,148.92,40,,,percent of total billed charges,40% of total billed charges,316.46,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,297.84,80,,,percent of total billed charges,80% of total billed charges,144.45,38.8,,,percent of total billed charges,38.8% of total billed charges,316.46,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,353.69,
92524 Behavioral and qualitative analysis of voice and reson,42692524,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,383.6,306.88,GN,287.7,75,,,percent of total billed charges,75% of total billed charges,153.44,40,,,percent of total billed charges,40% of total billed charges,303.81,79.2,,,percent of total billed charges,79.2% of total billed charges,326.06,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,364.42,95,,,percent of total billed charges,95% of total billed charges,306.88,80,,,percent of total billed charges,80% of total billed charges,326.06,85,,,percent of total billed charges,85% of total billed charges,345.24,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,153.44,40,,,percent of total billed charges,40% of total billed charges,153.44,40,,,percent of total billed charges,40% of total billed charges,345.24,90,,,percent of total billed charges,90% of total billed charges,291.54,76,,,percent of total billed charges,76% of total billed charges,153.44,40,,,percent of total billed charges,40% of total billed charges,326.06,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,306.88,80,,,percent of total billed charges,80% of total billed charges,148.84,38.8,,,percent of total billed charges,38.8% of total billed charges,326.06,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,364.42,
92523 Evaluation of speech sound production; with evaluation,42692523,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,491.6,393.28,GN,368.7,75,,,percent of total billed charges,75% of total billed charges,196.64,40,,,percent of total billed charges,40% of total billed charges,389.35,79.2,,,percent of total billed charges,79.2% of total billed charges,417.86,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,467.02,95,,,percent of total billed charges,95% of total billed charges,393.28,80,,,percent of total billed charges,80% of total billed charges,417.86,85,,,percent of total billed charges,85% of total billed charges,442.44,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,196.64,40,,,percent of total billed charges,40% of total billed charges,196.64,40,,,percent of total billed charges,40% of total billed charges,442.44,90,,,percent of total billed charges,90% of total billed charges,373.62,76,,,percent of total billed charges,76% of total billed charges,196.64,40,,,percent of total billed charges,40% of total billed charges,417.86,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,393.28,80,,,percent of total billed charges,80% of total billed charges,190.74,38.8,,,percent of total billed charges,38.8% of total billed charges,417.86,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,467.02,
Hgb Frac. Profile LC,40021679,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,50.1,40.08,,37.58,75,,,percent of total billed charges,75% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,39.68,79.2,,,percent of total billed charges,79.2% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,47.6,95,,,percent of total billed charges,95% of total billed charges,40.08,80,,,percent of total billed charges,80% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,45.09,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,20.04,40,,,percent of total billed charges,40% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,45.09,90,,,percent of total billed charges,90% of total billed charges,38.08,76,,,percent of total billed charges,76% of total billed charges,20.04,40,,,percent of total billed charges,40% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,40.08,80,,,percent of total billed charges,80% of total billed charges,19.44,38.8,,,percent of total billed charges,38.8% of total billed charges,42.59,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,47.6,
.AChR Modulating Ab LC,40083519,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,313,250.4,,234.75,75,,,percent of total billed charges,75% of total billed charges,125.2,40,,,percent of total billed charges,40% of total billed charges,247.9,79.2,,,percent of total billed charges,79.2% of total billed charges,266.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,297.35,95,,,percent of total billed charges,95% of total billed charges,250.4,80,,,percent of total billed charges,80% of total billed charges,266.05,85,,,percent of total billed charges,85% of total billed charges,281.7,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,125.2,40,,,percent of total billed charges,40% of total billed charges,125.2,40,,,percent of total billed charges,40% of total billed charges,281.7,90,,,percent of total billed charges,90% of total billed charges,237.88,76,,,percent of total billed charges,76% of total billed charges,125.2,40,,,percent of total billed charges,40% of total billed charges,266.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,250.4,80,,,percent of total billed charges,80% of total billed charges,121.44,38.8,,,percent of total billed charges,38.8% of total billed charges,266.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,297.35,
13153 CMPLX RPR E/N/E/L ADDL 5CM/<,46013153,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,683.3,546.64,,512.48,75,,,percent of total billed charges,75% of total billed charges,273.32,40,,,percent of total billed charges,40% of total billed charges,541.17,79.2,,,percent of total billed charges,79.2% of total billed charges,580.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,649.14,95,,,percent of total billed charges,95% of total billed charges,546.64,80,,,percent of total billed charges,80% of total billed charges,580.81,85,,,percent of total billed charges,85% of total billed charges,614.97,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,273.32,40,,,percent of total billed charges,40% of total billed charges,273.32,40,,,percent of total billed charges,40% of total billed charges,614.97,90,,,percent of total billed charges,90% of total billed charges,519.31,76,,,percent of total billed charges,76% of total billed charges,273.32,40,,,percent of total billed charges,40% of total billed charges,580.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,546.64,80,,,percent of total billed charges,80% of total billed charges,265.12,38.8,,,percent of total billed charges,38.8% of total billed charges,580.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,649.14,
28192 REMOV OF FOOT FOREIGN B-D,60000287,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4995.1,3996.08,,3746.33,75,,,percent of total billed charges,75% of total billed charges,1998.04,40,,,percent of total billed charges,40% of total billed charges,3956.12,79.2,,,percent of total billed charges,79.2% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4745.35,95,,,percent of total billed charges,95% of total billed charges,3996.08,80,,,percent of total billed charges,80% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,4495.59,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1998.04,40,,,percent of total billed charges,40% of total billed charges,1998.04,40,,,percent of total billed charges,40% of total billed charges,4495.59,90,,,percent of total billed charges,90% of total billed charges,3796.28,76,,,percent of total billed charges,76% of total billed charges,1998.04,40,,,percent of total billed charges,40% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3996.08,80,,,percent of total billed charges,80% of total billed charges,1938.1,38.8,,,percent of total billed charges,38.8% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4745.35,
28193 REMOV OF FOOT FOREIGN B-C,60000399,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4995.1,3996.08,,3746.33,75,,,percent of total billed charges,75% of total billed charges,1998.04,40,,,percent of total billed charges,40% of total billed charges,3956.12,79.2,,,percent of total billed charges,79.2% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4745.35,95,,,percent of total billed charges,95% of total billed charges,3996.08,80,,,percent of total billed charges,80% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,4495.59,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1998.04,40,,,percent of total billed charges,40% of total billed charges,1998.04,40,,,percent of total billed charges,40% of total billed charges,4495.59,90,,,percent of total billed charges,90% of total billed charges,3796.28,76,,,percent of total billed charges,76% of total billed charges,1998.04,40,,,percent of total billed charges,40% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3996.08,80,,,percent of total billed charges,80% of total billed charges,1938.1,38.8,,,percent of total billed charges,38.8% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4745.35,
36405 BL DRAW <3 YRS SCALP VEIN,60000285,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,86.3,69.04,,64.73,75,,,percent of total billed charges,75% of total billed charges,34.52,40,,,percent of total billed charges,40% of total billed charges,68.35,79.2,,,percent of total billed charges,79.2% of total billed charges,73.36,85,,,percent of total billed charges,85% of total billed charges,86.3,100,,,fee schedule,100% of CO APG rates,81.99,95,,,percent of total billed charges,95% of total billed charges,69.04,80,,,percent of total billed charges,80% of total billed charges,73.36,85,,,percent of total billed charges,85% of total billed charges,77.67,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,86.3,100,,,fee schedule,100% of NM APC rate,34.52,40,,,percent of total billed charges,40% of total billed charges,34.52,40,,,percent of total billed charges,40% of total billed charges,77.67,90,,,percent of total billed charges,90% of total billed charges,65.59,76,,,percent of total billed charges,76% of total billed charges,34.52,40,,,percent of total billed charges,40% of total billed charges,73.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,69.04,80,,,percent of total billed charges,80% of total billed charges,33.48,38.8,,,percent of total billed charges,38.8% of total billed charges,73.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,172.6,200,,,fee schedule,200% of CMS fee schedule,33.48,215.49,
A0434 SPECIALTY CARE TRANSPORT,49000007,CDM,540,RC,,,OUTPATIENT,,,2948,2358.4,,2211,75,,,percent of total billed charges,75% of total billed charges,1179.2,40,,,percent of total billed charges,40% of total billed charges,2334.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2505.8,85,,,percent of total billed charges,85% of total billed charges,2948,100,,,fee schedule,100% of CO APG rates,2800.6,95,,,percent of total billed charges,95% of total billed charges,2505.8,80,,,percent of total billed charges,80% of total billed charges,2505.8,85,,,percent of total billed charges,85% of total billed charges,2653.2,90,,,percent of total billed charges,90% of total billed charges,2948,100,,,fee schedule,100% of CO APG rates,2948,100,,,fee schedule,100% of CO APG rates,2948,100,,,fee schedule,100% of NM fee schedule,1179.2,40,,,percent of total billed charges,40% of total billed charges,1179.2,40,,,percent of total billed charges,40% of total billed charges,2653.2,90,,,percent of total billed charges,90% of total billed charges,2240.48,76,,,percent of total billed charges,76% of total billed charges,1179.2,40,,,percent of total billed charges,40% of total billed charges,2505.8,85,,,percent of total billed charges,85% of total billed charges,2948,100,,,fee schedule,100% of CO APG rate,2358.4,80,,,percent of total billed charges,80% of total billed charges,1143.82,38.8,,,percent of total billed charges,38.8% of total billed charges,2505.8,85,,,percent of total billed charges,85% of total billed charges,2948,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1143.82,2948,
Ammonia Level 1,40082140,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,162.6,130.08,,121.95,75,,,percent of total billed charges,75% of total billed charges,65.04,40,,,percent of total billed charges,40% of total billed charges,128.78,79.2,,,percent of total billed charges,79.2% of total billed charges,138.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,154.47,95,,,percent of total billed charges,95% of total billed charges,130.08,80,,,percent of total billed charges,80% of total billed charges,138.21,85,,,percent of total billed charges,85% of total billed charges,146.34,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,65.04,40,,,percent of total billed charges,40% of total billed charges,65.04,40,,,percent of total billed charges,40% of total billed charges,146.34,90,,,percent of total billed charges,90% of total billed charges,123.58,76,,,percent of total billed charges,76% of total billed charges,65.04,40,,,percent of total billed charges,40% of total billed charges,138.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,130.08,80,,,percent of total billed charges,80% of total billed charges,63.09,38.8,,,percent of total billed charges,38.8% of total billed charges,138.21,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,154.47,
27780 Closed Tx Prox Fibula Clinic Charge,60000061,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,642.7,514.16,,482.03,75,,,percent of total billed charges,75% of total billed charges,257.08,40,,,percent of total billed charges,40% of total billed charges,509.02,79.2,,,percent of total billed charges,79.2% of total billed charges,546.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,610.57,95,,,percent of total billed charges,95% of total billed charges,514.16,80,,,percent of total billed charges,80% of total billed charges,546.3,85,,,percent of total billed charges,85% of total billed charges,578.43,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,257.08,40,,,percent of total billed charges,40% of total billed charges,257.08,40,,,percent of total billed charges,40% of total billed charges,578.43,90,,,percent of total billed charges,90% of total billed charges,488.45,76,,,percent of total billed charges,76% of total billed charges,257.08,40,,,percent of total billed charges,40% of total billed charges,546.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,514.16,80,,,percent of total billed charges,80% of total billed charges,249.37,38.8,,,percent of total billed charges,38.8% of total billed charges,546.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,610.57,
27808 Closed TX ankle FX w/o Man Clinic Charge,60000063,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
51705 Change of Cystostomy tube; simple,60000094,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,859,687.2,,644.25,75,,,percent of total billed charges,75% of total billed charges,343.6,40,,,percent of total billed charges,40% of total billed charges,680.33,79.2,,,percent of total billed charges,79.2% of total billed charges,730.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,816.05,95,,,percent of total billed charges,95% of total billed charges,687.2,80,,,percent of total billed charges,80% of total billed charges,730.15,85,,,percent of total billed charges,85% of total billed charges,773.1,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,343.6,40,,,percent of total billed charges,40% of total billed charges,343.6,40,,,percent of total billed charges,40% of total billed charges,773.1,90,,,percent of total billed charges,90% of total billed charges,652.84,76,,,percent of total billed charges,76% of total billed charges,343.6,40,,,percent of total billed charges,40% of total billed charges,730.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,687.2,80,,,percent of total billed charges,80% of total billed charges,333.29,38.8,,,percent of total billed charges,38.8% of total billed charges,730.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,816.05,
Lactic Acid,40083605,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,121.2,96.96,,90.9,75,,,percent of total billed charges,75% of total billed charges,48.48,40,,,percent of total billed charges,40% of total billed charges,95.99,79.2,,,percent of total billed charges,79.2% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,115.14,95,,,percent of total billed charges,95% of total billed charges,96.96,80,,,percent of total billed charges,80% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,109.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,48.48,40,,,percent of total billed charges,40% of total billed charges,48.48,40,,,percent of total billed charges,40% of total billed charges,109.08,90,,,percent of total billed charges,90% of total billed charges,92.11,76,,,percent of total billed charges,76% of total billed charges,48.48,40,,,percent of total billed charges,40% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,96.96,80,,,percent of total billed charges,80% of total billed charges,47.03,38.8,,,percent of total billed charges,38.8% of total billed charges,103.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,115.14,
54700 DRAINAGE OF SCROTUM,31054700,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,6282.6,5026.08,,4711.95,75,,,percent of total billed charges,75% of total billed charges,2513.04,40,,,percent of total billed charges,40% of total billed charges,4975.82,79.2,,,percent of total billed charges,79.2% of total billed charges,5340.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,5968.47,95,,,percent of total billed charges,95% of total billed charges,5026.08,80,,,percent of total billed charges,80% of total billed charges,5340.21,85,,,percent of total billed charges,85% of total billed charges,5654.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,3163.87,100,,,fee schedule,100% of NM APC rate,2513.04,40,,,percent of total billed charges,40% of total billed charges,2513.04,40,,,percent of total billed charges,40% of total billed charges,5654.34,90,,,percent of total billed charges,90% of total billed charges,4774.78,76,,,percent of total billed charges,76% of total billed charges,2513.04,40,,,percent of total billed charges,40% of total billed charges,5340.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,5026.08,80,,,percent of total billed charges,80% of total billed charges,2437.65,38.8,,,percent of total billed charges,38.8% of total billed charges,5340.21,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,215.49,5968.47,
20526 - INJ OF CARPAL TUNNEL CHARGE,46020526,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,904.8,723.84,,678.6,75,,,percent of total billed charges,75% of total billed charges,361.92,40,,,percent of total billed charges,40% of total billed charges,716.6,79.2,,,percent of total billed charges,79.2% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,859.56,95,,,percent of total billed charges,95% of total billed charges,723.84,80,,,percent of total billed charges,80% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,814.32,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,361.92,40,,,percent of total billed charges,40% of total billed charges,361.92,40,,,percent of total billed charges,40% of total billed charges,814.32,90,,,percent of total billed charges,90% of total billed charges,687.65,76,,,percent of total billed charges,76% of total billed charges,361.92,40,,,percent of total billed charges,40% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,723.84,80,,,percent of total billed charges,80% of total billed charges,351.06,38.8,,,percent of total billed charges,38.8% of total billed charges,769.08,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,859.56,
24655 Closed Treatment Of Radial Head Or Neck Fracture; With,46024655,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2126.8,1701.44,,1595.1,75,,,percent of total billed charges,75% of total billed charges,850.72,40,,,percent of total billed charges,40% of total billed charges,1684.43,79.2,,,percent of total billed charges,79.2% of total billed charges,1807.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2020.46,95,,,percent of total billed charges,95% of total billed charges,1701.44,80,,,percent of total billed charges,80% of total billed charges,1807.78,85,,,percent of total billed charges,85% of total billed charges,1914.12,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,850.72,40,,,percent of total billed charges,40% of total billed charges,850.72,40,,,percent of total billed charges,40% of total billed charges,1914.12,90,,,percent of total billed charges,90% of total billed charges,1616.37,76,,,percent of total billed charges,76% of total billed charges,850.72,40,,,percent of total billed charges,40% of total billed charges,1807.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1701.44,80,,,percent of total billed charges,80% of total billed charges,825.2,38.8,,,percent of total billed charges,38.8% of total billed charges,1807.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2020.46,
"Pancreatic Elastase, Fecal LC",40082656,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,181.8,145.44,,136.35,75,,,percent of total billed charges,75% of total billed charges,72.72,40,,,percent of total billed charges,40% of total billed charges,143.99,79.2,,,percent of total billed charges,79.2% of total billed charges,154.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,172.71,95,,,percent of total billed charges,95% of total billed charges,145.44,80,,,percent of total billed charges,80% of total billed charges,154.53,85,,,percent of total billed charges,85% of total billed charges,163.62,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,72.72,40,,,percent of total billed charges,40% of total billed charges,72.72,40,,,percent of total billed charges,40% of total billed charges,163.62,90,,,percent of total billed charges,90% of total billed charges,138.17,76,,,percent of total billed charges,76% of total billed charges,72.72,40,,,percent of total billed charges,40% of total billed charges,154.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,145.44,80,,,percent of total billed charges,80% of total billed charges,70.54,38.8,,,percent of total billed charges,38.8% of total billed charges,154.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,172.71,
"Cardiolipin (phospholipid) antibody, each Ig class",40086147,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,134,107.2,,100.5,75,,,percent of total billed charges,75% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,106.13,79.2,,,percent of total billed charges,79.2% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,127.3,95,,,percent of total billed charges,95% of total billed charges,107.2,80,,,percent of total billed charges,80% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,53.6,40,,,percent of total billed charges,40% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,101.84,76,,,percent of total billed charges,76% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,107.2,80,,,percent of total billed charges,80% of total billed charges,51.99,38.8,,,percent of total billed charges,38.8% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,127.3,
.Viral Id Varicella LC,40087254,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,111.7,89.36,,83.78,75,,,percent of total billed charges,75% of total billed charges,44.68,40,,,percent of total billed charges,40% of total billed charges,88.47,79.2,,,percent of total billed charges,79.2% of total billed charges,94.95,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,106.12,95,,,percent of total billed charges,95% of total billed charges,89.36,80,,,percent of total billed charges,80% of total billed charges,94.95,85,,,percent of total billed charges,85% of total billed charges,100.53,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,44.68,40,,,percent of total billed charges,40% of total billed charges,44.68,40,,,percent of total billed charges,40% of total billed charges,100.53,90,,,percent of total billed charges,90% of total billed charges,84.89,76,,,percent of total billed charges,76% of total billed charges,44.68,40,,,percent of total billed charges,40% of total billed charges,94.95,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,89.36,80,,,percent of total billed charges,80% of total billed charges,43.34,38.8,,,percent of total billed charges,38.8% of total billed charges,94.95,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,106.12,
".Thyroglobulin, Serum LC",40069817,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,28.1,22.48,,21.08,75,,,percent of total billed charges,75% of total billed charges,11.24,40,,,percent of total billed charges,40% of total billed charges,22.26,79.2,,,percent of total billed charges,79.2% of total billed charges,23.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,26.7,95,,,percent of total billed charges,95% of total billed charges,22.48,80,,,percent of total billed charges,80% of total billed charges,23.89,85,,,percent of total billed charges,85% of total billed charges,25.29,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,11.24,40,,,percent of total billed charges,40% of total billed charges,11.24,40,,,percent of total billed charges,40% of total billed charges,25.29,90,,,percent of total billed charges,90% of total billed charges,21.36,76,,,percent of total billed charges,76% of total billed charges,11.24,40,,,percent of total billed charges,40% of total billed charges,23.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,22.48,80,,,percent of total billed charges,80% of total billed charges,10.9,38.8,,,percent of total billed charges,38.8% of total billed charges,23.89,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,26.7,
.Thyroglobulin (TG-RIA) LC,40069818,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,113.2,90.56,,84.9,75,,,percent of total billed charges,75% of total billed charges,45.28,40,,,percent of total billed charges,40% of total billed charges,89.65,79.2,,,percent of total billed charges,79.2% of total billed charges,96.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,107.54,95,,,percent of total billed charges,95% of total billed charges,90.56,80,,,percent of total billed charges,80% of total billed charges,96.22,85,,,percent of total billed charges,85% of total billed charges,101.88,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,45.28,40,,,percent of total billed charges,40% of total billed charges,45.28,40,,,percent of total billed charges,40% of total billed charges,101.88,90,,,percent of total billed charges,90% of total billed charges,86.03,76,,,percent of total billed charges,76% of total billed charges,45.28,40,,,percent of total billed charges,40% of total billed charges,96.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,90.56,80,,,percent of total billed charges,80% of total billed charges,43.92,38.8,,,percent of total billed charges,38.8% of total billed charges,96.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,107.54,
Computer DX Mammogram ADD,41577065,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,35.9,28.72,TC,26.93,75,,,percent of total billed charges,75% of total billed charges,14.36,40,,,percent of total billed charges,40% of total billed charges,28.43,79.2,,,percent of total billed charges,79.2% of total billed charges,30.52,85,,,percent of total billed charges,85% of total billed charges,35.9,100,,,fee schedule,100% of CO APG rates,34.11,95,,,percent of total billed charges,95% of total billed charges,28.72,80,,,percent of total billed charges,80% of total billed charges,30.52,85,,,percent of total billed charges,85% of total billed charges,32.31,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,35.9,100,,,fee schedule,100% of NM APC rate,14.36,40,,,percent of total billed charges,40% of total billed charges,14.36,40,,,percent of total billed charges,40% of total billed charges,32.31,90,,,percent of total billed charges,90% of total billed charges,27.28,76,,,percent of total billed charges,76% of total billed charges,14.36,40,,,percent of total billed charges,40% of total billed charges,30.52,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,28.72,80,,,percent of total billed charges,80% of total billed charges,13.93,38.8,,,percent of total billed charges,38.8% of total billed charges,30.52,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,71.8,200,,,fee schedule,200% of CMS fee schedule,13.93,159.09,
23500 - CLOSED TREATMENT OF CLAVICULAR FRACTURE W/O MANIPULATION,46023500,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
25505 Closed Treatment Of Radial Shaft Fracture; With Manipu,46025505,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1666.1,1332.88,,1249.58,75,,,percent of total billed charges,75% of total billed charges,666.44,40,,,percent of total billed charges,40% of total billed charges,1319.55,79.2,,,percent of total billed charges,79.2% of total billed charges,1416.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1582.8,95,,,percent of total billed charges,95% of total billed charges,1332.88,80,,,percent of total billed charges,80% of total billed charges,1416.19,85,,,percent of total billed charges,85% of total billed charges,1499.49,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,666.44,40,,,percent of total billed charges,40% of total billed charges,666.44,40,,,percent of total billed charges,40% of total billed charges,1499.49,90,,,percent of total billed charges,90% of total billed charges,1266.24,76,,,percent of total billed charges,76% of total billed charges,666.44,40,,,percent of total billed charges,40% of total billed charges,1416.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1332.88,80,,,percent of total billed charges,80% of total billed charges,646.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1416.19,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1582.8,
25560 - CLOSED TREATMENT OF RADIAL SHAFT FRACTURE W/O MANIPULATION,46025560,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
25565 - CLOSED TREATMENT OF RADIAL SHAFT FRACTURE W MANIPULA,46025565,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
ADHESIVE DERMABOND 0.5ML,51165,CDM,270,RC,,,OUTPATIENT,,,115.7,92.56,,86.78,75,,,percent of total billed charges,75% of total billed charges,46.28,40,,,percent of total billed charges,40% of total billed charges,91.63,79.2,,,percent of total billed charges,79.2% of total billed charges,98.35,85,,,percent of total billed charges,85% of total billed charges,115.7,100,,,fee schedule,100% of CO APG rates,109.92,95,,,percent of total billed charges,95% of total billed charges,92.56,80,,,percent of total billed charges,80% of total billed charges,98.35,85,,,percent of total billed charges,85% of total billed charges,104.13,90,,,percent of total billed charges,90% of total billed charges,115.7,100,,,fee schedule,100% of CO APG rates,115.7,100,,,fee schedule,100% of CO APG rates,115.7,100,,,fee schedule,100% of NM fee schedule,46.28,40,,,percent of total billed charges,40% of total billed charges,46.28,40,,,percent of total billed charges,40% of total billed charges,104.13,90,,,percent of total billed charges,90% of total billed charges,87.93,76,,,percent of total billed charges,76% of total billed charges,46.28,40,,,percent of total billed charges,40% of total billed charges,98.35,85,,,percent of total billed charges,85% of total billed charges,115.7,100,,,fee schedule,100% of CO APG rate,92.56,80,,,percent of total billed charges,80% of total billed charges,44.89,38.8,,,percent of total billed charges,38.8% of total billed charges,98.35,85,,,percent of total billed charges,85% of total billed charges,115.7,100,,,fee schedule,100% of APG fee schedule,231.4,200,,,percent of total billed charges,200% of total billed charges,44.89,231.4,
STRAP RESTRAINT HOOK-N-LOOP,46051166,CDM,270,RC,,,OUTPATIENT,,,230.6,184.48,,172.95,75,,,percent of total billed charges,75% of total billed charges,92.24,40,,,percent of total billed charges,40% of total billed charges,182.64,79.2,,,percent of total billed charges,79.2% of total billed charges,196.01,85,,,percent of total billed charges,85% of total billed charges,230.6,100,,,fee schedule,100% of CO APG rates,219.07,95,,,percent of total billed charges,95% of total billed charges,184.48,80,,,percent of total billed charges,80% of total billed charges,196.01,85,,,percent of total billed charges,85% of total billed charges,207.54,90,,,percent of total billed charges,90% of total billed charges,230.6,100,,,fee schedule,100% of CO APG rates,230.6,100,,,fee schedule,100% of CO APG rates,230.6,100,,,fee schedule,100% of NM fee schedule,92.24,40,,,percent of total billed charges,40% of total billed charges,92.24,40,,,percent of total billed charges,40% of total billed charges,207.54,90,,,percent of total billed charges,90% of total billed charges,175.26,76,,,percent of total billed charges,76% of total billed charges,92.24,40,,,percent of total billed charges,40% of total billed charges,196.01,85,,,percent of total billed charges,85% of total billed charges,230.6,100,,,fee schedule,100% of CO APG rate,184.48,80,,,percent of total billed charges,80% of total billed charges,89.47,38.8,,,percent of total billed charges,38.8% of total billed charges,196.01,85,,,percent of total billed charges,85% of total billed charges,230.6,100,,,fee schedule,100% of APG fee schedule,461.2,200,,,percent of total billed charges,200% of total billed charges,89.47,461.2,
INTERPULSE HANDPIECE W/ HIGH FLOW TIP,51170,CDM,270,RC,,,OUTPATIENT,,,138.8,111.04,,104.1,75,,,percent of total billed charges,75% of total billed charges,55.52,40,,,percent of total billed charges,40% of total billed charges,109.93,79.2,,,percent of total billed charges,79.2% of total billed charges,117.98,85,,,percent of total billed charges,85% of total billed charges,138.8,100,,,fee schedule,100% of CO APG rates,131.86,95,,,percent of total billed charges,95% of total billed charges,111.04,80,,,percent of total billed charges,80% of total billed charges,117.98,85,,,percent of total billed charges,85% of total billed charges,124.92,90,,,percent of total billed charges,90% of total billed charges,138.8,100,,,fee schedule,100% of CO APG rates,138.8,100,,,fee schedule,100% of CO APG rates,138.8,100,,,fee schedule,100% of NM fee schedule,55.52,40,,,percent of total billed charges,40% of total billed charges,55.52,40,,,percent of total billed charges,40% of total billed charges,124.92,90,,,percent of total billed charges,90% of total billed charges,105.49,76,,,percent of total billed charges,76% of total billed charges,55.52,40,,,percent of total billed charges,40% of total billed charges,117.98,85,,,percent of total billed charges,85% of total billed charges,138.8,100,,,fee schedule,100% of CO APG rate,111.04,80,,,percent of total billed charges,80% of total billed charges,53.85,38.8,,,percent of total billed charges,38.8% of total billed charges,117.98,85,,,percent of total billed charges,85% of total billed charges,138.8,100,,,fee schedule,100% of APG fee schedule,277.6,200,,,percent of total billed charges,200% of total billed charges,53.85,277.6,
"ANTI-EMBOLISM STOCKING, THIGH  LG REG",52876,CDM,270,RC,,,OUTPATIENT,,,21.8,17.44,,16.35,75,,,percent of total billed charges,75% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,17.27,79.2,,,percent of total billed charges,79.2% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rates,20.71,95,,,percent of total billed charges,95% of total billed charges,17.44,80,,,percent of total billed charges,80% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,19.62,90,,,percent of total billed charges,90% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rates,21.8,100,,,fee schedule,100% of CO APG rates,21.8,100,,,fee schedule,100% of NM fee schedule,8.72,40,,,percent of total billed charges,40% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,19.62,90,,,percent of total billed charges,90% of total billed charges,16.57,76,,,percent of total billed charges,76% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rate,17.44,80,,,percent of total billed charges,80% of total billed charges,8.46,38.8,,,percent of total billed charges,38.8% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of APG fee schedule,43.6,200,,,percent of total billed charges,200% of total billed charges,8.46,43.6,
KWIRE TR PTS 6X045MM,60001011,CDM,270,RC,,,OUTPATIENT,,,30.2,24.16,,22.65,75,,,percent of total billed charges,75% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,23.92,79.2,,,percent of total billed charges,79.2% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,30.2,100,,,fee schedule,100% of CO APG rates,28.69,95,,,percent of total billed charges,95% of total billed charges,24.16,80,,,percent of total billed charges,80% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,27.18,90,,,percent of total billed charges,90% of total billed charges,30.2,100,,,fee schedule,100% of CO APG rates,30.2,100,,,fee schedule,100% of CO APG rates,30.2,100,,,fee schedule,100% of NM fee schedule,12.08,40,,,percent of total billed charges,40% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,27.18,90,,,percent of total billed charges,90% of total billed charges,22.95,76,,,percent of total billed charges,76% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,30.2,100,,,fee schedule,100% of CO APG rate,24.16,80,,,percent of total billed charges,80% of total billed charges,11.72,38.8,,,percent of total billed charges,38.8% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,30.2,100,,,fee schedule,100% of APG fee schedule,60.4,200,,,percent of total billed charges,200% of total billed charges,11.72,60.4,
CERVICAL COLLAR ADLT (VISTA),31051186,CDM,270,RC,,,OUTPATIENT,,,215.3,172.24,,161.48,75,,,percent of total billed charges,75% of total billed charges,86.12,40,,,percent of total billed charges,40% of total billed charges,170.52,79.2,,,percent of total billed charges,79.2% of total billed charges,183.01,85,,,percent of total billed charges,85% of total billed charges,215.3,100,,,fee schedule,100% of CO APG rates,204.54,95,,,percent of total billed charges,95% of total billed charges,172.24,80,,,percent of total billed charges,80% of total billed charges,183.01,85,,,percent of total billed charges,85% of total billed charges,193.77,90,,,percent of total billed charges,90% of total billed charges,215.3,100,,,fee schedule,100% of CO APG rates,215.3,100,,,fee schedule,100% of CO APG rates,215.3,100,,,fee schedule,100% of NM fee schedule,86.12,40,,,percent of total billed charges,40% of total billed charges,86.12,40,,,percent of total billed charges,40% of total billed charges,193.77,90,,,percent of total billed charges,90% of total billed charges,163.63,76,,,percent of total billed charges,76% of total billed charges,86.12,40,,,percent of total billed charges,40% of total billed charges,183.01,85,,,percent of total billed charges,85% of total billed charges,215.3,100,,,fee schedule,100% of CO APG rate,172.24,80,,,percent of total billed charges,80% of total billed charges,83.54,38.8,,,percent of total billed charges,38.8% of total billed charges,183.01,85,,,percent of total billed charges,85% of total billed charges,215.3,100,,,fee schedule,100% of APG fee schedule,430.6,200,,,percent of total billed charges,200% of total billed charges,83.54,430.6,
ANKLE SPRAIN CARE KIT,31051187,CDM,270,RC,,,OUTPATIENT,,,143,114.4,,107.25,75,,,percent of total billed charges,75% of total billed charges,57.2,40,,,percent of total billed charges,40% of total billed charges,113.26,79.2,,,percent of total billed charges,79.2% of total billed charges,121.55,85,,,percent of total billed charges,85% of total billed charges,143,100,,,fee schedule,100% of CO APG rates,135.85,95,,,percent of total billed charges,95% of total billed charges,114.4,80,,,percent of total billed charges,80% of total billed charges,121.55,85,,,percent of total billed charges,85% of total billed charges,128.7,90,,,percent of total billed charges,90% of total billed charges,143,100,,,fee schedule,100% of CO APG rates,143,100,,,fee schedule,100% of CO APG rates,143,100,,,fee schedule,100% of NM fee schedule,57.2,40,,,percent of total billed charges,40% of total billed charges,57.2,40,,,percent of total billed charges,40% of total billed charges,128.7,90,,,percent of total billed charges,90% of total billed charges,108.68,76,,,percent of total billed charges,76% of total billed charges,57.2,40,,,percent of total billed charges,40% of total billed charges,121.55,85,,,percent of total billed charges,85% of total billed charges,143,100,,,fee schedule,100% of CO APG rate,114.4,80,,,percent of total billed charges,80% of total billed charges,55.48,38.8,,,percent of total billed charges,38.8% of total billed charges,121.55,85,,,percent of total billed charges,85% of total billed charges,143,100,,,fee schedule,100% of APG fee schedule,286,200,,,percent of total billed charges,200% of total billed charges,55.48,286,
CROSSFLOW INFLOW CASSETTE TUBING,46051189,CDM,270,RC,,,OUTPATIENT,,,260,208,,195,75,,,percent of total billed charges,75% of total billed charges,104,40,,,percent of total billed charges,40% of total billed charges,205.92,79.2,,,percent of total billed charges,79.2% of total billed charges,221,85,,,percent of total billed charges,85% of total billed charges,260,100,,,fee schedule,100% of CO APG rates,247,95,,,percent of total billed charges,95% of total billed charges,208,80,,,percent of total billed charges,80% of total billed charges,221,85,,,percent of total billed charges,85% of total billed charges,234,90,,,percent of total billed charges,90% of total billed charges,260,100,,,fee schedule,100% of CO APG rates,260,100,,,fee schedule,100% of CO APG rates,260,100,,,fee schedule,100% of NM fee schedule,104,40,,,percent of total billed charges,40% of total billed charges,104,40,,,percent of total billed charges,40% of total billed charges,234,90,,,percent of total billed charges,90% of total billed charges,197.6,76,,,percent of total billed charges,76% of total billed charges,104,40,,,percent of total billed charges,40% of total billed charges,221,85,,,percent of total billed charges,85% of total billed charges,260,100,,,fee schedule,100% of CO APG rate,208,80,,,percent of total billed charges,80% of total billed charges,100.88,38.8,,,percent of total billed charges,38.8% of total billed charges,221,85,,,percent of total billed charges,85% of total billed charges,260,100,,,fee schedule,100% of APG fee schedule,520,200,,,percent of total billed charges,200% of total billed charges,100.88,520,
"RESECTOR SHAVE BLADE, F-SERIES 4.0MM",46051191,CDM,270,RC,,,OUTPATIENT,,,271.02,216.816,,203.27,75,,,percent of total billed charges,75% of total billed charges,108.41,40,,,percent of total billed charges,40% of total billed charges,214.65,79.2,,,percent of total billed charges,79.2% of total billed charges,230.37,85,,,percent of total billed charges,85% of total billed charges,271.02,100,,,fee schedule,100% of CO APG rates,257.47,95,,,percent of total billed charges,95% of total billed charges,216.82,80,,,percent of total billed charges,80% of total billed charges,230.37,85,,,percent of total billed charges,85% of total billed charges,243.92,90,,,percent of total billed charges,90% of total billed charges,271.02,100,,,fee schedule,100% of CO APG rates,271.02,100,,,fee schedule,100% of CO APG rates,271.02,100,,,fee schedule,100% of NM fee schedule,108.41,40,,,percent of total billed charges,40% of total billed charges,108.41,40,,,percent of total billed charges,40% of total billed charges,243.92,90,,,percent of total billed charges,90% of total billed charges,205.98,76,,,percent of total billed charges,76% of total billed charges,108.41,40,,,percent of total billed charges,40% of total billed charges,230.37,85,,,percent of total billed charges,85% of total billed charges,271.02,100,,,fee schedule,100% of CO APG rate,216.82,80,,,percent of total billed charges,80% of total billed charges,105.16,38.8,,,percent of total billed charges,38.8% of total billed charges,230.37,85,,,percent of total billed charges,85% of total billed charges,271.02,100,,,fee schedule,100% of APG fee schedule,542.04,200,,,percent of total billed charges,200% of total billed charges,105.16,542.04,
"BARREL BUR, 6 FLUTE, F-SERIES 5.0MM",46051193,CDM,270,RC,,,OUTPATIENT,,,261,208.8,,195.75,75,,,percent of total billed charges,75% of total billed charges,104.4,40,,,percent of total billed charges,40% of total billed charges,206.71,79.2,,,percent of total billed charges,79.2% of total billed charges,221.85,85,,,percent of total billed charges,85% of total billed charges,261,100,,,fee schedule,100% of CO APG rates,247.95,95,,,percent of total billed charges,95% of total billed charges,208.8,80,,,percent of total billed charges,80% of total billed charges,221.85,85,,,percent of total billed charges,85% of total billed charges,234.9,90,,,percent of total billed charges,90% of total billed charges,261,100,,,fee schedule,100% of CO APG rates,261,100,,,fee schedule,100% of CO APG rates,261,100,,,fee schedule,100% of NM fee schedule,104.4,40,,,percent of total billed charges,40% of total billed charges,104.4,40,,,percent of total billed charges,40% of total billed charges,234.9,90,,,percent of total billed charges,90% of total billed charges,198.36,76,,,percent of total billed charges,76% of total billed charges,104.4,40,,,percent of total billed charges,40% of total billed charges,221.85,85,,,percent of total billed charges,85% of total billed charges,261,100,,,fee schedule,100% of CO APG rate,208.8,80,,,percent of total billed charges,80% of total billed charges,101.27,38.8,,,percent of total billed charges,38.8% of total billed charges,221.85,85,,,percent of total billed charges,85% of total billed charges,261,100,,,fee schedule,100% of APG fee schedule,522,200,,,percent of total billed charges,200% of total billed charges,101.27,522,
"AGG. PLUS SHAVER BLADE, F-SERIES 5.0MM",46051194,CDM,270,RC,,,OUTPATIENT,,,255.6,204.48,,191.7,75,,,percent of total billed charges,75% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,202.44,79.2,,,percent of total billed charges,79.2% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,255.6,100,,,fee schedule,100% of CO APG rates,242.82,95,,,percent of total billed charges,95% of total billed charges,204.48,80,,,percent of total billed charges,80% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,230.04,90,,,percent of total billed charges,90% of total billed charges,255.6,100,,,fee schedule,100% of CO APG rates,255.6,100,,,fee schedule,100% of CO APG rates,255.6,100,,,fee schedule,100% of NM fee schedule,102.24,40,,,percent of total billed charges,40% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,230.04,90,,,percent of total billed charges,90% of total billed charges,194.26,76,,,percent of total billed charges,76% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,255.6,100,,,fee schedule,100% of CO APG rate,204.48,80,,,percent of total billed charges,80% of total billed charges,99.17,38.8,,,percent of total billed charges,38.8% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,255.6,100,,,fee schedule,100% of APG fee schedule,511.2,200,,,percent of total billed charges,200% of total billed charges,99.17,511.2,
90-S ACCELERATOR,46051195,CDM,270,RC,,,OUTPATIENT,,,865.2,692.16,,648.9,75,,,percent of total billed charges,75% of total billed charges,346.08,40,,,percent of total billed charges,40% of total billed charges,685.24,79.2,,,percent of total billed charges,79.2% of total billed charges,735.42,85,,,percent of total billed charges,85% of total billed charges,865.2,100,,,fee schedule,100% of CO APG rates,821.94,95,,,percent of total billed charges,95% of total billed charges,692.16,80,,,percent of total billed charges,80% of total billed charges,735.42,85,,,percent of total billed charges,85% of total billed charges,778.68,90,,,percent of total billed charges,90% of total billed charges,865.2,100,,,fee schedule,100% of CO APG rates,865.2,100,,,fee schedule,100% of CO APG rates,865.2,100,,,fee schedule,100% of NM fee schedule,346.08,40,,,percent of total billed charges,40% of total billed charges,346.08,40,,,percent of total billed charges,40% of total billed charges,778.68,90,,,percent of total billed charges,90% of total billed charges,657.55,76,,,percent of total billed charges,76% of total billed charges,346.08,40,,,percent of total billed charges,40% of total billed charges,735.42,85,,,percent of total billed charges,85% of total billed charges,865.2,100,,,fee schedule,100% of CO APG rate,692.16,80,,,percent of total billed charges,80% of total billed charges,335.7,38.8,,,percent of total billed charges,38.8% of total billed charges,735.42,85,,,percent of total billed charges,85% of total billed charges,865.2,100,,,fee schedule,100% of APG fee schedule,1730.4,200,,,percent of total billed charges,200% of total billed charges,335.7,1730.4,
"6.5MM X 75MM, THREADED",46051198,CDM,270,RC,,,OUTPATIENT,,,132.21,105.768,,99.16,75,,,percent of total billed charges,75% of total billed charges,52.88,40,,,percent of total billed charges,40% of total billed charges,104.71,79.2,,,percent of total billed charges,79.2% of total billed charges,112.38,85,,,percent of total billed charges,85% of total billed charges,132.21,100,,,fee schedule,100% of CO APG rates,125.6,95,,,percent of total billed charges,95% of total billed charges,105.77,80,,,percent of total billed charges,80% of total billed charges,112.38,85,,,percent of total billed charges,85% of total billed charges,118.99,90,,,percent of total billed charges,90% of total billed charges,132.21,100,,,fee schedule,100% of CO APG rates,132.21,100,,,fee schedule,100% of CO APG rates,132.21,100,,,fee schedule,100% of NM fee schedule,52.88,40,,,percent of total billed charges,40% of total billed charges,52.88,40,,,percent of total billed charges,40% of total billed charges,118.99,90,,,percent of total billed charges,90% of total billed charges,100.48,76,,,percent of total billed charges,76% of total billed charges,52.88,40,,,percent of total billed charges,40% of total billed charges,112.38,85,,,percent of total billed charges,85% of total billed charges,132.21,100,,,fee schedule,100% of CO APG rate,105.77,80,,,percent of total billed charges,80% of total billed charges,51.3,38.8,,,percent of total billed charges,38.8% of total billed charges,112.38,85,,,percent of total billed charges,85% of total billed charges,132.21,100,,,fee schedule,100% of APG fee schedule,264.42,200,,,percent of total billed charges,200% of total billed charges,51.3,264.42,
SUTURE 1-0 VICRYL CT-1 VCP947H,51201,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,15,200,,,percent of total billed charges,200% of total billed charges,2.91,15,
SUTURE 4-0 ETHILON P-3,51203,CDM,270,RC,,,OUTPATIENT,,,15.3,12.24,,11.48,75,,,percent of total billed charges,75% of total billed charges,6.12,40,,,percent of total billed charges,40% of total billed charges,12.12,79.2,,,percent of total billed charges,79.2% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,15.3,100,,,fee schedule,100% of CO APG rates,14.54,95,,,percent of total billed charges,95% of total billed charges,12.24,80,,,percent of total billed charges,80% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,13.77,90,,,percent of total billed charges,90% of total billed charges,15.3,100,,,fee schedule,100% of CO APG rates,15.3,100,,,fee schedule,100% of CO APG rates,15.3,100,,,fee schedule,100% of NM fee schedule,6.12,40,,,percent of total billed charges,40% of total billed charges,6.12,40,,,percent of total billed charges,40% of total billed charges,13.77,90,,,percent of total billed charges,90% of total billed charges,11.63,76,,,percent of total billed charges,76% of total billed charges,6.12,40,,,percent of total billed charges,40% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,15.3,100,,,fee schedule,100% of CO APG rate,12.24,80,,,percent of total billed charges,80% of total billed charges,5.94,38.8,,,percent of total billed charges,38.8% of total billed charges,13.01,85,,,percent of total billed charges,85% of total billed charges,15.3,100,,,fee schedule,100% of APG fee schedule,30.6,200,,,percent of total billed charges,200% of total billed charges,5.94,30.6,
EH UDS,40080305,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,65.8,52.64,,49.35,75,,,percent of total billed charges,75% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,52.11,79.2,,,percent of total billed charges,79.2% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,62.51,95,,,percent of total billed charges,95% of total billed charges,52.64,80,,,percent of total billed charges,80% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,26.32,40,,,percent of total billed charges,40% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,50.01,76,,,percent of total billed charges,76% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,52.64,80,,,percent of total billed charges,80% of total billed charges,25.53,38.8,,,percent of total billed charges,38.8% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,62.51,
SUTURE 4-0 PROLENE PS-2 8682H,51233,CDM,270,RC,,,OUTPATIENT,,,17.4,13.92,,13.05,75,,,percent of total billed charges,75% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,13.78,79.2,,,percent of total billed charges,79.2% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,16.53,95,,,percent of total billed charges,95% of total billed charges,13.92,80,,,percent of total billed charges,80% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of NM fee schedule,6.96,40,,,percent of total billed charges,40% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,13.22,76,,,percent of total billed charges,76% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rate,13.92,80,,,percent of total billed charges,80% of total billed charges,6.75,38.8,,,percent of total billed charges,38.8% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.75,17.4,
87070  Environmental Culture 1,40087070,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,78.5,62.8,,58.88,75,,,percent of total billed charges,75% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,62.17,79.2,,,percent of total billed charges,79.2% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,74.58,95,,,percent of total billed charges,95% of total billed charges,62.8,80,,,percent of total billed charges,80% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,70.65,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,31.4,40,,,percent of total billed charges,40% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,70.65,90,,,percent of total billed charges,90% of total billed charges,59.66,76,,,percent of total billed charges,76% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,62.8,80,,,percent of total billed charges,80% of total billed charges,30.46,38.8,,,percent of total billed charges,38.8% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,74.58,
Birthday Test Male,40039147,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,153,122.4,,114.75,75,,,percent of total billed charges,75% of total billed charges,61.2,40,,,percent of total billed charges,40% of total billed charges,121.18,79.2,,,percent of total billed charges,79.2% of total billed charges,130.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,145.35,95,,,percent of total billed charges,95% of total billed charges,122.4,80,,,percent of total billed charges,80% of total billed charges,130.05,85,,,percent of total billed charges,85% of total billed charges,137.7,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,61.2,40,,,percent of total billed charges,40% of total billed charges,61.2,40,,,percent of total billed charges,40% of total billed charges,137.7,90,,,percent of total billed charges,90% of total billed charges,116.28,76,,,percent of total billed charges,76% of total billed charges,61.2,40,,,percent of total billed charges,40% of total billed charges,130.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,122.4,80,,,percent of total billed charges,80% of total billed charges,59.36,38.8,,,percent of total billed charges,38.8% of total billed charges,130.05,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,145.35,
Birthday Test Female,40039153,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,116.3,93.04,,87.23,75,,,percent of total billed charges,75% of total billed charges,46.52,40,,,percent of total billed charges,40% of total billed charges,92.11,79.2,,,percent of total billed charges,79.2% of total billed charges,98.86,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,110.49,95,,,percent of total billed charges,95% of total billed charges,93.04,80,,,percent of total billed charges,80% of total billed charges,98.86,85,,,percent of total billed charges,85% of total billed charges,104.67,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,46.52,40,,,percent of total billed charges,40% of total billed charges,46.52,40,,,percent of total billed charges,40% of total billed charges,104.67,90,,,percent of total billed charges,90% of total billed charges,88.39,76,,,percent of total billed charges,76% of total billed charges,46.52,40,,,percent of total billed charges,40% of total billed charges,98.86,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,93.04,80,,,percent of total billed charges,80% of total billed charges,45.12,38.8,,,percent of total billed charges,38.8% of total billed charges,98.86,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,110.49,
"Free K+L Lt Chains,Qnt,Urine LC",40083883,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,12.35,
K Free Light Chains Qnt. Urine LC,30083883,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,113,90.4,,84.75,75,,,percent of total billed charges,75% of total billed charges,45.2,40,,,percent of total billed charges,40% of total billed charges,89.5,79.2,,,percent of total billed charges,79.2% of total billed charges,96.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,107.35,95,,,percent of total billed charges,95% of total billed charges,90.4,80,,,percent of total billed charges,80% of total billed charges,96.05,85,,,percent of total billed charges,85% of total billed charges,101.7,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,45.2,40,,,percent of total billed charges,40% of total billed charges,45.2,40,,,percent of total billed charges,40% of total billed charges,101.7,90,,,percent of total billed charges,90% of total billed charges,85.88,76,,,percent of total billed charges,76% of total billed charges,45.2,40,,,percent of total billed charges,40% of total billed charges,96.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,90.4,80,,,percent of total billed charges,80% of total billed charges,43.84,38.8,,,percent of total billed charges,38.8% of total billed charges,96.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,107.35,
"Nephelometry, each analyte not elsewhere specified",40083883,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,119.2,95.36,,89.4,75,,,percent of total billed charges,75% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,94.41,79.2,,,percent of total billed charges,79.2% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,113.24,95,,,percent of total billed charges,95% of total billed charges,95.36,80,,,percent of total billed charges,80% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,107.28,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,47.68,40,,,percent of total billed charges,40% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,107.28,90,,,percent of total billed charges,90% of total billed charges,90.59,76,,,percent of total billed charges,76% of total billed charges,47.68,40,,,percent of total billed charges,40% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,95.36,80,,,percent of total billed charges,80% of total billed charges,46.25,38.8,,,percent of total billed charges,38.8% of total billed charges,101.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,113.24,
Factor VIII Antigen LC,40083520,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,262.9,210.32,,197.18,75,,,percent of total billed charges,75% of total billed charges,105.16,40,,,percent of total billed charges,40% of total billed charges,208.22,79.2,,,percent of total billed charges,79.2% of total billed charges,223.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,249.76,95,,,percent of total billed charges,95% of total billed charges,210.32,80,,,percent of total billed charges,80% of total billed charges,223.47,85,,,percent of total billed charges,85% of total billed charges,236.61,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,105.16,40,,,percent of total billed charges,40% of total billed charges,105.16,40,,,percent of total billed charges,40% of total billed charges,236.61,90,,,percent of total billed charges,90% of total billed charges,199.8,76,,,percent of total billed charges,76% of total billed charges,105.16,40,,,percent of total billed charges,40% of total billed charges,223.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,210.32,80,,,percent of total billed charges,80% of total billed charges,102.01,38.8,,,percent of total billed charges,38.8% of total billed charges,223.47,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,249.76,
"96374 - IV Injection, Initial, w/ Patient Supplied Medicatio",60000723,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,349.8,279.84,,262.35,75,,,percent of total billed charges,75% of total billed charges,139.92,40,,,percent of total billed charges,40% of total billed charges,277.04,79.2,,,percent of total billed charges,79.2% of total billed charges,297.33,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,332.31,95,,,percent of total billed charges,95% of total billed charges,279.84,80,,,percent of total billed charges,80% of total billed charges,297.33,85,,,percent of total billed charges,85% of total billed charges,314.82,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,139.92,40,,,percent of total billed charges,40% of total billed charges,139.92,40,,,percent of total billed charges,40% of total billed charges,314.82,90,,,percent of total billed charges,90% of total billed charges,265.85,76,,,percent of total billed charges,76% of total billed charges,139.92,40,,,percent of total billed charges,40% of total billed charges,297.33,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,279.84,80,,,percent of total billed charges,80% of total billed charges,135.72,38.8,,,percent of total billed charges,38.8% of total billed charges,297.33,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,332.31,
VITAMIN B12,40082607,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,142.4,113.92,,106.8,75,,,percent of total billed charges,75% of total billed charges,56.96,40,,,percent of total billed charges,40% of total billed charges,112.78,79.2,,,percent of total billed charges,79.2% of total billed charges,121.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,135.28,95,,,percent of total billed charges,95% of total billed charges,113.92,80,,,percent of total billed charges,80% of total billed charges,121.04,85,,,percent of total billed charges,85% of total billed charges,128.16,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,56.96,40,,,percent of total billed charges,40% of total billed charges,56.96,40,,,percent of total billed charges,40% of total billed charges,128.16,90,,,percent of total billed charges,90% of total billed charges,108.22,76,,,percent of total billed charges,76% of total billed charges,56.96,40,,,percent of total billed charges,40% of total billed charges,121.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,113.92,80,,,percent of total billed charges,80% of total billed charges,55.25,38.8,,,percent of total billed charges,38.8% of total billed charges,121.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,135.28,
Fructosamine LC,40082985,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,22.1,17.68,,16.58,75,,,percent of total billed charges,75% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,17.5,79.2,,,percent of total billed charges,79.2% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,21,95,,,percent of total billed charges,95% of total billed charges,17.68,80,,,percent of total billed charges,80% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,19.89,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,8.84,40,,,percent of total billed charges,40% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,19.89,90,,,percent of total billed charges,90% of total billed charges,16.8,76,,,percent of total billed charges,76% of total billed charges,8.84,40,,,percent of total billed charges,40% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,17.68,80,,,percent of total billed charges,80% of total billed charges,8.57,38.8,,,percent of total billed charges,38.8% of total billed charges,18.79,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,21,
NM Hepa Duct System w/ EF,41578227,CDM,341,RC,78227,HCPCS,OUTPATIENT,,,1443.4,1154.72,TC,1082.55,75,,,percent of total billed charges,75% of total billed charges,577.36,40,,,percent of total billed charges,40% of total billed charges,1143.17,79.2,,,percent of total billed charges,79.2% of total billed charges,1226.89,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rates,1371.23,95,,,percent of total billed charges,95% of total billed charges,1154.72,80,,,percent of total billed charges,80% of total billed charges,1226.89,85,,,percent of total billed charges,85% of total billed charges,1299.06,90,,,percent of total billed charges,90% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rates,505.7,100,,,fee schedule,100% of CO APG rates,504.5,100,,,fee schedule,100% of NM APC rate,577.36,40,,,percent of total billed charges,40% of total billed charges,577.36,40,,,percent of total billed charges,40% of total billed charges,1299.06,90,,,percent of total billed charges,90% of total billed charges,1096.98,76,,,percent of total billed charges,76% of total billed charges,577.36,40,,,percent of total billed charges,40% of total billed charges,1226.89,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of CO APG rate,1154.72,80,,,percent of total billed charges,80% of total billed charges,560.04,38.8,,,percent of total billed charges,38.8% of total billed charges,1226.89,85,,,percent of total billed charges,85% of total billed charges,505.7,100,,,fee schedule,100% of APG fee schedule,862.84,200,,,fee schedule,200% of CMS fee schedule,504.5,1371.23,
IV Therapy Infusion - First Hour,42196365,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,324.3,259.44,,243.23,75,,,percent of total billed charges,75% of total billed charges,129.72,40,,,percent of total billed charges,40% of total billed charges,256.85,79.2,,,percent of total billed charges,79.2% of total billed charges,275.66,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,308.09,95,,,percent of total billed charges,95% of total billed charges,259.44,80,,,percent of total billed charges,80% of total billed charges,275.66,85,,,percent of total billed charges,85% of total billed charges,291.87,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,129.72,40,,,percent of total billed charges,40% of total billed charges,129.72,40,,,percent of total billed charges,40% of total billed charges,291.87,90,,,percent of total billed charges,90% of total billed charges,246.47,76,,,percent of total billed charges,76% of total billed charges,129.72,40,,,percent of total billed charges,40% of total billed charges,275.66,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,259.44,80,,,percent of total billed charges,80% of total billed charges,125.83,38.8,,,percent of total billed charges,38.8% of total billed charges,275.66,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,308.09,
96360 IV Therapy Hydration - First Hour,42196360,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,299.6,239.68,,224.7,75,,,percent of total billed charges,75% of total billed charges,119.84,40,,,percent of total billed charges,40% of total billed charges,237.28,79.2,,,percent of total billed charges,79.2% of total billed charges,254.66,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,284.62,95,,,percent of total billed charges,95% of total billed charges,239.68,80,,,percent of total billed charges,80% of total billed charges,254.66,85,,,percent of total billed charges,85% of total billed charges,269.64,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,119.84,40,,,percent of total billed charges,40% of total billed charges,119.84,40,,,percent of total billed charges,40% of total billed charges,269.64,90,,,percent of total billed charges,90% of total billed charges,227.7,76,,,percent of total billed charges,76% of total billed charges,119.84,40,,,percent of total billed charges,40% of total billed charges,254.66,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,239.68,80,,,percent of total billed charges,80% of total billed charges,116.24,38.8,,,percent of total billed charges,38.8% of total billed charges,254.66,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,284.62,
"96372 Injection, subcutaneous or intramuscular, first inject",46596372,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,111.2,88.96,,83.4,75,,,percent of total billed charges,75% of total billed charges,44.48,40,,,percent of total billed charges,40% of total billed charges,88.07,79.2,,,percent of total billed charges,79.2% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,105.64,95,,,percent of total billed charges,95% of total billed charges,88.96,80,,,percent of total billed charges,80% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,100.08,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,111.2,100,,,fee schedule,100% of NM APC rate,44.48,40,,,percent of total billed charges,40% of total billed charges,44.48,40,,,percent of total billed charges,40% of total billed charges,100.08,90,,,percent of total billed charges,90% of total billed charges,84.51,76,,,percent of total billed charges,76% of total billed charges,44.48,40,,,percent of total billed charges,40% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,88.96,80,,,percent of total billed charges,80% of total billed charges,43.15,38.8,,,percent of total billed charges,38.8% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,43.15,111.2,
"96368 - IV tx, concurrent infusion",31096368,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,82.2,65.76,,61.65,75,,,percent of total billed charges,75% of total billed charges,32.88,40,,,percent of total billed charges,40% of total billed charges,65.1,79.2,,,percent of total billed charges,79.2% of total billed charges,69.87,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,78.09,95,,,percent of total billed charges,95% of total billed charges,65.76,80,,,percent of total billed charges,80% of total billed charges,69.87,85,,,percent of total billed charges,85% of total billed charges,73.98,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,82.2,100,,,fee schedule,100% of NM APC rate,32.88,40,,,percent of total billed charges,40% of total billed charges,32.88,40,,,percent of total billed charges,40% of total billed charges,73.98,90,,,percent of total billed charges,90% of total billed charges,62.47,76,,,percent of total billed charges,76% of total billed charges,32.88,40,,,percent of total billed charges,40% of total billed charges,69.87,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,65.76,80,,,percent of total billed charges,80% of total billed charges,31.89,38.8,,,percent of total billed charges,38.8% of total billed charges,69.87,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,31.89,82.2,
"33016 - Pericardiocentesis, including imaging guidance",60000731,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4887,3909.6,,3665.25,75,,,percent of total billed charges,75% of total billed charges,1954.8,40,,,percent of total billed charges,40% of total billed charges,3870.5,79.2,,,percent of total billed charges,79.2% of total billed charges,4153.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4642.65,95,,,percent of total billed charges,95% of total billed charges,3909.6,80,,,percent of total billed charges,80% of total billed charges,4153.95,85,,,percent of total billed charges,85% of total billed charges,4398.3,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1954.8,40,,,percent of total billed charges,40% of total billed charges,1954.8,40,,,percent of total billed charges,40% of total billed charges,4398.3,90,,,percent of total billed charges,90% of total billed charges,3714.12,76,,,percent of total billed charges,76% of total billed charges,1954.8,40,,,percent of total billed charges,40% of total billed charges,4153.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3909.6,80,,,percent of total billed charges,80% of total billed charges,1896.16,38.8,,,percent of total billed charges,38.8% of total billed charges,4153.95,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4642.65,
ADH LC,40084588,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,81.2,64.96,,60.9,75,,,percent of total billed charges,75% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,64.31,79.2,,,percent of total billed charges,79.2% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,77.14,95,,,percent of total billed charges,95% of total billed charges,64.96,80,,,percent of total billed charges,80% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,32.48,40,,,percent of total billed charges,40% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,61.71,76,,,percent of total billed charges,76% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,64.96,80,,,percent of total billed charges,80% of total billed charges,31.51,38.8,,,percent of total billed charges,38.8% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,77.14,
I-Stat BNP,40083880,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,237.7,190.16,,178.28,75,,,percent of total billed charges,75% of total billed charges,95.08,40,,,percent of total billed charges,40% of total billed charges,188.26,79.2,,,percent of total billed charges,79.2% of total billed charges,202.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,225.82,95,,,percent of total billed charges,95% of total billed charges,190.16,80,,,percent of total billed charges,80% of total billed charges,202.05,85,,,percent of total billed charges,85% of total billed charges,213.93,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,95.08,40,,,percent of total billed charges,40% of total billed charges,95.08,40,,,percent of total billed charges,40% of total billed charges,213.93,90,,,percent of total billed charges,90% of total billed charges,180.65,76,,,percent of total billed charges,76% of total billed charges,95.08,40,,,percent of total billed charges,40% of total billed charges,202.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,190.16,80,,,percent of total billed charges,80% of total billed charges,92.23,38.8,,,percent of total billed charges,38.8% of total billed charges,202.05,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,225.82,
"CAPNOLINE SMART, ETCO2 ADULT",51236,CDM,270,RC,,,OUTPATIENT,,,60.1,48.08,,45.08,75,,,percent of total billed charges,75% of total billed charges,24.04,40,,,percent of total billed charges,40% of total billed charges,47.6,79.2,,,percent of total billed charges,79.2% of total billed charges,51.09,85,,,percent of total billed charges,85% of total billed charges,60.1,100,,,fee schedule,100% of CO APG rates,57.1,95,,,percent of total billed charges,95% of total billed charges,48.08,80,,,percent of total billed charges,80% of total billed charges,51.09,85,,,percent of total billed charges,85% of total billed charges,54.09,90,,,percent of total billed charges,90% of total billed charges,60.1,100,,,fee schedule,100% of CO APG rates,60.1,100,,,fee schedule,100% of CO APG rates,60.1,100,,,fee schedule,100% of NM fee schedule,24.04,40,,,percent of total billed charges,40% of total billed charges,24.04,40,,,percent of total billed charges,40% of total billed charges,54.09,90,,,percent of total billed charges,90% of total billed charges,45.68,76,,,percent of total billed charges,76% of total billed charges,24.04,40,,,percent of total billed charges,40% of total billed charges,51.09,85,,,percent of total billed charges,85% of total billed charges,60.1,100,,,fee schedule,100% of CO APG rate,48.08,80,,,percent of total billed charges,80% of total billed charges,23.32,38.8,,,percent of total billed charges,38.8% of total billed charges,51.09,85,,,percent of total billed charges,85% of total billed charges,60.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,23.32,60.1,
SELF TAP CORTICAL SCREW 3.5X65mm,46051323,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X70mm,46051324,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X75mm,46051325,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X80mm,46051326,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X85mm,46051327,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X90mm,46051328,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 3.5X95mm,46051329,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X14mm,46051330,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X16mm,46051331,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X18mm,46051332,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X20mm,46051333,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X22mm,46051334,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X24mm,46051335,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X26mm,46051336,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X28mm,46051337,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X30mm,46051338,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X32mm,46051339,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X34mm,46051340,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X36mm,46051341,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X38mm,46051342,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X40mm,46051343,CDM,278,RC,,,OUTPATIENT,,,73.2,58.56,,54.9,75,,,percent of total billed charges,75% of total billed charges,29.28,40,,,percent of total billed charges,40% of total billed charges,57.97,79.2,,,percent of total billed charges,79.2% of total billed charges,62.22,85,,,percent of total billed charges,85% of total billed charges,73.2,100,,,fee schedule,100% of CO APG rates,69.54,95,,,percent of total billed charges,95% of total billed charges,58.56,80,,,percent of total billed charges,80% of total billed charges,62.22,85,,,percent of total billed charges,85% of total billed charges,65.88,90,,,percent of total billed charges,90% of total billed charges,73.2,100,,,fee schedule,100% of CO APG rates,73.2,100,,,fee schedule,100% of CO APG rates,73.2,100,,,fee schedule,100% of NM fee schedule,29.28,40,,,percent of total billed charges,40% of total billed charges,29.28,40,,,percent of total billed charges,40% of total billed charges,65.88,90,,,percent of total billed charges,90% of total billed charges,55.63,76,,,percent of total billed charges,76% of total billed charges,29.28,40,,,percent of total billed charges,40% of total billed charges,62.22,85,,,percent of total billed charges,85% of total billed charges,73.2,100,,,fee schedule,100% of CO APG rate,58.56,80,,,percent of total billed charges,80% of total billed charges,28.4,38.8,,,percent of total billed charges,38.8% of total billed charges,62.22,85,,,percent of total billed charges,85% of total billed charges,73.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,28.4,73.2,
SELF TAP CORTICAL SCREW 4.5X42mm,46051344,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X44mm,46051345,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X46mm,46051346,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X48mm,46051347,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X50mm,46051348,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X52mm,46051349,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X54mm,46051350,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X55mm,46051351,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X60mm,46051354,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X65mm,46051357,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X70mm,46051360,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X75mm,46051361,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X80mm,46051362,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X85mm,46051363,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X90mm,46051364,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SELF TAP CORTICAL SCREW 4.5X95mm,46051365,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
ASNIS III WASHER FOR 6.5/8.0mm SCREWS SS,46051384,CDM,278,RC,,,OUTPATIENT,,,110.3,88.24,,82.73,75,,,percent of total billed charges,75% of total billed charges,44.12,40,,,percent of total billed charges,40% of total billed charges,87.36,79.2,,,percent of total billed charges,79.2% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,110.3,100,,,fee schedule,100% of CO APG rates,104.79,95,,,percent of total billed charges,95% of total billed charges,88.24,80,,,percent of total billed charges,80% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,99.27,90,,,percent of total billed charges,90% of total billed charges,110.3,100,,,fee schedule,100% of CO APG rates,110.3,100,,,fee schedule,100% of CO APG rates,110.3,100,,,fee schedule,100% of NM fee schedule,44.12,40,,,percent of total billed charges,40% of total billed charges,44.12,40,,,percent of total billed charges,40% of total billed charges,99.27,90,,,percent of total billed charges,90% of total billed charges,83.83,76,,,percent of total billed charges,76% of total billed charges,44.12,40,,,percent of total billed charges,40% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,110.3,100,,,fee schedule,100% of CO APG rate,88.24,80,,,percent of total billed charges,80% of total billed charges,42.8,38.8,,,percent of total billed charges,38.8% of total billed charges,93.76,85,,,percent of total billed charges,85% of total billed charges,110.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,42.8,110.3,
6.5X60mm CANCELLOUS SCREW 16mm T/L,46051403,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X60mm CANCELLOUS SCREW 32mm T/L,46051404,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X65MM CANC. SCREW 32MM T/L,46051405,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X65mm CANCELLOUS SCREW 16mm T/L,46051406,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X70MM CANC. SCREW 32MM T/L,46051407,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X70mm CANCELLOUS SCREW 16mm T/L,46051408,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X75MM CANC. SCREW 32MM T/L,46051409,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X75mm CANCELLOUS SCREW 16mm T/L,46051410,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X80MM CANC. SCREW 32MM T/L,46051411,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X80mm CANCELLOUS SCREW 16mm T/L,46051412,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X85MM CANC. SCREW 32MM T/L,46051413,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X85mm CANCELLOUS SCREW 16mm T/L,46051414,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X90MM CANC. SCREW 32MM T/L,46051415,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5X90mm CANCELLOUS SCREW 16mm T/L,46051416,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
ASNIS III SS WASHER 5.0mm,46051418,CDM,278,RC,,,OUTPATIENT,,,114.5,91.6,,85.88,75,,,percent of total billed charges,75% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,90.68,79.2,,,percent of total billed charges,79.2% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,114.5,100,,,fee schedule,100% of CO APG rates,108.78,95,,,percent of total billed charges,95% of total billed charges,91.6,80,,,percent of total billed charges,80% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,103.05,90,,,percent of total billed charges,90% of total billed charges,114.5,100,,,fee schedule,100% of CO APG rates,114.5,100,,,fee schedule,100% of CO APG rates,114.5,100,,,fee schedule,100% of NM fee schedule,45.8,40,,,percent of total billed charges,40% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,103.05,90,,,percent of total billed charges,90% of total billed charges,87.02,76,,,percent of total billed charges,76% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,114.5,100,,,fee schedule,100% of CO APG rate,91.6,80,,,percent of total billed charges,80% of total billed charges,44.43,38.8,,,percent of total billed charges,38.8% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,114.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44.43,114.5,
Ti ASNIS III WASHER 4.0mm,46051419,CDM,278,RC,,,OUTPATIENT,,,114.5,91.6,,85.88,75,,,percent of total billed charges,75% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,90.68,79.2,,,percent of total billed charges,79.2% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,114.5,100,,,fee schedule,100% of CO APG rates,108.78,95,,,percent of total billed charges,95% of total billed charges,91.6,80,,,percent of total billed charges,80% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,103.05,90,,,percent of total billed charges,90% of total billed charges,114.5,100,,,fee schedule,100% of CO APG rates,114.5,100,,,fee schedule,100% of CO APG rates,114.5,100,,,fee schedule,100% of NM fee schedule,45.8,40,,,percent of total billed charges,40% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,103.05,90,,,percent of total billed charges,90% of total billed charges,87.02,76,,,percent of total billed charges,76% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,114.5,100,,,fee schedule,100% of CO APG rate,91.6,80,,,percent of total billed charges,80% of total billed charges,44.43,38.8,,,percent of total billed charges,38.8% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,114.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44.43,114.5,
6.5X60mm CANCELLOUS SCREW F/T,46051422,CDM,278,RC,,,OUTPATIENT,,,135.5,108.4,,101.63,75,,,percent of total billed charges,75% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,107.32,79.2,,,percent of total billed charges,79.2% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,128.73,95,,,percent of total billed charges,95% of total billed charges,108.4,80,,,percent of total billed charges,80% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of NM fee schedule,54.2,40,,,percent of total billed charges,40% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,102.98,76,,,percent of total billed charges,76% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rate,108.4,80,,,percent of total billed charges,80% of total billed charges,52.57,38.8,,,percent of total billed charges,38.8% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,52.57,135.5,
6.5X65mm CANCELLOUS SCREW F/T,46051423,CDM,278,RC,,,OUTPATIENT,,,135.5,108.4,,101.63,75,,,percent of total billed charges,75% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,107.32,79.2,,,percent of total billed charges,79.2% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,128.73,95,,,percent of total billed charges,95% of total billed charges,108.4,80,,,percent of total billed charges,80% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of NM fee schedule,54.2,40,,,percent of total billed charges,40% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,102.98,76,,,percent of total billed charges,76% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rate,108.4,80,,,percent of total billed charges,80% of total billed charges,52.57,38.8,,,percent of total billed charges,38.8% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,52.57,135.5,
6.5X70mm CANCELLOUS SCREW F/T,46051424,CDM,278,RC,,,OUTPATIENT,,,135.5,108.4,,101.63,75,,,percent of total billed charges,75% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,107.32,79.2,,,percent of total billed charges,79.2% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,128.73,95,,,percent of total billed charges,95% of total billed charges,108.4,80,,,percent of total billed charges,80% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of NM fee schedule,54.2,40,,,percent of total billed charges,40% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,102.98,76,,,percent of total billed charges,76% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rate,108.4,80,,,percent of total billed charges,80% of total billed charges,52.57,38.8,,,percent of total billed charges,38.8% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,52.57,135.5,
6.5X75mm CANCELLOUS SCREW F/T,46051425,CDM,278,RC,,,OUTPATIENT,,,135.5,108.4,,101.63,75,,,percent of total billed charges,75% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,107.32,79.2,,,percent of total billed charges,79.2% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,128.73,95,,,percent of total billed charges,95% of total billed charges,108.4,80,,,percent of total billed charges,80% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of NM fee schedule,54.2,40,,,percent of total billed charges,40% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,102.98,76,,,percent of total billed charges,76% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rate,108.4,80,,,percent of total billed charges,80% of total billed charges,52.57,38.8,,,percent of total billed charges,38.8% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,52.57,135.5,
6.5X80mm CANCELLOUS SCREW F/T,46051426,CDM,278,RC,,,OUTPATIENT,,,135.5,108.4,,101.63,75,,,percent of total billed charges,75% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,107.32,79.2,,,percent of total billed charges,79.2% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,128.73,95,,,percent of total billed charges,95% of total billed charges,108.4,80,,,percent of total billed charges,80% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of NM fee schedule,54.2,40,,,percent of total billed charges,40% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,102.98,76,,,percent of total billed charges,76% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rate,108.4,80,,,percent of total billed charges,80% of total billed charges,52.57,38.8,,,percent of total billed charges,38.8% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,52.57,135.5,
6.5X85mm CANCELLOUS SCREW F/T,46051427,CDM,278,RC,,,OUTPATIENT,,,135.5,108.4,,101.63,75,,,percent of total billed charges,75% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,107.32,79.2,,,percent of total billed charges,79.2% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,128.73,95,,,percent of total billed charges,95% of total billed charges,108.4,80,,,percent of total billed charges,80% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of NM fee schedule,54.2,40,,,percent of total billed charges,40% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,102.98,76,,,percent of total billed charges,76% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rate,108.4,80,,,percent of total billed charges,80% of total billed charges,52.57,38.8,,,percent of total billed charges,38.8% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,52.57,135.5,
6.5X90mm CANCELLOUS SCREW F/T,46051428,CDM,278,RC,,,OUTPATIENT,,,135.5,108.4,,101.63,75,,,percent of total billed charges,75% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,107.32,79.2,,,percent of total billed charges,79.2% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,128.73,95,,,percent of total billed charges,95% of total billed charges,108.4,80,,,percent of total billed charges,80% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of NM fee schedule,54.2,40,,,percent of total billed charges,40% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,102.98,76,,,percent of total billed charges,76% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rate,108.4,80,,,percent of total billed charges,80% of total billed charges,52.57,38.8,,,percent of total billed charges,38.8% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,52.57,135.5,
6.5X95mm CANCELLOUS SCREW F/T,46051429,CDM,278,RC,,,OUTPATIENT,,,135.5,108.4,,101.63,75,,,percent of total billed charges,75% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,107.32,79.2,,,percent of total billed charges,79.2% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,128.73,95,,,percent of total billed charges,95% of total billed charges,108.4,80,,,percent of total billed charges,80% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of CO APG rates,135.5,100,,,fee schedule,100% of NM fee schedule,54.2,40,,,percent of total billed charges,40% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,121.95,90,,,percent of total billed charges,90% of total billed charges,102.98,76,,,percent of total billed charges,76% of total billed charges,54.2,40,,,percent of total billed charges,40% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of CO APG rate,108.4,80,,,percent of total billed charges,80% of total billed charges,52.57,38.8,,,percent of total billed charges,38.8% of total billed charges,115.18,85,,,percent of total billed charges,85% of total billed charges,135.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,52.57,135.5,
6.5X95MM CANC. SCREW 32MM T/L,46051430,CDM,278,RC,,,OUTPATIENT,,,136.6,109.28,,102.45,75,,,percent of total billed charges,75% of total billed charges,54.64,40,,,percent of total billed charges,40% of total billed charges,108.19,79.2,,,percent of total billed charges,79.2% of total billed charges,116.11,85,,,percent of total billed charges,85% of total billed charges,136.6,100,,,fee schedule,100% of CO APG rates,129.77,95,,,percent of total billed charges,95% of total billed charges,109.28,80,,,percent of total billed charges,80% of total billed charges,116.11,85,,,percent of total billed charges,85% of total billed charges,122.94,90,,,percent of total billed charges,90% of total billed charges,136.6,100,,,fee schedule,100% of CO APG rates,136.6,100,,,fee schedule,100% of CO APG rates,136.6,100,,,fee schedule,100% of NM fee schedule,54.64,40,,,percent of total billed charges,40% of total billed charges,54.64,40,,,percent of total billed charges,40% of total billed charges,122.94,90,,,percent of total billed charges,90% of total billed charges,103.82,76,,,percent of total billed charges,76% of total billed charges,54.64,40,,,percent of total billed charges,40% of total billed charges,116.11,85,,,percent of total billed charges,85% of total billed charges,136.6,100,,,fee schedule,100% of CO APG rate,109.28,80,,,percent of total billed charges,80% of total billed charges,53,38.8,,,percent of total billed charges,38.8% of total billed charges,116.11,85,,,percent of total billed charges,85% of total billed charges,136.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,53,136.6,
6.5X95mm CANCELLOUS SCREW 16mm T/L,46051431,CDM,278,RC,,,OUTPATIENT,,,136.6,109.28,,102.45,75,,,percent of total billed charges,75% of total billed charges,54.64,40,,,percent of total billed charges,40% of total billed charges,108.19,79.2,,,percent of total billed charges,79.2% of total billed charges,116.11,85,,,percent of total billed charges,85% of total billed charges,136.6,100,,,fee schedule,100% of CO APG rates,129.77,95,,,percent of total billed charges,95% of total billed charges,109.28,80,,,percent of total billed charges,80% of total billed charges,116.11,85,,,percent of total billed charges,85% of total billed charges,122.94,90,,,percent of total billed charges,90% of total billed charges,136.6,100,,,fee schedule,100% of CO APG rates,136.6,100,,,fee schedule,100% of CO APG rates,136.6,100,,,fee schedule,100% of NM fee schedule,54.64,40,,,percent of total billed charges,40% of total billed charges,54.64,40,,,percent of total billed charges,40% of total billed charges,122.94,90,,,percent of total billed charges,90% of total billed charges,103.82,76,,,percent of total billed charges,76% of total billed charges,54.64,40,,,percent of total billed charges,40% of total billed charges,116.11,85,,,percent of total billed charges,85% of total billed charges,136.6,100,,,fee schedule,100% of CO APG rate,109.28,80,,,percent of total billed charges,80% of total billed charges,53,38.8,,,percent of total billed charges,38.8% of total billed charges,116.11,85,,,percent of total billed charges,85% of total billed charges,136.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,53,136.6,
3.0 LOCKING INSERT,46051450,CDM,278,RC,,,OUTPATIENT,,,193.3,154.64,,144.98,75,,,percent of total billed charges,75% of total billed charges,77.32,40,,,percent of total billed charges,40% of total billed charges,153.09,79.2,,,percent of total billed charges,79.2% of total billed charges,164.31,85,,,percent of total billed charges,85% of total billed charges,193.3,100,,,fee schedule,100% of CO APG rates,183.64,95,,,percent of total billed charges,95% of total billed charges,154.64,80,,,percent of total billed charges,80% of total billed charges,164.31,85,,,percent of total billed charges,85% of total billed charges,173.97,90,,,percent of total billed charges,90% of total billed charges,193.3,100,,,fee schedule,100% of CO APG rates,193.3,100,,,fee schedule,100% of CO APG rates,193.3,100,,,fee schedule,100% of NM fee schedule,77.32,40,,,percent of total billed charges,40% of total billed charges,77.32,40,,,percent of total billed charges,40% of total billed charges,173.97,90,,,percent of total billed charges,90% of total billed charges,146.91,76,,,percent of total billed charges,76% of total billed charges,77.32,40,,,percent of total billed charges,40% of total billed charges,164.31,85,,,percent of total billed charges,85% of total billed charges,193.3,100,,,fee schedule,100% of CO APG rate,154.64,80,,,percent of total billed charges,80% of total billed charges,75,38.8,,,percent of total billed charges,38.8% of total billed charges,164.31,85,,,percent of total billed charges,85% of total billed charges,193.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,75,193.3,
5.0 CABLE PLUG,46051455,CDM,270,RC,,,OUTPATIENT,,,241.5,193.2,,181.13,75,,,percent of total billed charges,75% of total billed charges,96.6,40,,,percent of total billed charges,40% of total billed charges,191.27,79.2,,,percent of total billed charges,79.2% of total billed charges,205.28,85,,,percent of total billed charges,85% of total billed charges,241.5,100,,,fee schedule,100% of CO APG rates,229.43,95,,,percent of total billed charges,95% of total billed charges,193.2,80,,,percent of total billed charges,80% of total billed charges,205.28,85,,,percent of total billed charges,85% of total billed charges,217.35,90,,,percent of total billed charges,90% of total billed charges,241.5,100,,,fee schedule,100% of CO APG rates,241.5,100,,,fee schedule,100% of CO APG rates,241.5,100,,,fee schedule,100% of NM fee schedule,96.6,40,,,percent of total billed charges,40% of total billed charges,96.6,40,,,percent of total billed charges,40% of total billed charges,217.35,90,,,percent of total billed charges,90% of total billed charges,183.54,76,,,percent of total billed charges,76% of total billed charges,96.6,40,,,percent of total billed charges,40% of total billed charges,205.28,85,,,percent of total billed charges,85% of total billed charges,241.5,100,,,fee schedule,100% of CO APG rate,193.2,80,,,percent of total billed charges,80% of total billed charges,93.7,38.8,,,percent of total billed charges,38.8% of total billed charges,205.28,85,,,percent of total billed charges,85% of total billed charges,241.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,93.7,241.5,
5.0 LOCKING INSERT,46051456,CDM,278,RC,,,OUTPATIENT,,,232.1,185.68,,174.08,75,,,percent of total billed charges,75% of total billed charges,92.84,40,,,percent of total billed charges,40% of total billed charges,183.82,79.2,,,percent of total billed charges,79.2% of total billed charges,197.29,85,,,percent of total billed charges,85% of total billed charges,232.1,100,,,fee schedule,100% of CO APG rates,220.5,95,,,percent of total billed charges,95% of total billed charges,185.68,80,,,percent of total billed charges,80% of total billed charges,197.29,85,,,percent of total billed charges,85% of total billed charges,208.89,90,,,percent of total billed charges,90% of total billed charges,232.1,100,,,fee schedule,100% of CO APG rates,232.1,100,,,fee schedule,100% of CO APG rates,232.1,100,,,fee schedule,100% of NM fee schedule,92.84,40,,,percent of total billed charges,40% of total billed charges,92.84,40,,,percent of total billed charges,40% of total billed charges,208.89,90,,,percent of total billed charges,90% of total billed charges,176.4,76,,,percent of total billed charges,76% of total billed charges,92.84,40,,,percent of total billed charges,40% of total billed charges,197.29,85,,,percent of total billed charges,85% of total billed charges,232.1,100,,,fee schedule,100% of CO APG rate,185.68,80,,,percent of total billed charges,80% of total billed charges,90.05,38.8,,,percent of total billed charges,38.8% of total billed charges,197.29,85,,,percent of total billed charges,85% of total billed charges,232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,90.05,232.1,
BONE SCREW T7 2.3X10 MM,46051495,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X12 MM,46051496,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X14MM,46051497,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X16 MM,46051498,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X18 MM,46051499,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X20 MM,46051500,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X22MM,46051501,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X24 MM,46051502,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X26 MM,46051503,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X28 MM,46051504,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X30 MM,46051505,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X32 MM,46051506,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X34 MM,46051507,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X36 MM,46051508,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
BONE SCREW T7 2.3X38 MM,46051509,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
LOCKING PEGS T7 2.0 X26MM,46051519,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
LOCKING PEGS T7 2.0X16MM,46051520,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
LOCKING PEGS T7 2.0X18MM,46051521,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
LOCKING PEGS T7 2.0X20MM,46051522,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
LOCKING PEGS T7 2.0X22MM,46051523,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
LOCKING PEGS T7 2.0X24MM,46051524,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.35,354,
LOCKING SCREWS T7 2.3X10MM,46051527,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X14MM,46051528,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X16MM,46051529,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X18MM,46051530,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X20MM,46051531,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X22MM,46051532,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X24MM,46051533,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X26MM,46051534,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X28MM,46051535,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X30MM,46051536,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X32MM,46051537,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X34MM,46051538,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X36MM,46051539,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.3X38MM,46051540,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.7X10MM,46051541,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.7X12MM,46051542,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.7X14MM,46051543,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.7X16MM,46051544,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.7X18MM,46051545,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.7X20MM,46051546,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.7X22MM,46051547,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T7 2.7X24MM,46051548,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREWS T72 3X12MM,46051549,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
PARTIALLY THREADED BONE SCREW T7 2 7X24,46051550,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
PARTIALLY THREADED BONE SCREW T7 2.7X16,46051551,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
PARTIALLY THREADED BONE SCREW T7 2.7X18,46051552,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
PARTIALLY THREADED BONE SCREW T7 2.7X20,46051553,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
PARTIALLY THREADED BONE SCREW T7 2.7X22,46051554,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
PARTIALLY THREADED BONE SCREW T7 2.7X26,46051555,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,156.91,404.4,
LOCKING SCREW AXSOS 5.0mm / L22mm,46051564,CDM,278,RC,,,OUTPATIENT,,,450.6,360.48,,337.95,75,,,percent of total billed charges,75% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,356.88,79.2,,,percent of total billed charges,79.2% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,428.07,95,,,percent of total billed charges,95% of total billed charges,360.48,80,,,percent of total billed charges,80% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of CO APG rates,450.6,100,,,fee schedule,100% of NM fee schedule,180.24,40,,,percent of total billed charges,40% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,405.54,90,,,percent of total billed charges,90% of total billed charges,342.46,76,,,percent of total billed charges,76% of total billed charges,180.24,40,,,percent of total billed charges,40% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of CO APG rate,360.48,80,,,percent of total billed charges,80% of total billed charges,174.83,38.8,,,percent of total billed charges,38.8% of total billed charges,383.01,85,,,percent of total billed charges,85% of total billed charges,450.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.83,450.6,
LOCKING SCREW AXSOS 5.0mm / L28mm,46051566,CDM,278,RC,,,OUTPATIENT,,,464.3,371.44,,348.23,75,,,percent of total billed charges,75% of total billed charges,185.72,40,,,percent of total billed charges,40% of total billed charges,367.73,79.2,,,percent of total billed charges,79.2% of total billed charges,394.66,85,,,percent of total billed charges,85% of total billed charges,464.3,100,,,fee schedule,100% of CO APG rates,441.09,95,,,percent of total billed charges,95% of total billed charges,371.44,80,,,percent of total billed charges,80% of total billed charges,394.66,85,,,percent of total billed charges,85% of total billed charges,417.87,90,,,percent of total billed charges,90% of total billed charges,464.3,100,,,fee schedule,100% of CO APG rates,464.3,100,,,fee schedule,100% of CO APG rates,464.3,100,,,fee schedule,100% of NM fee schedule,185.72,40,,,percent of total billed charges,40% of total billed charges,185.72,40,,,percent of total billed charges,40% of total billed charges,417.87,90,,,percent of total billed charges,90% of total billed charges,352.87,76,,,percent of total billed charges,76% of total billed charges,185.72,40,,,percent of total billed charges,40% of total billed charges,394.66,85,,,percent of total billed charges,85% of total billed charges,464.3,100,,,fee schedule,100% of CO APG rate,371.44,80,,,percent of total billed charges,80% of total billed charges,180.15,38.8,,,percent of total billed charges,38.8% of total billed charges,394.66,85,,,percent of total billed charges,85% of total billed charges,464.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,180.15,464.3,
LOCKING SCREW AXSOS 5.0mm / L24mm,46051568,CDM,278,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
5.0X10MM PERIPROSTH. SCREW,46051569,CDM,278,RC,,,OUTPATIENT,,,471.6,377.28,,353.7,75,,,percent of total billed charges,75% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,373.51,79.2,,,percent of total billed charges,79.2% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,448.02,95,,,percent of total billed charges,95% of total billed charges,377.28,80,,,percent of total billed charges,80% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of NM fee schedule,188.64,40,,,percent of total billed charges,40% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,358.42,76,,,percent of total billed charges,76% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rate,377.28,80,,,percent of total billed charges,80% of total billed charges,182.98,38.8,,,percent of total billed charges,38.8% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.98,471.6,
5.0X12MM PERIPROSTH. SCREW,46051570,CDM,278,RC,,,OUTPATIENT,,,471.6,377.28,,353.7,75,,,percent of total billed charges,75% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,373.51,79.2,,,percent of total billed charges,79.2% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,448.02,95,,,percent of total billed charges,95% of total billed charges,377.28,80,,,percent of total billed charges,80% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of NM fee schedule,188.64,40,,,percent of total billed charges,40% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,358.42,76,,,percent of total billed charges,76% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rate,377.28,80,,,percent of total billed charges,80% of total billed charges,182.98,38.8,,,percent of total billed charges,38.8% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.98,471.6,
5.0X14MM PERIPROSTH. SCREW,46051571,CDM,278,RC,,,OUTPATIENT,,,471.6,377.28,,353.7,75,,,percent of total billed charges,75% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,373.51,79.2,,,percent of total billed charges,79.2% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,448.02,95,,,percent of total billed charges,95% of total billed charges,377.28,80,,,percent of total billed charges,80% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of NM fee schedule,188.64,40,,,percent of total billed charges,40% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,358.42,76,,,percent of total billed charges,76% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rate,377.28,80,,,percent of total billed charges,80% of total billed charges,182.98,38.8,,,percent of total billed charges,38.8% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.98,471.6,
5.0X16MM PERIPROSTH. SCREW,46051572,CDM,278,RC,,,OUTPATIENT,,,471.6,377.28,,353.7,75,,,percent of total billed charges,75% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,373.51,79.2,,,percent of total billed charges,79.2% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,448.02,95,,,percent of total billed charges,95% of total billed charges,377.28,80,,,percent of total billed charges,80% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of NM fee schedule,188.64,40,,,percent of total billed charges,40% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,358.42,76,,,percent of total billed charges,76% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rate,377.28,80,,,percent of total billed charges,80% of total billed charges,182.98,38.8,,,percent of total billed charges,38.8% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.98,471.6,
5.0X18MM PERIPROSTH. SCREW,46051573,CDM,278,RC,,,OUTPATIENT,,,471.6,377.28,,353.7,75,,,percent of total billed charges,75% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,373.51,79.2,,,percent of total billed charges,79.2% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,448.02,95,,,percent of total billed charges,95% of total billed charges,377.28,80,,,percent of total billed charges,80% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of NM fee schedule,188.64,40,,,percent of total billed charges,40% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,358.42,76,,,percent of total billed charges,76% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rate,377.28,80,,,percent of total billed charges,80% of total billed charges,182.98,38.8,,,percent of total billed charges,38.8% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.98,471.6,
5.0X20MM PERIPROSTH. SCREW,46051574,CDM,278,RC,,,OUTPATIENT,,,471.6,377.28,,353.7,75,,,percent of total billed charges,75% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,373.51,79.2,,,percent of total billed charges,79.2% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,448.02,95,,,percent of total billed charges,95% of total billed charges,377.28,80,,,percent of total billed charges,80% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of NM fee schedule,188.64,40,,,percent of total billed charges,40% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,358.42,76,,,percent of total billed charges,76% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rate,377.28,80,,,percent of total billed charges,80% of total billed charges,182.98,38.8,,,percent of total billed charges,38.8% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.98,471.6,
LOCKING SCREW AXSOS 5.0mm / L50mm,46051577,CDM,278,RC,,,OUTPATIENT,,,435.9,348.72,,326.93,75,,,percent of total billed charges,75% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,345.23,79.2,,,percent of total billed charges,79.2% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rates,414.11,95,,,percent of total billed charges,95% of total billed charges,348.72,80,,,percent of total billed charges,80% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,392.31,90,,,percent of total billed charges,90% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rates,435.9,100,,,fee schedule,100% of CO APG rates,435.9,100,,,fee schedule,100% of NM fee schedule,174.36,40,,,percent of total billed charges,40% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,392.31,90,,,percent of total billed charges,90% of total billed charges,331.28,76,,,percent of total billed charges,76% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rate,348.72,80,,,percent of total billed charges,80% of total billed charges,169.13,38.8,,,percent of total billed charges,38.8% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,169.13,435.9,
LOCKING SCREW AXSOS 5.0mm / L34mm,46051578,CDM,278,RC,,,OUTPATIENT,,,435.9,348.72,,326.93,75,,,percent of total billed charges,75% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,345.23,79.2,,,percent of total billed charges,79.2% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rates,414.11,95,,,percent of total billed charges,95% of total billed charges,348.72,80,,,percent of total billed charges,80% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,392.31,90,,,percent of total billed charges,90% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rates,435.9,100,,,fee schedule,100% of CO APG rates,435.9,100,,,fee schedule,100% of NM fee schedule,174.36,40,,,percent of total billed charges,40% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,392.31,90,,,percent of total billed charges,90% of total billed charges,331.28,76,,,percent of total billed charges,76% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rate,348.72,80,,,percent of total billed charges,80% of total billed charges,169.13,38.8,,,percent of total billed charges,38.8% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,169.13,435.9,
LOCKING SCREW AXSOS 5.0mm / L32mm,46051580,CDM,278,RC,,,OUTPATIENT,,,435.9,348.72,,326.93,75,,,percent of total billed charges,75% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,345.23,79.2,,,percent of total billed charges,79.2% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rates,414.11,95,,,percent of total billed charges,95% of total billed charges,348.72,80,,,percent of total billed charges,80% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,392.31,90,,,percent of total billed charges,90% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rates,435.9,100,,,fee schedule,100% of CO APG rates,435.9,100,,,fee schedule,100% of NM fee schedule,174.36,40,,,percent of total billed charges,40% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,392.31,90,,,percent of total billed charges,90% of total billed charges,331.28,76,,,percent of total billed charges,76% of total billed charges,174.36,40,,,percent of total billed charges,40% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of CO APG rate,348.72,80,,,percent of total billed charges,80% of total billed charges,169.13,38.8,,,percent of total billed charges,38.8% of total billed charges,370.52,85,,,percent of total billed charges,85% of total billed charges,435.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,169.13,435.9,
LOCKING SCREW AXSOS 5.0mm / L26mm,46051581,CDM,278,RC,,,OUTPATIENT,,,447.5,358,,335.63,75,,,percent of total billed charges,75% of total billed charges,179,40,,,percent of total billed charges,40% of total billed charges,354.42,79.2,,,percent of total billed charges,79.2% of total billed charges,380.38,85,,,percent of total billed charges,85% of total billed charges,447.5,100,,,fee schedule,100% of CO APG rates,425.13,95,,,percent of total billed charges,95% of total billed charges,358,80,,,percent of total billed charges,80% of total billed charges,380.38,85,,,percent of total billed charges,85% of total billed charges,402.75,90,,,percent of total billed charges,90% of total billed charges,447.5,100,,,fee schedule,100% of CO APG rates,447.5,100,,,fee schedule,100% of CO APG rates,447.5,100,,,fee schedule,100% of NM fee schedule,179,40,,,percent of total billed charges,40% of total billed charges,179,40,,,percent of total billed charges,40% of total billed charges,402.75,90,,,percent of total billed charges,90% of total billed charges,340.1,76,,,percent of total billed charges,76% of total billed charges,179,40,,,percent of total billed charges,40% of total billed charges,380.38,85,,,percent of total billed charges,85% of total billed charges,447.5,100,,,fee schedule,100% of CO APG rate,358,80,,,percent of total billed charges,80% of total billed charges,173.63,38.8,,,percent of total billed charges,38.8% of total billed charges,380.38,85,,,percent of total billed charges,85% of total billed charges,447.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,173.63,447.5,
LOCKING SCREW AXSOS 5.0mm / L65mm,46051582,CDM,278,RC,,,OUTPATIENT,,,449.6,359.68,,337.2,75,,,percent of total billed charges,75% of total billed charges,179.84,40,,,percent of total billed charges,40% of total billed charges,356.08,79.2,,,percent of total billed charges,79.2% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,449.6,100,,,fee schedule,100% of CO APG rates,427.12,95,,,percent of total billed charges,95% of total billed charges,359.68,80,,,percent of total billed charges,80% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,404.64,90,,,percent of total billed charges,90% of total billed charges,449.6,100,,,fee schedule,100% of CO APG rates,449.6,100,,,fee schedule,100% of CO APG rates,449.6,100,,,fee schedule,100% of NM fee schedule,179.84,40,,,percent of total billed charges,40% of total billed charges,179.84,40,,,percent of total billed charges,40% of total billed charges,404.64,90,,,percent of total billed charges,90% of total billed charges,341.7,76,,,percent of total billed charges,76% of total billed charges,179.84,40,,,percent of total billed charges,40% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,449.6,100,,,fee schedule,100% of CO APG rate,359.68,80,,,percent of total billed charges,80% of total billed charges,174.44,38.8,,,percent of total billed charges,38.8% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,449.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.44,449.6,
LOCKING SCREW AXSOS 5.0mm / L40mm,46051583,CDM,278,RC,,,OUTPATIENT,,,449.6,359.68,,337.2,75,,,percent of total billed charges,75% of total billed charges,179.84,40,,,percent of total billed charges,40% of total billed charges,356.08,79.2,,,percent of total billed charges,79.2% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,449.6,100,,,fee schedule,100% of CO APG rates,427.12,95,,,percent of total billed charges,95% of total billed charges,359.68,80,,,percent of total billed charges,80% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,404.64,90,,,percent of total billed charges,90% of total billed charges,449.6,100,,,fee schedule,100% of CO APG rates,449.6,100,,,fee schedule,100% of CO APG rates,449.6,100,,,fee schedule,100% of NM fee schedule,179.84,40,,,percent of total billed charges,40% of total billed charges,179.84,40,,,percent of total billed charges,40% of total billed charges,404.64,90,,,percent of total billed charges,90% of total billed charges,341.7,76,,,percent of total billed charges,76% of total billed charges,179.84,40,,,percent of total billed charges,40% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,449.6,100,,,fee schedule,100% of CO APG rate,359.68,80,,,percent of total billed charges,80% of total billed charges,174.44,38.8,,,percent of total billed charges,38.8% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,449.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.44,449.6,
LOCKING SCREW AXSOS 5.0mm / L44mm,46051584,CDM,278,RC,,,OUTPATIENT,,,449.6,359.68,,337.2,75,,,percent of total billed charges,75% of total billed charges,179.84,40,,,percent of total billed charges,40% of total billed charges,356.08,79.2,,,percent of total billed charges,79.2% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,449.6,100,,,fee schedule,100% of CO APG rates,427.12,95,,,percent of total billed charges,95% of total billed charges,359.68,80,,,percent of total billed charges,80% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,404.64,90,,,percent of total billed charges,90% of total billed charges,449.6,100,,,fee schedule,100% of CO APG rates,449.6,100,,,fee schedule,100% of CO APG rates,449.6,100,,,fee schedule,100% of NM fee schedule,179.84,40,,,percent of total billed charges,40% of total billed charges,179.84,40,,,percent of total billed charges,40% of total billed charges,404.64,90,,,percent of total billed charges,90% of total billed charges,341.7,76,,,percent of total billed charges,76% of total billed charges,179.84,40,,,percent of total billed charges,40% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,449.6,100,,,fee schedule,100% of CO APG rate,359.68,80,,,percent of total billed charges,80% of total billed charges,174.44,38.8,,,percent of total billed charges,38.8% of total billed charges,382.16,85,,,percent of total billed charges,85% of total billed charges,449.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.44,449.6,
LOCKING SCREW AXSOS 4.0mm / L95mm,46051585,CDM,278,RC,,,OUTPATIENT,,,451.7,361.36,,338.78,75,,,percent of total billed charges,75% of total billed charges,180.68,40,,,percent of total billed charges,40% of total billed charges,357.75,79.2,,,percent of total billed charges,79.2% of total billed charges,383.95,85,,,percent of total billed charges,85% of total billed charges,451.7,100,,,fee schedule,100% of CO APG rates,429.12,95,,,percent of total billed charges,95% of total billed charges,361.36,80,,,percent of total billed charges,80% of total billed charges,383.95,85,,,percent of total billed charges,85% of total billed charges,406.53,90,,,percent of total billed charges,90% of total billed charges,451.7,100,,,fee schedule,100% of CO APG rates,451.7,100,,,fee schedule,100% of CO APG rates,451.7,100,,,fee schedule,100% of NM fee schedule,180.68,40,,,percent of total billed charges,40% of total billed charges,180.68,40,,,percent of total billed charges,40% of total billed charges,406.53,90,,,percent of total billed charges,90% of total billed charges,343.29,76,,,percent of total billed charges,76% of total billed charges,180.68,40,,,percent of total billed charges,40% of total billed charges,383.95,85,,,percent of total billed charges,85% of total billed charges,451.7,100,,,fee schedule,100% of CO APG rate,361.36,80,,,percent of total billed charges,80% of total billed charges,175.26,38.8,,,percent of total billed charges,38.8% of total billed charges,383.95,85,,,percent of total billed charges,85% of total billed charges,451.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,175.26,451.7,
LOCKING SCREW AXSOS 5.0mm / L60mm,46051586,CDM,278,RC,,,OUTPATIENT,,,458,366.4,,343.5,75,,,percent of total billed charges,75% of total billed charges,183.2,40,,,percent of total billed charges,40% of total billed charges,362.74,79.2,,,percent of total billed charges,79.2% of total billed charges,389.3,85,,,percent of total billed charges,85% of total billed charges,458,100,,,fee schedule,100% of CO APG rates,435.1,95,,,percent of total billed charges,95% of total billed charges,366.4,80,,,percent of total billed charges,80% of total billed charges,389.3,85,,,percent of total billed charges,85% of total billed charges,412.2,90,,,percent of total billed charges,90% of total billed charges,458,100,,,fee schedule,100% of CO APG rates,458,100,,,fee schedule,100% of CO APG rates,458,100,,,fee schedule,100% of NM fee schedule,183.2,40,,,percent of total billed charges,40% of total billed charges,183.2,40,,,percent of total billed charges,40% of total billed charges,412.2,90,,,percent of total billed charges,90% of total billed charges,348.08,76,,,percent of total billed charges,76% of total billed charges,183.2,40,,,percent of total billed charges,40% of total billed charges,389.3,85,,,percent of total billed charges,85% of total billed charges,458,100,,,fee schedule,100% of CO APG rate,366.4,80,,,percent of total billed charges,80% of total billed charges,177.7,38.8,,,percent of total billed charges,38.8% of total billed charges,389.3,85,,,percent of total billed charges,85% of total billed charges,458,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,177.7,458,
LOCKING SCREW AXSOS 4.0mm / L65mm,46051602,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0mm / L70mm,46051603,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0mm / L75mm,46051604,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0mm / L80mm,46051605,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,178.52,460.1,
LOCKING SCREW AXSOS 4.0mm / L85mm,46051606,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,920.2,200,,,percent of total billed charges,200% of total billed charges,178.52,920.2,
LOCKING SCREW AXSOS 4.0mm / L90mm,46051607,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,920.2,200,,,percent of total billed charges,200% of total billed charges,178.52,920.2,
LOCKING SCREW AXSOS 5.0mm / L75mm,46051608,CDM,278,RC,,,OUTPATIENT,,,460.1,368.08,,345.08,75,,,percent of total billed charges,75% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,364.4,79.2,,,percent of total billed charges,79.2% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,437.1,95,,,percent of total billed charges,95% of total billed charges,368.08,80,,,percent of total billed charges,80% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of CO APG rates,460.1,100,,,fee schedule,100% of NM fee schedule,184.04,40,,,percent of total billed charges,40% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,414.09,90,,,percent of total billed charges,90% of total billed charges,349.68,76,,,percent of total billed charges,76% of total billed charges,184.04,40,,,percent of total billed charges,40% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of CO APG rate,368.08,80,,,percent of total billed charges,80% of total billed charges,178.52,38.8,,,percent of total billed charges,38.8% of total billed charges,391.09,85,,,percent of total billed charges,85% of total billed charges,460.1,100,,,fee schedule,100% of APG fee schedule,920.2,200,,,percent of total billed charges,200% of total billed charges,178.52,920.2,
LOCKING SCREW AXSOS 5.0mm / L30mm,46051609,CDM,278,RC,,,OUTPATIENT,,,461.1,368.88,,345.83,75,,,percent of total billed charges,75% of total billed charges,184.44,40,,,percent of total billed charges,40% of total billed charges,365.19,79.2,,,percent of total billed charges,79.2% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,461.1,100,,,fee schedule,100% of CO APG rates,438.05,95,,,percent of total billed charges,95% of total billed charges,368.88,80,,,percent of total billed charges,80% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,414.99,90,,,percent of total billed charges,90% of total billed charges,461.1,100,,,fee schedule,100% of CO APG rates,461.1,100,,,fee schedule,100% of CO APG rates,461.1,100,,,fee schedule,100% of NM fee schedule,184.44,40,,,percent of total billed charges,40% of total billed charges,184.44,40,,,percent of total billed charges,40% of total billed charges,414.99,90,,,percent of total billed charges,90% of total billed charges,350.44,76,,,percent of total billed charges,76% of total billed charges,184.44,40,,,percent of total billed charges,40% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,461.1,100,,,fee schedule,100% of CO APG rate,368.88,80,,,percent of total billed charges,80% of total billed charges,178.91,38.8,,,percent of total billed charges,38.8% of total billed charges,391.94,85,,,percent of total billed charges,85% of total billed charges,461.1,100,,,fee schedule,100% of APG fee schedule,922.2,200,,,percent of total billed charges,200% of total billed charges,178.91,922.2,
LOCKING SCREW AXSOS 5.0mm / L42mm,46051610,CDM,278,RC,,,OUTPATIENT,,,462.2,369.76,,346.65,75,,,percent of total billed charges,75% of total billed charges,184.88,40,,,percent of total billed charges,40% of total billed charges,366.06,79.2,,,percent of total billed charges,79.2% of total billed charges,392.87,85,,,percent of total billed charges,85% of total billed charges,462.2,100,,,fee schedule,100% of CO APG rates,439.09,95,,,percent of total billed charges,95% of total billed charges,369.76,80,,,percent of total billed charges,80% of total billed charges,392.87,85,,,percent of total billed charges,85% of total billed charges,415.98,90,,,percent of total billed charges,90% of total billed charges,462.2,100,,,fee schedule,100% of CO APG rates,462.2,100,,,fee schedule,100% of CO APG rates,462.2,100,,,fee schedule,100% of NM fee schedule,184.88,40,,,percent of total billed charges,40% of total billed charges,184.88,40,,,percent of total billed charges,40% of total billed charges,415.98,90,,,percent of total billed charges,90% of total billed charges,351.27,76,,,percent of total billed charges,76% of total billed charges,184.88,40,,,percent of total billed charges,40% of total billed charges,392.87,85,,,percent of total billed charges,85% of total billed charges,462.2,100,,,fee schedule,100% of CO APG rate,369.76,80,,,percent of total billed charges,80% of total billed charges,179.33,38.8,,,percent of total billed charges,38.8% of total billed charges,392.87,85,,,percent of total billed charges,85% of total billed charges,462.2,100,,,fee schedule,100% of APG fee schedule,924.4,200,,,percent of total billed charges,200% of total billed charges,179.33,924.4,
LOCKING SCREW AXSOS 5.0mm / L90mm,46051611,CDM,278,RC,,,OUTPATIENT,,,466.4,373.12,,349.8,75,,,percent of total billed charges,75% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,369.39,79.2,,,percent of total billed charges,79.2% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,443.08,95,,,percent of total billed charges,95% of total billed charges,373.12,80,,,percent of total billed charges,80% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of NM fee schedule,186.56,40,,,percent of total billed charges,40% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,354.46,76,,,percent of total billed charges,76% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rate,373.12,80,,,percent of total billed charges,80% of total billed charges,180.96,38.8,,,percent of total billed charges,38.8% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of APG fee schedule,932.8,200,,,percent of total billed charges,200% of total billed charges,180.96,932.8,
LOCKING COMPR NARROW 4 HOLE / L79MM,46051612,CDM,278,RC,,,OUTPATIENT,,,467.4,373.92,,350.55,75,,,percent of total billed charges,75% of total billed charges,186.96,40,,,percent of total billed charges,40% of total billed charges,370.18,79.2,,,percent of total billed charges,79.2% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,467.4,100,,,fee schedule,100% of CO APG rates,444.03,95,,,percent of total billed charges,95% of total billed charges,373.92,80,,,percent of total billed charges,80% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,420.66,90,,,percent of total billed charges,90% of total billed charges,467.4,100,,,fee schedule,100% of CO APG rates,467.4,100,,,fee schedule,100% of CO APG rates,467.4,100,,,fee schedule,100% of NM fee schedule,186.96,40,,,percent of total billed charges,40% of total billed charges,186.96,40,,,percent of total billed charges,40% of total billed charges,420.66,90,,,percent of total billed charges,90% of total billed charges,355.22,76,,,percent of total billed charges,76% of total billed charges,186.96,40,,,percent of total billed charges,40% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,467.4,100,,,fee schedule,100% of CO APG rate,373.92,80,,,percent of total billed charges,80% of total billed charges,181.35,38.8,,,percent of total billed charges,38.8% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,467.4,100,,,fee schedule,100% of APG fee schedule,934.8,200,,,percent of total billed charges,200% of total billed charges,181.35,934.8,
LOCKING COMPR NARROW 5 HOLE / L97MM,46051613,CDM,278,RC,,,OUTPATIENT,,,467.4,373.92,,350.55,75,,,percent of total billed charges,75% of total billed charges,186.96,40,,,percent of total billed charges,40% of total billed charges,370.18,79.2,,,percent of total billed charges,79.2% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,467.4,100,,,fee schedule,100% of CO APG rates,444.03,95,,,percent of total billed charges,95% of total billed charges,373.92,80,,,percent of total billed charges,80% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,420.66,90,,,percent of total billed charges,90% of total billed charges,467.4,100,,,fee schedule,100% of CO APG rates,467.4,100,,,fee schedule,100% of CO APG rates,467.4,100,,,fee schedule,100% of NM fee schedule,186.96,40,,,percent of total billed charges,40% of total billed charges,186.96,40,,,percent of total billed charges,40% of total billed charges,420.66,90,,,percent of total billed charges,90% of total billed charges,355.22,76,,,percent of total billed charges,76% of total billed charges,186.96,40,,,percent of total billed charges,40% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,467.4,100,,,fee schedule,100% of CO APG rate,373.92,80,,,percent of total billed charges,80% of total billed charges,181.35,38.8,,,percent of total billed charges,38.8% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,467.4,100,,,fee schedule,100% of APG fee schedule,934.8,200,,,percent of total billed charges,200% of total billed charges,181.35,934.8,
LOCKING COMPR NARROW 6 HOLE / L115MM,46051614,CDM,278,RC,,,OUTPATIENT,,,467.4,373.92,,350.55,75,,,percent of total billed charges,75% of total billed charges,186.96,40,,,percent of total billed charges,40% of total billed charges,370.18,79.2,,,percent of total billed charges,79.2% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,467.4,100,,,fee schedule,100% of CO APG rates,444.03,95,,,percent of total billed charges,95% of total billed charges,373.92,80,,,percent of total billed charges,80% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,420.66,90,,,percent of total billed charges,90% of total billed charges,467.4,100,,,fee schedule,100% of CO APG rates,467.4,100,,,fee schedule,100% of CO APG rates,467.4,100,,,fee schedule,100% of NM fee schedule,186.96,40,,,percent of total billed charges,40% of total billed charges,186.96,40,,,percent of total billed charges,40% of total billed charges,420.66,90,,,percent of total billed charges,90% of total billed charges,355.22,76,,,percent of total billed charges,76% of total billed charges,186.96,40,,,percent of total billed charges,40% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,467.4,100,,,fee schedule,100% of CO APG rate,373.92,80,,,percent of total billed charges,80% of total billed charges,181.35,38.8,,,percent of total billed charges,38.8% of total billed charges,397.29,85,,,percent of total billed charges,85% of total billed charges,467.4,100,,,fee schedule,100% of APG fee schedule,934.8,200,,,percent of total billed charges,200% of total billed charges,181.35,934.8,
LOCKING SCREW AXSOS 5.0mm / L14mm,46051615,CDM,278,RC,,,OUTPATIENT,,,468.5,374.8,,351.38,75,,,percent of total billed charges,75% of total billed charges,187.4,40,,,percent of total billed charges,40% of total billed charges,371.05,79.2,,,percent of total billed charges,79.2% of total billed charges,398.23,85,,,percent of total billed charges,85% of total billed charges,468.5,100,,,fee schedule,100% of CO APG rates,445.08,95,,,percent of total billed charges,95% of total billed charges,374.8,80,,,percent of total billed charges,80% of total billed charges,398.23,85,,,percent of total billed charges,85% of total billed charges,421.65,90,,,percent of total billed charges,90% of total billed charges,468.5,100,,,fee schedule,100% of CO APG rates,468.5,100,,,fee schedule,100% of CO APG rates,468.5,100,,,fee schedule,100% of NM fee schedule,187.4,40,,,percent of total billed charges,40% of total billed charges,187.4,40,,,percent of total billed charges,40% of total billed charges,421.65,90,,,percent of total billed charges,90% of total billed charges,356.06,76,,,percent of total billed charges,76% of total billed charges,187.4,40,,,percent of total billed charges,40% of total billed charges,398.23,85,,,percent of total billed charges,85% of total billed charges,468.5,100,,,fee schedule,100% of CO APG rate,374.8,80,,,percent of total billed charges,80% of total billed charges,181.78,38.8,,,percent of total billed charges,38.8% of total billed charges,398.23,85,,,percent of total billed charges,85% of total billed charges,468.5,100,,,fee schedule,100% of APG fee schedule,937,200,,,percent of total billed charges,200% of total billed charges,181.78,937,
LOCKING SCREW AXSOS 5.0mm / L48mm,46051616,CDM,278,RC,,,OUTPATIENT,,,468.5,374.8,,351.38,75,,,percent of total billed charges,75% of total billed charges,187.4,40,,,percent of total billed charges,40% of total billed charges,371.05,79.2,,,percent of total billed charges,79.2% of total billed charges,398.23,85,,,percent of total billed charges,85% of total billed charges,468.5,100,,,fee schedule,100% of CO APG rates,445.08,95,,,percent of total billed charges,95% of total billed charges,374.8,80,,,percent of total billed charges,80% of total billed charges,398.23,85,,,percent of total billed charges,85% of total billed charges,421.65,90,,,percent of total billed charges,90% of total billed charges,468.5,100,,,fee schedule,100% of CO APG rates,468.5,100,,,fee schedule,100% of CO APG rates,468.5,100,,,fee schedule,100% of NM fee schedule,187.4,40,,,percent of total billed charges,40% of total billed charges,187.4,40,,,percent of total billed charges,40% of total billed charges,421.65,90,,,percent of total billed charges,90% of total billed charges,356.06,76,,,percent of total billed charges,76% of total billed charges,187.4,40,,,percent of total billed charges,40% of total billed charges,398.23,85,,,percent of total billed charges,85% of total billed charges,468.5,100,,,fee schedule,100% of CO APG rate,374.8,80,,,percent of total billed charges,80% of total billed charges,181.78,38.8,,,percent of total billed charges,38.8% of total billed charges,398.23,85,,,percent of total billed charges,85% of total billed charges,468.5,100,,,fee schedule,100% of APG fee schedule,937,200,,,percent of total billed charges,200% of total billed charges,181.78,937,
LOCKING SCREW AXSOS 5.0mm / L46mm,46051617,CDM,278,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,939,200,,,percent of total billed charges,200% of total billed charges,182.17,939,
4.0 X44MM TI CANNULATED SCREW,46051618,CDM,278,RC,,,OUTPATIENT,,,471.6,377.28,,353.7,75,,,percent of total billed charges,75% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,373.51,79.2,,,percent of total billed charges,79.2% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,448.02,95,,,percent of total billed charges,95% of total billed charges,377.28,80,,,percent of total billed charges,80% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of NM fee schedule,188.64,40,,,percent of total billed charges,40% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,358.42,76,,,percent of total billed charges,76% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rate,377.28,80,,,percent of total billed charges,80% of total billed charges,182.98,38.8,,,percent of total billed charges,38.8% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of APG fee schedule,943.2,200,,,percent of total billed charges,200% of total billed charges,182.98,943.2,
4.0 X48MM TI CANNULATED SCREW,46051619,CDM,278,RC,,,OUTPATIENT,,,471.6,377.28,,353.7,75,,,percent of total billed charges,75% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,373.51,79.2,,,percent of total billed charges,79.2% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,448.02,95,,,percent of total billed charges,95% of total billed charges,377.28,80,,,percent of total billed charges,80% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of NM fee schedule,188.64,40,,,percent of total billed charges,40% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,358.42,76,,,percent of total billed charges,76% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rate,377.28,80,,,percent of total billed charges,80% of total billed charges,182.98,38.8,,,percent of total billed charges,38.8% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of APG fee schedule,943.2,200,,,percent of total billed charges,200% of total billed charges,182.98,943.2,
4.0 X50MM TI CANNULATED SCREW,46051620,CDM,278,RC,,,OUTPATIENT,,,471.6,377.28,,353.7,75,,,percent of total billed charges,75% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,373.51,79.2,,,percent of total billed charges,79.2% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,448.02,95,,,percent of total billed charges,95% of total billed charges,377.28,80,,,percent of total billed charges,80% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of NM fee schedule,188.64,40,,,percent of total billed charges,40% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,358.42,76,,,percent of total billed charges,76% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rate,377.28,80,,,percent of total billed charges,80% of total billed charges,182.98,38.8,,,percent of total billed charges,38.8% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of APG fee schedule,943.2,200,,,percent of total billed charges,200% of total billed charges,182.98,943.2,
4.0 X55MM TI CANNULATED SCREW,46051621,CDM,278,RC,,,OUTPATIENT,,,471.6,377.28,,353.7,75,,,percent of total billed charges,75% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,373.51,79.2,,,percent of total billed charges,79.2% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,448.02,95,,,percent of total billed charges,95% of total billed charges,377.28,80,,,percent of total billed charges,80% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of NM fee schedule,188.64,40,,,percent of total billed charges,40% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,358.42,76,,,percent of total billed charges,76% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rate,377.28,80,,,percent of total billed charges,80% of total billed charges,182.98,38.8,,,percent of total billed charges,38.8% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of APG fee schedule,943.2,200,,,percent of total billed charges,200% of total billed charges,182.98,943.2,
LOCKING SCREW AXSOS 5.0mm / L70mm,46051622,CDM,278,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,945.4,200,,,percent of total billed charges,200% of total billed charges,183.41,945.4,
LOCKING SCREW AXSOS 5.0mm / L38mm,46051623,CDM,278,RC,,,OUTPATIENT,,,474.8,379.84,,356.1,75,,,percent of total billed charges,75% of total billed charges,189.92,40,,,percent of total billed charges,40% of total billed charges,376.04,79.2,,,percent of total billed charges,79.2% of total billed charges,403.58,85,,,percent of total billed charges,85% of total billed charges,474.8,100,,,fee schedule,100% of CO APG rates,451.06,95,,,percent of total billed charges,95% of total billed charges,379.84,80,,,percent of total billed charges,80% of total billed charges,403.58,85,,,percent of total billed charges,85% of total billed charges,427.32,90,,,percent of total billed charges,90% of total billed charges,474.8,100,,,fee schedule,100% of CO APG rates,474.8,100,,,fee schedule,100% of CO APG rates,474.8,100,,,fee schedule,100% of NM fee schedule,189.92,40,,,percent of total billed charges,40% of total billed charges,189.92,40,,,percent of total billed charges,40% of total billed charges,427.32,90,,,percent of total billed charges,90% of total billed charges,360.85,76,,,percent of total billed charges,76% of total billed charges,189.92,40,,,percent of total billed charges,40% of total billed charges,403.58,85,,,percent of total billed charges,85% of total billed charges,474.8,100,,,fee schedule,100% of CO APG rate,379.84,80,,,percent of total billed charges,80% of total billed charges,184.22,38.8,,,percent of total billed charges,38.8% of total billed charges,403.58,85,,,percent of total billed charges,85% of total billed charges,474.8,100,,,fee schedule,100% of APG fee schedule,949.6,200,,,percent of total billed charges,200% of total billed charges,184.22,949.6,
LOCKING SCREW AXSOS 5.0mm / L20mm,46051624,CDM,278,RC,,,OUTPATIENT,,,477.9,382.32,,358.43,75,,,percent of total billed charges,75% of total billed charges,191.16,40,,,percent of total billed charges,40% of total billed charges,378.5,79.2,,,percent of total billed charges,79.2% of total billed charges,406.22,85,,,percent of total billed charges,85% of total billed charges,477.9,100,,,fee schedule,100% of CO APG rates,454.01,95,,,percent of total billed charges,95% of total billed charges,382.32,80,,,percent of total billed charges,80% of total billed charges,406.22,85,,,percent of total billed charges,85% of total billed charges,430.11,90,,,percent of total billed charges,90% of total billed charges,477.9,100,,,fee schedule,100% of CO APG rates,477.9,100,,,fee schedule,100% of CO APG rates,477.9,100,,,fee schedule,100% of NM fee schedule,191.16,40,,,percent of total billed charges,40% of total billed charges,191.16,40,,,percent of total billed charges,40% of total billed charges,430.11,90,,,percent of total billed charges,90% of total billed charges,363.2,76,,,percent of total billed charges,76% of total billed charges,191.16,40,,,percent of total billed charges,40% of total billed charges,406.22,85,,,percent of total billed charges,85% of total billed charges,477.9,100,,,fee schedule,100% of CO APG rate,382.32,80,,,percent of total billed charges,80% of total billed charges,185.43,38.8,,,percent of total billed charges,38.8% of total billed charges,406.22,85,,,percent of total billed charges,85% of total billed charges,477.9,100,,,fee schedule,100% of APG fee schedule,955.8,200,,,percent of total billed charges,200% of total billed charges,185.43,955.8,
LOCKING SCREW AXSOS 5.0mm / L55mm,46051652,CDM,278,RC,,,OUTPATIENT,,,488.4,390.72,,366.3,75,,,percent of total billed charges,75% of total billed charges,195.36,40,,,percent of total billed charges,40% of total billed charges,386.81,79.2,,,percent of total billed charges,79.2% of total billed charges,415.14,85,,,percent of total billed charges,85% of total billed charges,488.4,100,,,fee schedule,100% of CO APG rates,463.98,95,,,percent of total billed charges,95% of total billed charges,390.72,80,,,percent of total billed charges,80% of total billed charges,415.14,85,,,percent of total billed charges,85% of total billed charges,439.56,90,,,percent of total billed charges,90% of total billed charges,488.4,100,,,fee schedule,100% of CO APG rates,488.4,100,,,fee schedule,100% of CO APG rates,488.4,100,,,fee schedule,100% of NM fee schedule,195.36,40,,,percent of total billed charges,40% of total billed charges,195.36,40,,,percent of total billed charges,40% of total billed charges,439.56,90,,,percent of total billed charges,90% of total billed charges,371.18,76,,,percent of total billed charges,76% of total billed charges,195.36,40,,,percent of total billed charges,40% of total billed charges,415.14,85,,,percent of total billed charges,85% of total billed charges,488.4,100,,,fee schedule,100% of CO APG rate,390.72,80,,,percent of total billed charges,80% of total billed charges,189.5,38.8,,,percent of total billed charges,38.8% of total billed charges,415.14,85,,,percent of total billed charges,85% of total billed charges,488.4,100,,,fee schedule,100% of APG fee schedule,976.8,200,,,percent of total billed charges,200% of total billed charges,189.5,976.8,
LOCKING SCREW AXSOS 5.0mm / L95mm,46051653,CDM,278,RC,,,OUTPATIENT,,,490.5,392.4,,367.88,75,,,percent of total billed charges,75% of total billed charges,196.2,40,,,percent of total billed charges,40% of total billed charges,388.48,79.2,,,percent of total billed charges,79.2% of total billed charges,416.93,85,,,percent of total billed charges,85% of total billed charges,490.5,100,,,fee schedule,100% of CO APG rates,465.98,95,,,percent of total billed charges,95% of total billed charges,392.4,80,,,percent of total billed charges,80% of total billed charges,416.93,85,,,percent of total billed charges,85% of total billed charges,441.45,90,,,percent of total billed charges,90% of total billed charges,490.5,100,,,fee schedule,100% of CO APG rates,490.5,100,,,fee schedule,100% of CO APG rates,490.5,100,,,fee schedule,100% of NM fee schedule,196.2,40,,,percent of total billed charges,40% of total billed charges,196.2,40,,,percent of total billed charges,40% of total billed charges,441.45,90,,,percent of total billed charges,90% of total billed charges,372.78,76,,,percent of total billed charges,76% of total billed charges,196.2,40,,,percent of total billed charges,40% of total billed charges,416.93,85,,,percent of total billed charges,85% of total billed charges,490.5,100,,,fee schedule,100% of CO APG rate,392.4,80,,,percent of total billed charges,80% of total billed charges,190.31,38.8,,,percent of total billed charges,38.8% of total billed charges,416.93,85,,,percent of total billed charges,85% of total billed charges,490.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,190.31,490.5,
LOCKING SCREW AXSOS 5.0mm / L16mm,46051654,CDM,278,RC,,,OUTPATIENT,,,492.6,394.08,,369.45,75,,,percent of total billed charges,75% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,390.14,79.2,,,percent of total billed charges,79.2% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,467.97,95,,,percent of total billed charges,95% of total billed charges,394.08,80,,,percent of total billed charges,80% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of NM fee schedule,197.04,40,,,percent of total billed charges,40% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,374.38,76,,,percent of total billed charges,76% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rate,394.08,80,,,percent of total billed charges,80% of total billed charges,191.13,38.8,,,percent of total billed charges,38.8% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,191.13,492.6,
LOCKING SCREW AXSOS 5.0mm / L18mm,46051655,CDM,278,RC,,,OUTPATIENT,,,492.6,394.08,,369.45,75,,,percent of total billed charges,75% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,390.14,79.2,,,percent of total billed charges,79.2% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,467.97,95,,,percent of total billed charges,95% of total billed charges,394.08,80,,,percent of total billed charges,80% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of NM fee schedule,197.04,40,,,percent of total billed charges,40% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,374.38,76,,,percent of total billed charges,76% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rate,394.08,80,,,percent of total billed charges,80% of total billed charges,191.13,38.8,,,percent of total billed charges,38.8% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,191.13,492.6,
LOCKING SCREW AXSOS 5.0mm / L36mm,46051656,CDM,278,RC,,,OUTPATIENT,,,492.6,394.08,,369.45,75,,,percent of total billed charges,75% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,390.14,79.2,,,percent of total billed charges,79.2% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,467.97,95,,,percent of total billed charges,95% of total billed charges,394.08,80,,,percent of total billed charges,80% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of NM fee schedule,197.04,40,,,percent of total billed charges,40% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,374.38,76,,,percent of total billed charges,76% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rate,394.08,80,,,percent of total billed charges,80% of total billed charges,191.13,38.8,,,percent of total billed charges,38.8% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,191.13,492.6,
LOCKING SCREW AXSOS 5.0mm / L80mm,46051657,CDM,278,RC,,,OUTPATIENT,,,492.6,394.08,,369.45,75,,,percent of total billed charges,75% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,390.14,79.2,,,percent of total billed charges,79.2% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,467.97,95,,,percent of total billed charges,95% of total billed charges,394.08,80,,,percent of total billed charges,80% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of NM fee schedule,197.04,40,,,percent of total billed charges,40% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,374.38,76,,,percent of total billed charges,76% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rate,394.08,80,,,percent of total billed charges,80% of total billed charges,191.13,38.8,,,percent of total billed charges,38.8% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,191.13,492.6,
LOCKING SCREW AXSOS 5.0mm / L85mm,46051658,CDM,278,RC,,,OUTPATIENT,,,492.6,394.08,,369.45,75,,,percent of total billed charges,75% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,390.14,79.2,,,percent of total billed charges,79.2% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,467.97,95,,,percent of total billed charges,95% of total billed charges,394.08,80,,,percent of total billed charges,80% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of NM fee schedule,197.04,40,,,percent of total billed charges,40% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,374.38,76,,,percent of total billed charges,76% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rate,394.08,80,,,percent of total billed charges,80% of total billed charges,191.13,38.8,,,percent of total billed charges,38.8% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,191.13,492.6,
T2 +10mm END CAP,46051661,CDM,270,RC,,,OUTPATIENT,,,533,426.4,,399.75,75,,,percent of total billed charges,75% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,422.14,79.2,,,percent of total billed charges,79.2% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of CO APG rates,506.35,95,,,percent of total billed charges,95% of total billed charges,426.4,80,,,percent of total billed charges,80% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,479.7,90,,,percent of total billed charges,90% of total billed charges,533,100,,,fee schedule,100% of CO APG rates,533,100,,,fee schedule,100% of CO APG rates,533,100,,,fee schedule,100% of NM fee schedule,213.2,40,,,percent of total billed charges,40% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,479.7,90,,,percent of total billed charges,90% of total billed charges,405.08,76,,,percent of total billed charges,76% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of CO APG rate,426.4,80,,,percent of total billed charges,80% of total billed charges,206.8,38.8,,,percent of total billed charges,38.8% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,206.8,533,
T2 +15mm END CAP,46051662,CDM,270,RC,,,OUTPATIENT,,,533,426.4,,399.75,75,,,percent of total billed charges,75% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,422.14,79.2,,,percent of total billed charges,79.2% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of CO APG rates,506.35,95,,,percent of total billed charges,95% of total billed charges,426.4,80,,,percent of total billed charges,80% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,479.7,90,,,percent of total billed charges,90% of total billed charges,533,100,,,fee schedule,100% of CO APG rates,533,100,,,fee schedule,100% of CO APG rates,533,100,,,fee schedule,100% of NM fee schedule,213.2,40,,,percent of total billed charges,40% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,479.7,90,,,percent of total billed charges,90% of total billed charges,405.08,76,,,percent of total billed charges,76% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of CO APG rate,426.4,80,,,percent of total billed charges,80% of total billed charges,206.8,38.8,,,percent of total billed charges,38.8% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,206.8,533,
T2 +5mm END CAP,46051663,CDM,270,RC,,,OUTPATIENT,,,533,426.4,,399.75,75,,,percent of total billed charges,75% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,422.14,79.2,,,percent of total billed charges,79.2% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of CO APG rates,506.35,95,,,percent of total billed charges,95% of total billed charges,426.4,80,,,percent of total billed charges,80% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,479.7,90,,,percent of total billed charges,90% of total billed charges,533,100,,,fee schedule,100% of CO APG rates,533,100,,,fee schedule,100% of CO APG rates,533,100,,,fee schedule,100% of NM fee schedule,213.2,40,,,percent of total billed charges,40% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,479.7,90,,,percent of total billed charges,90% of total billed charges,405.08,76,,,percent of total billed charges,76% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of CO APG rate,426.4,80,,,percent of total billed charges,80% of total billed charges,206.8,38.8,,,percent of total billed charges,38.8% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,206.8,533,
T2 ADV COMP SCREW TIBIA,46051664,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX100mm,46051682,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX105mm,46051683,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX110mm,46051684,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX115mm,46051685,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX120mm,46051686,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX25mm,46051687,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX27.5mm,46051688,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX32.5mm,46051689,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX47.5mm,46051690,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX52.5mm,46051691,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX57.5mm,46051692,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX65mm,46051693,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX70mm,46051694,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX75mm,46051695,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX80mm,46051696,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX85mm,46051697,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX90mm,46051698,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX95mm,46051699,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 STANDARD END CAP - 8mm,46051702,CDM,270,RC,,,OUTPATIENT,,,533,426.4,,399.75,75,,,percent of total billed charges,75% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,422.14,79.2,,,percent of total billed charges,79.2% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of CO APG rates,506.35,95,,,percent of total billed charges,95% of total billed charges,426.4,80,,,percent of total billed charges,80% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,479.7,90,,,percent of total billed charges,90% of total billed charges,533,100,,,fee schedule,100% of CO APG rates,533,100,,,fee schedule,100% of CO APG rates,533,100,,,fee schedule,100% of NM fee schedule,213.2,40,,,percent of total billed charges,40% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,479.7,90,,,percent of total billed charges,90% of total billed charges,405.08,76,,,percent of total billed charges,76% of total billed charges,213.2,40,,,percent of total billed charges,40% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of CO APG rate,426.4,80,,,percent of total billed charges,80% of total billed charges,206.8,38.8,,,percent of total billed charges,38.8% of total billed charges,453.05,85,,,percent of total billed charges,85% of total billed charges,533,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,206.8,533,
Ti SET SCREW 8X17.5mm,46051706,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
T2 F/T LOCKING SCREW 5mmX30mm,46051707,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
T2 F/T LOCKING SCREW 5mmX35mm,46051708,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
T2 F/T LOCKING SCREW 5mmX37.5mm,46051709,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
T2 F/T LOCKING SCREW 5mmX40mm,46051710,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
T2 F/T LOCKING SCREW 5mmX42.5mm,46051711,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
T2 F/T LOCKING SCREW 5mmX45mm,46051712,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
T2 F/T LOCKING SCREW 5mmX50mm,46051713,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
T2 F/T LOCKING SCREW 5mmX55mm,46051714,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
T2 F/T LOCKING SCREW 5mmX60mm,46051715,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
4.0 X40MM TI CANNULATED SCREW,46051716,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
4.0 X42MM TI CANNULATED SCREW,46051717,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
4.0 X46MM TI CANNULATED SCREW,46051718,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
4.0 X60MM TI CANNULATED SCREW,46051719,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
4.0 X70MM TI CANNULATED SCREW,46051720,CDM,278,RC,,,OUTPATIENT,,,524.2,419.36,,393.15,75,,,percent of total billed charges,75% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,415.17,79.2,,,percent of total billed charges,79.2% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,497.99,95,,,percent of total billed charges,95% of total billed charges,419.36,80,,,percent of total billed charges,80% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of CO APG rates,524.2,100,,,fee schedule,100% of NM fee schedule,209.68,40,,,percent of total billed charges,40% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,471.78,90,,,percent of total billed charges,90% of total billed charges,398.39,76,,,percent of total billed charges,76% of total billed charges,209.68,40,,,percent of total billed charges,40% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of CO APG rate,419.36,80,,,percent of total billed charges,80% of total billed charges,203.39,38.8,,,percent of total billed charges,38.8% of total billed charges,445.57,85,,,percent of total billed charges,85% of total billed charges,524.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.39,524.2,
4.0 X65MM TI CANNULATED SCREW,46051723,CDM,278,RC,,,OUTPATIENT,,,535.7,428.56,,401.78,75,,,percent of total billed charges,75% of total billed charges,214.28,40,,,percent of total billed charges,40% of total billed charges,424.27,79.2,,,percent of total billed charges,79.2% of total billed charges,455.35,85,,,percent of total billed charges,85% of total billed charges,535.7,100,,,fee schedule,100% of CO APG rates,508.92,95,,,percent of total billed charges,95% of total billed charges,428.56,80,,,percent of total billed charges,80% of total billed charges,455.35,85,,,percent of total billed charges,85% of total billed charges,482.13,90,,,percent of total billed charges,90% of total billed charges,535.7,100,,,fee schedule,100% of CO APG rates,535.7,100,,,fee schedule,100% of CO APG rates,535.7,100,,,fee schedule,100% of NM fee schedule,214.28,40,,,percent of total billed charges,40% of total billed charges,214.28,40,,,percent of total billed charges,40% of total billed charges,482.13,90,,,percent of total billed charges,90% of total billed charges,407.13,76,,,percent of total billed charges,76% of total billed charges,214.28,40,,,percent of total billed charges,40% of total billed charges,455.35,85,,,percent of total billed charges,85% of total billed charges,535.7,100,,,fee schedule,100% of CO APG rate,428.56,80,,,percent of total billed charges,80% of total billed charges,207.85,38.8,,,percent of total billed charges,38.8% of total billed charges,455.35,85,,,percent of total billed charges,85% of total billed charges,535.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,207.85,535.7,
4 0 X40mm Ti ASNIS III CANNULATED SCR,46051726,CDM,278,RC,,,OUTPATIENT,,,554.6,443.68,,415.95,75,,,percent of total billed charges,75% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,439.24,79.2,,,percent of total billed charges,79.2% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,526.87,95,,,percent of total billed charges,95% of total billed charges,443.68,80,,,percent of total billed charges,80% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of NM fee schedule,221.84,40,,,percent of total billed charges,40% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,421.5,76,,,percent of total billed charges,76% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rate,443.68,80,,,percent of total billed charges,80% of total billed charges,215.18,38.8,,,percent of total billed charges,38.8% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,215.18,554.6,
4.0 X38mm Ti ASNIS III CANNULATED SCR,46051727,CDM,278,RC,,,OUTPATIENT,,,554.6,443.68,,415.95,75,,,percent of total billed charges,75% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,439.24,79.2,,,percent of total billed charges,79.2% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,526.87,95,,,percent of total billed charges,95% of total billed charges,443.68,80,,,percent of total billed charges,80% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of NM fee schedule,221.84,40,,,percent of total billed charges,40% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,421.5,76,,,percent of total billed charges,76% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rate,443.68,80,,,percent of total billed charges,80% of total billed charges,215.18,38.8,,,percent of total billed charges,38.8% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,215.18,554.6,
4.0 X42mm Ti ASNIS III CANNULATED SCR,46051728,CDM,278,RC,,,OUTPATIENT,,,554.6,443.68,,415.95,75,,,percent of total billed charges,75% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,439.24,79.2,,,percent of total billed charges,79.2% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,526.87,95,,,percent of total billed charges,95% of total billed charges,443.68,80,,,percent of total billed charges,80% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of NM fee schedule,221.84,40,,,percent of total billed charges,40% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,421.5,76,,,percent of total billed charges,76% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rate,443.68,80,,,percent of total billed charges,80% of total billed charges,215.18,38.8,,,percent of total billed charges,38.8% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,215.18,554.6,
4.0 X44mm Ti ASNIS III CANNULATED SCR,46051729,CDM,278,RC,,,OUTPATIENT,,,554.6,443.68,,415.95,75,,,percent of total billed charges,75% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,439.24,79.2,,,percent of total billed charges,79.2% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,526.87,95,,,percent of total billed charges,95% of total billed charges,443.68,80,,,percent of total billed charges,80% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of NM fee schedule,221.84,40,,,percent of total billed charges,40% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,421.5,76,,,percent of total billed charges,76% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rate,443.68,80,,,percent of total billed charges,80% of total billed charges,215.18,38.8,,,percent of total billed charges,38.8% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,215.18,554.6,
4.0 X46mm Ti ASNIS III CANNULATED SCR,46051730,CDM,278,RC,,,OUTPATIENT,,,554.6,443.68,,415.95,75,,,percent of total billed charges,75% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,439.24,79.2,,,percent of total billed charges,79.2% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,526.87,95,,,percent of total billed charges,95% of total billed charges,443.68,80,,,percent of total billed charges,80% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of NM fee schedule,221.84,40,,,percent of total billed charges,40% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,421.5,76,,,percent of total billed charges,76% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rate,443.68,80,,,percent of total billed charges,80% of total billed charges,215.18,38.8,,,percent of total billed charges,38.8% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,215.18,554.6,
4.0 X48mm Ti ASNIS III CANNULATED SCR,46051731,CDM,278,RC,,,OUTPATIENT,,,554.6,443.68,,415.95,75,,,percent of total billed charges,75% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,439.24,79.2,,,percent of total billed charges,79.2% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,526.87,95,,,percent of total billed charges,95% of total billed charges,443.68,80,,,percent of total billed charges,80% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of NM fee schedule,221.84,40,,,percent of total billed charges,40% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,421.5,76,,,percent of total billed charges,76% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rate,443.68,80,,,percent of total billed charges,80% of total billed charges,215.18,38.8,,,percent of total billed charges,38.8% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,215.18,554.6,
4.0 X50mm Ti ASNIS III CANNULATED SCR,46051732,CDM,278,RC,,,OUTPATIENT,,,554.6,443.68,,415.95,75,,,percent of total billed charges,75% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,439.24,79.2,,,percent of total billed charges,79.2% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,526.87,95,,,percent of total billed charges,95% of total billed charges,443.68,80,,,percent of total billed charges,80% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of CO APG rates,554.6,100,,,fee schedule,100% of NM fee schedule,221.84,40,,,percent of total billed charges,40% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,499.14,90,,,percent of total billed charges,90% of total billed charges,421.5,76,,,percent of total billed charges,76% of total billed charges,221.84,40,,,percent of total billed charges,40% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of CO APG rate,443.68,80,,,percent of total billed charges,80% of total billed charges,215.18,38.8,,,percent of total billed charges,38.8% of total billed charges,471.41,85,,,percent of total billed charges,85% of total billed charges,554.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,215.18,554.6,
ASNIS III SS CANNULATED SCR 4X32MM FULL THREAD,46051733,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X34MM FULL THREAD,46051734,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X36MM FULL THREAD,46051735,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X38MM FULL THREAD,46051736,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X10mm FULL THREAD,46051738,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X12mm FULL THREAD,46051739,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X65mm FULL THREAD,46051775,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
ASNIS III SS CANNULATED SCR 4X70mm FULL THREAD,46051776,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,218.06,562,
4.0 X38MM TI CANNULATED SCREW,46051821,CDM,278,RC,,,OUTPATIENT,,,569.3,455.44,,426.98,75,,,percent of total billed charges,75% of total billed charges,227.72,40,,,percent of total billed charges,40% of total billed charges,450.89,79.2,,,percent of total billed charges,79.2% of total billed charges,483.91,85,,,percent of total billed charges,85% of total billed charges,569.3,100,,,fee schedule,100% of CO APG rates,540.84,95,,,percent of total billed charges,95% of total billed charges,455.44,80,,,percent of total billed charges,80% of total billed charges,483.91,85,,,percent of total billed charges,85% of total billed charges,512.37,90,,,percent of total billed charges,90% of total billed charges,569.3,100,,,fee schedule,100% of CO APG rates,569.3,100,,,fee schedule,100% of CO APG rates,569.3,100,,,fee schedule,100% of NM fee schedule,227.72,40,,,percent of total billed charges,40% of total billed charges,227.72,40,,,percent of total billed charges,40% of total billed charges,512.37,90,,,percent of total billed charges,90% of total billed charges,432.67,76,,,percent of total billed charges,76% of total billed charges,227.72,40,,,percent of total billed charges,40% of total billed charges,483.91,85,,,percent of total billed charges,85% of total billed charges,569.3,100,,,fee schedule,100% of CO APG rate,455.44,80,,,percent of total billed charges,80% of total billed charges,220.89,38.8,,,percent of total billed charges,38.8% of total billed charges,483.91,85,,,percent of total billed charges,85% of total billed charges,569.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,220.89,569.3,
LOCKING COMPR NARROW 10 HOLE / L187MM,46051822,CDM,278,RC,,,OUTPATIENT,,,584,467.2,,438,75,,,percent of total billed charges,75% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,462.53,79.2,,,percent of total billed charges,79.2% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of CO APG rates,554.8,95,,,percent of total billed charges,95% of total billed charges,467.2,80,,,percent of total billed charges,80% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,525.6,90,,,percent of total billed charges,90% of total billed charges,584,100,,,fee schedule,100% of CO APG rates,584,100,,,fee schedule,100% of CO APG rates,584,100,,,fee schedule,100% of NM fee schedule,233.6,40,,,percent of total billed charges,40% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,525.6,90,,,percent of total billed charges,90% of total billed charges,443.84,76,,,percent of total billed charges,76% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of CO APG rate,467.2,80,,,percent of total billed charges,80% of total billed charges,226.59,38.8,,,percent of total billed charges,38.8% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,226.59,584,
LOCKING COMPR NARROW 7 HOLE / L133MM,46051823,CDM,278,RC,,,OUTPATIENT,,,584,467.2,,438,75,,,percent of total billed charges,75% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,462.53,79.2,,,percent of total billed charges,79.2% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of CO APG rates,554.8,95,,,percent of total billed charges,95% of total billed charges,467.2,80,,,percent of total billed charges,80% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,525.6,90,,,percent of total billed charges,90% of total billed charges,584,100,,,fee schedule,100% of CO APG rates,584,100,,,fee schedule,100% of CO APG rates,584,100,,,fee schedule,100% of NM fee schedule,233.6,40,,,percent of total billed charges,40% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,525.6,90,,,percent of total billed charges,90% of total billed charges,443.84,76,,,percent of total billed charges,76% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of CO APG rate,467.2,80,,,percent of total billed charges,80% of total billed charges,226.59,38.8,,,percent of total billed charges,38.8% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,226.59,584,
LOCKING COMPR NARROW 8 HOLE / L151MM,46051824,CDM,278,RC,,,OUTPATIENT,,,584,467.2,,438,75,,,percent of total billed charges,75% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,462.53,79.2,,,percent of total billed charges,79.2% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of CO APG rates,554.8,95,,,percent of total billed charges,95% of total billed charges,467.2,80,,,percent of total billed charges,80% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,525.6,90,,,percent of total billed charges,90% of total billed charges,584,100,,,fee schedule,100% of CO APG rates,584,100,,,fee schedule,100% of CO APG rates,584,100,,,fee schedule,100% of NM fee schedule,233.6,40,,,percent of total billed charges,40% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,525.6,90,,,percent of total billed charges,90% of total billed charges,443.84,76,,,percent of total billed charges,76% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of CO APG rate,467.2,80,,,percent of total billed charges,80% of total billed charges,226.59,38.8,,,percent of total billed charges,38.8% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,226.59,584,
LOCKING COMPR NARROW 9 HOLE / L169MM,46051825,CDM,278,RC,,,OUTPATIENT,,,584,467.2,,438,75,,,percent of total billed charges,75% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,462.53,79.2,,,percent of total billed charges,79.2% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of CO APG rates,554.8,95,,,percent of total billed charges,95% of total billed charges,467.2,80,,,percent of total billed charges,80% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,525.6,90,,,percent of total billed charges,90% of total billed charges,584,100,,,fee schedule,100% of CO APG rates,584,100,,,fee schedule,100% of CO APG rates,584,100,,,fee schedule,100% of NM fee schedule,233.6,40,,,percent of total billed charges,40% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,525.6,90,,,percent of total billed charges,90% of total billed charges,443.84,76,,,percent of total billed charges,76% of total billed charges,233.6,40,,,percent of total billed charges,40% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of CO APG rate,467.2,80,,,percent of total billed charges,80% of total billed charges,226.59,38.8,,,percent of total billed charges,38.8% of total billed charges,496.4,85,,,percent of total billed charges,85% of total billed charges,584,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,226.59,584,
ASNIS III SS CANNULATED SCR 5X26mm FULL THREAD,46051826,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X48mm FULL THREAD,46051827,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X20mm,46051828,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X22mm,46051830,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X24mm,46051832,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X26mm,46051834,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X28mm,46051835,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X30mm,46051837,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X32mm,46051839,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X34mm,46051841,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X36mm,46051843,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X38mm,46051845,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X40mm,46051847,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X42mm,46051849,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X44mm,46051851,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X46mm,46051853,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X48mm,46051855,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X50mm,46051856,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X55mm,46051858,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X60mm,46051860,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X65mm,46051862,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X70mm,46051864,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X75mm,46051866,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
ASNIS III SS CANNULATED SCR 5X80mm,46051867,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.22,588.2,
LOCKING COMPR BROAD 6 HOLE / L119MM,46051912,CDM,278,RC,,,OUTPATIENT,,,693.3,554.64,,519.98,75,,,percent of total billed charges,75% of total billed charges,277.32,40,,,percent of total billed charges,40% of total billed charges,549.09,79.2,,,percent of total billed charges,79.2% of total billed charges,589.31,85,,,percent of total billed charges,85% of total billed charges,693.3,100,,,fee schedule,100% of CO APG rates,658.64,95,,,percent of total billed charges,95% of total billed charges,554.64,80,,,percent of total billed charges,80% of total billed charges,589.31,85,,,percent of total billed charges,85% of total billed charges,623.97,90,,,percent of total billed charges,90% of total billed charges,693.3,100,,,fee schedule,100% of CO APG rates,693.3,100,,,fee schedule,100% of CO APG rates,693.3,100,,,fee schedule,100% of NM fee schedule,277.32,40,,,percent of total billed charges,40% of total billed charges,277.32,40,,,percent of total billed charges,40% of total billed charges,623.97,90,,,percent of total billed charges,90% of total billed charges,526.91,76,,,percent of total billed charges,76% of total billed charges,277.32,40,,,percent of total billed charges,40% of total billed charges,589.31,85,,,percent of total billed charges,85% of total billed charges,693.3,100,,,fee schedule,100% of CO APG rate,554.64,80,,,percent of total billed charges,80% of total billed charges,269,38.8,,,percent of total billed charges,38.8% of total billed charges,589.31,85,,,percent of total billed charges,85% of total billed charges,693.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,269,693.3,
ASNIS III SS CANNULATED SCR 6.5X100mm PARTIAL THREAD 20,46051913,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X105mm PARTIAL THREAD 20,46051915,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X110mm PARTIAL THREAD 20,46051917,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X115mm PARTIAL THREAD 20,46051919,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X120mm PARTIAL THREAD 20,46051921,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X40mm THREAD 20MM,46051923,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X45mm THREAD 20MM,46051924,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X50mm THREAD 20MM,46051925,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X55mm THREAD 20MM,46051926,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X60mm THREAD 20MM,46051928,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X65mm THREAD 20MM,46051930,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X70mm THREAD 20MM,46051932,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X75mm THREAD 20MM,46051934,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X80mm THREAD 20MM,46051936,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X85mm THREAD 20MM,46051938,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X90mm THREAD 20MM,46051940,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X95mm THREAD 20MM,46051942,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
LOCKING COMPR NARROW 12 HOLE / L223MM,46051975,CDM,278,RC,,,OUTPATIENT,,,738.4,590.72,,553.8,75,,,percent of total billed charges,75% of total billed charges,295.36,40,,,percent of total billed charges,40% of total billed charges,584.81,79.2,,,percent of total billed charges,79.2% of total billed charges,627.64,85,,,percent of total billed charges,85% of total billed charges,738.4,100,,,fee schedule,100% of CO APG rates,701.48,95,,,percent of total billed charges,95% of total billed charges,590.72,80,,,percent of total billed charges,80% of total billed charges,627.64,85,,,percent of total billed charges,85% of total billed charges,664.56,90,,,percent of total billed charges,90% of total billed charges,738.4,100,,,fee schedule,100% of CO APG rates,738.4,100,,,fee schedule,100% of CO APG rates,738.4,100,,,fee schedule,100% of NM fee schedule,295.36,40,,,percent of total billed charges,40% of total billed charges,295.36,40,,,percent of total billed charges,40% of total billed charges,664.56,90,,,percent of total billed charges,90% of total billed charges,561.18,76,,,percent of total billed charges,76% of total billed charges,295.36,40,,,percent of total billed charges,40% of total billed charges,627.64,85,,,percent of total billed charges,85% of total billed charges,738.4,100,,,fee schedule,100% of CO APG rate,590.72,80,,,percent of total billed charges,80% of total billed charges,286.5,38.8,,,percent of total billed charges,38.8% of total billed charges,627.64,85,,,percent of total billed charges,85% of total billed charges,738.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,286.5,738.4,
ASNIS III SS CANNULATED SCR 8.0X100mm,46051977,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X105mm,46051978,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X110mm,46051979,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X115mm,46051980,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X120mm,46051981,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X40mm,46051982,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X45mm,46051983,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X50mm,46051984,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X55mm,46051985,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X60mm,46051986,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X65mm,46051987,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X70mm,46051988,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X75mm,46051989,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X80mm,46051990,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X85mm,46051991,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X90mm,46051992,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
ASNIS III SS CANNULATED SCR 8.0X95mm,46051993,CDM,278,RC,,,OUTPATIENT,,,768.9,615.12,,576.68,75,,,percent of total billed charges,75% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,608.97,79.2,,,percent of total billed charges,79.2% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,730.46,95,,,percent of total billed charges,95% of total billed charges,615.12,80,,,percent of total billed charges,80% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of CO APG rates,768.9,100,,,fee schedule,100% of NM fee schedule,307.56,40,,,percent of total billed charges,40% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,692.01,90,,,percent of total billed charges,90% of total billed charges,584.36,76,,,percent of total billed charges,76% of total billed charges,307.56,40,,,percent of total billed charges,40% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of CO APG rate,615.12,80,,,percent of total billed charges,80% of total billed charges,298.33,38.8,,,percent of total billed charges,38.8% of total billed charges,653.57,85,,,percent of total billed charges,85% of total billed charges,768.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,298.33,768.9,
LOCKING COMPR BROAD 7 HOLE / L137MM,46052011,CDM,278,RC,,,OUTPATIENT,,,776.3,621.04,,582.23,75,,,percent of total billed charges,75% of total billed charges,310.52,40,,,percent of total billed charges,40% of total billed charges,614.83,79.2,,,percent of total billed charges,79.2% of total billed charges,659.86,85,,,percent of total billed charges,85% of total billed charges,776.3,100,,,fee schedule,100% of CO APG rates,737.49,95,,,percent of total billed charges,95% of total billed charges,621.04,80,,,percent of total billed charges,80% of total billed charges,659.86,85,,,percent of total billed charges,85% of total billed charges,698.67,90,,,percent of total billed charges,90% of total billed charges,776.3,100,,,fee schedule,100% of CO APG rates,776.3,100,,,fee schedule,100% of CO APG rates,776.3,100,,,fee schedule,100% of NM fee schedule,310.52,40,,,percent of total billed charges,40% of total billed charges,310.52,40,,,percent of total billed charges,40% of total billed charges,698.67,90,,,percent of total billed charges,90% of total billed charges,589.99,76,,,percent of total billed charges,76% of total billed charges,310.52,40,,,percent of total billed charges,40% of total billed charges,659.86,85,,,percent of total billed charges,85% of total billed charges,776.3,100,,,fee schedule,100% of CO APG rate,621.04,80,,,percent of total billed charges,80% of total billed charges,301.2,38.8,,,percent of total billed charges,38.8% of total billed charges,659.86,85,,,percent of total billed charges,85% of total billed charges,776.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,301.2,776.3,
LOCKING COMPR BROAD 10 HOLE / L191MM,46052012,CDM,278,RC,,,OUTPATIENT,,,779.4,623.52,,584.55,75,,,percent of total billed charges,75% of total billed charges,311.76,40,,,percent of total billed charges,40% of total billed charges,617.28,79.2,,,percent of total billed charges,79.2% of total billed charges,662.49,85,,,percent of total billed charges,85% of total billed charges,779.4,100,,,fee schedule,100% of CO APG rates,740.43,95,,,percent of total billed charges,95% of total billed charges,623.52,80,,,percent of total billed charges,80% of total billed charges,662.49,85,,,percent of total billed charges,85% of total billed charges,701.46,90,,,percent of total billed charges,90% of total billed charges,779.4,100,,,fee schedule,100% of CO APG rates,779.4,100,,,fee schedule,100% of CO APG rates,779.4,100,,,fee schedule,100% of NM fee schedule,311.76,40,,,percent of total billed charges,40% of total billed charges,311.76,40,,,percent of total billed charges,40% of total billed charges,701.46,90,,,percent of total billed charges,90% of total billed charges,592.34,76,,,percent of total billed charges,76% of total billed charges,311.76,40,,,percent of total billed charges,40% of total billed charges,662.49,85,,,percent of total billed charges,85% of total billed charges,779.4,100,,,fee schedule,100% of CO APG rate,623.52,80,,,percent of total billed charges,80% of total billed charges,302.41,38.8,,,percent of total billed charges,38.8% of total billed charges,662.49,85,,,percent of total billed charges,85% of total billed charges,779.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.41,779.4,
LOCKING COMPR BROAD 8 HOLE / L155MM,46052013,CDM,278,RC,,,OUTPATIENT,,,779.4,623.52,,584.55,75,,,percent of total billed charges,75% of total billed charges,311.76,40,,,percent of total billed charges,40% of total billed charges,617.28,79.2,,,percent of total billed charges,79.2% of total billed charges,662.49,85,,,percent of total billed charges,85% of total billed charges,779.4,100,,,fee schedule,100% of CO APG rates,740.43,95,,,percent of total billed charges,95% of total billed charges,623.52,80,,,percent of total billed charges,80% of total billed charges,662.49,85,,,percent of total billed charges,85% of total billed charges,701.46,90,,,percent of total billed charges,90% of total billed charges,779.4,100,,,fee schedule,100% of CO APG rates,779.4,100,,,fee schedule,100% of CO APG rates,779.4,100,,,fee schedule,100% of NM fee schedule,311.76,40,,,percent of total billed charges,40% of total billed charges,311.76,40,,,percent of total billed charges,40% of total billed charges,701.46,90,,,percent of total billed charges,90% of total billed charges,592.34,76,,,percent of total billed charges,76% of total billed charges,311.76,40,,,percent of total billed charges,40% of total billed charges,662.49,85,,,percent of total billed charges,85% of total billed charges,779.4,100,,,fee schedule,100% of CO APG rate,623.52,80,,,percent of total billed charges,80% of total billed charges,302.41,38.8,,,percent of total billed charges,38.8% of total billed charges,662.49,85,,,percent of total billed charges,85% of total billed charges,779.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.41,779.4,
LOCKING COMPR BROAD 11 HOLE / L209MM,46052015,CDM,278,RC,,,OUTPATIENT,,,865.5,692.4,,649.13,75,,,percent of total billed charges,75% of total billed charges,346.2,40,,,percent of total billed charges,40% of total billed charges,685.48,79.2,,,percent of total billed charges,79.2% of total billed charges,735.68,85,,,percent of total billed charges,85% of total billed charges,865.5,100,,,fee schedule,100% of CO APG rates,822.23,95,,,percent of total billed charges,95% of total billed charges,692.4,80,,,percent of total billed charges,80% of total billed charges,735.68,85,,,percent of total billed charges,85% of total billed charges,778.95,90,,,percent of total billed charges,90% of total billed charges,865.5,100,,,fee schedule,100% of CO APG rates,865.5,100,,,fee schedule,100% of CO APG rates,865.5,100,,,fee schedule,100% of NM fee schedule,346.2,40,,,percent of total billed charges,40% of total billed charges,346.2,40,,,percent of total billed charges,40% of total billed charges,778.95,90,,,percent of total billed charges,90% of total billed charges,657.78,76,,,percent of total billed charges,76% of total billed charges,346.2,40,,,percent of total billed charges,40% of total billed charges,735.68,85,,,percent of total billed charges,85% of total billed charges,865.5,100,,,fee schedule,100% of CO APG rate,692.4,80,,,percent of total billed charges,80% of total billed charges,335.81,38.8,,,percent of total billed charges,38.8% of total billed charges,735.68,85,,,percent of total billed charges,85% of total billed charges,865.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,335.81,865.5,
"OMEGA3 STANDARD BARREL HIP PLATE, KEYED 135?, 2 HOLES",46052019,CDM,278,RC,,,OUTPATIENT,,,1120.8,896.64,,840.6,75,,,percent of total billed charges,75% of total billed charges,448.32,40,,,percent of total billed charges,40% of total billed charges,887.67,79.2,,,percent of total billed charges,79.2% of total billed charges,952.68,85,,,percent of total billed charges,85% of total billed charges,1120.8,100,,,fee schedule,100% of CO APG rates,1064.76,95,,,percent of total billed charges,95% of total billed charges,896.64,80,,,percent of total billed charges,80% of total billed charges,952.68,85,,,percent of total billed charges,85% of total billed charges,1008.72,90,,,percent of total billed charges,90% of total billed charges,1120.8,100,,,fee schedule,100% of CO APG rates,1120.8,100,,,fee schedule,100% of CO APG rates,1120.8,100,,,fee schedule,100% of NM fee schedule,448.32,40,,,percent of total billed charges,40% of total billed charges,448.32,40,,,percent of total billed charges,40% of total billed charges,1008.72,90,,,percent of total billed charges,90% of total billed charges,851.81,76,,,percent of total billed charges,76% of total billed charges,448.32,40,,,percent of total billed charges,40% of total billed charges,952.68,85,,,percent of total billed charges,85% of total billed charges,1120.8,100,,,fee schedule,100% of CO APG rate,896.64,80,,,percent of total billed charges,80% of total billed charges,434.87,38.8,,,percent of total billed charges,38.8% of total billed charges,952.68,85,,,percent of total billed charges,85% of total billed charges,1120.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,434.87,1120.8,
"OMEGA3 STANDARD BARREL HIP PLATE, KEYED 135?, 3 HOLES",46052022,CDM,278,RC,,,OUTPATIENT,,,1153.3,922.64,,864.98,75,,,percent of total billed charges,75% of total billed charges,461.32,40,,,percent of total billed charges,40% of total billed charges,913.41,79.2,,,percent of total billed charges,79.2% of total billed charges,980.31,85,,,percent of total billed charges,85% of total billed charges,1153.3,100,,,fee schedule,100% of CO APG rates,1095.64,95,,,percent of total billed charges,95% of total billed charges,922.64,80,,,percent of total billed charges,80% of total billed charges,980.31,85,,,percent of total billed charges,85% of total billed charges,1037.97,90,,,percent of total billed charges,90% of total billed charges,1153.3,100,,,fee schedule,100% of CO APG rates,1153.3,100,,,fee schedule,100% of CO APG rates,1153.3,100,,,fee schedule,100% of NM fee schedule,461.32,40,,,percent of total billed charges,40% of total billed charges,461.32,40,,,percent of total billed charges,40% of total billed charges,1037.97,90,,,percent of total billed charges,90% of total billed charges,876.51,76,,,percent of total billed charges,76% of total billed charges,461.32,40,,,percent of total billed charges,40% of total billed charges,980.31,85,,,percent of total billed charges,85% of total billed charges,1153.3,100,,,fee schedule,100% of CO APG rate,922.64,80,,,percent of total billed charges,80% of total billed charges,447.48,38.8,,,percent of total billed charges,38.8% of total billed charges,980.31,85,,,percent of total billed charges,85% of total billed charges,1153.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,447.48,1153.3,
"OMEGA3 STANDARD BARREL HIP PLATE, KEYED 140?, 3 HOLES",46052023,CDM,278,RC,,,OUTPATIENT,,,1153.3,922.64,,864.98,75,,,percent of total billed charges,75% of total billed charges,461.32,40,,,percent of total billed charges,40% of total billed charges,913.41,79.2,,,percent of total billed charges,79.2% of total billed charges,980.31,85,,,percent of total billed charges,85% of total billed charges,1153.3,100,,,fee schedule,100% of CO APG rates,1095.64,95,,,percent of total billed charges,95% of total billed charges,922.64,80,,,percent of total billed charges,80% of total billed charges,980.31,85,,,percent of total billed charges,85% of total billed charges,1037.97,90,,,percent of total billed charges,90% of total billed charges,1153.3,100,,,fee schedule,100% of CO APG rates,1153.3,100,,,fee schedule,100% of CO APG rates,1153.3,100,,,fee schedule,100% of NM fee schedule,461.32,40,,,percent of total billed charges,40% of total billed charges,461.32,40,,,percent of total billed charges,40% of total billed charges,1037.97,90,,,percent of total billed charges,90% of total billed charges,876.51,76,,,percent of total billed charges,76% of total billed charges,461.32,40,,,percent of total billed charges,40% of total billed charges,980.31,85,,,percent of total billed charges,85% of total billed charges,1153.3,100,,,fee schedule,100% of CO APG rate,922.64,80,,,percent of total billed charges,80% of total billed charges,447.48,38.8,,,percent of total billed charges,38.8% of total billed charges,980.31,85,,,percent of total billed charges,85% of total billed charges,1153.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,447.48,1153.3,
VARIAX STRAIGHT PLATE 2 HOLE,46052027,CDM,278,RC,,,OUTPATIENT,,,1169.1,935.28,,876.83,75,,,percent of total billed charges,75% of total billed charges,467.64,40,,,percent of total billed charges,40% of total billed charges,925.93,79.2,,,percent of total billed charges,79.2% of total billed charges,993.74,85,,,percent of total billed charges,85% of total billed charges,1169.1,100,,,fee schedule,100% of CO APG rates,1110.65,95,,,percent of total billed charges,95% of total billed charges,935.28,80,,,percent of total billed charges,80% of total billed charges,993.74,85,,,percent of total billed charges,85% of total billed charges,1052.19,90,,,percent of total billed charges,90% of total billed charges,1169.1,100,,,fee schedule,100% of CO APG rates,1169.1,100,,,fee schedule,100% of CO APG rates,1169.1,100,,,fee schedule,100% of NM fee schedule,467.64,40,,,percent of total billed charges,40% of total billed charges,467.64,40,,,percent of total billed charges,40% of total billed charges,1052.19,90,,,percent of total billed charges,90% of total billed charges,888.52,76,,,percent of total billed charges,76% of total billed charges,467.64,40,,,percent of total billed charges,40% of total billed charges,993.74,85,,,percent of total billed charges,85% of total billed charges,1169.1,100,,,fee schedule,100% of CO APG rate,935.28,80,,,percent of total billed charges,80% of total billed charges,453.61,38.8,,,percent of total billed charges,38.8% of total billed charges,993.74,85,,,percent of total billed charges,85% of total billed charges,1169.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,453.61,1169.1,
VARIAX STRAIGHT PLATE 3 HOLE,46052028,CDM,278,RC,,,OUTPATIENT,,,1169.1,935.28,,876.83,75,,,percent of total billed charges,75% of total billed charges,467.64,40,,,percent of total billed charges,40% of total billed charges,925.93,79.2,,,percent of total billed charges,79.2% of total billed charges,993.74,85,,,percent of total billed charges,85% of total billed charges,1169.1,100,,,fee schedule,100% of CO APG rates,1110.65,95,,,percent of total billed charges,95% of total billed charges,935.28,80,,,percent of total billed charges,80% of total billed charges,993.74,85,,,percent of total billed charges,85% of total billed charges,1052.19,90,,,percent of total billed charges,90% of total billed charges,1169.1,100,,,fee schedule,100% of CO APG rates,1169.1,100,,,fee schedule,100% of CO APG rates,1169.1,100,,,fee schedule,100% of NM fee schedule,467.64,40,,,percent of total billed charges,40% of total billed charges,467.64,40,,,percent of total billed charges,40% of total billed charges,1052.19,90,,,percent of total billed charges,90% of total billed charges,888.52,76,,,percent of total billed charges,76% of total billed charges,467.64,40,,,percent of total billed charges,40% of total billed charges,993.74,85,,,percent of total billed charges,85% of total billed charges,1169.1,100,,,fee schedule,100% of CO APG rate,935.28,80,,,percent of total billed charges,80% of total billed charges,453.61,38.8,,,percent of total billed charges,38.8% of total billed charges,993.74,85,,,percent of total billed charges,85% of total billed charges,1169.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,453.61,1169.1,
"OMEGA3 STANDARD BARREL HIP PLATE, KEYED 135?, 4 HOLES",46052029,CDM,278,RC,,,OUTPATIENT,,,1200.6,960.48,,900.45,75,,,percent of total billed charges,75% of total billed charges,480.24,40,,,percent of total billed charges,40% of total billed charges,950.88,79.2,,,percent of total billed charges,79.2% of total billed charges,1020.51,85,,,percent of total billed charges,85% of total billed charges,1200.6,100,,,fee schedule,100% of CO APG rates,1140.57,95,,,percent of total billed charges,95% of total billed charges,960.48,80,,,percent of total billed charges,80% of total billed charges,1020.51,85,,,percent of total billed charges,85% of total billed charges,1080.54,90,,,percent of total billed charges,90% of total billed charges,1200.6,100,,,fee schedule,100% of CO APG rates,1200.6,100,,,fee schedule,100% of CO APG rates,1200.6,100,,,fee schedule,100% of NM fee schedule,480.24,40,,,percent of total billed charges,40% of total billed charges,480.24,40,,,percent of total billed charges,40% of total billed charges,1080.54,90,,,percent of total billed charges,90% of total billed charges,912.46,76,,,percent of total billed charges,76% of total billed charges,480.24,40,,,percent of total billed charges,40% of total billed charges,1020.51,85,,,percent of total billed charges,85% of total billed charges,1200.6,100,,,fee schedule,100% of CO APG rate,960.48,80,,,percent of total billed charges,80% of total billed charges,465.83,38.8,,,percent of total billed charges,38.8% of total billed charges,1020.51,85,,,percent of total billed charges,85% of total billed charges,1200.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,465.83,1200.6,
"OMEGA3 STANDARD BARREL HIP PLATE, KEYED 140?, 4 HOLES",46052030,CDM,278,RC,,,OUTPATIENT,,,1200.6,960.48,,900.45,75,,,percent of total billed charges,75% of total billed charges,480.24,40,,,percent of total billed charges,40% of total billed charges,950.88,79.2,,,percent of total billed charges,79.2% of total billed charges,1020.51,85,,,percent of total billed charges,85% of total billed charges,1200.6,100,,,fee schedule,100% of CO APG rates,1140.57,95,,,percent of total billed charges,95% of total billed charges,960.48,80,,,percent of total billed charges,80% of total billed charges,1020.51,85,,,percent of total billed charges,85% of total billed charges,1080.54,90,,,percent of total billed charges,90% of total billed charges,1200.6,100,,,fee schedule,100% of CO APG rates,1200.6,100,,,fee schedule,100% of CO APG rates,1200.6,100,,,fee schedule,100% of NM fee schedule,480.24,40,,,percent of total billed charges,40% of total billed charges,480.24,40,,,percent of total billed charges,40% of total billed charges,1080.54,90,,,percent of total billed charges,90% of total billed charges,912.46,76,,,percent of total billed charges,76% of total billed charges,480.24,40,,,percent of total billed charges,40% of total billed charges,1020.51,85,,,percent of total billed charges,85% of total billed charges,1200.6,100,,,fee schedule,100% of CO APG rate,960.48,80,,,percent of total billed charges,80% of total billed charges,465.83,38.8,,,percent of total billed charges,38.8% of total billed charges,1020.51,85,,,percent of total billed charges,85% of total billed charges,1200.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,465.83,1200.6,
"OMEGA3 STANDARD BARREL HIP PLATE, KEYED 130?, 2 HOLES",46052040,CDM,278,RC,,,OUTPATIENT,,,1247.9,998.32,,935.93,75,,,percent of total billed charges,75% of total billed charges,499.16,40,,,percent of total billed charges,40% of total billed charges,988.34,79.2,,,percent of total billed charges,79.2% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1247.9,100,,,fee schedule,100% of CO APG rates,1185.51,95,,,percent of total billed charges,95% of total billed charges,998.32,80,,,percent of total billed charges,80% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1123.11,90,,,percent of total billed charges,90% of total billed charges,1247.9,100,,,fee schedule,100% of CO APG rates,1247.9,100,,,fee schedule,100% of CO APG rates,1247.9,100,,,fee schedule,100% of NM fee schedule,499.16,40,,,percent of total billed charges,40% of total billed charges,499.16,40,,,percent of total billed charges,40% of total billed charges,1123.11,90,,,percent of total billed charges,90% of total billed charges,948.4,76,,,percent of total billed charges,76% of total billed charges,499.16,40,,,percent of total billed charges,40% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1247.9,100,,,fee schedule,100% of CO APG rate,998.32,80,,,percent of total billed charges,80% of total billed charges,484.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1247.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,484.19,1247.9,
"OMEGA3 STANDARD BARREL HIP PLATE, KEYED 130?, 3 HOLES",46052041,CDM,278,RC,,,OUTPATIENT,,,1247.9,998.32,,935.93,75,,,percent of total billed charges,75% of total billed charges,499.16,40,,,percent of total billed charges,40% of total billed charges,988.34,79.2,,,percent of total billed charges,79.2% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1247.9,100,,,fee schedule,100% of CO APG rates,1185.51,95,,,percent of total billed charges,95% of total billed charges,998.32,80,,,percent of total billed charges,80% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1123.11,90,,,percent of total billed charges,90% of total billed charges,1247.9,100,,,fee schedule,100% of CO APG rates,1247.9,100,,,fee schedule,100% of CO APG rates,1247.9,100,,,fee schedule,100% of NM fee schedule,499.16,40,,,percent of total billed charges,40% of total billed charges,499.16,40,,,percent of total billed charges,40% of total billed charges,1123.11,90,,,percent of total billed charges,90% of total billed charges,948.4,76,,,percent of total billed charges,76% of total billed charges,499.16,40,,,percent of total billed charges,40% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1247.9,100,,,fee schedule,100% of CO APG rate,998.32,80,,,percent of total billed charges,80% of total billed charges,484.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1247.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,484.19,1247.9,
"OMEGA3 STANDARD BARREL HIP PLATE, KEYED 130?, 4 HOLES",46052042,CDM,278,RC,,,OUTPATIENT,,,1247.9,998.32,,935.93,75,,,percent of total billed charges,75% of total billed charges,499.16,40,,,percent of total billed charges,40% of total billed charges,988.34,79.2,,,percent of total billed charges,79.2% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1247.9,100,,,fee schedule,100% of CO APG rates,1185.51,95,,,percent of total billed charges,95% of total billed charges,998.32,80,,,percent of total billed charges,80% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1123.11,90,,,percent of total billed charges,90% of total billed charges,1247.9,100,,,fee schedule,100% of CO APG rates,1247.9,100,,,fee schedule,100% of CO APG rates,1247.9,100,,,fee schedule,100% of NM fee schedule,499.16,40,,,percent of total billed charges,40% of total billed charges,499.16,40,,,percent of total billed charges,40% of total billed charges,1123.11,90,,,percent of total billed charges,90% of total billed charges,948.4,76,,,percent of total billed charges,76% of total billed charges,499.16,40,,,percent of total billed charges,40% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1247.9,100,,,fee schedule,100% of CO APG rate,998.32,80,,,percent of total billed charges,80% of total billed charges,484.19,38.8,,,percent of total billed charges,38.8% of total billed charges,1060.72,85,,,percent of total billed charges,85% of total billed charges,1247.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,484.19,1247.9,
Ti LAG SCREW 10.5X120mm,46052046,CDM,278,RC,,,OUTPATIENT,,,1248.9,999.12,,936.68,75,,,percent of total billed charges,75% of total billed charges,499.56,40,,,percent of total billed charges,40% of total billed charges,989.13,79.2,,,percent of total billed charges,79.2% of total billed charges,1061.57,85,,,percent of total billed charges,85% of total billed charges,1248.9,100,,,fee schedule,100% of CO APG rates,1186.46,95,,,percent of total billed charges,95% of total billed charges,999.12,80,,,percent of total billed charges,80% of total billed charges,1061.57,85,,,percent of total billed charges,85% of total billed charges,1124.01,90,,,percent of total billed charges,90% of total billed charges,1248.9,100,,,fee schedule,100% of CO APG rates,1248.9,100,,,fee schedule,100% of CO APG rates,1248.9,100,,,fee schedule,100% of NM fee schedule,499.56,40,,,percent of total billed charges,40% of total billed charges,499.56,40,,,percent of total billed charges,40% of total billed charges,1124.01,90,,,percent of total billed charges,90% of total billed charges,949.16,76,,,percent of total billed charges,76% of total billed charges,499.56,40,,,percent of total billed charges,40% of total billed charges,1061.57,85,,,percent of total billed charges,85% of total billed charges,1248.9,100,,,fee schedule,100% of CO APG rate,999.12,80,,,percent of total billed charges,80% of total billed charges,484.57,38.8,,,percent of total billed charges,38.8% of total billed charges,1061.57,85,,,percent of total billed charges,85% of total billed charges,1248.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,484.57,1248.9,
Ti LAG SCREW 10.5X75mm,46052047,CDM,278,RC,,,OUTPATIENT,,,1248.9,999.12,,936.68,75,,,percent of total billed charges,75% of total billed charges,499.56,40,,,percent of total billed charges,40% of total billed charges,989.13,79.2,,,percent of total billed charges,79.2% of total billed charges,1061.57,85,,,percent of total billed charges,85% of total billed charges,1248.9,100,,,fee schedule,100% of CO APG rates,1186.46,95,,,percent of total billed charges,95% of total billed charges,999.12,80,,,percent of total billed charges,80% of total billed charges,1061.57,85,,,percent of total billed charges,85% of total billed charges,1124.01,90,,,percent of total billed charges,90% of total billed charges,1248.9,100,,,fee schedule,100% of CO APG rates,1248.9,100,,,fee schedule,100% of CO APG rates,1248.9,100,,,fee schedule,100% of NM fee schedule,499.56,40,,,percent of total billed charges,40% of total billed charges,499.56,40,,,percent of total billed charges,40% of total billed charges,1124.01,90,,,percent of total billed charges,90% of total billed charges,949.16,76,,,percent of total billed charges,76% of total billed charges,499.56,40,,,percent of total billed charges,40% of total billed charges,1061.57,85,,,percent of total billed charges,85% of total billed charges,1248.9,100,,,fee schedule,100% of CO APG rate,999.12,80,,,percent of total billed charges,80% of total billed charges,484.57,38.8,,,percent of total billed charges,38.8% of total billed charges,1061.57,85,,,percent of total billed charges,85% of total billed charges,1248.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,484.57,1248.9,
Ti LAG SCREW 10.5X80mm,46052053,CDM,278,RC,,,OUTPATIENT,,,1277.3,1021.84,,957.98,75,,,percent of total billed charges,75% of total billed charges,510.92,40,,,percent of total billed charges,40% of total billed charges,1011.62,79.2,,,percent of total billed charges,79.2% of total billed charges,1085.71,85,,,percent of total billed charges,85% of total billed charges,1277.3,100,,,fee schedule,100% of CO APG rates,1213.44,95,,,percent of total billed charges,95% of total billed charges,1021.84,80,,,percent of total billed charges,80% of total billed charges,1085.71,85,,,percent of total billed charges,85% of total billed charges,1149.57,90,,,percent of total billed charges,90% of total billed charges,1277.3,100,,,fee schedule,100% of CO APG rates,1277.3,100,,,fee schedule,100% of CO APG rates,1277.3,100,,,fee schedule,100% of NM fee schedule,510.92,40,,,percent of total billed charges,40% of total billed charges,510.92,40,,,percent of total billed charges,40% of total billed charges,1149.57,90,,,percent of total billed charges,90% of total billed charges,970.75,76,,,percent of total billed charges,76% of total billed charges,510.92,40,,,percent of total billed charges,40% of total billed charges,1085.71,85,,,percent of total billed charges,85% of total billed charges,1277.3,100,,,fee schedule,100% of CO APG rate,1021.84,80,,,percent of total billed charges,80% of total billed charges,495.59,38.8,,,percent of total billed charges,38.8% of total billed charges,1085.71,85,,,percent of total billed charges,85% of total billed charges,1277.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,495.59,1277.3,
Ti LAG SCREW 10.5X85mm,46052054,CDM,278,RC,,,OUTPATIENT,,,1277.3,1021.84,,957.98,75,,,percent of total billed charges,75% of total billed charges,510.92,40,,,percent of total billed charges,40% of total billed charges,1011.62,79.2,,,percent of total billed charges,79.2% of total billed charges,1085.71,85,,,percent of total billed charges,85% of total billed charges,1277.3,100,,,fee schedule,100% of CO APG rates,1213.44,95,,,percent of total billed charges,95% of total billed charges,1021.84,80,,,percent of total billed charges,80% of total billed charges,1085.71,85,,,percent of total billed charges,85% of total billed charges,1149.57,90,,,percent of total billed charges,90% of total billed charges,1277.3,100,,,fee schedule,100% of CO APG rates,1277.3,100,,,fee schedule,100% of CO APG rates,1277.3,100,,,fee schedule,100% of NM fee schedule,510.92,40,,,percent of total billed charges,40% of total billed charges,510.92,40,,,percent of total billed charges,40% of total billed charges,1149.57,90,,,percent of total billed charges,90% of total billed charges,970.75,76,,,percent of total billed charges,76% of total billed charges,510.92,40,,,percent of total billed charges,40% of total billed charges,1085.71,85,,,percent of total billed charges,85% of total billed charges,1277.3,100,,,fee schedule,100% of CO APG rate,1021.84,80,,,percent of total billed charges,80% of total billed charges,495.59,38.8,,,percent of total billed charges,38.8% of total billed charges,1085.71,85,,,percent of total billed charges,85% of total billed charges,1277.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,495.59,1277.3,
"OMEGA3 SHORT BARREL HIP PLATE, KEYED 135?, 4 HOLES",46052057,CDM,278,RC,,,OUTPATIENT,,,1327.7,1062.16,,995.78,75,,,percent of total billed charges,75% of total billed charges,531.08,40,,,percent of total billed charges,40% of total billed charges,1051.54,79.2,,,percent of total billed charges,79.2% of total billed charges,1128.55,85,,,percent of total billed charges,85% of total billed charges,1327.7,100,,,fee schedule,100% of CO APG rates,1261.32,95,,,percent of total billed charges,95% of total billed charges,1062.16,80,,,percent of total billed charges,80% of total billed charges,1128.55,85,,,percent of total billed charges,85% of total billed charges,1194.93,90,,,percent of total billed charges,90% of total billed charges,1327.7,100,,,fee schedule,100% of CO APG rates,1327.7,100,,,fee schedule,100% of CO APG rates,1327.7,100,,,fee schedule,100% of NM fee schedule,531.08,40,,,percent of total billed charges,40% of total billed charges,531.08,40,,,percent of total billed charges,40% of total billed charges,1194.93,90,,,percent of total billed charges,90% of total billed charges,1009.05,76,,,percent of total billed charges,76% of total billed charges,531.08,40,,,percent of total billed charges,40% of total billed charges,1128.55,85,,,percent of total billed charges,85% of total billed charges,1327.7,100,,,fee schedule,100% of CO APG rate,1062.16,80,,,percent of total billed charges,80% of total billed charges,515.15,38.8,,,percent of total billed charges,38.8% of total billed charges,1128.55,85,,,percent of total billed charges,85% of total billed charges,1327.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,515.15,1327.7,
DISTAL LATERAL FIBULA PLATE 3 HOLE,46052062,CDM,278,RC,,,OUTPATIENT,,,1566.2,1252.96,,1174.65,75,,,percent of total billed charges,75% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1240.43,79.2,,,percent of total billed charges,79.2% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rates,1487.89,95,,,percent of total billed charges,95% of total billed charges,1252.96,80,,,percent of total billed charges,80% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1409.58,90,,,percent of total billed charges,90% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rates,1566.2,100,,,fee schedule,100% of CO APG rates,1566.2,100,,,fee schedule,100% of NM fee schedule,626.48,40,,,percent of total billed charges,40% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1409.58,90,,,percent of total billed charges,90% of total billed charges,1190.31,76,,,percent of total billed charges,76% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rate,1252.96,80,,,percent of total billed charges,80% of total billed charges,607.69,38.8,,,percent of total billed charges,38.8% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,607.69,1566.2,
DISTAL LATERAL FIBULA PLATE 4 HOLE,46052063,CDM,278,RC,,,OUTPATIENT,,,1566.2,1252.96,,1174.65,75,,,percent of total billed charges,75% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1240.43,79.2,,,percent of total billed charges,79.2% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rates,1487.89,95,,,percent of total billed charges,95% of total billed charges,1252.96,80,,,percent of total billed charges,80% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1409.58,90,,,percent of total billed charges,90% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rates,1566.2,100,,,fee schedule,100% of CO APG rates,1566.2,100,,,fee schedule,100% of NM fee schedule,626.48,40,,,percent of total billed charges,40% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1409.58,90,,,percent of total billed charges,90% of total billed charges,1190.31,76,,,percent of total billed charges,76% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rate,1252.96,80,,,percent of total billed charges,80% of total billed charges,607.69,38.8,,,percent of total billed charges,38.8% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,607.69,1566.2,
DISTAL LATERAL FIBULA PLATE 5 HOLE,46052064,CDM,278,RC,,,OUTPATIENT,,,1566.2,1252.96,,1174.65,75,,,percent of total billed charges,75% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1240.43,79.2,,,percent of total billed charges,79.2% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rates,1487.89,95,,,percent of total billed charges,95% of total billed charges,1252.96,80,,,percent of total billed charges,80% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1409.58,90,,,percent of total billed charges,90% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rates,1566.2,100,,,fee schedule,100% of CO APG rates,1566.2,100,,,fee schedule,100% of NM fee schedule,626.48,40,,,percent of total billed charges,40% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1409.58,90,,,percent of total billed charges,90% of total billed charges,1190.31,76,,,percent of total billed charges,76% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rate,1252.96,80,,,percent of total billed charges,80% of total billed charges,607.69,38.8,,,percent of total billed charges,38.8% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,607.69,1566.2,
DISTAL LATERAL FIBULA PLATE 6 HOLE,46052065,CDM,278,RC,,,OUTPATIENT,,,1566.2,1252.96,,1174.65,75,,,percent of total billed charges,75% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1240.43,79.2,,,percent of total billed charges,79.2% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rates,1487.89,95,,,percent of total billed charges,95% of total billed charges,1252.96,80,,,percent of total billed charges,80% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1409.58,90,,,percent of total billed charges,90% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rates,1566.2,100,,,fee schedule,100% of CO APG rates,1566.2,100,,,fee schedule,100% of NM fee schedule,626.48,40,,,percent of total billed charges,40% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1409.58,90,,,percent of total billed charges,90% of total billed charges,1190.31,76,,,percent of total billed charges,76% of total billed charges,626.48,40,,,percent of total billed charges,40% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of CO APG rate,1252.96,80,,,percent of total billed charges,80% of total billed charges,607.69,38.8,,,percent of total billed charges,38.8% of total billed charges,1331.27,85,,,percent of total billed charges,85% of total billed charges,1566.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,607.69,1566.2,
STRAIGHT PLATE VARIAX  FIBULA 4 HOLE  L60MM,46052069,CDM,278,RC,,,OUTPATIENT,,,1658.6,1326.88,,1243.95,75,,,percent of total billed charges,75% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1313.61,79.2,,,percent of total billed charges,79.2% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rates,1575.67,95,,,percent of total billed charges,95% of total billed charges,1326.88,80,,,percent of total billed charges,80% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1492.74,90,,,percent of total billed charges,90% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rates,1658.6,100,,,fee schedule,100% of CO APG rates,1658.6,100,,,fee schedule,100% of NM fee schedule,663.44,40,,,percent of total billed charges,40% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1492.74,90,,,percent of total billed charges,90% of total billed charges,1260.54,76,,,percent of total billed charges,76% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rate,1326.88,80,,,percent of total billed charges,80% of total billed charges,643.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,643.54,1658.6,
"VARIAX STRAIGHT PLATE, 5 HOLE",46052070,CDM,278,RC,,,OUTPATIENT,,,1658.6,1326.88,,1243.95,75,,,percent of total billed charges,75% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1313.61,79.2,,,percent of total billed charges,79.2% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rates,1575.67,95,,,percent of total billed charges,95% of total billed charges,1326.88,80,,,percent of total billed charges,80% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1492.74,90,,,percent of total billed charges,90% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rates,1658.6,100,,,fee schedule,100% of CO APG rates,1658.6,100,,,fee schedule,100% of NM fee schedule,663.44,40,,,percent of total billed charges,40% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1492.74,90,,,percent of total billed charges,90% of total billed charges,1260.54,76,,,percent of total billed charges,76% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rate,1326.88,80,,,percent of total billed charges,80% of total billed charges,643.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,643.54,1658.6,
"VARIAX STRAIGHT PLATE, 6 HOLE",46052071,CDM,278,RC,,,OUTPATIENT,,,1658.6,1326.88,,1243.95,75,,,percent of total billed charges,75% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1313.61,79.2,,,percent of total billed charges,79.2% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rates,1575.67,95,,,percent of total billed charges,95% of total billed charges,1326.88,80,,,percent of total billed charges,80% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1492.74,90,,,percent of total billed charges,90% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rates,1658.6,100,,,fee schedule,100% of CO APG rates,1658.6,100,,,fee schedule,100% of NM fee schedule,663.44,40,,,percent of total billed charges,40% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1492.74,90,,,percent of total billed charges,90% of total billed charges,1260.54,76,,,percent of total billed charges,76% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rate,1326.88,80,,,percent of total billed charges,80% of total billed charges,643.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,643.54,1658.6,
"VARIAX STRAIGHT PLATE, 7 HOLE",46052072,CDM,278,RC,,,OUTPATIENT,,,1658.6,1326.88,,1243.95,75,,,percent of total billed charges,75% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1313.61,79.2,,,percent of total billed charges,79.2% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rates,1575.67,95,,,percent of total billed charges,95% of total billed charges,1326.88,80,,,percent of total billed charges,80% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1492.74,90,,,percent of total billed charges,90% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rates,1658.6,100,,,fee schedule,100% of CO APG rates,1658.6,100,,,fee schedule,100% of NM fee schedule,663.44,40,,,percent of total billed charges,40% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1492.74,90,,,percent of total billed charges,90% of total billed charges,1260.54,76,,,percent of total billed charges,76% of total billed charges,663.44,40,,,percent of total billed charges,40% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of CO APG rate,1326.88,80,,,percent of total billed charges,80% of total billed charges,643.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1409.81,85,,,percent of total billed charges,85% of total billed charges,1658.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,643.54,1658.6,
DISTAL LATERAL FIBULA PLATE 7 HOLE,46052073,CDM,278,RC,,,OUTPATIENT,,,1703.8,1363.04,,1277.85,75,,,percent of total billed charges,75% of total billed charges,681.52,40,,,percent of total billed charges,40% of total billed charges,1349.41,79.2,,,percent of total billed charges,79.2% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1703.8,100,,,fee schedule,100% of CO APG rates,1618.61,95,,,percent of total billed charges,95% of total billed charges,1363.04,80,,,percent of total billed charges,80% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1533.42,90,,,percent of total billed charges,90% of total billed charges,1703.8,100,,,fee schedule,100% of CO APG rates,1703.8,100,,,fee schedule,100% of CO APG rates,1703.8,100,,,fee schedule,100% of NM fee schedule,681.52,40,,,percent of total billed charges,40% of total billed charges,681.52,40,,,percent of total billed charges,40% of total billed charges,1533.42,90,,,percent of total billed charges,90% of total billed charges,1294.89,76,,,percent of total billed charges,76% of total billed charges,681.52,40,,,percent of total billed charges,40% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1703.8,100,,,fee schedule,100% of CO APG rate,1363.04,80,,,percent of total billed charges,80% of total billed charges,661.07,38.8,,,percent of total billed charges,38.8% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1703.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,661.07,1703.8,
DISTAL LATERAL FIBULA PLATE 8 HOLE,46052074,CDM,278,RC,,,OUTPATIENT,,,1703.8,1363.04,,1277.85,75,,,percent of total billed charges,75% of total billed charges,681.52,40,,,percent of total billed charges,40% of total billed charges,1349.41,79.2,,,percent of total billed charges,79.2% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1703.8,100,,,fee schedule,100% of CO APG rates,1618.61,95,,,percent of total billed charges,95% of total billed charges,1363.04,80,,,percent of total billed charges,80% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1533.42,90,,,percent of total billed charges,90% of total billed charges,1703.8,100,,,fee schedule,100% of CO APG rates,1703.8,100,,,fee schedule,100% of CO APG rates,1703.8,100,,,fee schedule,100% of NM fee schedule,681.52,40,,,percent of total billed charges,40% of total billed charges,681.52,40,,,percent of total billed charges,40% of total billed charges,1533.42,90,,,percent of total billed charges,90% of total billed charges,1294.89,76,,,percent of total billed charges,76% of total billed charges,681.52,40,,,percent of total billed charges,40% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1703.8,100,,,fee schedule,100% of CO APG rate,1363.04,80,,,percent of total billed charges,80% of total billed charges,661.07,38.8,,,percent of total billed charges,38.8% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1703.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,661.07,1703.8,
DISTAL LATERAL FIBULA PLATE 9 HOLE,46052075,CDM,278,RC,,,OUTPATIENT,,,1703.8,1363.04,,1277.85,75,,,percent of total billed charges,75% of total billed charges,681.52,40,,,percent of total billed charges,40% of total billed charges,1349.41,79.2,,,percent of total billed charges,79.2% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1703.8,100,,,fee schedule,100% of CO APG rates,1618.61,95,,,percent of total billed charges,95% of total billed charges,1363.04,80,,,percent of total billed charges,80% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1533.42,90,,,percent of total billed charges,90% of total billed charges,1703.8,100,,,fee schedule,100% of CO APG rates,1703.8,100,,,fee schedule,100% of CO APG rates,1703.8,100,,,fee schedule,100% of NM fee schedule,681.52,40,,,percent of total billed charges,40% of total billed charges,681.52,40,,,percent of total billed charges,40% of total billed charges,1533.42,90,,,percent of total billed charges,90% of total billed charges,1294.89,76,,,percent of total billed charges,76% of total billed charges,681.52,40,,,percent of total billed charges,40% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1703.8,100,,,fee schedule,100% of CO APG rate,1363.04,80,,,percent of total billed charges,80% of total billed charges,661.07,38.8,,,percent of total billed charges,38.8% of total billed charges,1448.23,85,,,percent of total billed charges,85% of total billed charges,1703.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,661.07,1703.8,
"RADIAL COLUMN SMARTLOCK PLATE, LONG",46052076,CDM,278,RC,,,OUTPATIENT,,,1735.3,1388.24,,1301.48,75,,,percent of total billed charges,75% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1374.36,79.2,,,percent of total billed charges,79.2% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1648.54,95,,,percent of total billed charges,95% of total billed charges,1388.24,80,,,percent of total billed charges,80% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of NM fee schedule,694.12,40,,,percent of total billed charges,40% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1318.83,76,,,percent of total billed charges,76% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rate,1388.24,80,,,percent of total billed charges,80% of total billed charges,673.3,38.8,,,percent of total billed charges,38.8% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,673.3,1735.3,
"RADIAL COLUMN SMARTLOCK PLATE, SHORT",46052077,CDM,278,RC,,,OUTPATIENT,,,1735.3,1388.24,,1301.48,75,,,percent of total billed charges,75% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1374.36,79.2,,,percent of total billed charges,79.2% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1648.54,95,,,percent of total billed charges,95% of total billed charges,1388.24,80,,,percent of total billed charges,80% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of NM fee schedule,694.12,40,,,percent of total billed charges,40% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1318.83,76,,,percent of total billed charges,76% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rate,1388.24,80,,,percent of total billed charges,80% of total billed charges,673.3,38.8,,,percent of total billed charges,38.8% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,673.3,1735.3,
"ULNAR COLUMN SMARTLOCK PLATE, LONG, LEFT",46052078,CDM,278,RC,,,OUTPATIENT,,,1735.3,1388.24,,1301.48,75,,,percent of total billed charges,75% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1374.36,79.2,,,percent of total billed charges,79.2% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1648.54,95,,,percent of total billed charges,95% of total billed charges,1388.24,80,,,percent of total billed charges,80% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of NM fee schedule,694.12,40,,,percent of total billed charges,40% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1318.83,76,,,percent of total billed charges,76% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rate,1388.24,80,,,percent of total billed charges,80% of total billed charges,673.3,38.8,,,percent of total billed charges,38.8% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,673.3,1735.3,
"ULNAR COLUMN SMARTLOCK PLATE, LONG, RIGHT",46052079,CDM,278,RC,,,OUTPATIENT,,,1735.3,1388.24,,1301.48,75,,,percent of total billed charges,75% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1374.36,79.2,,,percent of total billed charges,79.2% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1648.54,95,,,percent of total billed charges,95% of total billed charges,1388.24,80,,,percent of total billed charges,80% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of NM fee schedule,694.12,40,,,percent of total billed charges,40% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1318.83,76,,,percent of total billed charges,76% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rate,1388.24,80,,,percent of total billed charges,80% of total billed charges,673.3,38.8,,,percent of total billed charges,38.8% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,673.3,1735.3,
"ULNAR COLUMN SMARTLOCK PLATE, SHORT, LEFT",46052080,CDM,278,RC,,,OUTPATIENT,,,1735.3,1388.24,,1301.48,75,,,percent of total billed charges,75% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1374.36,79.2,,,percent of total billed charges,79.2% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1648.54,95,,,percent of total billed charges,95% of total billed charges,1388.24,80,,,percent of total billed charges,80% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of NM fee schedule,694.12,40,,,percent of total billed charges,40% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1318.83,76,,,percent of total billed charges,76% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rate,1388.24,80,,,percent of total billed charges,80% of total billed charges,673.3,38.8,,,percent of total billed charges,38.8% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,673.3,1735.3,
"ULNAR COLUMN SMARTLOCK PLATE, SHORT, RIGHT",46052081,CDM,278,RC,,,OUTPATIENT,,,1735.3,1388.24,,1301.48,75,,,percent of total billed charges,75% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1374.36,79.2,,,percent of total billed charges,79.2% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1648.54,95,,,percent of total billed charges,95% of total billed charges,1388.24,80,,,percent of total billed charges,80% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of CO APG rates,1735.3,100,,,fee schedule,100% of NM fee schedule,694.12,40,,,percent of total billed charges,40% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1561.77,90,,,percent of total billed charges,90% of total billed charges,1318.83,76,,,percent of total billed charges,76% of total billed charges,694.12,40,,,percent of total billed charges,40% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of CO APG rate,1388.24,80,,,percent of total billed charges,80% of total billed charges,673.3,38.8,,,percent of total billed charges,38.8% of total billed charges,1475.01,85,,,percent of total billed charges,85% of total billed charges,1735.3,100,,,fee schedule,100% of APG fee schedule,3470.6,200,,,percent of total billed charges,200% of total billed charges,673.3,3470.6,
"DORSAL SMARTLOCK  PLATE STANDARD, LEFT",46052091,CDM,278,RC,,,OUTPATIENT,,,1820.3,1456.24,,1365.23,75,,,percent of total billed charges,75% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1441.68,79.2,,,percent of total billed charges,79.2% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rates,1729.29,95,,,percent of total billed charges,95% of total billed charges,1456.24,80,,,percent of total billed charges,80% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1638.27,90,,,percent of total billed charges,90% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rates,1820.3,100,,,fee schedule,100% of CO APG rates,1820.3,100,,,fee schedule,100% of NM fee schedule,728.12,40,,,percent of total billed charges,40% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1638.27,90,,,percent of total billed charges,90% of total billed charges,1383.43,76,,,percent of total billed charges,76% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rate,1456.24,80,,,percent of total billed charges,80% of total billed charges,706.28,38.8,,,percent of total billed charges,38.8% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of APG fee schedule,3640.6,200,,,percent of total billed charges,200% of total billed charges,706.28,3640.6,
"DORSAL SMARTLOCK  PLATE STANDARD, RIGHT",46052092,CDM,278,RC,,,OUTPATIENT,,,1820.3,1456.24,,1365.23,75,,,percent of total billed charges,75% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1441.68,79.2,,,percent of total billed charges,79.2% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rates,1729.29,95,,,percent of total billed charges,95% of total billed charges,1456.24,80,,,percent of total billed charges,80% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1638.27,90,,,percent of total billed charges,90% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rates,1820.3,100,,,fee schedule,100% of CO APG rates,1820.3,100,,,fee schedule,100% of NM fee schedule,728.12,40,,,percent of total billed charges,40% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1638.27,90,,,percent of total billed charges,90% of total billed charges,1383.43,76,,,percent of total billed charges,76% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rate,1456.24,80,,,percent of total billed charges,80% of total billed charges,706.28,38.8,,,percent of total billed charges,38.8% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of APG fee schedule,3640.6,200,,,percent of total billed charges,200% of total billed charges,706.28,3640.6,
"DORSAL SMARTLOCK  PLATE WIDE, RIGHT",46052093,CDM,278,RC,,,OUTPATIENT,,,1820.3,1456.24,,1365.23,75,,,percent of total billed charges,75% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1441.68,79.2,,,percent of total billed charges,79.2% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rates,1729.29,95,,,percent of total billed charges,95% of total billed charges,1456.24,80,,,percent of total billed charges,80% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1638.27,90,,,percent of total billed charges,90% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rates,1820.3,100,,,fee schedule,100% of CO APG rates,1820.3,100,,,fee schedule,100% of NM fee schedule,728.12,40,,,percent of total billed charges,40% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1638.27,90,,,percent of total billed charges,90% of total billed charges,1383.43,76,,,percent of total billed charges,76% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rate,1456.24,80,,,percent of total billed charges,80% of total billed charges,706.28,38.8,,,percent of total billed charges,38.8% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of APG fee schedule,3640.6,200,,,percent of total billed charges,200% of total billed charges,706.28,3640.6,
"DORSAL SMARTLOCK PLATE WIDE, LEFT",46052094,CDM,278,RC,,,OUTPATIENT,,,1820.3,1456.24,,1365.23,75,,,percent of total billed charges,75% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1441.68,79.2,,,percent of total billed charges,79.2% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rates,1729.29,95,,,percent of total billed charges,95% of total billed charges,1456.24,80,,,percent of total billed charges,80% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1638.27,90,,,percent of total billed charges,90% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rates,1820.3,100,,,fee schedule,100% of CO APG rates,1820.3,100,,,fee schedule,100% of NM fee schedule,728.12,40,,,percent of total billed charges,40% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1638.27,90,,,percent of total billed charges,90% of total billed charges,1383.43,76,,,percent of total billed charges,76% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rate,1456.24,80,,,percent of total billed charges,80% of total billed charges,706.28,38.8,,,percent of total billed charges,38.8% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of APG fee schedule,3640.6,200,,,percent of total billed charges,200% of total billed charges,706.28,3640.6,
"DORSAL SMARTLOCK DR PLATE, STANDARD, LEFT, X LONG",46052096,CDM,278,RC,,,OUTPATIENT,,,2067.2,1653.76,,1550.4,75,,,percent of total billed charges,75% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1637.22,79.2,,,percent of total billed charges,79.2% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rates,1963.84,95,,,percent of total billed charges,95% of total billed charges,1653.76,80,,,percent of total billed charges,80% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,1860.48,90,,,percent of total billed charges,90% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rates,2067.2,100,,,fee schedule,100% of CO APG rates,2067.2,100,,,fee schedule,100% of NM fee schedule,826.88,40,,,percent of total billed charges,40% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1860.48,90,,,percent of total billed charges,90% of total billed charges,1571.07,76,,,percent of total billed charges,76% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rate,1653.76,80,,,percent of total billed charges,80% of total billed charges,802.07,38.8,,,percent of total billed charges,38.8% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of APG fee schedule,4134.4,200,,,percent of total billed charges,200% of total billed charges,802.07,4134.4,
"DORSAL SMARTLOCK DR PLATE, STANDARD, RIGHT, X LONG",46052097,CDM,278,RC,,,OUTPATIENT,,,2067.2,1653.76,,1550.4,75,,,percent of total billed charges,75% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1637.22,79.2,,,percent of total billed charges,79.2% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rates,1963.84,95,,,percent of total billed charges,95% of total billed charges,1653.76,80,,,percent of total billed charges,80% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,1860.48,90,,,percent of total billed charges,90% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rates,2067.2,100,,,fee schedule,100% of CO APG rates,2067.2,100,,,fee schedule,100% of NM fee schedule,826.88,40,,,percent of total billed charges,40% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1860.48,90,,,percent of total billed charges,90% of total billed charges,1571.07,76,,,percent of total billed charges,76% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rate,1653.76,80,,,percent of total billed charges,80% of total billed charges,802.07,38.8,,,percent of total billed charges,38.8% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of APG fee schedule,4134.4,200,,,percent of total billed charges,200% of total billed charges,802.07,4134.4,
"DORSAL SMARTLOCK DR PLATE, WIDE, LEFT, X LONG",46052098,CDM,278,RC,,,OUTPATIENT,,,2067.2,1653.76,,1550.4,75,,,percent of total billed charges,75% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1637.22,79.2,,,percent of total billed charges,79.2% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rates,1963.84,95,,,percent of total billed charges,95% of total billed charges,1653.76,80,,,percent of total billed charges,80% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,1860.48,90,,,percent of total billed charges,90% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rates,2067.2,100,,,fee schedule,100% of CO APG rates,2067.2,100,,,fee schedule,100% of NM fee schedule,826.88,40,,,percent of total billed charges,40% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1860.48,90,,,percent of total billed charges,90% of total billed charges,1571.07,76,,,percent of total billed charges,76% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rate,1653.76,80,,,percent of total billed charges,80% of total billed charges,802.07,38.8,,,percent of total billed charges,38.8% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of APG fee schedule,4134.4,200,,,percent of total billed charges,200% of total billed charges,802.07,4134.4,
"DORSAL SMARTLOCK DR PLATE, WIDE, RIGHT, X LONG",46052099,CDM,278,RC,,,OUTPATIENT,,,2067.2,1653.76,,1550.4,75,,,percent of total billed charges,75% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1637.22,79.2,,,percent of total billed charges,79.2% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rates,1963.84,95,,,percent of total billed charges,95% of total billed charges,1653.76,80,,,percent of total billed charges,80% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,1860.48,90,,,percent of total billed charges,90% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rates,2067.2,100,,,fee schedule,100% of CO APG rates,2067.2,100,,,fee schedule,100% of NM fee schedule,826.88,40,,,percent of total billed charges,40% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1860.48,90,,,percent of total billed charges,90% of total billed charges,1571.07,76,,,percent of total billed charges,76% of total billed charges,826.88,40,,,percent of total billed charges,40% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of CO APG rate,1653.76,80,,,percent of total billed charges,80% of total billed charges,802.07,38.8,,,percent of total billed charges,38.8% of total billed charges,1757.12,85,,,percent of total billed charges,85% of total billed charges,2067.2,100,,,fee schedule,100% of APG fee schedule,4134.4,200,,,percent of total billed charges,200% of total billed charges,802.07,4134.4,
VOLAR SMARTLOCK DR PLATE  NARROW  LEFT,46052100,CDM,278,RC,,,OUTPATIENT,,,2199.5,1759.6,,1649.63,75,,,percent of total billed charges,75% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1742,79.2,,,percent of total billed charges,79.2% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2089.53,95,,,percent of total billed charges,95% of total billed charges,1759.6,80,,,percent of total billed charges,80% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of NM fee schedule,879.8,40,,,percent of total billed charges,40% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,1671.62,76,,,percent of total billed charges,76% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rate,1759.6,80,,,percent of total billed charges,80% of total billed charges,853.41,38.8,,,percent of total billed charges,38.8% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of APG fee schedule,4399,200,,,percent of total billed charges,200% of total billed charges,853.41,4399,
VOLAR SMARTLOCK DR PLATE  NARROW  LEFT  LONG,46052101,CDM,278,RC,,,OUTPATIENT,,,2199.5,1759.6,,1649.63,75,,,percent of total billed charges,75% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1742,79.2,,,percent of total billed charges,79.2% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2089.53,95,,,percent of total billed charges,95% of total billed charges,1759.6,80,,,percent of total billed charges,80% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of NM fee schedule,879.8,40,,,percent of total billed charges,40% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,1671.62,76,,,percent of total billed charges,76% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rate,1759.6,80,,,percent of total billed charges,80% of total billed charges,853.41,38.8,,,percent of total billed charges,38.8% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of APG fee schedule,4399,200,,,percent of total billed charges,200% of total billed charges,853.41,4399,
VOLAR SMARTLOCK DR PLATE  NARROW  RIGHT,46052102,CDM,278,RC,,,OUTPATIENT,,,2199.5,1759.6,,1649.63,75,,,percent of total billed charges,75% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1742,79.2,,,percent of total billed charges,79.2% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2089.53,95,,,percent of total billed charges,95% of total billed charges,1759.6,80,,,percent of total billed charges,80% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of NM fee schedule,879.8,40,,,percent of total billed charges,40% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,1671.62,76,,,percent of total billed charges,76% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rate,1759.6,80,,,percent of total billed charges,80% of total billed charges,853.41,38.8,,,percent of total billed charges,38.8% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of APG fee schedule,4399,200,,,percent of total billed charges,200% of total billed charges,853.41,4399,
VOLAR SMARTLOCK DR PLATE  NARROW  RIGHT  LONG,46052103,CDM,278,RC,,,OUTPATIENT,,,2199.5,1759.6,,1649.63,75,,,percent of total billed charges,75% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1742,79.2,,,percent of total billed charges,79.2% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2089.53,95,,,percent of total billed charges,95% of total billed charges,1759.6,80,,,percent of total billed charges,80% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of NM fee schedule,879.8,40,,,percent of total billed charges,40% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,1671.62,76,,,percent of total billed charges,76% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rate,1759.6,80,,,percent of total billed charges,80% of total billed charges,853.41,38.8,,,percent of total billed charges,38.8% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of APG fee schedule,4399,200,,,percent of total billed charges,200% of total billed charges,853.41,4399,
VOLAR SMARTLOCK DR PLATE  STANDARD  LEFT,46052104,CDM,278,RC,,,OUTPATIENT,,,2199.5,1759.6,,1649.63,75,,,percent of total billed charges,75% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1742,79.2,,,percent of total billed charges,79.2% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2089.53,95,,,percent of total billed charges,95% of total billed charges,1759.6,80,,,percent of total billed charges,80% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of NM fee schedule,879.8,40,,,percent of total billed charges,40% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,1671.62,76,,,percent of total billed charges,76% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rate,1759.6,80,,,percent of total billed charges,80% of total billed charges,853.41,38.8,,,percent of total billed charges,38.8% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of APG fee schedule,4399,200,,,percent of total billed charges,200% of total billed charges,853.41,4399,
VOLAR SMARTLOCK DR PLATE  STANDARD  LEFT  LONG,46052105,CDM,278,RC,,,OUTPATIENT,,,2199.5,1759.6,,1649.63,75,,,percent of total billed charges,75% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1742,79.2,,,percent of total billed charges,79.2% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2089.53,95,,,percent of total billed charges,95% of total billed charges,1759.6,80,,,percent of total billed charges,80% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of NM fee schedule,879.8,40,,,percent of total billed charges,40% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,1671.62,76,,,percent of total billed charges,76% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rate,1759.6,80,,,percent of total billed charges,80% of total billed charges,853.41,38.8,,,percent of total billed charges,38.8% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of APG fee schedule,4399,200,,,percent of total billed charges,200% of total billed charges,853.41,4399,
VOLAR SMARTLOCK DR PLATE  STANDARD  RIGHT,46052106,CDM,278,RC,,,OUTPATIENT,,,2199.5,1759.6,,1649.63,75,,,percent of total billed charges,75% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1742,79.2,,,percent of total billed charges,79.2% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2089.53,95,,,percent of total billed charges,95% of total billed charges,1759.6,80,,,percent of total billed charges,80% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of NM fee schedule,879.8,40,,,percent of total billed charges,40% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,1671.62,76,,,percent of total billed charges,76% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rate,1759.6,80,,,percent of total billed charges,80% of total billed charges,853.41,38.8,,,percent of total billed charges,38.8% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of APG fee schedule,4399,200,,,percent of total billed charges,200% of total billed charges,853.41,4399,
VOLAR SMARTLOCK DR PLATE  STANDARD  RIGHT  LONG,46052107,CDM,278,RC,,,OUTPATIENT,,,2199.5,1759.6,,1649.63,75,,,percent of total billed charges,75% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1742,79.2,,,percent of total billed charges,79.2% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2089.53,95,,,percent of total billed charges,95% of total billed charges,1759.6,80,,,percent of total billed charges,80% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of CO APG rates,2199.5,100,,,fee schedule,100% of NM fee schedule,879.8,40,,,percent of total billed charges,40% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1979.55,90,,,percent of total billed charges,90% of total billed charges,1671.62,76,,,percent of total billed charges,76% of total billed charges,879.8,40,,,percent of total billed charges,40% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of CO APG rate,1759.6,80,,,percent of total billed charges,80% of total billed charges,853.41,38.8,,,percent of total billed charges,38.8% of total billed charges,1869.58,85,,,percent of total billed charges,85% of total billed charges,2199.5,100,,,fee schedule,100% of APG fee schedule,4399,200,,,percent of total billed charges,200% of total billed charges,853.41,4399,
T2 STD. TIBIAL NAIL 10mmX270mm,46052132,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 10mmX285mm,46052133,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 10mmX300mm,46052134,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 10mmX315mm,46052135,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 10mmX375mm,46052136,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 10mmX390mm,46052137,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 10MMX405MM,46052138,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 11mmX270mm,46052140,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 11mmX285mm,46052141,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 11mmX300mm,46052142,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 11mmX315mm,46052143,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 11mmX330mm,46052144,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 11mmX345mm,46052145,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 11mmX360mm,46052146,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 11mmX375mm,46052147,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 11mmX390mm,46052148,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 11MMX405MM,46052149,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 12mmX270mm,46052151,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 12MMX285MM,46052152,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 12MMX300MM,46052153,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 12MMX315MM,46052154,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 12MMX330MM,46052155,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 12MMX345MM,46052156,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 12MMX360MM,46052157,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 12MMX375MM,46052158,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 12MMX390MM,46052159,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 12MMX405MM,46052160,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 9mmX270mm,46052163,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 9mmX285mm,46052164,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 9mmX300mm,46052165,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 9mmX315mm,46052166,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 9mmX330mm,46052167,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 9mmX360mm,46052168,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 9mmX375mm,46052169,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 9mmX390mm,46052170,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 9MMX405MM,46052171,CDM,278,RC,,,OUTPATIENT,,,2685.9,2148.72,,2014.43,75,,,percent of total billed charges,75% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2127.23,79.2,,,percent of total billed charges,79.2% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2551.61,95,,,percent of total billed charges,95% of total billed charges,2148.72,80,,,percent of total billed charges,80% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of CO APG rates,2685.9,100,,,fee schedule,100% of NM fee schedule,1074.36,40,,,percent of total billed charges,40% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2417.31,90,,,percent of total billed charges,90% of total billed charges,2041.28,76,,,percent of total billed charges,76% of total billed charges,1074.36,40,,,percent of total billed charges,40% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of CO APG rate,2148.72,80,,,percent of total billed charges,80% of total billed charges,1042.13,38.8,,,percent of total billed charges,38.8% of total billed charges,2283.02,85,,,percent of total billed charges,85% of total billed charges,2685.9,100,,,fee schedule,100% of APG fee schedule,5371.8,200,,,percent of total billed charges,200% of total billed charges,1042.13,5371.8,
T2 STD. TIBIAL NAIL 10mmX330mm,46052175,CDM,278,RC,,,OUTPATIENT,,,2747.9,2198.32,,2060.93,75,,,percent of total billed charges,75% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2176.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rates,2610.51,95,,,percent of total billed charges,95% of total billed charges,2198.32,80,,,percent of total billed charges,80% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2473.11,90,,,percent of total billed charges,90% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rates,2747.9,100,,,fee schedule,100% of CO APG rates,2747.9,100,,,fee schedule,100% of NM fee schedule,1099.16,40,,,percent of total billed charges,40% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2473.11,90,,,percent of total billed charges,90% of total billed charges,2088.4,76,,,percent of total billed charges,76% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rate,2198.32,80,,,percent of total billed charges,80% of total billed charges,1066.19,38.8,,,percent of total billed charges,38.8% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of APG fee schedule,5495.8,200,,,percent of total billed charges,200% of total billed charges,1066.19,5495.8,
T2 STD. TIBIAL NAIL 10mmX345mm,46052176,CDM,278,RC,,,OUTPATIENT,,,2747.9,2198.32,,2060.93,75,,,percent of total billed charges,75% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2176.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rates,2610.51,95,,,percent of total billed charges,95% of total billed charges,2198.32,80,,,percent of total billed charges,80% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2473.11,90,,,percent of total billed charges,90% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rates,2747.9,100,,,fee schedule,100% of CO APG rates,2747.9,100,,,fee schedule,100% of NM fee schedule,1099.16,40,,,percent of total billed charges,40% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2473.11,90,,,percent of total billed charges,90% of total billed charges,2088.4,76,,,percent of total billed charges,76% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rate,2198.32,80,,,percent of total billed charges,80% of total billed charges,1066.19,38.8,,,percent of total billed charges,38.8% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of APG fee schedule,5495.8,200,,,percent of total billed charges,200% of total billed charges,1066.19,5495.8,
T2 STD. TIBIAL NAIL 10mmX360mm,46052177,CDM,278,RC,,,OUTPATIENT,,,2747.9,2198.32,,2060.93,75,,,percent of total billed charges,75% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2176.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rates,2610.51,95,,,percent of total billed charges,95% of total billed charges,2198.32,80,,,percent of total billed charges,80% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2473.11,90,,,percent of total billed charges,90% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rates,2747.9,100,,,fee schedule,100% of CO APG rates,2747.9,100,,,fee schedule,100% of NM fee schedule,1099.16,40,,,percent of total billed charges,40% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2473.11,90,,,percent of total billed charges,90% of total billed charges,2088.4,76,,,percent of total billed charges,76% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rate,2198.32,80,,,percent of total billed charges,80% of total billed charges,1066.19,38.8,,,percent of total billed charges,38.8% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of APG fee schedule,5495.8,200,,,percent of total billed charges,200% of total billed charges,1066.19,5495.8,
T2 STD. TIBIAL NAIL 9mmX345mm,46052178,CDM,278,RC,,,OUTPATIENT,,,2747.9,2198.32,,2060.93,75,,,percent of total billed charges,75% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2176.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rates,2610.51,95,,,percent of total billed charges,95% of total billed charges,2198.32,80,,,percent of total billed charges,80% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2473.11,90,,,percent of total billed charges,90% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rates,2747.9,100,,,fee schedule,100% of CO APG rates,2747.9,100,,,fee schedule,100% of NM fee schedule,1099.16,40,,,percent of total billed charges,40% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2473.11,90,,,percent of total billed charges,90% of total billed charges,2088.4,76,,,percent of total billed charges,76% of total billed charges,1099.16,40,,,percent of total billed charges,40% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of CO APG rate,2198.32,80,,,percent of total billed charges,80% of total billed charges,1066.19,38.8,,,percent of total billed charges,38.8% of total billed charges,2335.72,85,,,percent of total billed charges,85% of total billed charges,2747.9,100,,,fee schedule,100% of APG fee schedule,5495.8,200,,,percent of total billed charges,200% of total billed charges,1066.19,5495.8,
Distal Medial Tibia Plate TS 10 Hole / Left,46052179,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 10 Hole / Right,46052180,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 12 Hole / Left,46052181,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 12 Hole / Right,46052182,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 14 Hole / Left,46052183,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 14 Hole / Right,46052184,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 16 Hole / Left,46052185,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 16 Hole / Right,46052186,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 4 Hole / Left,46052187,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 4 Hole / Right,46052188,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 6 Hole / Left,46052189,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 6 Hole / Right,46052190,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 8 Hole / Left,46052191,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Medial Tibia Plate TS 8 Hole / Right,46052192,CDM,278,RC,,,OUTPATIENT,,,2953.7,2362.96,,2215.28,75,,,percent of total billed charges,75% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2339.33,79.2,,,percent of total billed charges,79.2% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2806.02,95,,,percent of total billed charges,95% of total billed charges,2362.96,80,,,percent of total billed charges,80% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of CO APG rates,2953.7,100,,,fee schedule,100% of NM fee schedule,1181.48,40,,,percent of total billed charges,40% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2658.33,90,,,percent of total billed charges,90% of total billed charges,2244.81,76,,,percent of total billed charges,76% of total billed charges,1181.48,40,,,percent of total billed charges,40% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of CO APG rate,2362.96,80,,,percent of total billed charges,80% of total billed charges,1146.04,38.8,,,percent of total billed charges,38.8% of total billed charges,2510.65,85,,,percent of total billed charges,85% of total billed charges,2953.7,100,,,fee schedule,100% of APG fee schedule,5907.4,200,,,percent of total billed charges,200% of total billed charges,1146.04,5907.4,
Distal Anterolateral Tibia Plate TS 10 Hole / Left,46052199,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Anterolateral Tibia Plate TS 10 Hole / Right,46052200,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Anterolateral Tibia Plate TS 4 Hole / Left,46052201,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Anterolateral Tibia Plate TS 4 Hole / Right,46052202,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Anterolateral Tibia Plate TS 6 Hole / Left,46052203,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Anterolateral Tibia Plate TS 6 Hole / Right,46052204,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Anterolateral Tibia Plate TS 8 Hole / Left,46052205,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Anterolateral Tibia Plate TS 8 Hole / Right,46052206,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 10 Hole / Left,46052207,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 10 Hole / Right,46052208,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 12 Hole / Left,46052209,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 12 Hole / Right,46052210,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 14 Hole / Left,46052211,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 14 Hole / Right,46052212,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 16 Hole / Left,46052213,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 16 Hole / Right,46052214,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 4 Hole / Left,46052215,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 4 Hole / Right,46052216,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 6 Hole / Left,46052217,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 6 Hole / Right,46052218,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 8 Hole / Left,46052219,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Lateral Femur Plate TS 8 Hole / Right,46052220,CDM,278,RC,,,OUTPATIENT,,,3063,2450.4,,2297.25,75,,,percent of total billed charges,75% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2425.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,2909.85,95,,,percent of total billed charges,95% of total billed charges,2450.4,80,,,percent of total billed charges,80% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of CO APG rates,3063,100,,,fee schedule,100% of NM fee schedule,1225.2,40,,,percent of total billed charges,40% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2756.7,90,,,percent of total billed charges,90% of total billed charges,2327.88,76,,,percent of total billed charges,76% of total billed charges,1225.2,40,,,percent of total billed charges,40% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of CO APG rate,2450.4,80,,,percent of total billed charges,80% of total billed charges,1188.44,38.8,,,percent of total billed charges,38.8% of total billed charges,2603.55,85,,,percent of total billed charges,85% of total billed charges,3063,100,,,fee schedule,100% of APG fee schedule,6126,200,,,percent of total billed charges,200% of total billed charges,1188.44,6126,
Distal Anterolateral Tibia Plate TS 12 Hole / Left,46052223,CDM,278,RC,,,OUTPATIENT,,,3499.9,2799.92,,2624.93,75,,,percent of total billed charges,75% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2771.92,79.2,,,percent of total billed charges,79.2% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3324.91,95,,,percent of total billed charges,95% of total billed charges,2799.92,80,,,percent of total billed charges,80% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of NM fee schedule,1399.96,40,,,percent of total billed charges,40% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,2659.92,76,,,percent of total billed charges,76% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rate,2799.92,80,,,percent of total billed charges,80% of total billed charges,1357.96,38.8,,,percent of total billed charges,38.8% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of APG fee schedule,6999.8,200,,,percent of total billed charges,200% of total billed charges,1357.96,6999.8,
Distal Anterolateral Tibia Plate TS 12 Hole / Right,46052224,CDM,278,RC,,,OUTPATIENT,,,3499.9,2799.92,,2624.93,75,,,percent of total billed charges,75% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2771.92,79.2,,,percent of total billed charges,79.2% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3324.91,95,,,percent of total billed charges,95% of total billed charges,2799.92,80,,,percent of total billed charges,80% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of NM fee schedule,1399.96,40,,,percent of total billed charges,40% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,2659.92,76,,,percent of total billed charges,76% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rate,2799.92,80,,,percent of total billed charges,80% of total billed charges,1357.96,38.8,,,percent of total billed charges,38.8% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of APG fee schedule,6999.8,200,,,percent of total billed charges,200% of total billed charges,1357.96,6999.8,
Distal Anterolateral Tibia Plate TS 14 Hole / Left,46052225,CDM,278,RC,,,OUTPATIENT,,,3499.9,2799.92,,2624.93,75,,,percent of total billed charges,75% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2771.92,79.2,,,percent of total billed charges,79.2% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3324.91,95,,,percent of total billed charges,95% of total billed charges,2799.92,80,,,percent of total billed charges,80% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of NM fee schedule,1399.96,40,,,percent of total billed charges,40% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,2659.92,76,,,percent of total billed charges,76% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rate,2799.92,80,,,percent of total billed charges,80% of total billed charges,1357.96,38.8,,,percent of total billed charges,38.8% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of APG fee schedule,6999.8,200,,,percent of total billed charges,200% of total billed charges,1357.96,6999.8,
Distal Anterolateral Tibia Plate TS 14 Hole / Right,46052226,CDM,278,RC,,,OUTPATIENT,,,3499.9,2799.92,,2624.93,75,,,percent of total billed charges,75% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2771.92,79.2,,,percent of total billed charges,79.2% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3324.91,95,,,percent of total billed charges,95% of total billed charges,2799.92,80,,,percent of total billed charges,80% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of NM fee schedule,1399.96,40,,,percent of total billed charges,40% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,2659.92,76,,,percent of total billed charges,76% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rate,2799.92,80,,,percent of total billed charges,80% of total billed charges,1357.96,38.8,,,percent of total billed charges,38.8% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of APG fee schedule,6999.8,200,,,percent of total billed charges,200% of total billed charges,1357.96,6999.8,
Distal Anterolateral Tibia Plate TS 16 Hole / Left,46052227,CDM,278,RC,,,OUTPATIENT,,,3499.9,2799.92,,2624.93,75,,,percent of total billed charges,75% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2771.92,79.2,,,percent of total billed charges,79.2% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3324.91,95,,,percent of total billed charges,95% of total billed charges,2799.92,80,,,percent of total billed charges,80% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of NM fee schedule,1399.96,40,,,percent of total billed charges,40% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,2659.92,76,,,percent of total billed charges,76% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rate,2799.92,80,,,percent of total billed charges,80% of total billed charges,1357.96,38.8,,,percent of total billed charges,38.8% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of APG fee schedule,6999.8,200,,,percent of total billed charges,200% of total billed charges,1357.96,6999.8,
Distal Anterolateral Tibia Plate TS 16 Hole / Right,46052228,CDM,278,RC,,,OUTPATIENT,,,3499.9,2799.92,,2624.93,75,,,percent of total billed charges,75% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2771.92,79.2,,,percent of total billed charges,79.2% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3324.91,95,,,percent of total billed charges,95% of total billed charges,2799.92,80,,,percent of total billed charges,80% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of CO APG rates,3499.9,100,,,fee schedule,100% of NM fee schedule,1399.96,40,,,percent of total billed charges,40% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,3149.91,90,,,percent of total billed charges,90% of total billed charges,2659.92,76,,,percent of total billed charges,76% of total billed charges,1399.96,40,,,percent of total billed charges,40% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of CO APG rate,2799.92,80,,,percent of total billed charges,80% of total billed charges,1357.96,38.8,,,percent of total billed charges,38.8% of total billed charges,2974.92,85,,,percent of total billed charges,85% of total billed charges,3499.9,100,,,fee schedule,100% of APG fee schedule,6999.8,200,,,percent of total billed charges,200% of total billed charges,1357.96,6999.8,
GAMMA 3 S NAIL RIGHT 11x320mm x 125,46052288,CDM,278,RC,,,OUTPATIENT,,,3869.7,3095.76,,2902.28,75,,,percent of total billed charges,75% of total billed charges,1547.88,40,,,percent of total billed charges,40% of total billed charges,3064.8,79.2,,,percent of total billed charges,79.2% of total billed charges,3289.25,85,,,percent of total billed charges,85% of total billed charges,3869.7,100,,,fee schedule,100% of CO APG rates,3676.22,95,,,percent of total billed charges,95% of total billed charges,3095.76,80,,,percent of total billed charges,80% of total billed charges,3289.25,85,,,percent of total billed charges,85% of total billed charges,3482.73,90,,,percent of total billed charges,90% of total billed charges,3869.7,100,,,fee schedule,100% of CO APG rates,3869.7,100,,,fee schedule,100% of CO APG rates,3869.7,100,,,fee schedule,100% of NM fee schedule,1547.88,40,,,percent of total billed charges,40% of total billed charges,1547.88,40,,,percent of total billed charges,40% of total billed charges,3482.73,90,,,percent of total billed charges,90% of total billed charges,2940.97,76,,,percent of total billed charges,76% of total billed charges,1547.88,40,,,percent of total billed charges,40% of total billed charges,3289.25,85,,,percent of total billed charges,85% of total billed charges,3869.7,100,,,fee schedule,100% of CO APG rate,3095.76,80,,,percent of total billed charges,80% of total billed charges,1501.44,38.8,,,percent of total billed charges,38.8% of total billed charges,3289.25,85,,,percent of total billed charges,85% of total billed charges,3869.7,100,,,fee schedule,100% of APG fee schedule,7739.4,200,,,percent of total billed charges,200% of total billed charges,1501.44,7739.4,
OSCILLATING AND SAGITTAL BLADE,46051740,CDM,270,RC,,,OUTPATIENT,,,159.4,127.52,,119.55,75,,,percent of total billed charges,75% of total billed charges,63.76,40,,,percent of total billed charges,40% of total billed charges,126.24,79.2,,,percent of total billed charges,79.2% of total billed charges,135.49,85,,,percent of total billed charges,85% of total billed charges,159.4,100,,,fee schedule,100% of CO APG rates,151.43,95,,,percent of total billed charges,95% of total billed charges,127.52,80,,,percent of total billed charges,80% of total billed charges,135.49,85,,,percent of total billed charges,85% of total billed charges,143.46,90,,,percent of total billed charges,90% of total billed charges,159.4,100,,,fee schedule,100% of CO APG rates,159.4,100,,,fee schedule,100% of CO APG rates,159.4,100,,,fee schedule,100% of NM fee schedule,63.76,40,,,percent of total billed charges,40% of total billed charges,63.76,40,,,percent of total billed charges,40% of total billed charges,143.46,90,,,percent of total billed charges,90% of total billed charges,121.14,76,,,percent of total billed charges,76% of total billed charges,63.76,40,,,percent of total billed charges,40% of total billed charges,135.49,85,,,percent of total billed charges,85% of total billed charges,159.4,100,,,fee schedule,100% of CO APG rate,127.52,80,,,percent of total billed charges,80% of total billed charges,61.85,38.8,,,percent of total billed charges,38.8% of total billed charges,135.49,85,,,percent of total billed charges,85% of total billed charges,159.4,100,,,fee schedule,100% of APG fee schedule,318.8,200,,,percent of total billed charges,200% of total billed charges,61.85,318.8,
LOCKING SCREWS T7 2.7X26MM,46051526,CDM,278,RC,,,OUTPATIENT,,,404.4,323.52,,303.3,75,,,percent of total billed charges,75% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,320.28,79.2,,,percent of total billed charges,79.2% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,384.18,95,,,percent of total billed charges,95% of total billed charges,323.52,80,,,percent of total billed charges,80% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of CO APG rates,404.4,100,,,fee schedule,100% of NM fee schedule,161.76,40,,,percent of total billed charges,40% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,363.96,90,,,percent of total billed charges,90% of total billed charges,307.34,76,,,percent of total billed charges,76% of total billed charges,161.76,40,,,percent of total billed charges,40% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of CO APG rate,323.52,80,,,percent of total billed charges,80% of total billed charges,156.91,38.8,,,percent of total billed charges,38.8% of total billed charges,343.74,85,,,percent of total billed charges,85% of total billed charges,404.4,100,,,fee schedule,100% of APG fee schedule,808.8,200,,,percent of total billed charges,200% of total billed charges,156.91,808.8,
ASNIS III SS CANNULATED SCR 4X14mm FULL THREAD,46051741,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X16mm FULL THREAD,46051743,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X18mm FULL THREAD,46051745,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X20mm FULL THREAD,46051747,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X22mm FULL THREAD,46051749,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X24mm FULL THREAD,46051751,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X26mm FULL THREAD,46051753,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X28mm FULL THREAD,46051755,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X30mm FULL THREAD,46051757,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X40mm FULL THREAD,46051763,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X42mm FULL THREAD,46051765,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X44mm FULL THREAD,46051767,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X46mm FULL THREAD,46051768,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X48mm FULL THREAD,46051770,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 4X50mm FULL THREAD,46051772,CDM,278,RC,,,OUTPATIENT,,,562,449.6,,421.5,75,,,percent of total billed charges,75% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,445.1,79.2,,,percent of total billed charges,79.2% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,533.9,95,,,percent of total billed charges,95% of total billed charges,449.6,80,,,percent of total billed charges,80% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of CO APG rates,562,100,,,fee schedule,100% of NM fee schedule,224.8,40,,,percent of total billed charges,40% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,505.8,90,,,percent of total billed charges,90% of total billed charges,427.12,76,,,percent of total billed charges,76% of total billed charges,224.8,40,,,percent of total billed charges,40% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of CO APG rate,449.6,80,,,percent of total billed charges,80% of total billed charges,218.06,38.8,,,percent of total billed charges,38.8% of total billed charges,477.7,85,,,percent of total billed charges,85% of total billed charges,562,100,,,fee schedule,100% of APG fee schedule,1124,200,,,percent of total billed charges,200% of total billed charges,218.06,1124,
ASNIS III SS CANNULATED SCR 5X20mm FULL THREAD,46051829,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X22mm FULL THREAD,46051831,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X24mm FULL THREAD,46051833,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X28mm FULL THREAD,46051836,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X30mm FULL THREAD,46051838,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X32mm FULL THREAD,46051840,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X34mm FULL THREAD,46051842,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X36mm FULL THREAD,46051844,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X38mm FULL THREAD,46051846,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X40mm FULL THREAD,46051848,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X42mm FULL THREAD,46051850,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X44mm FULL THREAD,46051852,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X46mm FULL THREAD,46051854,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X50mm FULL THREAD,46051857,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X55mm FULL THREAD,46051859,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X60mm FULL THREAD,46051861,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X65mm FULL THREAD,46051863,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 5X70mm FULL THREAD,46051865,CDM,278,RC,,,OUTPATIENT,,,588.2,470.56,,441.15,75,,,percent of total billed charges,75% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,465.85,79.2,,,percent of total billed charges,79.2% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,558.79,95,,,percent of total billed charges,95% of total billed charges,470.56,80,,,percent of total billed charges,80% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of CO APG rates,588.2,100,,,fee schedule,100% of NM fee schedule,235.28,40,,,percent of total billed charges,40% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,529.38,90,,,percent of total billed charges,90% of total billed charges,447.03,76,,,percent of total billed charges,76% of total billed charges,235.28,40,,,percent of total billed charges,40% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of CO APG rate,470.56,80,,,percent of total billed charges,80% of total billed charges,228.22,38.8,,,percent of total billed charges,38.8% of total billed charges,499.97,85,,,percent of total billed charges,85% of total billed charges,588.2,100,,,fee schedule,100% of APG fee schedule,1176.4,200,,,percent of total billed charges,200% of total billed charges,228.22,1176.4,
ASNIS III SS CANNULATED SCR 6.5X100mm PARTIAL THREAD 40,46051914,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,1455.8,200,,,percent of total billed charges,200% of total billed charges,282.43,1455.8,
ASNIS III SS CANNULATED SCR 6.5X105mm PARTIAL THREAD 40,46051916,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,1455.8,200,,,percent of total billed charges,200% of total billed charges,282.43,1455.8,
ASNIS III SS CANNULATED SCR 6.5X110mm PARTIAL THREAD 40,46051918,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,1455.8,200,,,percent of total billed charges,200% of total billed charges,282.43,1455.8,
ASNIS III SS CANNULATED SCR 6.5X115mm PARTIAL THREAD 40,46051920,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,1455.8,200,,,percent of total billed charges,200% of total billed charges,282.43,1455.8,
ASNIS III SS CANNULATED SCR 6.5X120mm PARTIAL THREAD 40,46051922,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,1455.8,200,,,percent of total billed charges,200% of total billed charges,282.43,1455.8,
BONE SCREW T7 2.7X10 MM VARIAX DISTAL RADIUS,46051510,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,708,200,,,percent of total billed charges,200% of total billed charges,137.35,708,
BONE SCREW T7 2.7X12 MM VARIAX DISTAL RADIUS,46051511,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,708,200,,,percent of total billed charges,200% of total billed charges,137.35,708,
BONE SCREW T7 2.7X14 MM VARIAX DISTAL RADIUS,46051512,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,708,200,,,percent of total billed charges,200% of total billed charges,137.35,708,
BONE SCREW T7 2.7X16 MM VARIAX DISTAL RADIUS,46051513,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,708,200,,,percent of total billed charges,200% of total billed charges,137.35,708,
BONE SCREW T7 2.7X18 MM VARIAX DISTAL RADIUS,46051514,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,708,200,,,percent of total billed charges,200% of total billed charges,137.35,708,
BONE SCREW T7 2.7X20 MM VARIAX DISTAL RADIUS,46051515,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,708,200,,,percent of total billed charges,200% of total billed charges,137.35,708,
BONE SCREW T7 2.7X22 MM VARIAX DISTAL RADIUS,46051516,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,708,200,,,percent of total billed charges,200% of total billed charges,137.35,708,
BONE SCREW T7 2.7X24 MM VARIAX DISTAL RADIUS,46051517,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,708,200,,,percent of total billed charges,200% of total billed charges,137.35,708,
BONE SCREW T7 2.7X26 MM VARIAX DISTAL RADIUS,46051518,CDM,278,RC,,,OUTPATIENT,,,354,283.2,,265.5,75,,,percent of total billed charges,75% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,280.37,79.2,,,percent of total billed charges,79.2% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,336.3,95,,,percent of total billed charges,95% of total billed charges,283.2,80,,,percent of total billed charges,80% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of CO APG rates,354,100,,,fee schedule,100% of NM fee schedule,141.6,40,,,percent of total billed charges,40% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,318.6,90,,,percent of total billed charges,90% of total billed charges,269.04,76,,,percent of total billed charges,76% of total billed charges,141.6,40,,,percent of total billed charges,40% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of CO APG rate,283.2,80,,,percent of total billed charges,80% of total billed charges,137.35,38.8,,,percent of total billed charges,38.8% of total billed charges,300.9,85,,,percent of total billed charges,85% of total billed charges,354,100,,,fee schedule,100% of APG fee schedule,708,200,,,percent of total billed charges,200% of total billed charges,137.35,708,
CANCELLOUS SCREW 4.0 SS FULL THREAD X65,46051259,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS FULL THREAD X70,46051260,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS FULL THREAD X75,46051261,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS FULL THREAD X80,46051262,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS FULL THREAD X85,46051263,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS FULL THREAD X90,46051264,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS FULL THREAD X95,46051265,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X65,46051286,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X70,46051287,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X75,46051288,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X80,46051289,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,134.4,200,,,percent of total billed charges,200% of total billed charges,26.07,134.4,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X85,46051295,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X90,46051290,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
CANCELLOUS SCREW 4.0 SS PARTIAL THREAD X95,46051291,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
SUTURE 2 ETHIBOND V-37,46052296,CDM,270,RC,,,OUTPATIENT,,,42.6,34.08,,31.95,75,,,percent of total billed charges,75% of total billed charges,17.04,40,,,percent of total billed charges,40% of total billed charges,33.74,79.2,,,percent of total billed charges,79.2% of total billed charges,36.21,85,,,percent of total billed charges,85% of total billed charges,42.6,100,,,fee schedule,100% of CO APG rates,40.47,95,,,percent of total billed charges,95% of total billed charges,34.08,80,,,percent of total billed charges,80% of total billed charges,36.21,85,,,percent of total billed charges,85% of total billed charges,38.34,90,,,percent of total billed charges,90% of total billed charges,42.6,100,,,fee schedule,100% of CO APG rates,42.6,100,,,fee schedule,100% of CO APG rates,42.6,100,,,fee schedule,100% of NM fee schedule,17.04,40,,,percent of total billed charges,40% of total billed charges,17.04,40,,,percent of total billed charges,40% of total billed charges,38.34,90,,,percent of total billed charges,90% of total billed charges,32.38,76,,,percent of total billed charges,76% of total billed charges,17.04,40,,,percent of total billed charges,40% of total billed charges,36.21,85,,,percent of total billed charges,85% of total billed charges,42.6,100,,,fee schedule,100% of CO APG rate,34.08,80,,,percent of total billed charges,80% of total billed charges,16.53,38.8,,,percent of total billed charges,38.8% of total billed charges,36.21,85,,,percent of total billed charges,85% of total billed charges,42.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,16.53,42.6,
SUTURE 3-0 ETHILON FS-1 663G,52297,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.91,7.5,
SAGITTAL BLADE 25X1.27X90MM,46052299,CDM,270,RC,,,OUTPATIENT,,,273,218.4,,204.75,75,,,percent of total billed charges,75% of total billed charges,109.2,40,,,percent of total billed charges,40% of total billed charges,216.22,79.2,,,percent of total billed charges,79.2% of total billed charges,232.05,85,,,percent of total billed charges,85% of total billed charges,273,100,,,fee schedule,100% of CO APG rates,259.35,95,,,percent of total billed charges,95% of total billed charges,218.4,80,,,percent of total billed charges,80% of total billed charges,232.05,85,,,percent of total billed charges,85% of total billed charges,245.7,90,,,percent of total billed charges,90% of total billed charges,273,100,,,fee schedule,100% of CO APG rates,273,100,,,fee schedule,100% of CO APG rates,273,100,,,fee schedule,100% of NM fee schedule,109.2,40,,,percent of total billed charges,40% of total billed charges,109.2,40,,,percent of total billed charges,40% of total billed charges,245.7,90,,,percent of total billed charges,90% of total billed charges,207.48,76,,,percent of total billed charges,76% of total billed charges,109.2,40,,,percent of total billed charges,40% of total billed charges,232.05,85,,,percent of total billed charges,85% of total billed charges,273,100,,,fee schedule,100% of CO APG rate,218.4,80,,,percent of total billed charges,80% of total billed charges,105.92,38.8,,,percent of total billed charges,38.8% of total billed charges,232.05,85,,,percent of total billed charges,85% of total billed charges,273,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.92,273,
SAGITTAL BLADE 18.0X1.27X90MM,46052300,CDM,270,RC,,,OUTPATIENT,,,273,218.4,,204.75,75,,,percent of total billed charges,75% of total billed charges,109.2,40,,,percent of total billed charges,40% of total billed charges,216.22,79.2,,,percent of total billed charges,79.2% of total billed charges,232.05,85,,,percent of total billed charges,85% of total billed charges,273,100,,,fee schedule,100% of CO APG rates,259.35,95,,,percent of total billed charges,95% of total billed charges,218.4,80,,,percent of total billed charges,80% of total billed charges,232.05,85,,,percent of total billed charges,85% of total billed charges,245.7,90,,,percent of total billed charges,90% of total billed charges,273,100,,,fee schedule,100% of CO APG rates,273,100,,,fee schedule,100% of CO APG rates,273,100,,,fee schedule,100% of NM fee schedule,109.2,40,,,percent of total billed charges,40% of total billed charges,109.2,40,,,percent of total billed charges,40% of total billed charges,245.7,90,,,percent of total billed charges,90% of total billed charges,207.48,76,,,percent of total billed charges,76% of total billed charges,109.2,40,,,percent of total billed charges,40% of total billed charges,232.05,85,,,percent of total billed charges,85% of total billed charges,273,100,,,fee schedule,100% of CO APG rate,218.4,80,,,percent of total billed charges,80% of total billed charges,105.92,38.8,,,percent of total billed charges,38.8% of total billed charges,232.05,85,,,percent of total billed charges,85% of total billed charges,273,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.92,273,
SUTURE 2-0 PROLENE CT-1,52304,CDM,270,RC,,,OUTPATIENT,,,9.9,7.92,,7.43,75,,,percent of total billed charges,75% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,7.84,79.2,,,percent of total billed charges,79.2% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rates,9.41,95,,,percent of total billed charges,95% of total billed charges,7.92,80,,,percent of total billed charges,80% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,8.91,90,,,percent of total billed charges,90% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rates,9.9,100,,,fee schedule,100% of CO APG rates,9.9,100,,,fee schedule,100% of NM fee schedule,3.96,40,,,percent of total billed charges,40% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,8.91,90,,,percent of total billed charges,90% of total billed charges,7.52,76,,,percent of total billed charges,76% of total billed charges,3.96,40,,,percent of total billed charges,40% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of CO APG rate,7.92,80,,,percent of total billed charges,80% of total billed charges,3.84,38.8,,,percent of total billed charges,38.8% of total billed charges,8.42,85,,,percent of total billed charges,85% of total billed charges,9.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.84,9.9,
"TWIST DRILL 1.9X150MM, AO",46052305,CDM,270,RC,,,OUTPATIENT,,,463.1,370.48,,347.33,75,,,percent of total billed charges,75% of total billed charges,185.24,40,,,percent of total billed charges,40% of total billed charges,366.78,79.2,,,percent of total billed charges,79.2% of total billed charges,393.64,85,,,percent of total billed charges,85% of total billed charges,463.1,100,,,fee schedule,100% of CO APG rates,439.95,95,,,percent of total billed charges,95% of total billed charges,370.48,80,,,percent of total billed charges,80% of total billed charges,393.64,85,,,percent of total billed charges,85% of total billed charges,416.79,90,,,percent of total billed charges,90% of total billed charges,463.1,100,,,fee schedule,100% of CO APG rates,463.1,100,,,fee schedule,100% of CO APG rates,463.1,100,,,fee schedule,100% of NM fee schedule,185.24,40,,,percent of total billed charges,40% of total billed charges,185.24,40,,,percent of total billed charges,40% of total billed charges,416.79,90,,,percent of total billed charges,90% of total billed charges,351.96,76,,,percent of total billed charges,76% of total billed charges,185.24,40,,,percent of total billed charges,40% of total billed charges,393.64,85,,,percent of total billed charges,85% of total billed charges,463.1,100,,,fee schedule,100% of CO APG rate,370.48,80,,,percent of total billed charges,80% of total billed charges,179.68,38.8,,,percent of total billed charges,38.8% of total billed charges,393.64,85,,,percent of total billed charges,85% of total billed charges,463.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,179.68,463.1,
ASNIS III SS CANNULATED SCR 6.5X55mm THREAD 40MM,46051927,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X60mm THREAD 40MM,46051929,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X65mm THREAD 40MM,46051931,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X70mm THREAD 40MM,46051933,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X75mm THREAD 40MM,46051935,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X80mm THREAD 40MM,46051937,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X85mm THREAD 40MM,46051939,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X90mm THREAD 40MM,46051941,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
ASNIS III SS CANNULATED SCR 6.5X95mm THREAD 40MM,46051943,CDM,278,RC,,,OUTPATIENT,,,727.9,582.32,,545.93,75,,,percent of total billed charges,75% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,576.5,79.2,,,percent of total billed charges,79.2% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,691.51,95,,,percent of total billed charges,95% of total billed charges,582.32,80,,,percent of total billed charges,80% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of CO APG rates,727.9,100,,,fee schedule,100% of NM fee schedule,291.16,40,,,percent of total billed charges,40% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,655.11,90,,,percent of total billed charges,90% of total billed charges,553.2,76,,,percent of total billed charges,76% of total billed charges,291.16,40,,,percent of total billed charges,40% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of CO APG rate,582.32,80,,,percent of total billed charges,80% of total billed charges,282.43,38.8,,,percent of total billed charges,38.8% of total billed charges,618.72,85,,,percent of total billed charges,85% of total billed charges,727.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,282.43,727.9,
"KWIRE, 3.2X450MM",46052309,CDM,270,RC,,,OUTPATIENT,,,423.8,339.04,,317.85,75,,,percent of total billed charges,75% of total billed charges,169.52,40,,,percent of total billed charges,40% of total billed charges,335.65,79.2,,,percent of total billed charges,79.2% of total billed charges,360.23,85,,,percent of total billed charges,85% of total billed charges,423.8,100,,,fee schedule,100% of CO APG rates,402.61,95,,,percent of total billed charges,95% of total billed charges,339.04,80,,,percent of total billed charges,80% of total billed charges,360.23,85,,,percent of total billed charges,85% of total billed charges,381.42,90,,,percent of total billed charges,90% of total billed charges,423.8,100,,,fee schedule,100% of CO APG rates,423.8,100,,,fee schedule,100% of CO APG rates,423.8,100,,,fee schedule,100% of NM fee schedule,169.52,40,,,percent of total billed charges,40% of total billed charges,169.52,40,,,percent of total billed charges,40% of total billed charges,381.42,90,,,percent of total billed charges,90% of total billed charges,322.09,76,,,percent of total billed charges,76% of total billed charges,169.52,40,,,percent of total billed charges,40% of total billed charges,360.23,85,,,percent of total billed charges,85% of total billed charges,423.8,100,,,fee schedule,100% of CO APG rate,339.04,80,,,percent of total billed charges,80% of total billed charges,164.43,38.8,,,percent of total billed charges,38.8% of total billed charges,360.23,85,,,percent of total billed charges,85% of total billed charges,423.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,164.43,423.8,
"GUIDE WIRE, BALL TIP 3.0X800mm STERILE",46052310,CDM,270,RC,,,OUTPATIENT,,,602.9,482.32,,452.18,75,,,percent of total billed charges,75% of total billed charges,241.16,40,,,percent of total billed charges,40% of total billed charges,477.5,79.2,,,percent of total billed charges,79.2% of total billed charges,512.47,85,,,percent of total billed charges,85% of total billed charges,602.9,100,,,fee schedule,100% of CO APG rates,572.76,95,,,percent of total billed charges,95% of total billed charges,482.32,80,,,percent of total billed charges,80% of total billed charges,512.47,85,,,percent of total billed charges,85% of total billed charges,542.61,90,,,percent of total billed charges,90% of total billed charges,602.9,100,,,fee schedule,100% of CO APG rates,602.9,100,,,fee schedule,100% of CO APG rates,602.9,100,,,fee schedule,100% of NM fee schedule,241.16,40,,,percent of total billed charges,40% of total billed charges,241.16,40,,,percent of total billed charges,40% of total billed charges,542.61,90,,,percent of total billed charges,90% of total billed charges,458.2,76,,,percent of total billed charges,76% of total billed charges,241.16,40,,,percent of total billed charges,40% of total billed charges,512.47,85,,,percent of total billed charges,85% of total billed charges,602.9,100,,,fee schedule,100% of CO APG rate,482.32,80,,,percent of total billed charges,80% of total billed charges,233.93,38.8,,,percent of total billed charges,38.8% of total billed charges,512.47,85,,,percent of total billed charges,85% of total billed charges,602.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,233.93,602.9,
"REAMER SHAFT, MOD. TRINKLE",46052312,CDM,270,RC,,,OUTPATIENT,,,622.7,498.16,,467.03,75,,,percent of total billed charges,75% of total billed charges,249.08,40,,,percent of total billed charges,40% of total billed charges,493.18,79.2,,,percent of total billed charges,79.2% of total billed charges,529.3,85,,,percent of total billed charges,85% of total billed charges,622.7,100,,,fee schedule,100% of CO APG rates,591.57,95,,,percent of total billed charges,95% of total billed charges,498.16,80,,,percent of total billed charges,80% of total billed charges,529.3,85,,,percent of total billed charges,85% of total billed charges,560.43,90,,,percent of total billed charges,90% of total billed charges,622.7,100,,,fee schedule,100% of CO APG rates,622.7,100,,,fee schedule,100% of CO APG rates,622.7,100,,,fee schedule,100% of NM fee schedule,249.08,40,,,percent of total billed charges,40% of total billed charges,249.08,40,,,percent of total billed charges,40% of total billed charges,560.43,90,,,percent of total billed charges,90% of total billed charges,473.25,76,,,percent of total billed charges,76% of total billed charges,249.08,40,,,percent of total billed charges,40% of total billed charges,529.3,85,,,percent of total billed charges,85% of total billed charges,622.7,100,,,fee schedule,100% of CO APG rate,498.16,80,,,percent of total billed charges,80% of total billed charges,241.61,38.8,,,percent of total billed charges,38.8% of total billed charges,529.3,85,,,percent of total billed charges,85% of total billed charges,622.7,100,,,fee schedule,100% of APG fee schedule,1245.4,200,,,percent of total billed charges,200% of total billed charges,241.61,1245.4,
0.045 IN. (1.143mm) K-WIRE W/LENGTH MARKINGS,46052315,CDM,270,RC,,,OUTPATIENT,,,93.9,75.12,,70.43,75,,,percent of total billed charges,75% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,74.37,79.2,,,percent of total billed charges,79.2% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rates,89.21,95,,,percent of total billed charges,95% of total billed charges,75.12,80,,,percent of total billed charges,80% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,84.51,90,,,percent of total billed charges,90% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rates,93.9,100,,,fee schedule,100% of CO APG rates,93.9,100,,,fee schedule,100% of NM fee schedule,37.56,40,,,percent of total billed charges,40% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,84.51,90,,,percent of total billed charges,90% of total billed charges,71.36,76,,,percent of total billed charges,76% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rate,75.12,80,,,percent of total billed charges,80% of total billed charges,36.43,38.8,,,percent of total billed charges,38.8% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of APG fee schedule,187.8,200,,,percent of total billed charges,200% of total billed charges,36.43,187.8,
K-WIRE W/ 17mm STOP,46052316,CDM,270,RC,,,OUTPATIENT,,,93.9,75.12,,70.43,75,,,percent of total billed charges,75% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,74.37,79.2,,,percent of total billed charges,79.2% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rates,89.21,95,,,percent of total billed charges,95% of total billed charges,75.12,80,,,percent of total billed charges,80% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,84.51,90,,,percent of total billed charges,90% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rates,93.9,100,,,fee schedule,100% of CO APG rates,93.9,100,,,fee schedule,100% of NM fee schedule,37.56,40,,,percent of total billed charges,40% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,84.51,90,,,percent of total billed charges,90% of total billed charges,71.36,76,,,percent of total billed charges,76% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rate,75.12,80,,,percent of total billed charges,80% of total billed charges,36.43,38.8,,,percent of total billed charges,38.8% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of APG fee schedule,187.8,200,,,percent of total billed charges,200% of total billed charges,36.43,187.8,
ASNIS III THREADED GUIDE WIRE 3.2X300mm,46052319,CDM,270,RC,,,OUTPATIENT,,,134.4,107.52,,100.8,75,,,percent of total billed charges,75% of total billed charges,53.76,40,,,percent of total billed charges,40% of total billed charges,106.44,79.2,,,percent of total billed charges,79.2% of total billed charges,114.24,85,,,percent of total billed charges,85% of total billed charges,134.4,100,,,fee schedule,100% of CO APG rates,127.68,95,,,percent of total billed charges,95% of total billed charges,107.52,80,,,percent of total billed charges,80% of total billed charges,114.24,85,,,percent of total billed charges,85% of total billed charges,120.96,90,,,percent of total billed charges,90% of total billed charges,134.4,100,,,fee schedule,100% of CO APG rates,134.4,100,,,fee schedule,100% of CO APG rates,134.4,100,,,fee schedule,100% of NM fee schedule,53.76,40,,,percent of total billed charges,40% of total billed charges,53.76,40,,,percent of total billed charges,40% of total billed charges,120.96,90,,,percent of total billed charges,90% of total billed charges,102.14,76,,,percent of total billed charges,76% of total billed charges,53.76,40,,,percent of total billed charges,40% of total billed charges,114.24,85,,,percent of total billed charges,85% of total billed charges,134.4,100,,,fee schedule,100% of CO APG rate,107.52,80,,,percent of total billed charges,80% of total billed charges,52.15,38.8,,,percent of total billed charges,38.8% of total billed charges,114.24,85,,,percent of total billed charges,85% of total billed charges,134.4,100,,,fee schedule,100% of APG fee schedule,268.8,200,,,percent of total billed charges,200% of total billed charges,52.15,268.8,
ASNIS III 1.4X150mm GUIDE WIRE,46052320,CDM,270,RC,,,OUTPATIENT,,,153.9,123.12,,115.43,75,,,percent of total billed charges,75% of total billed charges,61.56,40,,,percent of total billed charges,40% of total billed charges,121.89,79.2,,,percent of total billed charges,79.2% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,153.9,100,,,fee schedule,100% of CO APG rates,146.21,95,,,percent of total billed charges,95% of total billed charges,123.12,80,,,percent of total billed charges,80% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,138.51,90,,,percent of total billed charges,90% of total billed charges,153.9,100,,,fee schedule,100% of CO APG rates,153.9,100,,,fee schedule,100% of CO APG rates,153.9,100,,,fee schedule,100% of NM fee schedule,61.56,40,,,percent of total billed charges,40% of total billed charges,61.56,40,,,percent of total billed charges,40% of total billed charges,138.51,90,,,percent of total billed charges,90% of total billed charges,116.96,76,,,percent of total billed charges,76% of total billed charges,61.56,40,,,percent of total billed charges,40% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,153.9,100,,,fee schedule,100% of CO APG rate,123.12,80,,,percent of total billed charges,80% of total billed charges,59.71,38.8,,,percent of total billed charges,38.8% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,153.9,100,,,fee schedule,100% of APG fee schedule,307.8,200,,,percent of total billed charges,200% of total billed charges,59.71,307.8,
ASNIS III 2.0X150mm GUIDE WIRE,46052321,CDM,270,RC,,,OUTPATIENT,,,153.9,123.12,,115.43,75,,,percent of total billed charges,75% of total billed charges,61.56,40,,,percent of total billed charges,40% of total billed charges,121.89,79.2,,,percent of total billed charges,79.2% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,153.9,100,,,fee schedule,100% of CO APG rates,146.21,95,,,percent of total billed charges,95% of total billed charges,123.12,80,,,percent of total billed charges,80% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,138.51,90,,,percent of total billed charges,90% of total billed charges,153.9,100,,,fee schedule,100% of CO APG rates,153.9,100,,,fee schedule,100% of CO APG rates,153.9,100,,,fee schedule,100% of NM fee schedule,61.56,40,,,percent of total billed charges,40% of total billed charges,61.56,40,,,percent of total billed charges,40% of total billed charges,138.51,90,,,percent of total billed charges,90% of total billed charges,116.96,76,,,percent of total billed charges,76% of total billed charges,61.56,40,,,percent of total billed charges,40% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,153.9,100,,,fee schedule,100% of CO APG rate,123.12,80,,,percent of total billed charges,80% of total billed charges,59.71,38.8,,,percent of total billed charges,38.8% of total billed charges,130.82,85,,,percent of total billed charges,85% of total billed charges,153.9,100,,,fee schedule,100% of APG fee schedule,307.8,200,,,percent of total billed charges,200% of total billed charges,59.71,307.8,
"2.0 DIAM. TWIST DRILL X 105mm, AO END, WORKING LENGTH MIN. 41mm",46052324,CDM,270,RC,,,OUTPATIENT,,,350.7,280.56,,263.03,75,,,percent of total billed charges,75% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,277.75,79.2,,,percent of total billed charges,79.2% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rates,333.17,95,,,percent of total billed charges,95% of total billed charges,280.56,80,,,percent of total billed charges,80% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,315.63,90,,,percent of total billed charges,90% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rates,350.7,100,,,fee schedule,100% of CO APG rates,350.7,100,,,fee schedule,100% of NM fee schedule,140.28,40,,,percent of total billed charges,40% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,315.63,90,,,percent of total billed charges,90% of total billed charges,266.53,76,,,percent of total billed charges,76% of total billed charges,140.28,40,,,percent of total billed charges,40% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of CO APG rate,280.56,80,,,percent of total billed charges,80% of total billed charges,136.07,38.8,,,percent of total billed charges,38.8% of total billed charges,298.1,85,,,percent of total billed charges,85% of total billed charges,350.7,100,,,fee schedule,100% of APG fee schedule,701.4,200,,,percent of total billed charges,200% of total billed charges,136.07,701.4,
"K-WIRE, 1.8X310mm, FOR CONDYLE SCREWS ONLY",46052325,CDM,270,RC,,,OUTPATIENT,,,407.4,325.92,,305.55,75,,,percent of total billed charges,75% of total billed charges,162.96,40,,,percent of total billed charges,40% of total billed charges,322.66,79.2,,,percent of total billed charges,79.2% of total billed charges,346.29,85,,,percent of total billed charges,85% of total billed charges,407.4,100,,,fee schedule,100% of CO APG rates,387.03,95,,,percent of total billed charges,95% of total billed charges,325.92,80,,,percent of total billed charges,80% of total billed charges,346.29,85,,,percent of total billed charges,85% of total billed charges,366.66,90,,,percent of total billed charges,90% of total billed charges,407.4,100,,,fee schedule,100% of CO APG rates,407.4,100,,,fee schedule,100% of CO APG rates,407.4,100,,,fee schedule,100% of NM fee schedule,162.96,40,,,percent of total billed charges,40% of total billed charges,162.96,40,,,percent of total billed charges,40% of total billed charges,366.66,90,,,percent of total billed charges,90% of total billed charges,309.62,76,,,percent of total billed charges,76% of total billed charges,162.96,40,,,percent of total billed charges,40% of total billed charges,346.29,85,,,percent of total billed charges,85% of total billed charges,407.4,100,,,fee schedule,100% of CO APG rate,325.92,80,,,percent of total billed charges,80% of total billed charges,158.07,38.8,,,percent of total billed charges,38.8% of total billed charges,346.29,85,,,percent of total billed charges,85% of total billed charges,407.4,100,,,fee schedule,100% of APG fee schedule,814.8,200,,,percent of total billed charges,200% of total billed charges,158.07,814.8,
"K-WIRE, 3mmX285mm STERILE",46052326,CDM,270,RC,,,OUTPATIENT,,,416.3,333.04,,312.23,75,,,percent of total billed charges,75% of total billed charges,166.52,40,,,percent of total billed charges,40% of total billed charges,329.71,79.2,,,percent of total billed charges,79.2% of total billed charges,353.86,85,,,percent of total billed charges,85% of total billed charges,416.3,100,,,fee schedule,100% of CO APG rates,395.49,95,,,percent of total billed charges,95% of total billed charges,333.04,80,,,percent of total billed charges,80% of total billed charges,353.86,85,,,percent of total billed charges,85% of total billed charges,374.67,90,,,percent of total billed charges,90% of total billed charges,416.3,100,,,fee schedule,100% of CO APG rates,416.3,100,,,fee schedule,100% of CO APG rates,416.3,100,,,fee schedule,100% of NM fee schedule,166.52,40,,,percent of total billed charges,40% of total billed charges,166.52,40,,,percent of total billed charges,40% of total billed charges,374.67,90,,,percent of total billed charges,90% of total billed charges,316.39,76,,,percent of total billed charges,76% of total billed charges,166.52,40,,,percent of total billed charges,40% of total billed charges,353.86,85,,,percent of total billed charges,85% of total billed charges,416.3,100,,,fee schedule,100% of CO APG rate,333.04,80,,,percent of total billed charges,80% of total billed charges,161.52,38.8,,,percent of total billed charges,38.8% of total billed charges,353.86,85,,,percent of total billed charges,85% of total billed charges,416.3,100,,,fee schedule,100% of APG fee schedule,832.6,200,,,percent of total billed charges,200% of total billed charges,161.52,832.6,
DRILL BIT 03.6mm x 122mm AO FITTING,46052327,CDM,270,RC,,,OUTPATIENT,,,444.6,355.68,,333.45,75,,,percent of total billed charges,75% of total billed charges,177.84,40,,,percent of total billed charges,40% of total billed charges,352.12,79.2,,,percent of total billed charges,79.2% of total billed charges,377.91,85,,,percent of total billed charges,85% of total billed charges,444.6,100,,,fee schedule,100% of CO APG rates,422.37,95,,,percent of total billed charges,95% of total billed charges,355.68,80,,,percent of total billed charges,80% of total billed charges,377.91,85,,,percent of total billed charges,85% of total billed charges,400.14,90,,,percent of total billed charges,90% of total billed charges,444.6,100,,,fee schedule,100% of CO APG rates,444.6,100,,,fee schedule,100% of CO APG rates,444.6,100,,,fee schedule,100% of NM fee schedule,177.84,40,,,percent of total billed charges,40% of total billed charges,177.84,40,,,percent of total billed charges,40% of total billed charges,400.14,90,,,percent of total billed charges,90% of total billed charges,337.9,76,,,percent of total billed charges,76% of total billed charges,177.84,40,,,percent of total billed charges,40% of total billed charges,377.91,85,,,percent of total billed charges,85% of total billed charges,444.6,100,,,fee schedule,100% of CO APG rate,355.68,80,,,percent of total billed charges,80% of total billed charges,172.5,38.8,,,percent of total billed charges,38.8% of total billed charges,377.91,85,,,percent of total billed charges,85% of total billed charges,444.6,100,,,fee schedule,100% of APG fee schedule,889.2,200,,,percent of total billed charges,200% of total billed charges,172.5,889.2,
DRILL BIT 2.0X125mm,46052330,CDM,270,RC,,,OUTPATIENT,,,459.9,367.92,,344.93,75,,,percent of total billed charges,75% of total billed charges,183.96,40,,,percent of total billed charges,40% of total billed charges,364.24,79.2,,,percent of total billed charges,79.2% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,459.9,100,,,fee schedule,100% of CO APG rates,436.91,95,,,percent of total billed charges,95% of total billed charges,367.92,80,,,percent of total billed charges,80% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,413.91,90,,,percent of total billed charges,90% of total billed charges,459.9,100,,,fee schedule,100% of CO APG rates,459.9,100,,,fee schedule,100% of CO APG rates,459.9,100,,,fee schedule,100% of NM fee schedule,183.96,40,,,percent of total billed charges,40% of total billed charges,183.96,40,,,percent of total billed charges,40% of total billed charges,413.91,90,,,percent of total billed charges,90% of total billed charges,349.52,76,,,percent of total billed charges,76% of total billed charges,183.96,40,,,percent of total billed charges,40% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,459.9,100,,,fee schedule,100% of CO APG rate,367.92,80,,,percent of total billed charges,80% of total billed charges,178.44,38.8,,,percent of total billed charges,38.8% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,459.9,100,,,fee schedule,100% of APG fee schedule,919.8,200,,,percent of total billed charges,200% of total billed charges,178.44,919.8,
DRILL BIT  4.3X262mm,46052333,CDM,270,RC,,,OUTPATIENT,,,459.9,367.92,,344.93,75,,,percent of total billed charges,75% of total billed charges,183.96,40,,,percent of total billed charges,40% of total billed charges,364.24,79.2,,,percent of total billed charges,79.2% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,459.9,100,,,fee schedule,100% of CO APG rates,436.91,95,,,percent of total billed charges,95% of total billed charges,367.92,80,,,percent of total billed charges,80% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,413.91,90,,,percent of total billed charges,90% of total billed charges,459.9,100,,,fee schedule,100% of CO APG rates,459.9,100,,,fee schedule,100% of CO APG rates,459.9,100,,,fee schedule,100% of NM fee schedule,183.96,40,,,percent of total billed charges,40% of total billed charges,183.96,40,,,percent of total billed charges,40% of total billed charges,413.91,90,,,percent of total billed charges,90% of total billed charges,349.52,76,,,percent of total billed charges,76% of total billed charges,183.96,40,,,percent of total billed charges,40% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,459.9,100,,,fee schedule,100% of CO APG rate,367.92,80,,,percent of total billed charges,80% of total billed charges,178.44,38.8,,,percent of total billed charges,38.8% of total billed charges,390.92,85,,,percent of total billed charges,85% of total billed charges,459.9,100,,,fee schedule,100% of APG fee schedule,919.8,200,,,percent of total billed charges,200% of total billed charges,178.44,919.8,
DRILL 2.6mm X 122mm WL70mm AO-SHAFT,46052335,CDM,270,RC,,,OUTPATIENT,,,486.2,388.96,,364.65,75,,,percent of total billed charges,75% of total billed charges,194.48,40,,,percent of total billed charges,40% of total billed charges,385.07,79.2,,,percent of total billed charges,79.2% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,486.2,100,,,fee schedule,100% of CO APG rates,461.89,95,,,percent of total billed charges,95% of total billed charges,388.96,80,,,percent of total billed charges,80% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,437.58,90,,,percent of total billed charges,90% of total billed charges,486.2,100,,,fee schedule,100% of CO APG rates,486.2,100,,,fee schedule,100% of CO APG rates,486.2,100,,,fee schedule,100% of NM fee schedule,194.48,40,,,percent of total billed charges,40% of total billed charges,194.48,40,,,percent of total billed charges,40% of total billed charges,437.58,90,,,percent of total billed charges,90% of total billed charges,369.51,76,,,percent of total billed charges,76% of total billed charges,194.48,40,,,percent of total billed charges,40% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,486.2,100,,,fee schedule,100% of CO APG rate,388.96,80,,,percent of total billed charges,80% of total billed charges,188.65,38.8,,,percent of total billed charges,38.8% of total billed charges,413.27,85,,,percent of total billed charges,85% of total billed charges,486.2,100,,,fee schedule,100% of APG fee schedule,972.4,200,,,percent of total billed charges,200% of total billed charges,188.65,972.4,
ASNIS III DRILL BIT 3.2X300mm,46052336,CDM,270,RC,,,OUTPATIENT,,,442.5,354,,331.88,75,,,percent of total billed charges,75% of total billed charges,177,40,,,percent of total billed charges,40% of total billed charges,350.46,79.2,,,percent of total billed charges,79.2% of total billed charges,376.13,85,,,percent of total billed charges,85% of total billed charges,442.5,100,,,fee schedule,100% of CO APG rates,420.38,95,,,percent of total billed charges,95% of total billed charges,354,80,,,percent of total billed charges,80% of total billed charges,376.13,85,,,percent of total billed charges,85% of total billed charges,398.25,90,,,percent of total billed charges,90% of total billed charges,442.5,100,,,fee schedule,100% of CO APG rates,442.5,100,,,fee schedule,100% of CO APG rates,442.5,100,,,fee schedule,100% of NM fee schedule,177,40,,,percent of total billed charges,40% of total billed charges,177,40,,,percent of total billed charges,40% of total billed charges,398.25,90,,,percent of total billed charges,90% of total billed charges,336.3,76,,,percent of total billed charges,76% of total billed charges,177,40,,,percent of total billed charges,40% of total billed charges,376.13,85,,,percent of total billed charges,85% of total billed charges,442.5,100,,,fee schedule,100% of CO APG rate,354,80,,,percent of total billed charges,80% of total billed charges,171.69,38.8,,,percent of total billed charges,38.8% of total billed charges,376.13,85,,,percent of total billed charges,85% of total billed charges,442.5,100,,,fee schedule,100% of APG fee schedule,885,200,,,percent of total billed charges,200% of total billed charges,171.69,885,
"DRILL BIT, 3.5X130mm AO, STERILE",46052337,CDM,270,RC,,,OUTPATIENT,,,551.7,441.36,,413.78,75,,,percent of total billed charges,75% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,436.95,79.2,,,percent of total billed charges,79.2% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rates,524.12,95,,,percent of total billed charges,95% of total billed charges,441.36,80,,,percent of total billed charges,80% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,496.53,90,,,percent of total billed charges,90% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rates,551.7,100,,,fee schedule,100% of CO APG rates,551.7,100,,,fee schedule,100% of NM fee schedule,220.68,40,,,percent of total billed charges,40% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,496.53,90,,,percent of total billed charges,90% of total billed charges,419.29,76,,,percent of total billed charges,76% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rate,441.36,80,,,percent of total billed charges,80% of total billed charges,214.06,38.8,,,percent of total billed charges,38.8% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of APG fee schedule,1103.4,200,,,percent of total billed charges,200% of total billed charges,214.06,1103.4,
"DRILL 4.2X230mm, AO SMALL, STERILE",46052338,CDM,270,RC,,,OUTPATIENT,,,551.7,441.36,,413.78,75,,,percent of total billed charges,75% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,436.95,79.2,,,percent of total billed charges,79.2% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rates,524.12,95,,,percent of total billed charges,95% of total billed charges,441.36,80,,,percent of total billed charges,80% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,496.53,90,,,percent of total billed charges,90% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rates,551.7,100,,,fee schedule,100% of CO APG rates,551.7,100,,,fee schedule,100% of NM fee schedule,220.68,40,,,percent of total billed charges,40% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,496.53,90,,,percent of total billed charges,90% of total billed charges,419.29,76,,,percent of total billed charges,76% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rate,441.36,80,,,percent of total billed charges,80% of total billed charges,214.06,38.8,,,percent of total billed charges,38.8% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of APG fee schedule,1103.4,200,,,percent of total billed charges,200% of total billed charges,214.06,1103.4,
"DRILL BIT, 5.0X230mm AO, STERILE",46052339,CDM,270,RC,,,OUTPATIENT,,,551.7,441.36,,413.78,75,,,percent of total billed charges,75% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,436.95,79.2,,,percent of total billed charges,79.2% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rates,524.12,95,,,percent of total billed charges,95% of total billed charges,441.36,80,,,percent of total billed charges,80% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,496.53,90,,,percent of total billed charges,90% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rates,551.7,100,,,fee schedule,100% of CO APG rates,551.7,100,,,fee schedule,100% of NM fee schedule,220.68,40,,,percent of total billed charges,40% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,496.53,90,,,percent of total billed charges,90% of total billed charges,419.29,76,,,percent of total billed charges,76% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rate,441.36,80,,,percent of total billed charges,80% of total billed charges,214.06,38.8,,,percent of total billed charges,38.8% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of APG fee schedule,1103.4,200,,,percent of total billed charges,200% of total billed charges,214.06,1103.4,
"DRILL 5X340mm, AO SMALL, STERILE (FOR SHAFT OR CONDYLE SCREWS)",46052341,CDM,270,RC,,,OUTPATIENT,,,551.7,441.36,,413.78,75,,,percent of total billed charges,75% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,436.95,79.2,,,percent of total billed charges,79.2% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rates,524.12,95,,,percent of total billed charges,95% of total billed charges,441.36,80,,,percent of total billed charges,80% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,496.53,90,,,percent of total billed charges,90% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rates,551.7,100,,,fee schedule,100% of CO APG rates,551.7,100,,,fee schedule,100% of NM fee schedule,220.68,40,,,percent of total billed charges,40% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,496.53,90,,,percent of total billed charges,90% of total billed charges,419.29,76,,,percent of total billed charges,76% of total billed charges,220.68,40,,,percent of total billed charges,40% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of CO APG rate,441.36,80,,,percent of total billed charges,80% of total billed charges,214.06,38.8,,,percent of total billed charges,38.8% of total billed charges,468.95,85,,,percent of total billed charges,85% of total billed charges,551.7,100,,,fee schedule,100% of APG fee schedule,1103.4,200,,,percent of total billed charges,200% of total billed charges,214.06,1103.4,
DRILL BIT 3.2mm/L145mm AO,46052342,CDM,270,RC,,,OUTPATIENT,,,554.8,443.84,,416.1,75,,,percent of total billed charges,75% of total billed charges,221.92,40,,,percent of total billed charges,40% of total billed charges,439.4,79.2,,,percent of total billed charges,79.2% of total billed charges,471.58,85,,,percent of total billed charges,85% of total billed charges,554.8,100,,,fee schedule,100% of CO APG rates,527.06,95,,,percent of total billed charges,95% of total billed charges,443.84,80,,,percent of total billed charges,80% of total billed charges,471.58,85,,,percent of total billed charges,85% of total billed charges,499.32,90,,,percent of total billed charges,90% of total billed charges,554.8,100,,,fee schedule,100% of CO APG rates,554.8,100,,,fee schedule,100% of CO APG rates,554.8,100,,,fee schedule,100% of NM fee schedule,221.92,40,,,percent of total billed charges,40% of total billed charges,221.92,40,,,percent of total billed charges,40% of total billed charges,499.32,90,,,percent of total billed charges,90% of total billed charges,421.65,76,,,percent of total billed charges,76% of total billed charges,221.92,40,,,percent of total billed charges,40% of total billed charges,471.58,85,,,percent of total billed charges,85% of total billed charges,554.8,100,,,fee schedule,100% of CO APG rate,443.84,80,,,percent of total billed charges,80% of total billed charges,215.26,38.8,,,percent of total billed charges,38.8% of total billed charges,471.58,85,,,percent of total billed charges,85% of total billed charges,554.8,100,,,fee schedule,100% of APG fee schedule,1109.6,200,,,percent of total billed charges,200% of total billed charges,215.26,1109.6,
"DRILL BIT, 4.2X340mm AO, STERILE",46052346,CDM,270,RC,,,OUTPATIENT,,,564.7,451.76,,423.53,75,,,percent of total billed charges,75% of total billed charges,225.88,40,,,percent of total billed charges,40% of total billed charges,447.24,79.2,,,percent of total billed charges,79.2% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,564.7,100,,,fee schedule,100% of CO APG rates,536.47,95,,,percent of total billed charges,95% of total billed charges,451.76,80,,,percent of total billed charges,80% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,508.23,90,,,percent of total billed charges,90% of total billed charges,564.7,100,,,fee schedule,100% of CO APG rates,564.7,100,,,fee schedule,100% of CO APG rates,564.7,100,,,fee schedule,100% of NM fee schedule,225.88,40,,,percent of total billed charges,40% of total billed charges,225.88,40,,,percent of total billed charges,40% of total billed charges,508.23,90,,,percent of total billed charges,90% of total billed charges,429.17,76,,,percent of total billed charges,76% of total billed charges,225.88,40,,,percent of total billed charges,40% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,564.7,100,,,fee schedule,100% of CO APG rate,451.76,80,,,percent of total billed charges,80% of total billed charges,219.1,38.8,,,percent of total billed charges,38.8% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,564.7,100,,,fee schedule,100% of APG fee schedule,1129.4,200,,,percent of total billed charges,200% of total billed charges,219.1,1129.4,
"DRILL 4.2X180mm, AO SMALL, STERILE",46052348,CDM,270,RC,,,OUTPATIENT,,,597.5,478,,448.13,75,,,percent of total billed charges,75% of total billed charges,239,40,,,percent of total billed charges,40% of total billed charges,473.22,79.2,,,percent of total billed charges,79.2% of total billed charges,507.88,85,,,percent of total billed charges,85% of total billed charges,597.5,100,,,fee schedule,100% of CO APG rates,567.63,95,,,percent of total billed charges,95% of total billed charges,478,80,,,percent of total billed charges,80% of total billed charges,507.88,85,,,percent of total billed charges,85% of total billed charges,537.75,90,,,percent of total billed charges,90% of total billed charges,597.5,100,,,fee schedule,100% of CO APG rates,597.5,100,,,fee schedule,100% of CO APG rates,597.5,100,,,fee schedule,100% of NM fee schedule,239,40,,,percent of total billed charges,40% of total billed charges,239,40,,,percent of total billed charges,40% of total billed charges,537.75,90,,,percent of total billed charges,90% of total billed charges,454.1,76,,,percent of total billed charges,76% of total billed charges,239,40,,,percent of total billed charges,40% of total billed charges,507.88,85,,,percent of total billed charges,85% of total billed charges,597.5,100,,,fee schedule,100% of CO APG rate,478,80,,,percent of total billed charges,80% of total billed charges,231.83,38.8,,,percent of total billed charges,38.8% of total billed charges,507.88,85,,,percent of total billed charges,85% of total billed charges,597.5,100,,,fee schedule,100% of APG fee schedule,1195,200,,,percent of total billed charges,200% of total billed charges,231.83,1195,
"DRILL BIT, 1.4X150mm",46052349,CDM,270,RC,,,OUTPATIENT,,,604,483.2,,453,75,,,percent of total billed charges,75% of total billed charges,241.6,40,,,percent of total billed charges,40% of total billed charges,478.37,79.2,,,percent of total billed charges,79.2% of total billed charges,513.4,85,,,percent of total billed charges,85% of total billed charges,604,100,,,fee schedule,100% of CO APG rates,573.8,95,,,percent of total billed charges,95% of total billed charges,483.2,80,,,percent of total billed charges,80% of total billed charges,513.4,85,,,percent of total billed charges,85% of total billed charges,543.6,90,,,percent of total billed charges,90% of total billed charges,604,100,,,fee schedule,100% of CO APG rates,604,100,,,fee schedule,100% of CO APG rates,604,100,,,fee schedule,100% of NM fee schedule,241.6,40,,,percent of total billed charges,40% of total billed charges,241.6,40,,,percent of total billed charges,40% of total billed charges,543.6,90,,,percent of total billed charges,90% of total billed charges,459.04,76,,,percent of total billed charges,76% of total billed charges,241.6,40,,,percent of total billed charges,40% of total billed charges,513.4,85,,,percent of total billed charges,85% of total billed charges,604,100,,,fee schedule,100% of CO APG rate,483.2,80,,,percent of total billed charges,80% of total billed charges,234.35,38.8,,,percent of total billed charges,38.8% of total billed charges,513.4,85,,,percent of total billed charges,85% of total billed charges,604,100,,,fee schedule,100% of APG fee schedule,1208,200,,,percent of total billed charges,200% of total billed charges,234.35,1208,
"DRILL BIT, 2.0X150mm",46052350,CDM,270,RC,,,OUTPATIENT,,,604,483.2,,453,75,,,percent of total billed charges,75% of total billed charges,241.6,40,,,percent of total billed charges,40% of total billed charges,478.37,79.2,,,percent of total billed charges,79.2% of total billed charges,513.4,85,,,percent of total billed charges,85% of total billed charges,604,100,,,fee schedule,100% of CO APG rates,573.8,95,,,percent of total billed charges,95% of total billed charges,483.2,80,,,percent of total billed charges,80% of total billed charges,513.4,85,,,percent of total billed charges,85% of total billed charges,543.6,90,,,percent of total billed charges,90% of total billed charges,604,100,,,fee schedule,100% of CO APG rates,604,100,,,fee schedule,100% of CO APG rates,604,100,,,fee schedule,100% of NM fee schedule,241.6,40,,,percent of total billed charges,40% of total billed charges,241.6,40,,,percent of total billed charges,40% of total billed charges,543.6,90,,,percent of total billed charges,90% of total billed charges,459.04,76,,,percent of total billed charges,76% of total billed charges,241.6,40,,,percent of total billed charges,40% of total billed charges,513.4,85,,,percent of total billed charges,85% of total billed charges,604,100,,,fee schedule,100% of CO APG rate,483.2,80,,,percent of total billed charges,80% of total billed charges,234.35,38.8,,,percent of total billed charges,38.8% of total billed charges,513.4,85,,,percent of total billed charges,85% of total billed charges,604,100,,,fee schedule,100% of APG fee schedule,1208,200,,,percent of total billed charges,200% of total billed charges,234.35,1208,
"GUIDE WIRE, BALL TIP 3X1000 STERILE",46052353,CDM,270,RC,,,OUTPATIENT,,,639.1,511.28,,479.33,75,,,percent of total billed charges,75% of total billed charges,255.64,40,,,percent of total billed charges,40% of total billed charges,506.17,79.2,,,percent of total billed charges,79.2% of total billed charges,543.24,85,,,percent of total billed charges,85% of total billed charges,639.1,100,,,fee schedule,100% of CO APG rates,607.15,95,,,percent of total billed charges,95% of total billed charges,511.28,80,,,percent of total billed charges,80% of total billed charges,543.24,85,,,percent of total billed charges,85% of total billed charges,575.19,90,,,percent of total billed charges,90% of total billed charges,639.1,100,,,fee schedule,100% of CO APG rates,639.1,100,,,fee schedule,100% of CO APG rates,639.1,100,,,fee schedule,100% of NM fee schedule,255.64,40,,,percent of total billed charges,40% of total billed charges,255.64,40,,,percent of total billed charges,40% of total billed charges,575.19,90,,,percent of total billed charges,90% of total billed charges,485.72,76,,,percent of total billed charges,76% of total billed charges,255.64,40,,,percent of total billed charges,40% of total billed charges,543.24,85,,,percent of total billed charges,85% of total billed charges,639.1,100,,,fee schedule,100% of CO APG rate,511.28,80,,,percent of total billed charges,80% of total billed charges,247.97,38.8,,,percent of total billed charges,38.8% of total billed charges,543.24,85,,,percent of total billed charges,85% of total billed charges,639.1,100,,,fee schedule,100% of APG fee schedule,1278.2,200,,,percent of total billed charges,200% of total billed charges,247.97,1278.2,
TWIST DRILL 3.5mm/195mm AO FIT.,46052354,CDM,270,RC,,,OUTPATIENT,,,673.9,539.12,,505.43,75,,,percent of total billed charges,75% of total billed charges,269.56,40,,,percent of total billed charges,40% of total billed charges,533.73,79.2,,,percent of total billed charges,79.2% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,673.9,100,,,fee schedule,100% of CO APG rates,640.21,95,,,percent of total billed charges,95% of total billed charges,539.12,80,,,percent of total billed charges,80% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,606.51,90,,,percent of total billed charges,90% of total billed charges,673.9,100,,,fee schedule,100% of CO APG rates,673.9,100,,,fee schedule,100% of CO APG rates,673.9,100,,,fee schedule,100% of NM fee schedule,269.56,40,,,percent of total billed charges,40% of total billed charges,269.56,40,,,percent of total billed charges,40% of total billed charges,606.51,90,,,percent of total billed charges,90% of total billed charges,512.16,76,,,percent of total billed charges,76% of total billed charges,269.56,40,,,percent of total billed charges,40% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,673.9,100,,,fee schedule,100% of CO APG rate,539.12,80,,,percent of total billed charges,80% of total billed charges,261.47,38.8,,,percent of total billed charges,38.8% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,673.9,100,,,fee schedule,100% of APG fee schedule,1347.8,200,,,percent of total billed charges,200% of total billed charges,261.47,1347.8,
TWIST DRILL BIT 4.5/6.5mm FIT.,46052355,CDM,270,RC,,,OUTPATIENT,,,673.9,539.12,,505.43,75,,,percent of total billed charges,75% of total billed charges,269.56,40,,,percent of total billed charges,40% of total billed charges,533.73,79.2,,,percent of total billed charges,79.2% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,673.9,100,,,fee schedule,100% of CO APG rates,640.21,95,,,percent of total billed charges,95% of total billed charges,539.12,80,,,percent of total billed charges,80% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,606.51,90,,,percent of total billed charges,90% of total billed charges,673.9,100,,,fee schedule,100% of CO APG rates,673.9,100,,,fee schedule,100% of CO APG rates,673.9,100,,,fee schedule,100% of NM fee schedule,269.56,40,,,percent of total billed charges,40% of total billed charges,269.56,40,,,percent of total billed charges,40% of total billed charges,606.51,90,,,percent of total billed charges,90% of total billed charges,512.16,76,,,percent of total billed charges,76% of total billed charges,269.56,40,,,percent of total billed charges,40% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,673.9,100,,,fee schedule,100% of CO APG rate,539.12,80,,,percent of total billed charges,80% of total billed charges,261.47,38.8,,,percent of total billed charges,38.8% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,673.9,100,,,fee schedule,100% of APG fee schedule,1347.8,200,,,percent of total billed charges,200% of total billed charges,261.47,1347.8,
DRILL BIT 2.5mm/L230mm AO/CALIB,46052356,CDM,270,RC,,,OUTPATIENT,,,673.9,539.12,,505.43,75,,,percent of total billed charges,75% of total billed charges,269.56,40,,,percent of total billed charges,40% of total billed charges,533.73,79.2,,,percent of total billed charges,79.2% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,673.9,100,,,fee schedule,100% of CO APG rates,640.21,95,,,percent of total billed charges,95% of total billed charges,539.12,80,,,percent of total billed charges,80% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,606.51,90,,,percent of total billed charges,90% of total billed charges,673.9,100,,,fee schedule,100% of CO APG rates,673.9,100,,,fee schedule,100% of CO APG rates,673.9,100,,,fee schedule,100% of NM fee schedule,269.56,40,,,percent of total billed charges,40% of total billed charges,269.56,40,,,percent of total billed charges,40% of total billed charges,606.51,90,,,percent of total billed charges,90% of total billed charges,512.16,76,,,percent of total billed charges,76% of total billed charges,269.56,40,,,percent of total billed charges,40% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,673.9,100,,,fee schedule,100% of CO APG rate,539.12,80,,,percent of total billed charges,80% of total billed charges,261.47,38.8,,,percent of total billed charges,38.8% of total billed charges,572.82,85,,,percent of total billed charges,85% of total billed charges,673.9,100,,,fee schedule,100% of APG fee schedule,1347.8,200,,,percent of total billed charges,200% of total billed charges,261.47,1347.8,
OT Vasopneumatic Device Charge,42797016,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,70.8,56.64,GO,53.1,75,,,percent of total billed charges,75% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,56.07,79.2,,,percent of total billed charges,79.2% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,67.26,95,,,percent of total billed charges,95% of total billed charges,56.64,80,,,percent of total billed charges,80% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,63.72,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,28.32,40,,,percent of total billed charges,40% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,63.72,90,,,percent of total billed charges,90% of total billed charges,53.81,76,,,percent of total billed charges,76% of total billed charges,28.32,40,,,percent of total billed charges,40% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,56.64,80,,,percent of total billed charges,80% of total billed charges,27.47,38.8,,,percent of total billed charges,38.8% of total billed charges,60.18,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,67.26,
23570 Closed Treatment Of Scapular Fracture; Without Manipul,60000031,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,767.5,614,,575.63,75,,,percent of total billed charges,75% of total billed charges,307,40,,,percent of total billed charges,40% of total billed charges,607.86,79.2,,,percent of total billed charges,79.2% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,729.13,95,,,percent of total billed charges,95% of total billed charges,614,80,,,percent of total billed charges,80% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,690.75,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,307,40,,,percent of total billed charges,40% of total billed charges,307,40,,,percent of total billed charges,40% of total billed charges,690.75,90,,,percent of total billed charges,90% of total billed charges,583.3,76,,,percent of total billed charges,76% of total billed charges,307,40,,,percent of total billed charges,40% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,614,80,,,percent of total billed charges,80% of total billed charges,297.79,38.8,,,percent of total billed charges,38.8% of total billed charges,652.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,729.13,
"10140 Incision And Drainage Of Hematoma, Seroma Or Fluid Col",60000007,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4898.4,3918.72,,3673.8,75,,,percent of total billed charges,75% of total billed charges,1959.36,40,,,percent of total billed charges,40% of total billed charges,3879.53,79.2,,,percent of total billed charges,79.2% of total billed charges,4163.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4653.48,95,,,percent of total billed charges,95% of total billed charges,3918.72,80,,,percent of total billed charges,80% of total billed charges,4163.64,85,,,percent of total billed charges,85% of total billed charges,4408.56,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1959.36,40,,,percent of total billed charges,40% of total billed charges,1959.36,40,,,percent of total billed charges,40% of total billed charges,4408.56,90,,,percent of total billed charges,90% of total billed charges,3722.78,76,,,percent of total billed charges,76% of total billed charges,1959.36,40,,,percent of total billed charges,40% of total billed charges,4163.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3918.72,80,,,percent of total billed charges,80% of total billed charges,1900.58,38.8,,,percent of total billed charges,38.8% of total billed charges,4163.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4653.48,
20612 ASP/INJ GANGLION CYST,60000026,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,880.7,704.56,,660.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,697.51,79.2,,,percent of total billed charges,79.2% of total billed charges,748.6,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,836.67,95,,,percent of total billed charges,95% of total billed charges,704.56,80,,,percent of total billed charges,80% of total billed charges,748.6,85,,,percent of total billed charges,85% of total billed charges,792.63,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,880.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,792.63,90,,,percent of total billed charges,90% of total billed charges,669.33,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,748.6,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,704.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,748.6,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
25500 Closed Treatment Of Radial Shaft Fracture; Without Man,60000042,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4424.2,3539.36,,3318.15,75,,,percent of total billed charges,75% of total billed charges,1769.68,40,,,percent of total billed charges,40% of total billed charges,3503.97,79.2,,,percent of total billed charges,79.2% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4202.99,95,,,percent of total billed charges,95% of total billed charges,3539.36,80,,,percent of total billed charges,80% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,3981.78,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1769.68,40,,,percent of total billed charges,40% of total billed charges,1769.68,40,,,percent of total billed charges,40% of total billed charges,3981.78,90,,,percent of total billed charges,90% of total billed charges,3362.39,76,,,percent of total billed charges,76% of total billed charges,1769.68,40,,,percent of total billed charges,40% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3539.36,80,,,percent of total billed charges,80% of total billed charges,1716.59,38.8,,,percent of total billed charges,38.8% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4202.99,
29515 Application Of Short Leg Splint,60000072,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,454.5,363.6,,340.88,75,,,percent of total billed charges,75% of total billed charges,181.8,40,,,percent of total billed charges,40% of total billed charges,359.96,79.2,,,percent of total billed charges,79.2% of total billed charges,386.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,431.78,95,,,percent of total billed charges,95% of total billed charges,363.6,80,,,percent of total billed charges,80% of total billed charges,386.33,85,,,percent of total billed charges,85% of total billed charges,409.05,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,181.8,40,,,percent of total billed charges,40% of total billed charges,181.8,40,,,percent of total billed charges,40% of total billed charges,409.05,90,,,percent of total billed charges,90% of total billed charges,345.42,76,,,percent of total billed charges,76% of total billed charges,181.8,40,,,percent of total billed charges,40% of total billed charges,386.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,363.6,80,,,percent of total billed charges,80% of total billed charges,176.35,38.8,,,percent of total billed charges,38.8% of total billed charges,386.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,176.35,431.78,
29425 Application Of Short Leg Cast Walking,60000070,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,801.8,641.44,,601.35,75,,,percent of total billed charges,75% of total billed charges,320.72,40,,,percent of total billed charges,40% of total billed charges,635.03,79.2,,,percent of total billed charges,79.2% of total billed charges,681.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,761.71,95,,,percent of total billed charges,95% of total billed charges,641.44,80,,,percent of total billed charges,80% of total billed charges,681.53,85,,,percent of total billed charges,85% of total billed charges,721.62,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,320.72,40,,,percent of total billed charges,40% of total billed charges,320.72,40,,,percent of total billed charges,40% of total billed charges,721.62,90,,,percent of total billed charges,90% of total billed charges,609.37,76,,,percent of total billed charges,76% of total billed charges,320.72,40,,,percent of total billed charges,40% of total billed charges,681.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,641.44,80,,,percent of total billed charges,80% of total billed charges,311.1,38.8,,,percent of total billed charges,38.8% of total billed charges,681.53,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,761.71,
27750 Fx Tibia Shaft W/O Manipulation,60000004,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
27810 Fx Bimalleolar W/ Manip,60000064,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4424.2,3539.36,,3318.15,75,,,percent of total billed charges,75% of total billed charges,1769.68,40,,,percent of total billed charges,40% of total billed charges,3503.97,79.2,,,percent of total billed charges,79.2% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4202.99,95,,,percent of total billed charges,95% of total billed charges,3539.36,80,,,percent of total billed charges,80% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,3981.78,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1769.68,40,,,percent of total billed charges,40% of total billed charges,1769.68,40,,,percent of total billed charges,40% of total billed charges,3981.78,90,,,percent of total billed charges,90% of total billed charges,3362.39,76,,,percent of total billed charges,76% of total billed charges,1769.68,40,,,percent of total billed charges,40% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3539.36,80,,,percent of total billed charges,80% of total billed charges,1716.59,38.8,,,percent of total billed charges,38.8% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4202.99,
27816 TX OF ANKLE FX W/O MANIP,60000288,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,796.6,637.28,,597.45,75,,,percent of total billed charges,75% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,630.91,79.2,,,percent of total billed charges,79.2% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,756.77,95,,,percent of total billed charges,95% of total billed charges,637.28,80,,,percent of total billed charges,80% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,716.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,318.64,40,,,percent of total billed charges,40% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,716.94,90,,,percent of total billed charges,90% of total billed charges,605.42,76,,,percent of total billed charges,76% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,637.28,80,,,percent of total billed charges,80% of total billed charges,309.08,38.8,,,percent of total billed charges,38.8% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,756.77,
"28039 Exc Tumor, Soft Tissue Foot,Toe; 1.5Cm",60000065,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,8449,6759.2,,6336.75,75,,,percent of total billed charges,75% of total billed charges,3379.6,40,,,percent of total billed charges,40% of total billed charges,6691.61,79.2,,,percent of total billed charges,79.2% of total billed charges,7181.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,8026.55,95,,,percent of total billed charges,95% of total billed charges,6759.2,80,,,percent of total billed charges,80% of total billed charges,7181.65,85,,,percent of total billed charges,85% of total billed charges,7604.1,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,4247.07,100,,,fee schedule,100% of NM APC rate,3379.6,40,,,percent of total billed charges,40% of total billed charges,3379.6,40,,,percent of total billed charges,40% of total billed charges,7604.1,90,,,percent of total billed charges,90% of total billed charges,6421.24,76,,,percent of total billed charges,76% of total billed charges,3379.6,40,,,percent of total billed charges,40% of total billed charges,7181.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,6759.2,80,,,percent of total billed charges,80% of total billed charges,3278.21,38.8,,,percent of total billed charges,38.8% of total billed charges,7181.65,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,215.49,8026.55,
Immunohisto/cyto chem 1st st,40088342,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,291.8,233.44,,218.85,75,,,percent of total billed charges,75% of total billed charges,116.72,40,,,percent of total billed charges,40% of total billed charges,231.11,79.2,,,percent of total billed charges,79.2% of total billed charges,248.03,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,277.21,95,,,percent of total billed charges,95% of total billed charges,233.44,80,,,percent of total billed charges,80% of total billed charges,248.03,85,,,percent of total billed charges,85% of total billed charges,262.62,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,116.72,40,,,percent of total billed charges,40% of total billed charges,116.72,40,,,percent of total billed charges,40% of total billed charges,262.62,90,,,percent of total billed charges,90% of total billed charges,221.77,76,,,percent of total billed charges,76% of total billed charges,116.72,40,,,percent of total billed charges,40% of total billed charges,248.03,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,233.44,80,,,percent of total billed charges,80% of total billed charges,113.22,38.8,,,percent of total billed charges,38.8% of total billed charges,248.03,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,277.21,
Immunohisto/cyto chem add,40088341,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,224.9,179.92,,168.68,75,,,percent of total billed charges,75% of total billed charges,89.96,40,,,percent of total billed charges,40% of total billed charges,178.12,79.2,,,percent of total billed charges,79.2% of total billed charges,191.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,213.66,95,,,percent of total billed charges,95% of total billed charges,179.92,80,,,percent of total billed charges,80% of total billed charges,191.17,85,,,percent of total billed charges,85% of total billed charges,202.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,89.96,40,,,percent of total billed charges,40% of total billed charges,89.96,40,,,percent of total billed charges,40% of total billed charges,202.41,90,,,percent of total billed charges,90% of total billed charges,170.92,76,,,percent of total billed charges,76% of total billed charges,89.96,40,,,percent of total billed charges,40% of total billed charges,191.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,179.92,80,,,percent of total billed charges,80% of total billed charges,87.26,38.8,,,percent of total billed charges,38.8% of total billed charges,191.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,213.66,
IMMUNOHISTO ANTIBODY SLIDE,40088342,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,281.2,224.96,,210.9,75,,,percent of total billed charges,75% of total billed charges,112.48,40,,,percent of total billed charges,40% of total billed charges,222.71,79.2,,,percent of total billed charges,79.2% of total billed charges,239.02,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,267.14,95,,,percent of total billed charges,95% of total billed charges,224.96,80,,,percent of total billed charges,80% of total billed charges,239.02,85,,,percent of total billed charges,85% of total billed charges,253.08,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,112.48,40,,,percent of total billed charges,40% of total billed charges,112.48,40,,,percent of total billed charges,40% of total billed charges,253.08,90,,,percent of total billed charges,90% of total billed charges,213.71,76,,,percent of total billed charges,76% of total billed charges,112.48,40,,,percent of total billed charges,40% of total billed charges,239.02,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,224.96,80,,,percent of total billed charges,80% of total billed charges,109.11,38.8,,,percent of total billed charges,38.8% of total billed charges,239.02,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,267.14,
IMMUNOHISTO ANTIBOD ADD SLID,40088343,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,207.1,165.68,,155.33,75,,,percent of total billed charges,75% of total billed charges,82.84,40,,,percent of total billed charges,40% of total billed charges,164.02,79.2,,,percent of total billed charges,79.2% of total billed charges,176.04,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,196.75,95,,,percent of total billed charges,95% of total billed charges,165.68,80,,,percent of total billed charges,80% of total billed charges,176.04,85,,,percent of total billed charges,85% of total billed charges,186.39,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,82.84,40,,,percent of total billed charges,40% of total billed charges,82.84,40,,,percent of total billed charges,40% of total billed charges,186.39,90,,,percent of total billed charges,90% of total billed charges,157.4,76,,,percent of total billed charges,76% of total billed charges,82.84,40,,,percent of total billed charges,40% of total billed charges,176.04,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,165.68,80,,,percent of total billed charges,80% of total billed charges,80.35,38.8,,,percent of total billed charges,38.8% of total billed charges,176.04,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,196.75,
10021 Fine needle aspiration; without imaging,60000005,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1106.9,885.52,,830.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,876.66,79.2,,,percent of total billed charges,79.2% of total billed charges,940.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1051.56,95,,,percent of total billed charges,95% of total billed charges,885.52,80,,,percent of total billed charges,80% of total billed charges,940.87,85,,,percent of total billed charges,85% of total billed charges,996.21,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1106.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,996.21,90,,,percent of total billed charges,90% of total billed charges,841.24,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,940.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,885.52,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,940.87,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
ROUND CARBIDE BUR (5.0MM),46052376,CDM,270,RC,,,OUTPATIENT,,,151.8,121.44,,113.85,75,,,percent of total billed charges,75% of total billed charges,60.72,40,,,percent of total billed charges,40% of total billed charges,120.23,79.2,,,percent of total billed charges,79.2% of total billed charges,129.03,85,,,percent of total billed charges,85% of total billed charges,151.8,100,,,fee schedule,100% of CO APG rates,144.21,95,,,percent of total billed charges,95% of total billed charges,121.44,80,,,percent of total billed charges,80% of total billed charges,129.03,85,,,percent of total billed charges,85% of total billed charges,136.62,90,,,percent of total billed charges,90% of total billed charges,151.8,100,,,fee schedule,100% of CO APG rates,151.8,100,,,fee schedule,100% of CO APG rates,151.8,100,,,fee schedule,100% of NM fee schedule,60.72,40,,,percent of total billed charges,40% of total billed charges,60.72,40,,,percent of total billed charges,40% of total billed charges,136.62,90,,,percent of total billed charges,90% of total billed charges,115.37,76,,,percent of total billed charges,76% of total billed charges,60.72,40,,,percent of total billed charges,40% of total billed charges,129.03,85,,,percent of total billed charges,85% of total billed charges,151.8,100,,,fee schedule,100% of CO APG rate,121.44,80,,,percent of total billed charges,80% of total billed charges,58.9,38.8,,,percent of total billed charges,38.8% of total billed charges,129.03,85,,,percent of total billed charges,85% of total billed charges,151.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,58.9,151.8,
"ECHOGENIC SINGLE SHOT NEEDLE, 100MM",46252379,CDM,270,RC,,,OUTPATIENT,,,64.5,51.6,,48.38,75,,,percent of total billed charges,75% of total billed charges,25.8,40,,,percent of total billed charges,40% of total billed charges,51.08,79.2,,,percent of total billed charges,79.2% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,64.5,100,,,fee schedule,100% of CO APG rates,61.28,95,,,percent of total billed charges,95% of total billed charges,51.6,80,,,percent of total billed charges,80% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,58.05,90,,,percent of total billed charges,90% of total billed charges,64.5,100,,,fee schedule,100% of CO APG rates,64.5,100,,,fee schedule,100% of CO APG rates,64.5,100,,,fee schedule,100% of NM fee schedule,25.8,40,,,percent of total billed charges,40% of total billed charges,25.8,40,,,percent of total billed charges,40% of total billed charges,58.05,90,,,percent of total billed charges,90% of total billed charges,49.02,76,,,percent of total billed charges,76% of total billed charges,25.8,40,,,percent of total billed charges,40% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,64.5,100,,,fee schedule,100% of CO APG rate,51.6,80,,,percent of total billed charges,80% of total billed charges,25.03,38.8,,,percent of total billed charges,38.8% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,64.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,25.03,64.5,
SUTURE 2-0 VICRYL + PS-2  VCP428H,52384,CDM,270,RC,,,OUTPATIENT,,,17.4,13.92,,13.05,75,,,percent of total billed charges,75% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,13.78,79.2,,,percent of total billed charges,79.2% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,16.53,95,,,percent of total billed charges,95% of total billed charges,13.92,80,,,percent of total billed charges,80% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of CO APG rates,17.4,100,,,fee schedule,100% of NM fee schedule,6.96,40,,,percent of total billed charges,40% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,15.66,90,,,percent of total billed charges,90% of total billed charges,13.22,76,,,percent of total billed charges,76% of total billed charges,6.96,40,,,percent of total billed charges,40% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of CO APG rate,13.92,80,,,percent of total billed charges,80% of total billed charges,6.75,38.8,,,percent of total billed charges,38.8% of total billed charges,14.79,85,,,percent of total billed charges,85% of total billed charges,17.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.75,17.4,
"Repair, intermediate, wounds of neck, hands, feet and/or ext",60000017,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1063.9,851.12,,797.93,75,,,percent of total billed charges,75% of total billed charges,425.56,40,,,percent of total billed charges,40% of total billed charges,842.61,79.2,,,percent of total billed charges,79.2% of total billed charges,904.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1010.71,95,,,percent of total billed charges,95% of total billed charges,851.12,80,,,percent of total billed charges,80% of total billed charges,904.32,85,,,percent of total billed charges,85% of total billed charges,957.51,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,425.56,40,,,percent of total billed charges,40% of total billed charges,425.56,40,,,percent of total billed charges,40% of total billed charges,957.51,90,,,percent of total billed charges,90% of total billed charges,808.56,76,,,percent of total billed charges,76% of total billed charges,425.56,40,,,percent of total billed charges,40% of total billed charges,904.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,851.12,80,,,percent of total billed charges,80% of total billed charges,412.79,38.8,,,percent of total billed charges,38.8% of total billed charges,904.32,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1010.71,
"19001 Puncture aspiration of cyst, each ad",60000733,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,84.3,67.44,,63.23,75,,,percent of total billed charges,75% of total billed charges,33.72,40,,,percent of total billed charges,40% of total billed charges,66.77,79.2,,,percent of total billed charges,79.2% of total billed charges,71.66,85,,,percent of total billed charges,85% of total billed charges,84.3,100,,,fee schedule,100% of CO APG rates,80.09,95,,,percent of total billed charges,95% of total billed charges,67.44,80,,,percent of total billed charges,80% of total billed charges,71.66,85,,,percent of total billed charges,85% of total billed charges,75.87,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,84.3,100,,,fee schedule,100% of NM APC rate,33.72,40,,,percent of total billed charges,40% of total billed charges,33.72,40,,,percent of total billed charges,40% of total billed charges,75.87,90,,,percent of total billed charges,90% of total billed charges,64.07,76,,,percent of total billed charges,76% of total billed charges,33.72,40,,,percent of total billed charges,40% of total billed charges,71.66,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,67.44,80,,,percent of total billed charges,80% of total billed charges,32.71,38.8,,,percent of total billed charges,38.8% of total billed charges,71.66,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,168.6,200,,,fee schedule,200% of CMS fee schedule,32.71,2713.28,
20527 - INJ DUPUYTREN CORD W/ENZYME,60000991,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,846.5,677.2,,634.88,75,,,percent of total billed charges,75% of total billed charges,338.6,40,,,percent of total billed charges,40% of total billed charges,670.43,79.2,,,percent of total billed charges,79.2% of total billed charges,719.53,85,,,percent of total billed charges,85% of total billed charges,846.5,100,,,fee schedule,100% of CO APG rates,804.18,95,,,percent of total billed charges,95% of total billed charges,677.2,80,,,percent of total billed charges,80% of total billed charges,719.53,85,,,percent of total billed charges,85% of total billed charges,761.85,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,846.5,100,,,fee schedule,100% of NM APC rate,338.6,40,,,percent of total billed charges,40% of total billed charges,338.6,40,,,percent of total billed charges,40% of total billed charges,761.85,90,,,percent of total billed charges,90% of total billed charges,643.34,76,,,percent of total billed charges,76% of total billed charges,338.6,40,,,percent of total billed charges,40% of total billed charges,719.53,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,677.2,80,,,percent of total billed charges,80% of total billed charges,328.44,38.8,,,percent of total billed charges,38.8% of total billed charges,719.53,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,328.44,2713.28,
24650 CLOSED TREATMENT OF RADIAL NECK OR HEAD.,60000041,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
26600 CLOSED METACARPAL FX ONE BONE.,60000049,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
26605 CLOSED TREATMENT OF METACARPAL FRACTURE.,60000050,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
26750 CLOSED TREATMENT OF DISTAL PHALAGEAL FRA.,60000056,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
27786 CLOSED TREATMENT OF DISTAL FIBULAR FRACT.,60000062,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
28470 CLOSED TREATMENT OF METATARSAL FRACTURE.,60000066,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
28490 CLTX FX GRT TOE PHLY PHLG W/O MNPJ.,60000068,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
"28515 Cl Tx Fx phalanx, phalanges w/ manip",60000470,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,834.1,667.28,,625.58,75,,,percent of total billed charges,75% of total billed charges,333.64,40,,,percent of total billed charges,40% of total billed charges,660.61,79.2,,,percent of total billed charges,79.2% of total billed charges,708.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,792.4,95,,,percent of total billed charges,95% of total billed charges,667.28,80,,,percent of total billed charges,80% of total billed charges,708.99,85,,,percent of total billed charges,85% of total billed charges,750.69,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,333.64,40,,,percent of total billed charges,40% of total billed charges,333.64,40,,,percent of total billed charges,40% of total billed charges,750.69,90,,,percent of total billed charges,90% of total billed charges,633.92,76,,,percent of total billed charges,76% of total billed charges,333.64,40,,,percent of total billed charges,40% of total billed charges,708.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,667.28,80,,,percent of total billed charges,80% of total billed charges,323.63,38.8,,,percent of total billed charges,38.8% of total billed charges,708.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,792.4,
36556 Insert non-tunnel CV catheter.,60000076,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1015,812,,761.25,75,,,percent of total billed charges,75% of total billed charges,406,40,,,percent of total billed charges,40% of total billed charges,803.88,79.2,,,percent of total billed charges,79.2% of total billed charges,862.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,964.25,95,,,percent of total billed charges,95% of total billed charges,812,80,,,percent of total billed charges,80% of total billed charges,862.75,85,,,percent of total billed charges,85% of total billed charges,913.5,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,406,40,,,percent of total billed charges,40% of total billed charges,406,40,,,percent of total billed charges,40% of total billed charges,913.5,90,,,percent of total billed charges,90% of total billed charges,771.4,76,,,percent of total billed charges,76% of total billed charges,406,40,,,percent of total billed charges,40% of total billed charges,862.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,812,80,,,percent of total billed charges,80% of total billed charges,393.82,38.8,,,percent of total billed charges,38.8% of total billed charges,862.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,964.25,
Immunoglobulin A,10587862,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,101,80.8,,75.75,75,,,percent of total billed charges,75% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,79.99,79.2,,,percent of total billed charges,79.2% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,95.95,95,,,percent of total billed charges,95% of total billed charges,80.8,80,,,percent of total billed charges,80% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,40.4,40,,,percent of total billed charges,40% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,76.76,76,,,percent of total billed charges,76% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,80.8,80,,,percent of total billed charges,80% of total billed charges,39.19,38.8,,,percent of total billed charges,38.8% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,95.95,
Immunoglobuli,40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,101,80.8,,75.75,75,,,percent of total billed charges,75% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,79.99,79.2,,,percent of total billed charges,79.2% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,95.95,95,,,percent of total billed charges,95% of total billed charges,80.8,80,,,percent of total billed charges,80% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,40.4,40,,,percent of total billed charges,40% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,76.76,76,,,percent of total billed charges,76% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,80.8,80,,,percent of total billed charges,80% of total billed charges,39.19,38.8,,,percent of total billed charges,38.8% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,95.95,
Immunoglobulin G,40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,101,80.8,,75.75,75,,,percent of total billed charges,75% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,79.99,79.2,,,percent of total billed charges,79.2% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,95.95,95,,,percent of total billed charges,95% of total billed charges,80.8,80,,,percent of total billed charges,80% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,40.4,40,,,percent of total billed charges,40% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,76.76,76,,,percent of total billed charges,76% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,80.8,80,,,percent of total billed charges,80% of total billed charges,39.19,38.8,,,percent of total billed charges,38.8% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,95.95,
HNK1 (CD57) Panel LC,40086356,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,111.5,89.2,,83.63,75,,,percent of total billed charges,75% of total billed charges,44.6,40,,,percent of total billed charges,40% of total billed charges,88.31,79.2,,,percent of total billed charges,79.2% of total billed charges,94.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,105.93,95,,,percent of total billed charges,95% of total billed charges,89.2,80,,,percent of total billed charges,80% of total billed charges,94.78,85,,,percent of total billed charges,85% of total billed charges,100.35,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,44.6,40,,,percent of total billed charges,40% of total billed charges,44.6,40,,,percent of total billed charges,40% of total billed charges,100.35,90,,,percent of total billed charges,90% of total billed charges,84.74,76,,,percent of total billed charges,76% of total billed charges,44.6,40,,,percent of total billed charges,40% of total billed charges,94.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,89.2,80,,,percent of total billed charges,80% of total billed charges,43.26,38.8,,,percent of total billed charges,38.8% of total billed charges,94.78,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,105.93,
Complement C3a LC,40086160,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,285.7,228.56,,214.28,75,,,percent of total billed charges,75% of total billed charges,114.28,40,,,percent of total billed charges,40% of total billed charges,226.27,79.2,,,percent of total billed charges,79.2% of total billed charges,242.85,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,271.42,95,,,percent of total billed charges,95% of total billed charges,228.56,80,,,percent of total billed charges,80% of total billed charges,242.85,85,,,percent of total billed charges,85% of total billed charges,257.13,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,114.28,40,,,percent of total billed charges,40% of total billed charges,114.28,40,,,percent of total billed charges,40% of total billed charges,257.13,90,,,percent of total billed charges,90% of total billed charges,217.13,76,,,percent of total billed charges,76% of total billed charges,114.28,40,,,percent of total billed charges,40% of total billed charges,242.85,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,228.56,80,,,percent of total billed charges,80% of total billed charges,110.85,38.8,,,percent of total billed charges,38.8% of total billed charges,242.85,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,271.42,
Melanocyte Stimulating Hormone LC,40083519,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,151.7,121.36,,113.78,75,,,percent of total billed charges,75% of total billed charges,60.68,40,,,percent of total billed charges,40% of total billed charges,120.15,79.2,,,percent of total billed charges,79.2% of total billed charges,128.95,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,144.12,95,,,percent of total billed charges,95% of total billed charges,121.36,80,,,percent of total billed charges,80% of total billed charges,128.95,85,,,percent of total billed charges,85% of total billed charges,136.53,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,60.68,40,,,percent of total billed charges,40% of total billed charges,60.68,40,,,percent of total billed charges,40% of total billed charges,136.53,90,,,percent of total billed charges,90% of total billed charges,115.29,76,,,percent of total billed charges,76% of total billed charges,60.68,40,,,percent of total billed charges,40% of total billed charges,128.95,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,121.36,80,,,percent of total billed charges,80% of total billed charges,58.86,38.8,,,percent of total billed charges,38.8% of total billed charges,128.95,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,144.12,
Amebiasis Antibodies LC,40086753,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,81.2,64.96,,60.9,75,,,percent of total billed charges,75% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,64.31,79.2,,,percent of total billed charges,79.2% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,77.14,95,,,percent of total billed charges,95% of total billed charges,64.96,80,,,percent of total billed charges,80% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,32.48,40,,,percent of total billed charges,40% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,73.08,90,,,percent of total billed charges,90% of total billed charges,61.71,76,,,percent of total billed charges,76% of total billed charges,32.48,40,,,percent of total billed charges,40% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,64.96,80,,,percent of total billed charges,80% of total billed charges,31.51,38.8,,,percent of total billed charges,38.8% of total billed charges,69.02,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,77.14,
"24560 Closed Treatment Of Humeral Epicondylar Fracture, Medi",60000039,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1102.1,881.68,,826.58,75,,,percent of total billed charges,75% of total billed charges,440.84,40,,,percent of total billed charges,40% of total billed charges,872.86,79.2,,,percent of total billed charges,79.2% of total billed charges,936.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1047,95,,,percent of total billed charges,95% of total billed charges,881.68,80,,,percent of total billed charges,80% of total billed charges,936.79,85,,,percent of total billed charges,85% of total billed charges,991.89,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,440.84,40,,,percent of total billed charges,40% of total billed charges,440.84,40,,,percent of total billed charges,40% of total billed charges,991.89,90,,,percent of total billed charges,90% of total billed charges,837.6,76,,,percent of total billed charges,76% of total billed charges,440.84,40,,,percent of total billed charges,40% of total billed charges,936.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,881.68,80,,,percent of total billed charges,80% of total billed charges,427.61,38.8,,,percent of total billed charges,38.8% of total billed charges,936.79,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1047,
23600 Closed Treatment Of Proximal Humeral Fracture; Without,60000032,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1178.2,942.56,,883.65,75,,,percent of total billed charges,75% of total billed charges,471.28,40,,,percent of total billed charges,40% of total billed charges,933.13,79.2,,,percent of total billed charges,79.2% of total billed charges,1001.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1119.29,95,,,percent of total billed charges,95% of total billed charges,942.56,80,,,percent of total billed charges,80% of total billed charges,1001.47,85,,,percent of total billed charges,85% of total billed charges,1060.38,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,471.28,40,,,percent of total billed charges,40% of total billed charges,471.28,40,,,percent of total billed charges,40% of total billed charges,1060.38,90,,,percent of total billed charges,90% of total billed charges,895.43,76,,,percent of total billed charges,76% of total billed charges,471.28,40,,,percent of total billed charges,40% of total billed charges,1001.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,942.56,80,,,percent of total billed charges,80% of total billed charges,457.14,38.8,,,percent of total billed charges,38.8% of total billed charges,1001.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1119.29,
10030 Image-Guided Fluid Collection Drainage By Catheter,46010030,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,703.6,562.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
20520 - FOREIGN BODY REMOVAL MUSCLE/TENDON SHEATH CHARGE,60000394,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4995.1,3996.08,,3746.33,75,,,percent of total billed charges,75% of total billed charges,1998.04,40,,,percent of total billed charges,40% of total billed charges,3956.12,79.2,,,percent of total billed charges,79.2% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4745.35,95,,,percent of total billed charges,95% of total billed charges,3996.08,80,,,percent of total billed charges,80% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,4495.59,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1998.04,40,,,percent of total billed charges,40% of total billed charges,1998.04,40,,,percent of total billed charges,40% of total billed charges,4495.59,90,,,percent of total billed charges,90% of total billed charges,3796.28,76,,,percent of total billed charges,76% of total billed charges,1998.04,40,,,percent of total billed charges,40% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3996.08,80,,,percent of total billed charges,80% of total billed charges,1938.1,38.8,,,percent of total billed charges,38.8% of total billed charges,4245.84,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4745.35,
"76942 - ULTRASONIC GUIDANCE FOR NEEDLE PLACEMENT, IMAGING SU",46276942,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,232.9,186.32,,174.68,75,,,percent of total billed charges,75% of total billed charges,93.16,40,,,percent of total billed charges,40% of total billed charges,184.46,79.2,,,percent of total billed charges,79.2% of total billed charges,197.97,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.26,95,,,percent of total billed charges,95% of total billed charges,186.32,80,,,percent of total billed charges,80% of total billed charges,197.97,85,,,percent of total billed charges,85% of total billed charges,209.61,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,93.16,40,,,percent of total billed charges,40% of total billed charges,93.16,40,,,percent of total billed charges,40% of total billed charges,209.61,90,,,percent of total billed charges,90% of total billed charges,177,76,,,percent of total billed charges,76% of total billed charges,93.16,40,,,percent of total billed charges,40% of total billed charges,197.97,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,186.32,80,,,percent of total billed charges,80% of total billed charges,90.37,38.8,,,percent of total billed charges,38.8% of total billed charges,197.97,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,90.37,246.44,
"64420 - INJECTION, ANESTHETIC AGENT, INTERCOSTAL NERVE, SING",46264420,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,2401.7,1921.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64421 - INJECTION, ANESTHETIC AGENT, INTERCOSTAL NERVES, MUL",46264421,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2395.4,1916.32,,1796.55,75,,,percent of total billed charges,75% of total billed charges,958.16,40,,,percent of total billed charges,40% of total billed charges,1897.16,79.2,,,percent of total billed charges,79.2% of total billed charges,2036.09,85,,,percent of total billed charges,85% of total billed charges,2395.4,100,,,fee schedule,100% of CO APG rates,2275.63,95,,,percent of total billed charges,95% of total billed charges,1916.32,80,,,percent of total billed charges,80% of total billed charges,2036.09,85,,,percent of total billed charges,85% of total billed charges,2155.86,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,958.16,40,,,percent of total billed charges,40% of total billed charges,958.16,40,,,percent of total billed charges,40% of total billed charges,2155.86,90,,,percent of total billed charges,90% of total billed charges,1820.5,76,,,percent of total billed charges,76% of total billed charges,958.16,40,,,percent of total billed charges,40% of total billed charges,2036.09,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1916.32,80,,,percent of total billed charges,80% of total billed charges,929.42,38.8,,,percent of total billed charges,38.8% of total billed charges,2036.09,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
"27250 - CLOSED TX OF HIP DISLOCATION;TRAUMATIC,W/O ANESTHESI",46027250,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
28450 - TX  OF TARSAL BONE FRACTURE CHARGE,46028450,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
"26951 - AMPUTATION FINGER OR THUMB, PRIMARY OR SECONDARY; WI",46026951,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,9556.6,7645.28,,7167.45,75,,,percent of total billed charges,75% of total billed charges,3822.64,40,,,percent of total billed charges,40% of total billed charges,7568.83,79.2,,,percent of total billed charges,79.2% of total billed charges,8123.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,9078.77,95,,,percent of total billed charges,95% of total billed charges,7645.28,80,,,percent of total billed charges,80% of total billed charges,8123.11,85,,,percent of total billed charges,85% of total billed charges,8600.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,4800.87,100,,,fee schedule,100% of NM APC rate,3822.64,40,,,percent of total billed charges,40% of total billed charges,3822.64,40,,,percent of total billed charges,40% of total billed charges,8600.94,90,,,percent of total billed charges,90% of total billed charges,7263.02,76,,,percent of total billed charges,76% of total billed charges,3822.64,40,,,percent of total billed charges,40% of total billed charges,8123.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,7645.28,80,,,percent of total billed charges,80% of total billed charges,3707.96,38.8,,,percent of total billed charges,38.8% of total billed charges,8123.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,215.49,9078.77,
25600 - CLOSED TX OF DISTAL RADIAL FX; W/O MANIPULATION CHAR,46025600,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
ASNIS CANNULATED DRILL BIT 2.7MM AO,46052387,CDM,270,RC,,,OUTPATIENT,,,1052,841.6,,789,75,,,percent of total billed charges,75% of total billed charges,420.8,40,,,percent of total billed charges,40% of total billed charges,833.18,79.2,,,percent of total billed charges,79.2% of total billed charges,894.2,85,,,percent of total billed charges,85% of total billed charges,1052,100,,,fee schedule,100% of CO APG rates,999.4,95,,,percent of total billed charges,95% of total billed charges,841.6,80,,,percent of total billed charges,80% of total billed charges,894.2,85,,,percent of total billed charges,85% of total billed charges,946.8,90,,,percent of total billed charges,90% of total billed charges,1052,100,,,fee schedule,100% of CO APG rates,1052,100,,,fee schedule,100% of CO APG rates,1052,100,,,fee schedule,100% of NM fee schedule,420.8,40,,,percent of total billed charges,40% of total billed charges,420.8,40,,,percent of total billed charges,40% of total billed charges,946.8,90,,,percent of total billed charges,90% of total billed charges,799.52,76,,,percent of total billed charges,76% of total billed charges,420.8,40,,,percent of total billed charges,40% of total billed charges,894.2,85,,,percent of total billed charges,85% of total billed charges,1052,100,,,fee schedule,100% of CO APG rate,841.6,80,,,percent of total billed charges,80% of total billed charges,408.18,38.8,,,percent of total billed charges,38.8% of total billed charges,894.2,85,,,percent of total billed charges,85% of total billed charges,1052,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,408.18,1052,
SUTURE 4-0 MONOCRYL P-3    Y494G,52389,CDM,270,RC,,,OUTPATIENT,,,18.5,14.8,,13.88,75,,,percent of total billed charges,75% of total billed charges,7.4,40,,,percent of total billed charges,40% of total billed charges,14.65,79.2,,,percent of total billed charges,79.2% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,18.5,100,,,fee schedule,100% of CO APG rates,17.58,95,,,percent of total billed charges,95% of total billed charges,14.8,80,,,percent of total billed charges,80% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,16.65,90,,,percent of total billed charges,90% of total billed charges,18.5,100,,,fee schedule,100% of CO APG rates,18.5,100,,,fee schedule,100% of CO APG rates,18.5,100,,,fee schedule,100% of NM fee schedule,7.4,40,,,percent of total billed charges,40% of total billed charges,7.4,40,,,percent of total billed charges,40% of total billed charges,16.65,90,,,percent of total billed charges,90% of total billed charges,14.06,76,,,percent of total billed charges,76% of total billed charges,7.4,40,,,percent of total billed charges,40% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,18.5,100,,,fee schedule,100% of CO APG rate,14.8,80,,,percent of total billed charges,80% of total billed charges,7.18,38.8,,,percent of total billed charges,38.8% of total billed charges,15.73,85,,,percent of total billed charges,85% of total billed charges,18.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,7.18,18.5,
"Poliovirus vaccine, inactivated (IPV), for subcutaneous or i",90713,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,78.9,63.12,,59.18,75,,,percent of total billed charges,75% of total billed charges,31.56,40,,,percent of total billed charges,40% of total billed charges,62.49,79.2,,,percent of total billed charges,79.2% of total billed charges,67.07,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,74.96,95,,,percent of total billed charges,95% of total billed charges,63.12,80,,,percent of total billed charges,80% of total billed charges,67.07,85,,,percent of total billed charges,85% of total billed charges,71.01,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,78.9,100,,,fee schedule,100% of NM fee schedule,31.56,40,,,percent of total billed charges,40% of total billed charges,31.56,40,,,percent of total billed charges,40% of total billed charges,71.01,90,,,percent of total billed charges,90% of total billed charges,59.96,76,,,percent of total billed charges,76% of total billed charges,31.56,40,,,percent of total billed charges,40% of total billed charges,67.07,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,63.12,80,,,percent of total billed charges,80% of total billed charges,30.61,38.8,,,percent of total billed charges,38.8% of total billed charges,67.07,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,30.61,78.9,
Rheumatoid Factor 3,40086431,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,85.1,68.08,,63.83,75,,,percent of total billed charges,75% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,67.4,79.2,,,percent of total billed charges,79.2% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,80.85,95,,,percent of total billed charges,95% of total billed charges,68.08,80,,,percent of total billed charges,80% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,34.04,40,,,percent of total billed charges,40% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,64.68,76,,,percent of total billed charges,76% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,68.08,80,,,percent of total billed charges,80% of total billed charges,33.02,38.8,,,percent of total billed charges,38.8% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,80.85,
STRESS TEST (without Imaging),42893017,CDM,482,RC,93017,HCPCS,OUTPATIENT,,,839.9,671.92,,629.93,75,,,percent of total billed charges,75% of total billed charges,335.96,40,,,percent of total billed charges,40% of total billed charges,665.2,79.2,,,percent of total billed charges,79.2% of total billed charges,713.92,85,,,percent of total billed charges,85% of total billed charges,220.84,100,,,fee schedule,100% of CO APG rates,797.91,95,,,percent of total billed charges,95% of total billed charges,671.92,80,,,percent of total billed charges,80% of total billed charges,713.92,85,,,percent of total billed charges,85% of total billed charges,755.91,90,,,percent of total billed charges,90% of total billed charges,220.84,100,,,fee schedule,100% of CO APG rates,220.84,100,,,fee schedule,100% of CO APG rates,280.06,100,,,fee schedule,100% of NM APC rate,335.96,40,,,percent of total billed charges,40% of total billed charges,335.96,40,,,percent of total billed charges,40% of total billed charges,755.91,90,,,percent of total billed charges,90% of total billed charges,638.32,76,,,percent of total billed charges,76% of total billed charges,335.96,40,,,percent of total billed charges,40% of total billed charges,713.92,85,,,percent of total billed charges,85% of total billed charges,220.84,100,,,fee schedule,100% of CO APG rate,671.92,80,,,percent of total billed charges,80% of total billed charges,325.88,38.8,,,percent of total billed charges,38.8% of total billed charges,713.92,85,,,percent of total billed charges,85% of total billed charges,220.84,100,,,fee schedule,100% of APG fee schedule,75.8,200,,,fee schedule,200% of CMS fee schedule,75.8,797.91,
MA Breast Ndl Loc Placement Additional,41519282,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,213.4,170.72,,160.05,75,,,percent of total billed charges,75% of total billed charges,85.36,40,,,percent of total billed charges,40% of total billed charges,169.01,79.2,,,percent of total billed charges,79.2% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,202.73,95,,,percent of total billed charges,95% of total billed charges,170.72,80,,,percent of total billed charges,80% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,192.06,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,213.4,100,,,fee schedule,100% of NM APC rate,85.36,40,,,percent of total billed charges,40% of total billed charges,85.36,40,,,percent of total billed charges,40% of total billed charges,192.06,90,,,percent of total billed charges,90% of total billed charges,162.18,76,,,percent of total billed charges,76% of total billed charges,85.36,40,,,percent of total billed charges,40% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,170.72,80,,,percent of total billed charges,80% of total billed charges,82.8,38.8,,,percent of total billed charges,38.8% of total billed charges,181.39,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,82.8,213.4,
US Renal Artery Duplex,41293308,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,819.1,655.28,,614.33,75,,,percent of total billed charges,75% of total billed charges,327.64,40,,,percent of total billed charges,40% of total billed charges,648.73,79.2,,,percent of total billed charges,79.2% of total billed charges,696.24,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,778.15,95,,,percent of total billed charges,95% of total billed charges,655.28,80,,,percent of total billed charges,80% of total billed charges,696.24,85,,,percent of total billed charges,85% of total billed charges,737.19,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,327.64,40,,,percent of total billed charges,40% of total billed charges,327.64,40,,,percent of total billed charges,40% of total billed charges,737.19,90,,,percent of total billed charges,90% of total billed charges,622.52,76,,,percent of total billed charges,76% of total billed charges,327.64,40,,,percent of total billed charges,40% of total billed charges,696.24,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,655.28,80,,,percent of total billed charges,80% of total billed charges,317.81,38.8,,,percent of total billed charges,38.8% of total billed charges,696.24,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,778.15,
B pertussis IGG Ab LC,40086615,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,66.2,52.96,,49.65,75,,,percent of total billed charges,75% of total billed charges,26.48,40,,,percent of total billed charges,40% of total billed charges,52.43,79.2,,,percent of total billed charges,79.2% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,62.89,95,,,percent of total billed charges,95% of total billed charges,52.96,80,,,percent of total billed charges,80% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,59.58,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,26.48,40,,,percent of total billed charges,40% of total billed charges,26.48,40,,,percent of total billed charges,40% of total billed charges,59.58,90,,,percent of total billed charges,90% of total billed charges,50.31,76,,,percent of total billed charges,76% of total billed charges,26.48,40,,,percent of total billed charges,40% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,52.96,80,,,percent of total billed charges,80% of total billed charges,25.69,38.8,,,percent of total billed charges,38.8% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,62.89,
B pertussis IGG/IGM Ab LC,40086615,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,79.7,63.76,,59.78,75,,,percent of total billed charges,75% of total billed charges,31.88,40,,,percent of total billed charges,40% of total billed charges,63.12,79.2,,,percent of total billed charges,79.2% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,75.72,95,,,percent of total billed charges,95% of total billed charges,63.76,80,,,percent of total billed charges,80% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,71.73,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,31.88,40,,,percent of total billed charges,40% of total billed charges,31.88,40,,,percent of total billed charges,40% of total billed charges,71.73,90,,,percent of total billed charges,90% of total billed charges,60.57,76,,,percent of total billed charges,76% of total billed charges,31.88,40,,,percent of total billed charges,40% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,63.76,80,,,percent of total billed charges,80% of total billed charges,30.92,38.8,,,percent of total billed charges,38.8% of total billed charges,67.75,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,75.72,
"24675 Closed Treatment Of Ulnar Fracture, Proximal End",31024675,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
25630 CO TX CARPAL W/O MANIP,31025630,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
"96372 - Subq or IM Injection, w/ Patient Supplied Med",60000722,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,195.6,156.48,,146.7,75,,,percent of total billed charges,75% of total billed charges,78.24,40,,,percent of total billed charges,40% of total billed charges,154.92,79.2,,,percent of total billed charges,79.2% of total billed charges,166.26,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,185.82,95,,,percent of total billed charges,95% of total billed charges,156.48,80,,,percent of total billed charges,80% of total billed charges,166.26,85,,,percent of total billed charges,85% of total billed charges,176.04,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,78.24,40,,,percent of total billed charges,40% of total billed charges,78.24,40,,,percent of total billed charges,40% of total billed charges,176.04,90,,,percent of total billed charges,90% of total billed charges,148.66,76,,,percent of total billed charges,76% of total billed charges,78.24,40,,,percent of total billed charges,40% of total billed charges,166.26,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,156.48,80,,,percent of total billed charges,80% of total billed charges,75.89,38.8,,,percent of total billed charges,38.8% of total billed charges,166.26,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,185.82,
"EPIDURAL TRAY, CUSTOM PACK",46252397,CDM,270,RC,,,OUTPATIENT,,,98.36,78.688,,73.77,75,,,percent of total billed charges,75% of total billed charges,39.34,40,,,percent of total billed charges,40% of total billed charges,77.9,79.2,,,percent of total billed charges,79.2% of total billed charges,83.61,85,,,percent of total billed charges,85% of total billed charges,98.36,100,,,fee schedule,100% of CO APG rates,93.44,95,,,percent of total billed charges,95% of total billed charges,78.69,80,,,percent of total billed charges,80% of total billed charges,83.61,85,,,percent of total billed charges,85% of total billed charges,88.52,90,,,percent of total billed charges,90% of total billed charges,98.36,100,,,fee schedule,100% of CO APG rates,98.36,100,,,fee schedule,100% of CO APG rates,98.36,100,,,fee schedule,100% of NM fee schedule,39.34,40,,,percent of total billed charges,40% of total billed charges,39.34,40,,,percent of total billed charges,40% of total billed charges,88.52,90,,,percent of total billed charges,90% of total billed charges,74.75,76,,,percent of total billed charges,76% of total billed charges,39.34,40,,,percent of total billed charges,40% of total billed charges,83.61,85,,,percent of total billed charges,85% of total billed charges,98.36,100,,,fee schedule,100% of CO APG rate,78.69,80,,,percent of total billed charges,80% of total billed charges,38.16,38.8,,,percent of total billed charges,38.8% of total billed charges,83.61,85,,,percent of total billed charges,85% of total billed charges,98.36,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,38.16,98.36,
Direct LDL,40083721,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,84.1,67.28,,63.08,75,,,percent of total billed charges,75% of total billed charges,33.64,40,,,percent of total billed charges,40% of total billed charges,66.61,79.2,,,percent of total billed charges,79.2% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,79.9,95,,,percent of total billed charges,95% of total billed charges,67.28,80,,,percent of total billed charges,80% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,75.69,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,33.64,40,,,percent of total billed charges,40% of total billed charges,33.64,40,,,percent of total billed charges,40% of total billed charges,75.69,90,,,percent of total billed charges,90% of total billed charges,63.92,76,,,percent of total billed charges,76% of total billed charges,33.64,40,,,percent of total billed charges,40% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,67.28,80,,,percent of total billed charges,80% of total billed charges,32.63,38.8,,,percent of total billed charges,38.8% of total billed charges,71.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,79.9,
"ECG 12-Lead, TRACING ONLY",42893005,CDM,730,RC,93005,HCPCS,OUTPATIENT,,,200.3,160.24,,150.23,75,,,percent of total billed charges,75% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,158.64,79.2,,,percent of total billed charges,79.2% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,190.29,95,,,percent of total billed charges,95% of total billed charges,160.24,80,,,percent of total billed charges,80% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,180.27,90,,,percent of total billed charges,90% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,34.77,100,,,fee schedule,100% of CO APG rates,57.48,100,,,fee schedule,100% of NM APC rate,80.12,40,,,percent of total billed charges,40% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,180.27,90,,,percent of total billed charges,90% of total billed charges,152.23,76,,,percent of total billed charges,76% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rate,160.24,80,,,percent of total billed charges,80% of total billed charges,77.72,38.8,,,percent of total billed charges,38.8% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of APG fee schedule,13.34,200,,,fee schedule,200% of CMS fee schedule,13.34,190.29,
"ECG 12-Lead, TRACING ONLY",42893005,CDM,730,RC,93005,HCPCS,OUTPATIENT,,,200.3,160.24,,150.23,75,,,percent of total billed charges,75% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,158.64,79.2,,,percent of total billed charges,79.2% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,190.29,95,,,percent of total billed charges,95% of total billed charges,160.24,80,,,percent of total billed charges,80% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,180.27,90,,,percent of total billed charges,90% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,34.77,100,,,fee schedule,100% of CO APG rates,57.48,100,,,fee schedule,100% of NM APC rate,80.12,40,,,percent of total billed charges,40% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,180.27,90,,,percent of total billed charges,90% of total billed charges,152.23,76,,,percent of total billed charges,76% of total billed charges,80.12,40,,,percent of total billed charges,40% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rate,160.24,80,,,percent of total billed charges,80% of total billed charges,77.72,38.8,,,percent of total billed charges,38.8% of total billed charges,170.26,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of APG fee schedule,13.34,200,,,fee schedule,200% of CMS fee schedule,13.34,190.29,
GASTROINTESTINAL ANCHOR SET,46052476,CDM,270,RC,,,OUTPATIENT,,,374.7,299.76,,281.03,75,,,percent of total billed charges,75% of total billed charges,149.88,40,,,percent of total billed charges,40% of total billed charges,296.76,79.2,,,percent of total billed charges,79.2% of total billed charges,318.5,85,,,percent of total billed charges,85% of total billed charges,374.7,100,,,fee schedule,100% of CO APG rates,355.97,95,,,percent of total billed charges,95% of total billed charges,299.76,80,,,percent of total billed charges,80% of total billed charges,318.5,85,,,percent of total billed charges,85% of total billed charges,337.23,90,,,percent of total billed charges,90% of total billed charges,374.7,100,,,fee schedule,100% of CO APG rates,374.7,100,,,fee schedule,100% of CO APG rates,374.7,100,,,fee schedule,100% of NM fee schedule,149.88,40,,,percent of total billed charges,40% of total billed charges,149.88,40,,,percent of total billed charges,40% of total billed charges,337.23,90,,,percent of total billed charges,90% of total billed charges,284.77,76,,,percent of total billed charges,76% of total billed charges,149.88,40,,,percent of total billed charges,40% of total billed charges,318.5,85,,,percent of total billed charges,85% of total billed charges,374.7,100,,,fee schedule,100% of CO APG rate,299.76,80,,,percent of total billed charges,80% of total billed charges,145.38,38.8,,,percent of total billed charges,38.8% of total billed charges,318.5,85,,,percent of total billed charges,85% of total billed charges,374.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,145.38,374.7,
BARONE JEJUNOSTOMY KIT 10.2 Fr,46052470,CDM,270,RC,,,OUTPATIENT,,,664.3,531.44,,498.23,75,,,percent of total billed charges,75% of total billed charges,265.72,40,,,percent of total billed charges,40% of total billed charges,526.13,79.2,,,percent of total billed charges,79.2% of total billed charges,564.66,85,,,percent of total billed charges,85% of total billed charges,664.3,100,,,fee schedule,100% of CO APG rates,631.09,95,,,percent of total billed charges,95% of total billed charges,531.44,80,,,percent of total billed charges,80% of total billed charges,564.66,85,,,percent of total billed charges,85% of total billed charges,597.87,90,,,percent of total billed charges,90% of total billed charges,664.3,100,,,fee schedule,100% of CO APG rates,664.3,100,,,fee schedule,100% of CO APG rates,664.3,100,,,fee schedule,100% of NM fee schedule,265.72,40,,,percent of total billed charges,40% of total billed charges,265.72,40,,,percent of total billed charges,40% of total billed charges,597.87,90,,,percent of total billed charges,90% of total billed charges,504.87,76,,,percent of total billed charges,76% of total billed charges,265.72,40,,,percent of total billed charges,40% of total billed charges,564.66,85,,,percent of total billed charges,85% of total billed charges,664.3,100,,,fee schedule,100% of CO APG rate,531.44,80,,,percent of total billed charges,80% of total billed charges,257.75,38.8,,,percent of total billed charges,38.8% of total billed charges,564.66,85,,,percent of total billed charges,85% of total billed charges,664.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,257.75,664.3,
MOLNAR DISC 12FR,52398,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,42.8,34.24,,32.1,75,,,percent of total billed charges,75% of total billed charges,17.12,40,,,percent of total billed charges,40% of total billed charges,33.9,79.2,,,percent of total billed charges,79.2% of total billed charges,36.38,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,40.66,95,,,percent of total billed charges,95% of total billed charges,34.24,80,,,percent of total billed charges,80% of total billed charges,36.38,85,,,percent of total billed charges,85% of total billed charges,38.52,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,17.12,40,,,percent of total billed charges,40% of total billed charges,17.12,40,,,percent of total billed charges,40% of total billed charges,38.52,90,,,percent of total billed charges,90% of total billed charges,32.53,76,,,percent of total billed charges,76% of total billed charges,17.12,40,,,percent of total billed charges,40% of total billed charges,36.38,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,34.24,80,,,percent of total billed charges,80% of total billed charges,16.61,38.8,,,percent of total billed charges,38.8% of total billed charges,36.38,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,40.66,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012032,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1159.6,927.68,,869.7,75,,,percent of total billed charges,75% of total billed charges,463.84,40,,,percent of total billed charges,40% of total billed charges,918.4,79.2,,,percent of total billed charges,79.2% of total billed charges,985.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1101.62,95,,,percent of total billed charges,95% of total billed charges,927.68,80,,,percent of total billed charges,80% of total billed charges,985.66,85,,,percent of total billed charges,85% of total billed charges,1043.64,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,463.84,40,,,percent of total billed charges,40% of total billed charges,463.84,40,,,percent of total billed charges,40% of total billed charges,1043.64,90,,,percent of total billed charges,90% of total billed charges,881.3,76,,,percent of total billed charges,76% of total billed charges,463.84,40,,,percent of total billed charges,40% of total billed charges,985.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,927.68,80,,,percent of total billed charges,80% of total billed charges,449.92,38.8,,,percent of total billed charges,38.8% of total billed charges,985.66,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1101.62,
"DRILL BIT, 4.2X130MM, AO, STERILE",46052399,CDM,270,RC,,,OUTPATIENT,,,564.7,451.76,,423.53,75,,,percent of total billed charges,75% of total billed charges,225.88,40,,,percent of total billed charges,40% of total billed charges,447.24,79.2,,,percent of total billed charges,79.2% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,564.7,100,,,fee schedule,100% of CO APG rates,536.47,95,,,percent of total billed charges,95% of total billed charges,451.76,80,,,percent of total billed charges,80% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,508.23,90,,,percent of total billed charges,90% of total billed charges,564.7,100,,,fee schedule,100% of CO APG rates,564.7,100,,,fee schedule,100% of CO APG rates,564.7,100,,,fee schedule,100% of NM fee schedule,225.88,40,,,percent of total billed charges,40% of total billed charges,225.88,40,,,percent of total billed charges,40% of total billed charges,508.23,90,,,percent of total billed charges,90% of total billed charges,429.17,76,,,percent of total billed charges,76% of total billed charges,225.88,40,,,percent of total billed charges,40% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,564.7,100,,,fee schedule,100% of CO APG rate,451.76,80,,,percent of total billed charges,80% of total billed charges,219.1,38.8,,,percent of total billed charges,38.8% of total billed charges,480,85,,,percent of total billed charges,85% of total billed charges,564.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,219.1,564.7,
XCEL BLADELESS TROCAR 5MM X 150MM B5XT,46052400,CDM,270,RC,,,OUTPATIENT,,,100.6,80.48,,75.45,75,,,percent of total billed charges,75% of total billed charges,40.24,40,,,percent of total billed charges,40% of total billed charges,79.68,79.2,,,percent of total billed charges,79.2% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,100.6,100,,,fee schedule,100% of CO APG rates,95.57,95,,,percent of total billed charges,95% of total billed charges,80.48,80,,,percent of total billed charges,80% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,90.54,90,,,percent of total billed charges,90% of total billed charges,100.6,100,,,fee schedule,100% of CO APG rates,100.6,100,,,fee schedule,100% of CO APG rates,100.6,100,,,fee schedule,100% of NM fee schedule,40.24,40,,,percent of total billed charges,40% of total billed charges,40.24,40,,,percent of total billed charges,40% of total billed charges,90.54,90,,,percent of total billed charges,90% of total billed charges,76.46,76,,,percent of total billed charges,76% of total billed charges,40.24,40,,,percent of total billed charges,40% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,100.6,100,,,fee schedule,100% of CO APG rate,80.48,80,,,percent of total billed charges,80% of total billed charges,39.03,38.8,,,percent of total billed charges,38.8% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,100.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,39.03,100.6,
INFANT/NEONATE INLINE CO2 FILTER H SET,52402,CDM,303,RC,,,OUTPATIENT,,,59.9,47.92,,44.93,75,,,percent of total billed charges,75% of total billed charges,23.96,40,,,percent of total billed charges,40% of total billed charges,47.44,79.2,,,percent of total billed charges,79.2% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,59.9,100,,,fee schedule,100% of CO APG rates,56.91,95,,,percent of total billed charges,95% of total billed charges,47.92,80,,,percent of total billed charges,80% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,53.91,90,,,percent of total billed charges,90% of total billed charges,59.9,100,,,fee schedule,100% of CO APG rates,59.9,100,,,fee schedule,100% of CO APG rates,59.9,100,,,fee schedule,100% of NM fee schedule,23.96,40,,,percent of total billed charges,40% of total billed charges,23.96,40,,,percent of total billed charges,40% of total billed charges,53.91,90,,,percent of total billed charges,90% of total billed charges,45.52,76,,,percent of total billed charges,76% of total billed charges,23.96,40,,,percent of total billed charges,40% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,59.9,100,,,fee schedule,100% of CO APG rate,47.92,80,,,percent of total billed charges,80% of total billed charges,23.24,38.8,,,percent of total billed charges,38.8% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,59.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,23.24,59.9,
Aph FFP CP2D Dv Thawed,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
27831 CLOSED TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOC,98127831,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,9035.5,7228.4,,6776.63,75,,,percent of total billed charges,75% of total billed charges,3614.2,40,,,percent of total billed charges,40% of total billed charges,7156.12,79.2,,,percent of total billed charges,79.2% of total billed charges,7680.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,8583.73,95,,,percent of total billed charges,95% of total billed charges,7228.4,80,,,percent of total billed charges,80% of total billed charges,7680.18,85,,,percent of total billed charges,85% of total billed charges,8131.95,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,4540.32,100,,,fee schedule,100% of NM APC rate,3614.2,40,,,percent of total billed charges,40% of total billed charges,3614.2,40,,,percent of total billed charges,40% of total billed charges,8131.95,90,,,percent of total billed charges,90% of total billed charges,6866.98,76,,,percent of total billed charges,76% of total billed charges,3614.2,40,,,percent of total billed charges,40% of total billed charges,7680.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,7228.4,80,,,percent of total billed charges,80% of total billed charges,3505.77,38.8,,,percent of total billed charges,38.8% of total billed charges,7680.18,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,215.49,8583.73,
57180 INTRODUCTION OF ANY HEMOSTATIC AGENT OR PACK FOR SPONT,98157180,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,597,477.6,,447.75,75,,,percent of total billed charges,75% of total billed charges,238.8,40,,,percent of total billed charges,40% of total billed charges,472.82,79.2,,,percent of total billed charges,79.2% of total billed charges,507.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,567.15,95,,,percent of total billed charges,95% of total billed charges,477.6,80,,,percent of total billed charges,80% of total billed charges,507.45,85,,,percent of total billed charges,85% of total billed charges,537.3,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,238.8,40,,,percent of total billed charges,40% of total billed charges,238.8,40,,,percent of total billed charges,40% of total billed charges,537.3,90,,,percent of total billed charges,90% of total billed charges,453.72,76,,,percent of total billed charges,76% of total billed charges,238.8,40,,,percent of total billed charges,40% of total billed charges,507.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,477.6,80,,,percent of total billed charges,80% of total billed charges,231.64,38.8,,,percent of total billed charges,38.8% of total billed charges,507.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,567.15,
49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,98149083,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2913,2330.4,,2184.75,75,,,percent of total billed charges,75% of total billed charges,1165.2,40,,,percent of total billed charges,40% of total billed charges,2307.1,79.2,,,percent of total billed charges,79.2% of total billed charges,2476.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2767.35,95,,,percent of total billed charges,95% of total billed charges,2330.4,80,,,percent of total billed charges,80% of total billed charges,2476.05,85,,,percent of total billed charges,85% of total billed charges,2621.7,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1165.2,40,,,percent of total billed charges,40% of total billed charges,1165.2,40,,,percent of total billed charges,40% of total billed charges,2621.7,90,,,percent of total billed charges,90% of total billed charges,2213.88,76,,,percent of total billed charges,76% of total billed charges,1165.2,40,,,percent of total billed charges,40% of total billed charges,2476.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,2330.4,80,,,percent of total billed charges,80% of total billed charges,1130.24,38.8,,,percent of total billed charges,38.8% of total billed charges,2476.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2767.35,
"CANCELLOUS CHIPS 4-10MM, 15CC",460ECON0172,CDM,278,RC,,,OUTPATIENT,,,977.9,782.32,,733.43,75,,,percent of total billed charges,75% of total billed charges,391.16,40,,,percent of total billed charges,40% of total billed charges,774.5,79.2,,,percent of total billed charges,79.2% of total billed charges,831.22,85,,,percent of total billed charges,85% of total billed charges,977.9,100,,,fee schedule,100% of CO APG rates,929.01,95,,,percent of total billed charges,95% of total billed charges,782.32,80,,,percent of total billed charges,80% of total billed charges,831.22,85,,,percent of total billed charges,85% of total billed charges,880.11,90,,,percent of total billed charges,90% of total billed charges,977.9,100,,,fee schedule,100% of CO APG rates,977.9,100,,,fee schedule,100% of CO APG rates,977.9,100,,,fee schedule,100% of NM fee schedule,391.16,40,,,percent of total billed charges,40% of total billed charges,391.16,40,,,percent of total billed charges,40% of total billed charges,880.11,90,,,percent of total billed charges,90% of total billed charges,743.2,76,,,percent of total billed charges,76% of total billed charges,391.16,40,,,percent of total billed charges,40% of total billed charges,831.22,85,,,percent of total billed charges,85% of total billed charges,977.9,100,,,fee schedule,100% of CO APG rate,782.32,80,,,percent of total billed charges,80% of total billed charges,379.43,38.8,,,percent of total billed charges,38.8% of total billed charges,831.22,85,,,percent of total billed charges,85% of total billed charges,977.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,379.43,977.9,
"CANCELLOUS CHIPS 4-10MM, 30CC",460ECON0173,CDM,278,RC,,,OUTPATIENT,,,1438,1150.4,,1078.5,75,,,percent of total billed charges,75% of total billed charges,575.2,40,,,percent of total billed charges,40% of total billed charges,1138.9,79.2,,,percent of total billed charges,79.2% of total billed charges,1222.3,85,,,percent of total billed charges,85% of total billed charges,1438,100,,,fee schedule,100% of CO APG rates,1366.1,95,,,percent of total billed charges,95% of total billed charges,1150.4,80,,,percent of total billed charges,80% of total billed charges,1222.3,85,,,percent of total billed charges,85% of total billed charges,1294.2,90,,,percent of total billed charges,90% of total billed charges,1438,100,,,fee schedule,100% of CO APG rates,1438,100,,,fee schedule,100% of CO APG rates,1438,100,,,fee schedule,100% of NM fee schedule,575.2,40,,,percent of total billed charges,40% of total billed charges,575.2,40,,,percent of total billed charges,40% of total billed charges,1294.2,90,,,percent of total billed charges,90% of total billed charges,1092.88,76,,,percent of total billed charges,76% of total billed charges,575.2,40,,,percent of total billed charges,40% of total billed charges,1222.3,85,,,percent of total billed charges,85% of total billed charges,1438,100,,,fee schedule,100% of CO APG rate,1150.4,80,,,percent of total billed charges,80% of total billed charges,557.94,38.8,,,percent of total billed charges,38.8% of total billed charges,1222.3,85,,,percent of total billed charges,85% of total billed charges,1438,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,557.94,1438,
"STRYKER DBM BONE MATRIX PUTTY, 5CC",460ECON0174,CDM,278,RC,,,OUTPATIENT,,,2521,2016.8,,1890.75,75,,,percent of total billed charges,75% of total billed charges,1008.4,40,,,percent of total billed charges,40% of total billed charges,1996.63,79.2,,,percent of total billed charges,79.2% of total billed charges,2142.85,85,,,percent of total billed charges,85% of total billed charges,2521,100,,,fee schedule,100% of CO APG rates,2394.95,95,,,percent of total billed charges,95% of total billed charges,2016.8,80,,,percent of total billed charges,80% of total billed charges,2142.85,85,,,percent of total billed charges,85% of total billed charges,2268.9,90,,,percent of total billed charges,90% of total billed charges,2521,100,,,fee schedule,100% of CO APG rates,2521,100,,,fee schedule,100% of CO APG rates,2521,100,,,fee schedule,100% of NM fee schedule,1008.4,40,,,percent of total billed charges,40% of total billed charges,1008.4,40,,,percent of total billed charges,40% of total billed charges,2268.9,90,,,percent of total billed charges,90% of total billed charges,1915.96,76,,,percent of total billed charges,76% of total billed charges,1008.4,40,,,percent of total billed charges,40% of total billed charges,2142.85,85,,,percent of total billed charges,85% of total billed charges,2521,100,,,fee schedule,100% of CO APG rate,2016.8,80,,,percent of total billed charges,80% of total billed charges,978.15,38.8,,,percent of total billed charges,38.8% of total billed charges,2142.85,85,,,percent of total billed charges,85% of total billed charges,2521,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,978.15,2521,
"EMG TUBE 6.0MM, NIM",46252406,CDM,270,RC,,,OUTPATIENT,,,1314.3,1051.44,,985.73,75,,,percent of total billed charges,75% of total billed charges,525.72,40,,,percent of total billed charges,40% of total billed charges,1040.93,79.2,,,percent of total billed charges,79.2% of total billed charges,1117.16,85,,,percent of total billed charges,85% of total billed charges,1314.3,100,,,fee schedule,100% of CO APG rates,1248.59,95,,,percent of total billed charges,95% of total billed charges,1051.44,80,,,percent of total billed charges,80% of total billed charges,1117.16,85,,,percent of total billed charges,85% of total billed charges,1182.87,90,,,percent of total billed charges,90% of total billed charges,1314.3,100,,,fee schedule,100% of CO APG rates,1314.3,100,,,fee schedule,100% of CO APG rates,1314.3,100,,,fee schedule,100% of NM fee schedule,525.72,40,,,percent of total billed charges,40% of total billed charges,525.72,40,,,percent of total billed charges,40% of total billed charges,1182.87,90,,,percent of total billed charges,90% of total billed charges,998.87,76,,,percent of total billed charges,76% of total billed charges,525.72,40,,,percent of total billed charges,40% of total billed charges,1117.16,85,,,percent of total billed charges,85% of total billed charges,1314.3,100,,,fee schedule,100% of CO APG rate,1051.44,80,,,percent of total billed charges,80% of total billed charges,509.95,38.8,,,percent of total billed charges,38.8% of total billed charges,1117.16,85,,,percent of total billed charges,85% of total billed charges,1314.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,509.95,1314.3,
"EMG TUBE 7.0MM, NIM",46252407,CDM,270,RC,,,OUTPATIENT,,,1353.6,1082.88,,1015.2,75,,,percent of total billed charges,75% of total billed charges,541.44,40,,,percent of total billed charges,40% of total billed charges,1072.05,79.2,,,percent of total billed charges,79.2% of total billed charges,1150.56,85,,,percent of total billed charges,85% of total billed charges,1353.6,100,,,fee schedule,100% of CO APG rates,1285.92,95,,,percent of total billed charges,95% of total billed charges,1082.88,80,,,percent of total billed charges,80% of total billed charges,1150.56,85,,,percent of total billed charges,85% of total billed charges,1218.24,90,,,percent of total billed charges,90% of total billed charges,1353.6,100,,,fee schedule,100% of CO APG rates,1353.6,100,,,fee schedule,100% of CO APG rates,1353.6,100,,,fee schedule,100% of NM fee schedule,541.44,40,,,percent of total billed charges,40% of total billed charges,541.44,40,,,percent of total billed charges,40% of total billed charges,1218.24,90,,,percent of total billed charges,90% of total billed charges,1028.74,76,,,percent of total billed charges,76% of total billed charges,541.44,40,,,percent of total billed charges,40% of total billed charges,1150.56,85,,,percent of total billed charges,85% of total billed charges,1353.6,100,,,fee schedule,100% of CO APG rate,1082.88,80,,,percent of total billed charges,80% of total billed charges,525.2,38.8,,,percent of total billed charges,38.8% of total billed charges,1150.56,85,,,percent of total billed charges,85% of total billed charges,1353.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,525.2,1353.6,
"EMG TUBE 8.0MM, NIM",46252408,CDM,270,RC,,,OUTPATIENT,,,1314.3,1051.44,,985.73,75,,,percent of total billed charges,75% of total billed charges,525.72,40,,,percent of total billed charges,40% of total billed charges,1040.93,79.2,,,percent of total billed charges,79.2% of total billed charges,1117.16,85,,,percent of total billed charges,85% of total billed charges,1314.3,100,,,fee schedule,100% of CO APG rates,1248.59,95,,,percent of total billed charges,95% of total billed charges,1051.44,80,,,percent of total billed charges,80% of total billed charges,1117.16,85,,,percent of total billed charges,85% of total billed charges,1182.87,90,,,percent of total billed charges,90% of total billed charges,1314.3,100,,,fee schedule,100% of CO APG rates,1314.3,100,,,fee schedule,100% of CO APG rates,1314.3,100,,,fee schedule,100% of NM fee schedule,525.72,40,,,percent of total billed charges,40% of total billed charges,525.72,40,,,percent of total billed charges,40% of total billed charges,1182.87,90,,,percent of total billed charges,90% of total billed charges,998.87,76,,,percent of total billed charges,76% of total billed charges,525.72,40,,,percent of total billed charges,40% of total billed charges,1117.16,85,,,percent of total billed charges,85% of total billed charges,1314.3,100,,,fee schedule,100% of CO APG rate,1051.44,80,,,percent of total billed charges,80% of total billed charges,509.95,38.8,,,percent of total billed charges,38.8% of total billed charges,1117.16,85,,,percent of total billed charges,85% of total billed charges,1314.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,509.95,1314.3,
"PROBE INCREMENT PRASS TIP, NIM",46252409,CDM,270,RC,,,OUTPATIENT,,,693.7,554.96,,520.28,75,,,percent of total billed charges,75% of total billed charges,277.48,40,,,percent of total billed charges,40% of total billed charges,549.41,79.2,,,percent of total billed charges,79.2% of total billed charges,589.65,85,,,percent of total billed charges,85% of total billed charges,693.7,100,,,fee schedule,100% of CO APG rates,659.02,95,,,percent of total billed charges,95% of total billed charges,554.96,80,,,percent of total billed charges,80% of total billed charges,589.65,85,,,percent of total billed charges,85% of total billed charges,624.33,90,,,percent of total billed charges,90% of total billed charges,693.7,100,,,fee schedule,100% of CO APG rates,693.7,100,,,fee schedule,100% of CO APG rates,693.7,100,,,fee schedule,100% of NM fee schedule,277.48,40,,,percent of total billed charges,40% of total billed charges,277.48,40,,,percent of total billed charges,40% of total billed charges,624.33,90,,,percent of total billed charges,90% of total billed charges,527.21,76,,,percent of total billed charges,76% of total billed charges,277.48,40,,,percent of total billed charges,40% of total billed charges,589.65,85,,,percent of total billed charges,85% of total billed charges,693.7,100,,,fee schedule,100% of CO APG rate,554.96,80,,,percent of total billed charges,80% of total billed charges,269.16,38.8,,,percent of total billed charges,38.8% of total billed charges,589.65,85,,,percent of total billed charges,85% of total billed charges,693.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,269.16,693.7,
Aph Thawed Plasma F24RT24,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Thawed Plasma F24RT24 C1,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Thawed Plasma F24RT24 C2,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Thawed Plasma F24RT24 C3,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Thawed Plasma F24RT24 C4,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Irr Thawed Plasma F24RT24,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Irr Thawed Plasma F24RT24 C1,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Irr Thawed Plasma F24RT24 C2,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Irr Thawed Plasma F24RT24 C3,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Irr Thawed Plasma F24RT24 C4,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Plasma ACDA Thawed C1,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Plasma ACDA Thawed C2,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Plasma ACDA Thawed C3,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Plasma ACDA Thawed C4,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Plasma ACDA Thawed Irr,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Plasma ACDA Thawed Irr C1,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Plasma ACDA Thawed Irr C2,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Plasma ACDA Thawed Irr C3,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
Aph Plasma ACDA Thawed Irr C4,4050102,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,388.3,310.64,,291.23,75,,,percent of total billed charges,75% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,307.53,79.2,,,percent of total billed charges,79.2% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,368.89,95,,,percent of total billed charges,95% of total billed charges,310.64,80,,,percent of total billed charges,80% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,155.32,40,,,percent of total billed charges,40% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,349.47,90,,,percent of total billed charges,90% of total billed charges,295.11,76,,,percent of total billed charges,76% of total billed charges,155.32,40,,,percent of total billed charges,40% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,310.64,80,,,percent of total billed charges,80% of total billed charges,150.66,38.8,,,percent of total billed charges,38.8% of total billed charges,330.06,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,368.89,
"ICONIX 1, 1.4MM ANCHOR 1 STRAND, #2 FIBER",46052430,CDM,278,RC,,,OUTPATIENT,,,1485.3,1188.24,,1113.98,75,,,percent of total billed charges,75% of total billed charges,594.12,40,,,percent of total billed charges,40% of total billed charges,1176.36,79.2,,,percent of total billed charges,79.2% of total billed charges,1262.51,85,,,percent of total billed charges,85% of total billed charges,1485.3,100,,,fee schedule,100% of CO APG rates,1411.04,95,,,percent of total billed charges,95% of total billed charges,1188.24,80,,,percent of total billed charges,80% of total billed charges,1262.51,85,,,percent of total billed charges,85% of total billed charges,1336.77,90,,,percent of total billed charges,90% of total billed charges,1485.3,100,,,fee schedule,100% of CO APG rates,1485.3,100,,,fee schedule,100% of CO APG rates,1485.3,100,,,fee schedule,100% of NM fee schedule,594.12,40,,,percent of total billed charges,40% of total billed charges,594.12,40,,,percent of total billed charges,40% of total billed charges,1336.77,90,,,percent of total billed charges,90% of total billed charges,1128.83,76,,,percent of total billed charges,76% of total billed charges,594.12,40,,,percent of total billed charges,40% of total billed charges,1262.51,85,,,percent of total billed charges,85% of total billed charges,1485.3,100,,,fee schedule,100% of CO APG rate,1188.24,80,,,percent of total billed charges,80% of total billed charges,576.3,38.8,,,percent of total billed charges,38.8% of total billed charges,1262.51,85,,,percent of total billed charges,85% of total billed charges,1485.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,576.3,1485.3,
ICONIX 1.4MM DISPOSABLE DRILL,460ECON0178,CDM,270,RC,,,OUTPATIENT,,,879.3,703.44,,659.48,75,,,percent of total billed charges,75% of total billed charges,351.72,40,,,percent of total billed charges,40% of total billed charges,696.41,79.2,,,percent of total billed charges,79.2% of total billed charges,747.41,85,,,percent of total billed charges,85% of total billed charges,879.3,100,,,fee schedule,100% of CO APG rates,835.34,95,,,percent of total billed charges,95% of total billed charges,703.44,80,,,percent of total billed charges,80% of total billed charges,747.41,85,,,percent of total billed charges,85% of total billed charges,791.37,90,,,percent of total billed charges,90% of total billed charges,879.3,100,,,fee schedule,100% of CO APG rates,879.3,100,,,fee schedule,100% of CO APG rates,879.3,100,,,fee schedule,100% of NM fee schedule,351.72,40,,,percent of total billed charges,40% of total billed charges,351.72,40,,,percent of total billed charges,40% of total billed charges,791.37,90,,,percent of total billed charges,90% of total billed charges,668.27,76,,,percent of total billed charges,76% of total billed charges,351.72,40,,,percent of total billed charges,40% of total billed charges,747.41,85,,,percent of total billed charges,85% of total billed charges,879.3,100,,,fee schedule,100% of CO APG rate,703.44,80,,,percent of total billed charges,80% of total billed charges,341.17,38.8,,,percent of total billed charges,38.8% of total billed charges,747.41,85,,,percent of total billed charges,85% of total billed charges,879.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,341.17,879.3,
"SUTURE RETRIEVER STRAIGHT, HOFFEE",46052416,CDM,270,RC,,,OUTPATIENT,,,286.3,229.04,,214.73,75,,,percent of total billed charges,75% of total billed charges,114.52,40,,,percent of total billed charges,40% of total billed charges,226.75,79.2,,,percent of total billed charges,79.2% of total billed charges,243.36,85,,,percent of total billed charges,85% of total billed charges,286.3,100,,,fee schedule,100% of CO APG rates,271.99,95,,,percent of total billed charges,95% of total billed charges,229.04,80,,,percent of total billed charges,80% of total billed charges,243.36,85,,,percent of total billed charges,85% of total billed charges,257.67,90,,,percent of total billed charges,90% of total billed charges,286.3,100,,,fee schedule,100% of CO APG rates,286.3,100,,,fee schedule,100% of CO APG rates,286.3,100,,,fee schedule,100% of NM fee schedule,114.52,40,,,percent of total billed charges,40% of total billed charges,114.52,40,,,percent of total billed charges,40% of total billed charges,257.67,90,,,percent of total billed charges,90% of total billed charges,217.59,76,,,percent of total billed charges,76% of total billed charges,114.52,40,,,percent of total billed charges,40% of total billed charges,243.36,85,,,percent of total billed charges,85% of total billed charges,286.3,100,,,fee schedule,100% of CO APG rate,229.04,80,,,percent of total billed charges,80% of total billed charges,111.08,38.8,,,percent of total billed charges,38.8% of total billed charges,243.36,85,,,percent of total billed charges,85% of total billed charges,286.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,111.08,286.3,
Debride of Nail(s) By Any Method(s); One to Five Charge,49111720,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,231.9,185.52,,173.93,75,,,percent of total billed charges,75% of total billed charges,92.76,40,,,percent of total billed charges,40% of total billed charges,183.66,79.2,,,percent of total billed charges,79.2% of total billed charges,197.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,220.31,95,,,percent of total billed charges,95% of total billed charges,185.52,80,,,percent of total billed charges,80% of total billed charges,197.12,85,,,percent of total billed charges,85% of total billed charges,208.71,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,92.76,40,,,percent of total billed charges,40% of total billed charges,92.76,40,,,percent of total billed charges,40% of total billed charges,208.71,90,,,percent of total billed charges,90% of total billed charges,176.24,76,,,percent of total billed charges,76% of total billed charges,92.76,40,,,percent of total billed charges,40% of total billed charges,197.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,185.52,80,,,percent of total billed charges,80% of total billed charges,89.98,38.8,,,percent of total billed charges,38.8% of total billed charges,197.12,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,89.98,220.31,
TRAUMA ACTIVATION LEVEL 1,31000011,CDM,684,RC,,,OUTPATIENT,,,5278.2,4222.56,,3958.65,75,,,percent of total billed charges,75% of total billed charges,2111.28,40,,,percent of total billed charges,40% of total billed charges,4180.33,79.2,,,percent of total billed charges,79.2% of total billed charges,4486.47,85,,,percent of total billed charges,85% of total billed charges,5278.2,100,,,fee schedule,100% of CO APG rates,5014.29,95,,,percent of total billed charges,95% of total billed charges,4222.56,80,,,percent of total billed charges,80% of total billed charges,4486.47,85,,,percent of total billed charges,85% of total billed charges,4750.38,90,,,percent of total billed charges,90% of total billed charges,5278.2,100,,,fee schedule,100% of CO APG rates,5278.2,100,,,fee schedule,100% of CO APG rates,5278.2,100,,,fee schedule,100% of NM fee schedule,2111.28,40,,,percent of total billed charges,40% of total billed charges,2111.28,40,,,percent of total billed charges,40% of total billed charges,4750.38,90,,,percent of total billed charges,90% of total billed charges,4011.43,76,,,percent of total billed charges,76% of total billed charges,2111.28,40,,,percent of total billed charges,40% of total billed charges,4486.47,85,,,percent of total billed charges,85% of total billed charges,5278.2,100,,,fee schedule,100% of CO APG rate,4222.56,80,,,percent of total billed charges,80% of total billed charges,2047.94,38.8,,,percent of total billed charges,38.8% of total billed charges,4486.47,85,,,percent of total billed charges,85% of total billed charges,5278.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2047.94,5278.2,
TRAUMA ACTIVATION LEVEL 2,31000012,CDM,684,RC,,,OUTPATIENT,,,2139.1,1711.28,,1604.33,75,,,percent of total billed charges,75% of total billed charges,855.64,40,,,percent of total billed charges,40% of total billed charges,1694.17,79.2,,,percent of total billed charges,79.2% of total billed charges,1818.24,85,,,percent of total billed charges,85% of total billed charges,2139.1,100,,,fee schedule,100% of CO APG rates,2032.15,95,,,percent of total billed charges,95% of total billed charges,1711.28,80,,,percent of total billed charges,80% of total billed charges,1818.24,85,,,percent of total billed charges,85% of total billed charges,1925.19,90,,,percent of total billed charges,90% of total billed charges,2139.1,100,,,fee schedule,100% of CO APG rates,2139.1,100,,,fee schedule,100% of CO APG rates,2139.1,100,,,fee schedule,100% of NM fee schedule,855.64,40,,,percent of total billed charges,40% of total billed charges,855.64,40,,,percent of total billed charges,40% of total billed charges,1925.19,90,,,percent of total billed charges,90% of total billed charges,1625.72,76,,,percent of total billed charges,76% of total billed charges,855.64,40,,,percent of total billed charges,40% of total billed charges,1818.24,85,,,percent of total billed charges,85% of total billed charges,2139.1,100,,,fee schedule,100% of CO APG rate,1711.28,80,,,percent of total billed charges,80% of total billed charges,829.97,38.8,,,percent of total billed charges,38.8% of total billed charges,1818.24,85,,,percent of total billed charges,85% of total billed charges,2139.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,829.97,2139.1,
AQUACEL AG (SILVER) SURGICAL 9 x 35cm,52417,CDM,270,RC,,,OUTPATIENT,,,210.9,168.72,,158.18,75,,,percent of total billed charges,75% of total billed charges,84.36,40,,,percent of total billed charges,40% of total billed charges,167.03,79.2,,,percent of total billed charges,79.2% of total billed charges,179.27,85,,,percent of total billed charges,85% of total billed charges,210.9,100,,,fee schedule,100% of CO APG rates,200.36,95,,,percent of total billed charges,95% of total billed charges,168.72,80,,,percent of total billed charges,80% of total billed charges,179.27,85,,,percent of total billed charges,85% of total billed charges,189.81,90,,,percent of total billed charges,90% of total billed charges,210.9,100,,,fee schedule,100% of CO APG rates,210.9,100,,,fee schedule,100% of CO APG rates,210.9,100,,,fee schedule,100% of NM fee schedule,84.36,40,,,percent of total billed charges,40% of total billed charges,84.36,40,,,percent of total billed charges,40% of total billed charges,189.81,90,,,percent of total billed charges,90% of total billed charges,160.28,76,,,percent of total billed charges,76% of total billed charges,84.36,40,,,percent of total billed charges,40% of total billed charges,179.27,85,,,percent of total billed charges,85% of total billed charges,210.9,100,,,fee schedule,100% of CO APG rate,168.72,80,,,percent of total billed charges,80% of total billed charges,81.83,38.8,,,percent of total billed charges,38.8% of total billed charges,179.27,85,,,percent of total billed charges,85% of total billed charges,210.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,81.83,210.9,
IRRIGATION OF IMPLANTED VENOUS ACCESS DEVICE FOR DRUG DELIVE,42096523,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,210.1,168.08,,157.58,75,,,percent of total billed charges,75% of total billed charges,84.04,40,,,percent of total billed charges,40% of total billed charges,166.4,79.2,,,percent of total billed charges,79.2% of total billed charges,178.59,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,199.6,95,,,percent of total billed charges,95% of total billed charges,168.08,80,,,percent of total billed charges,80% of total billed charges,178.59,85,,,percent of total billed charges,85% of total billed charges,189.09,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,84.04,40,,,percent of total billed charges,40% of total billed charges,84.04,40,,,percent of total billed charges,40% of total billed charges,189.09,90,,,percent of total billed charges,90% of total billed charges,159.68,76,,,percent of total billed charges,76% of total billed charges,84.04,40,,,percent of total billed charges,40% of total billed charges,178.59,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,168.08,80,,,percent of total billed charges,80% of total billed charges,81.52,38.8,,,percent of total billed charges,38.8% of total billed charges,178.59,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,199.6,
24500 Closed Treatment Of Humeral Shaft Fracture; Without Ma,46024500,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,697.7,558.16,,523.28,75,,,percent of total billed charges,75% of total billed charges,279.08,40,,,percent of total billed charges,40% of total billed charges,552.58,79.2,,,percent of total billed charges,79.2% of total billed charges,593.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,662.82,95,,,percent of total billed charges,95% of total billed charges,558.16,80,,,percent of total billed charges,80% of total billed charges,593.05,85,,,percent of total billed charges,85% of total billed charges,627.93,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,279.08,40,,,percent of total billed charges,40% of total billed charges,279.08,40,,,percent of total billed charges,40% of total billed charges,627.93,90,,,percent of total billed charges,90% of total billed charges,530.25,76,,,percent of total billed charges,76% of total billed charges,279.08,40,,,percent of total billed charges,40% of total billed charges,593.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,558.16,80,,,percent of total billed charges,80% of total billed charges,270.71,38.8,,,percent of total billed charges,38.8% of total billed charges,593.05,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,662.82,
27768 CLOSED TREATMENT OF POSTERIOR MALLEOLUS FRACTUREL W/MA,31027768,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,3333.2,2666.56,,2499.9,75,,,percent of total billed charges,75% of total billed charges,1333.28,40,,,percent of total billed charges,40% of total billed charges,2639.89,79.2,,,percent of total billed charges,79.2% of total billed charges,2833.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,3166.54,95,,,percent of total billed charges,95% of total billed charges,2666.56,80,,,percent of total billed charges,80% of total billed charges,2833.22,85,,,percent of total billed charges,85% of total billed charges,2999.88,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1333.28,40,,,percent of total billed charges,40% of total billed charges,1333.28,40,,,percent of total billed charges,40% of total billed charges,2999.88,90,,,percent of total billed charges,90% of total billed charges,2533.23,76,,,percent of total billed charges,76% of total billed charges,1333.28,40,,,percent of total billed charges,40% of total billed charges,2833.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,2666.56,80,,,percent of total billed charges,80% of total billed charges,1293.28,38.8,,,percent of total billed charges,38.8% of total billed charges,2833.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,3166.54,
28430 closed treatment of talus fx; without manipulation,31028420,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,796.6,637.28,,597.45,75,,,percent of total billed charges,75% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,630.91,79.2,,,percent of total billed charges,79.2% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,756.77,95,,,percent of total billed charges,95% of total billed charges,637.28,80,,,percent of total billed charges,80% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,716.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,318.64,40,,,percent of total billed charges,40% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,716.94,90,,,percent of total billed charges,90% of total billed charges,605.42,76,,,percent of total billed charges,76% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,637.28,80,,,percent of total billed charges,80% of total billed charges,309.08,38.8,,,percent of total billed charges,38.8% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,756.77,
19285 US Breast needle Loc w/localization device placement;,41219285,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,2131.2,1704.96,TC,1598.4,75,,,percent of total billed charges,75% of total billed charges,852.48,40,,,percent of total billed charges,40% of total billed charges,1687.91,79.2,,,percent of total billed charges,79.2% of total billed charges,1811.52,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,2024.64,95,,,percent of total billed charges,95% of total billed charges,1704.96,80,,,percent of total billed charges,80% of total billed charges,1811.52,85,,,percent of total billed charges,85% of total billed charges,1918.08,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,852.48,40,,,percent of total billed charges,40% of total billed charges,852.48,40,,,percent of total billed charges,40% of total billed charges,1918.08,90,,,percent of total billed charges,90% of total billed charges,1619.71,76,,,percent of total billed charges,76% of total billed charges,852.48,40,,,percent of total billed charges,40% of total billed charges,1811.52,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,1704.96,80,,,percent of total billed charges,80% of total billed charges,826.91,38.8,,,percent of total billed charges,38.8% of total billed charges,1811.52,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,2024.64,
36425 CUT DOWN,31036425,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1033.8,827.04,,775.35,75,,,percent of total billed charges,75% of total billed charges,413.52,40,,,percent of total billed charges,40% of total billed charges,818.77,79.2,,,percent of total billed charges,79.2% of total billed charges,878.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,982.11,95,,,percent of total billed charges,95% of total billed charges,827.04,80,,,percent of total billed charges,80% of total billed charges,878.73,85,,,percent of total billed charges,85% of total billed charges,930.42,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,413.52,40,,,percent of total billed charges,40% of total billed charges,413.52,40,,,percent of total billed charges,40% of total billed charges,930.42,90,,,percent of total billed charges,90% of total billed charges,785.69,76,,,percent of total billed charges,76% of total billed charges,413.52,40,,,percent of total billed charges,40% of total billed charges,878.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,827.04,80,,,percent of total billed charges,80% of total billed charges,401.11,38.8,,,percent of total billed charges,38.8% of total billed charges,878.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,982.11,
62284 - Injection Procedure For Myelography,60000693,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,1430.4,1144.32,,1072.8,75,,,percent of total billed charges,75% of total billed charges,572.16,40,,,percent of total billed charges,40% of total billed charges,1132.88,79.2,,,percent of total billed charges,79.2% of total billed charges,1215.84,85,,,percent of total billed charges,85% of total billed charges,1430.4,100,,,fee schedule,100% of CO APG rates,1358.88,95,,,percent of total billed charges,95% of total billed charges,1144.32,80,,,percent of total billed charges,80% of total billed charges,1215.84,85,,,percent of total billed charges,85% of total billed charges,1287.36,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1430.4,100,,,fee schedule,100% of NM APC rate,572.16,40,,,percent of total billed charges,40% of total billed charges,572.16,40,,,percent of total billed charges,40% of total billed charges,1287.36,90,,,percent of total billed charges,90% of total billed charges,1087.1,76,,,percent of total billed charges,76% of total billed charges,572.16,40,,,percent of total billed charges,40% of total billed charges,1215.84,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1144.32,80,,,percent of total billed charges,80% of total billed charges,555,38.8,,,percent of total billed charges,38.8% of total billed charges,1215.84,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
Voriconazole LC,40000353,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,559.5,447.6,,419.63,75,,,percent of total billed charges,75% of total billed charges,223.8,40,,,percent of total billed charges,40% of total billed charges,443.12,79.2,,,percent of total billed charges,79.2% of total billed charges,475.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,531.53,95,,,percent of total billed charges,95% of total billed charges,447.6,80,,,percent of total billed charges,80% of total billed charges,475.58,85,,,percent of total billed charges,85% of total billed charges,503.55,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,223.8,40,,,percent of total billed charges,40% of total billed charges,223.8,40,,,percent of total billed charges,40% of total billed charges,503.55,90,,,percent of total billed charges,90% of total billed charges,425.22,76,,,percent of total billed charges,76% of total billed charges,223.8,40,,,percent of total billed charges,40% of total billed charges,475.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,447.6,80,,,percent of total billed charges,80% of total billed charges,217.09,38.8,,,percent of total billed charges,38.8% of total billed charges,475.58,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,531.53,
Cholesterol Body Fluid,40082465,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Triglycerides Body Fluid,40083986,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Amylase Body Fluid 1,40082150,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
Reticulocyte Count w/ Ret-HeIRF,40085046,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,76.6,61.28,,57.45,75,,,percent of total billed charges,75% of total billed charges,30.64,40,,,percent of total billed charges,40% of total billed charges,60.67,79.2,,,percent of total billed charges,79.2% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,72.77,95,,,percent of total billed charges,95% of total billed charges,61.28,80,,,percent of total billed charges,80% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,68.94,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,30.64,40,,,percent of total billed charges,40% of total billed charges,30.64,40,,,percent of total billed charges,40% of total billed charges,68.94,90,,,percent of total billed charges,90% of total billed charges,58.22,76,,,percent of total billed charges,76% of total billed charges,30.64,40,,,percent of total billed charges,40% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,61.28,80,,,percent of total billed charges,80% of total billed charges,29.72,38.8,,,percent of total billed charges,38.8% of total billed charges,65.11,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,72.77,
PEG-24-S-PULL ENTERNAL FEEDING TUBE,46052420,CDM,270,RC,,,OUTPATIENT,,,642.5,514,,481.88,75,,,percent of total billed charges,75% of total billed charges,257,40,,,percent of total billed charges,40% of total billed charges,508.86,79.2,,,percent of total billed charges,79.2% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,642.5,100,,,fee schedule,100% of CO APG rates,610.38,95,,,percent of total billed charges,95% of total billed charges,514,80,,,percent of total billed charges,80% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,578.25,90,,,percent of total billed charges,90% of total billed charges,642.5,100,,,fee schedule,100% of CO APG rates,642.5,100,,,fee schedule,100% of CO APG rates,642.5,100,,,fee schedule,100% of NM fee schedule,257,40,,,percent of total billed charges,40% of total billed charges,257,40,,,percent of total billed charges,40% of total billed charges,578.25,90,,,percent of total billed charges,90% of total billed charges,488.3,76,,,percent of total billed charges,76% of total billed charges,257,40,,,percent of total billed charges,40% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,642.5,100,,,fee schedule,100% of CO APG rate,514,80,,,percent of total billed charges,80% of total billed charges,249.29,38.8,,,percent of total billed charges,38.8% of total billed charges,546.13,85,,,percent of total billed charges,85% of total billed charges,642.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,249.29,642.5,
CBC w/ Auto Diff 9,40085025,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,103.2,82.56,,77.4,75,,,percent of total billed charges,75% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,81.73,79.2,,,percent of total billed charges,79.2% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,98.04,95,,,percent of total billed charges,95% of total billed charges,82.56,80,,,percent of total billed charges,80% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,41.28,40,,,percent of total billed charges,40% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,78.43,76,,,percent of total billed charges,76% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,82.56,80,,,percent of total billed charges,80% of total billed charges,40.04,38.8,,,percent of total billed charges,38.8% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,98.04,
UA with Reflex to Microscopic,40081003,CDM,307,RC,81002,HCPCS,OUTPATIENT,,,40.3,32.24,,30.23,75,,,percent of total billed charges,75% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,31.92,79.2,,,percent of total billed charges,79.2% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,38.29,95,,,percent of total billed charges,95% of total billed charges,32.24,80,,,percent of total billed charges,80% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,3.61,100,,,fee schedule,100% of CO APG rates,3.27,100,,,fee schedule,100% of NM fee schedule,16.12,40,,,percent of total billed charges,40% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,30.63,76,,,percent of total billed charges,76% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rate,32.24,80,,,percent of total billed charges,80% of total billed charges,15.64,38.8,,,percent of total billed charges,38.8% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of APG fee schedule,6.96,200,,,fee schedule,200% of CMS fee schedule,3.27,38.29,
"1 LITER HYPERINLFATION SYSTEM, INFANT MANOMETER",52422,CDM,270,RC,,,OUTPATIENT,,,63.4,50.72,,47.55,75,,,percent of total billed charges,75% of total billed charges,25.36,40,,,percent of total billed charges,40% of total billed charges,50.21,79.2,,,percent of total billed charges,79.2% of total billed charges,53.89,85,,,percent of total billed charges,85% of total billed charges,63.4,100,,,fee schedule,100% of CO APG rates,60.23,95,,,percent of total billed charges,95% of total billed charges,50.72,80,,,percent of total billed charges,80% of total billed charges,53.89,85,,,percent of total billed charges,85% of total billed charges,57.06,90,,,percent of total billed charges,90% of total billed charges,63.4,100,,,fee schedule,100% of CO APG rates,63.4,100,,,fee schedule,100% of CO APG rates,63.4,100,,,fee schedule,100% of NM fee schedule,25.36,40,,,percent of total billed charges,40% of total billed charges,25.36,40,,,percent of total billed charges,40% of total billed charges,57.06,90,,,percent of total billed charges,90% of total billed charges,48.18,76,,,percent of total billed charges,76% of total billed charges,25.36,40,,,percent of total billed charges,40% of total billed charges,53.89,85,,,percent of total billed charges,85% of total billed charges,63.4,100,,,fee schedule,100% of CO APG rate,50.72,80,,,percent of total billed charges,80% of total billed charges,24.6,38.8,,,percent of total billed charges,38.8% of total billed charges,53.89,85,,,percent of total billed charges,85% of total billed charges,63.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,24.6,63.4,
"76645 Ultrasound, Breast",41276641,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,413.6,330.88,RT,310.2,75,,,percent of total billed charges,75% of total billed charges,165.44,40,,,percent of total billed charges,40% of total billed charges,327.57,79.2,,,percent of total billed charges,79.2% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,392.92,95,,,percent of total billed charges,95% of total billed charges,330.88,80,,,percent of total billed charges,80% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,372.24,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,165.44,40,,,percent of total billed charges,40% of total billed charges,165.44,40,,,percent of total billed charges,40% of total billed charges,372.24,90,,,percent of total billed charges,90% of total billed charges,314.34,76,,,percent of total billed charges,76% of total billed charges,165.44,40,,,percent of total billed charges,40% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,330.88,80,,,percent of total billed charges,80% of total billed charges,160.48,38.8,,,percent of total billed charges,38.8% of total billed charges,351.56,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,392.92,
"STRYKER DBM BONE MATRIX PUTTY, 2.5CC",460ECON0180,CDM,278,RC,,,OUTPATIENT,,,1877.1,1501.68,,1407.83,75,,,percent of total billed charges,75% of total billed charges,750.84,40,,,percent of total billed charges,40% of total billed charges,1486.66,79.2,,,percent of total billed charges,79.2% of total billed charges,1595.54,85,,,percent of total billed charges,85% of total billed charges,1877.1,100,,,fee schedule,100% of CO APG rates,1783.25,95,,,percent of total billed charges,95% of total billed charges,1501.68,80,,,percent of total billed charges,80% of total billed charges,1595.54,85,,,percent of total billed charges,85% of total billed charges,1689.39,90,,,percent of total billed charges,90% of total billed charges,1877.1,100,,,fee schedule,100% of CO APG rates,1877.1,100,,,fee schedule,100% of CO APG rates,1877.1,100,,,fee schedule,100% of NM fee schedule,750.84,40,,,percent of total billed charges,40% of total billed charges,750.84,40,,,percent of total billed charges,40% of total billed charges,1689.39,90,,,percent of total billed charges,90% of total billed charges,1426.6,76,,,percent of total billed charges,76% of total billed charges,750.84,40,,,percent of total billed charges,40% of total billed charges,1595.54,85,,,percent of total billed charges,85% of total billed charges,1877.1,100,,,fee schedule,100% of CO APG rate,1501.68,80,,,percent of total billed charges,80% of total billed charges,728.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1595.54,85,,,percent of total billed charges,85% of total billed charges,1877.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,728.31,1877.1,
"ANTI-EMBOLISM STOCKING,  THIGH 2 XL REGULAR",52871,CDM,270,RC,,,OUTPATIENT,,,92.8,74.24,,69.6,75,,,percent of total billed charges,75% of total billed charges,37.12,40,,,percent of total billed charges,40% of total billed charges,73.5,79.2,,,percent of total billed charges,79.2% of total billed charges,78.88,85,,,percent of total billed charges,85% of total billed charges,92.8,100,,,fee schedule,100% of CO APG rates,88.16,95,,,percent of total billed charges,95% of total billed charges,74.24,80,,,percent of total billed charges,80% of total billed charges,78.88,85,,,percent of total billed charges,85% of total billed charges,83.52,90,,,percent of total billed charges,90% of total billed charges,92.8,100,,,fee schedule,100% of CO APG rates,92.8,100,,,fee schedule,100% of CO APG rates,92.8,100,,,fee schedule,100% of NM fee schedule,37.12,40,,,percent of total billed charges,40% of total billed charges,37.12,40,,,percent of total billed charges,40% of total billed charges,83.52,90,,,percent of total billed charges,90% of total billed charges,70.53,76,,,percent of total billed charges,76% of total billed charges,37.12,40,,,percent of total billed charges,40% of total billed charges,78.88,85,,,percent of total billed charges,85% of total billed charges,92.8,100,,,fee schedule,100% of CO APG rate,74.24,80,,,percent of total billed charges,80% of total billed charges,36.01,38.8,,,percent of total billed charges,38.8% of total billed charges,78.88,85,,,percent of total billed charges,85% of total billed charges,92.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,36.01,92.8,
SHOULDER SUSPENSION KIT,46052434,CDM,270,RC,,,OUTPATIENT,,,155.2,124.16,,116.4,75,,,percent of total billed charges,75% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,122.92,79.2,,,percent of total billed charges,79.2% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rates,147.44,95,,,percent of total billed charges,95% of total billed charges,124.16,80,,,percent of total billed charges,80% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rates,155.2,100,,,fee schedule,100% of CO APG rates,155.2,100,,,fee schedule,100% of NM fee schedule,62.08,40,,,percent of total billed charges,40% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,117.95,76,,,percent of total billed charges,76% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rate,124.16,80,,,percent of total billed charges,80% of total billed charges,60.22,38.8,,,percent of total billed charges,38.8% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,60.22,155.2,
27840 - CL TX OF ANKLE DISLOCATION W/O ANESTHESIA,46027840,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
"62328 -Spinal puncture, lumbar, diagnostic; with fluor or CT",60000686,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2120.9,1696.72,,1590.68,75,,,percent of total billed charges,75% of total billed charges,848.36,40,,,percent of total billed charges,40% of total billed charges,1679.75,79.2,,,percent of total billed charges,79.2% of total billed charges,1802.77,85,,,percent of total billed charges,85% of total billed charges,2120.9,100,,,fee schedule,100% of CO APG rates,2014.86,95,,,percent of total billed charges,95% of total billed charges,1696.72,80,,,percent of total billed charges,80% of total billed charges,1802.77,85,,,percent of total billed charges,85% of total billed charges,1908.81,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,848.36,40,,,percent of total billed charges,40% of total billed charges,848.36,40,,,percent of total billed charges,40% of total billed charges,1908.81,90,,,percent of total billed charges,90% of total billed charges,1611.88,76,,,percent of total billed charges,76% of total billed charges,848.36,40,,,percent of total billed charges,40% of total billed charges,1802.77,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1696.72,80,,,percent of total billed charges,80% of total billed charges,822.91,38.8,,,percent of total billed charges,38.8% of total billed charges,1802.77,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
"ULTRASOUND PROBE COVER KIT, PORTABLE US",52435,CDM,270,RC,,,OUTPATIENT,,,47.1,37.68,,35.33,75,,,percent of total billed charges,75% of total billed charges,18.84,40,,,percent of total billed charges,40% of total billed charges,37.3,79.2,,,percent of total billed charges,79.2% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,47.1,100,,,fee schedule,100% of CO APG rates,44.75,95,,,percent of total billed charges,95% of total billed charges,37.68,80,,,percent of total billed charges,80% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,42.39,90,,,percent of total billed charges,90% of total billed charges,47.1,100,,,fee schedule,100% of CO APG rates,47.1,100,,,fee schedule,100% of CO APG rates,47.1,100,,,fee schedule,100% of NM fee schedule,18.84,40,,,percent of total billed charges,40% of total billed charges,18.84,40,,,percent of total billed charges,40% of total billed charges,42.39,90,,,percent of total billed charges,90% of total billed charges,35.8,76,,,percent of total billed charges,76% of total billed charges,18.84,40,,,percent of total billed charges,40% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,47.1,100,,,fee schedule,100% of CO APG rate,37.68,80,,,percent of total billed charges,80% of total billed charges,18.27,38.8,,,percent of total billed charges,38.8% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,47.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.27,47.1,
Immunoglobulins A/G/M,40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,91.2,72.96,,68.4,75,,,percent of total billed charges,75% of total billed charges,36.48,40,,,percent of total billed charges,40% of total billed charges,72.23,79.2,,,percent of total billed charges,79.2% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,86.64,95,,,percent of total billed charges,95% of total billed charges,72.96,80,,,percent of total billed charges,80% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,82.08,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,36.48,40,,,percent of total billed charges,40% of total billed charges,36.48,40,,,percent of total billed charges,40% of total billed charges,82.08,90,,,percent of total billed charges,90% of total billed charges,69.31,76,,,percent of total billed charges,76% of total billed charges,36.48,40,,,percent of total billed charges,40% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,72.96,80,,,percent of total billed charges,80% of total billed charges,35.39,38.8,,,percent of total billed charges,38.8% of total billed charges,77.52,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,86.64,
Immunoglobulins A/G/M,40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,101,80.8,,75.75,75,,,percent of total billed charges,75% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,79.99,79.2,,,percent of total billed charges,79.2% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,95.95,95,,,percent of total billed charges,95% of total billed charges,80.8,80,,,percent of total billed charges,80% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,40.4,40,,,percent of total billed charges,40% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,76.76,76,,,percent of total billed charges,76% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,80.8,80,,,percent of total billed charges,80% of total billed charges,39.19,38.8,,,percent of total billed charges,38.8% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,95.95,
FEMORAL CANAL BRUSH,46052436,CDM,270,RC,,,OUTPATIENT,,,52.5,42,,39.38,75,,,percent of total billed charges,75% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,41.58,79.2,,,percent of total billed charges,79.2% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rates,49.88,95,,,percent of total billed charges,95% of total billed charges,42,80,,,percent of total billed charges,80% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,47.25,90,,,percent of total billed charges,90% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rates,52.5,100,,,fee schedule,100% of CO APG rates,52.5,100,,,fee schedule,100% of NM fee schedule,21,40,,,percent of total billed charges,40% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,47.25,90,,,percent of total billed charges,90% of total billed charges,39.9,76,,,percent of total billed charges,76% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rate,42,80,,,percent of total billed charges,80% of total billed charges,20.37,38.8,,,percent of total billed charges,38.8% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,20.37,52.5,
28510 Closed treatment of FX phalanx or phalanges,60000069,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,725.9,580.72,,544.43,75,,,percent of total billed charges,75% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,574.91,79.2,,,percent of total billed charges,79.2% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,689.61,95,,,percent of total billed charges,95% of total billed charges,580.72,80,,,percent of total billed charges,80% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,290.36,40,,,percent of total billed charges,40% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,653.31,90,,,percent of total billed charges,90% of total billed charges,551.68,76,,,percent of total billed charges,76% of total billed charges,290.36,40,,,percent of total billed charges,40% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,580.72,80,,,percent of total billed charges,80% of total billed charges,281.65,38.8,,,percent of total billed charges,38.8% of total billed charges,617.02,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,689.61,
"FORCE FIBER #2, 38 STRAND, W/O NEEDLE",46052437,CDM,270,RC,,,OUTPATIENT,,,68.9,55.12,,51.68,75,,,percent of total billed charges,75% of total billed charges,27.56,40,,,percent of total billed charges,40% of total billed charges,54.57,79.2,,,percent of total billed charges,79.2% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,68.9,100,,,fee schedule,100% of CO APG rates,65.46,95,,,percent of total billed charges,95% of total billed charges,55.12,80,,,percent of total billed charges,80% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,62.01,90,,,percent of total billed charges,90% of total billed charges,68.9,100,,,fee schedule,100% of CO APG rates,68.9,100,,,fee schedule,100% of CO APG rates,68.9,100,,,fee schedule,100% of NM fee schedule,27.56,40,,,percent of total billed charges,40% of total billed charges,27.56,40,,,percent of total billed charges,40% of total billed charges,62.01,90,,,percent of total billed charges,90% of total billed charges,52.36,76,,,percent of total billed charges,76% of total billed charges,27.56,40,,,percent of total billed charges,40% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,68.9,100,,,fee schedule,100% of CO APG rate,55.12,80,,,percent of total billed charges,80% of total billed charges,26.73,38.8,,,percent of total billed charges,38.8% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,68.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.73,68.9,
US Echo w/ Cont,60000179,CDM,483,RC,,,OUTPATIENT,,,2217.3,1773.84,TC,1662.98,75,,,percent of total billed charges,75% of total billed charges,886.92,40,,,percent of total billed charges,40% of total billed charges,1756.1,79.2,,,percent of total billed charges,79.2% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,2217.3,100,,,fee schedule,100% of CO APG rates,2106.44,95,,,percent of total billed charges,95% of total billed charges,1773.84,80,,,percent of total billed charges,80% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,1995.57,90,,,percent of total billed charges,90% of total billed charges,2217.3,100,,,fee schedule,100% of CO APG rates,2217.3,100,,,fee schedule,100% of CO APG rates,2217.3,100,,,fee schedule,100% of NM fee schedule,886.92,40,,,percent of total billed charges,40% of total billed charges,886.92,40,,,percent of total billed charges,40% of total billed charges,1995.57,90,,,percent of total billed charges,90% of total billed charges,1685.15,76,,,percent of total billed charges,76% of total billed charges,886.92,40,,,percent of total billed charges,40% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,2217.3,100,,,fee schedule,100% of CO APG rate,1773.84,80,,,percent of total billed charges,80% of total billed charges,860.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,2217.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,860.31,2217.3,
"Vitamin B2, Whole Blood",40084252,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,233.7,186.96,,175.28,75,,,percent of total billed charges,75% of total billed charges,93.48,40,,,percent of total billed charges,40% of total billed charges,185.09,79.2,,,percent of total billed charges,79.2% of total billed charges,198.65,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,222.02,95,,,percent of total billed charges,95% of total billed charges,186.96,80,,,percent of total billed charges,80% of total billed charges,198.65,85,,,percent of total billed charges,85% of total billed charges,210.33,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,93.48,40,,,percent of total billed charges,40% of total billed charges,93.48,40,,,percent of total billed charges,40% of total billed charges,210.33,90,,,percent of total billed charges,90% of total billed charges,177.61,76,,,percent of total billed charges,76% of total billed charges,93.48,40,,,percent of total billed charges,40% of total billed charges,198.65,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,186.96,80,,,percent of total billed charges,80% of total billed charges,90.68,38.8,,,percent of total billed charges,38.8% of total billed charges,198.65,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,222.02,
Vitamin B3 (Niacin+Metabolite) LC,40084591,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,482.7,386.16,,362.03,75,,,percent of total billed charges,75% of total billed charges,193.08,40,,,percent of total billed charges,40% of total billed charges,382.3,79.2,,,percent of total billed charges,79.2% of total billed charges,410.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,458.57,95,,,percent of total billed charges,95% of total billed charges,386.16,80,,,percent of total billed charges,80% of total billed charges,410.3,85,,,percent of total billed charges,85% of total billed charges,434.43,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,193.08,40,,,percent of total billed charges,40% of total billed charges,193.08,40,,,percent of total billed charges,40% of total billed charges,434.43,90,,,percent of total billed charges,90% of total billed charges,366.85,76,,,percent of total billed charges,76% of total billed charges,193.08,40,,,percent of total billed charges,40% of total billed charges,410.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,386.16,80,,,percent of total billed charges,80% of total billed charges,187.29,38.8,,,percent of total billed charges,38.8% of total billed charges,410.3,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,458.57,
"Calprotectin, Fecal LC",40083993,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,151.5,121.2,,113.63,75,,,percent of total billed charges,75% of total billed charges,60.6,40,,,percent of total billed charges,40% of total billed charges,119.99,79.2,,,percent of total billed charges,79.2% of total billed charges,128.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,143.93,95,,,percent of total billed charges,95% of total billed charges,121.2,80,,,percent of total billed charges,80% of total billed charges,128.78,85,,,percent of total billed charges,85% of total billed charges,136.35,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,60.6,40,,,percent of total billed charges,40% of total billed charges,60.6,40,,,percent of total billed charges,40% of total billed charges,136.35,90,,,percent of total billed charges,90% of total billed charges,115.14,76,,,percent of total billed charges,76% of total billed charges,60.6,40,,,percent of total billed charges,40% of total billed charges,128.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,121.2,80,,,percent of total billed charges,80% of total billed charges,58.78,38.8,,,percent of total billed charges,38.8% of total billed charges,128.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,143.93,
"BCR-ABL1, CML/ALL, PCR, Quant LC",40081206,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,656.9,525.52,,492.68,75,,,percent of total billed charges,75% of total billed charges,262.76,40,,,percent of total billed charges,40% of total billed charges,520.26,79.2,,,percent of total billed charges,79.2% of total billed charges,558.37,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,624.06,95,,,percent of total billed charges,95% of total billed charges,525.52,80,,,percent of total billed charges,80% of total billed charges,558.37,85,,,percent of total billed charges,85% of total billed charges,591.21,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,262.76,40,,,percent of total billed charges,40% of total billed charges,262.76,40,,,percent of total billed charges,40% of total billed charges,591.21,90,,,percent of total billed charges,90% of total billed charges,499.24,76,,,percent of total billed charges,76% of total billed charges,262.76,40,,,percent of total billed charges,40% of total billed charges,558.37,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,525.52,80,,,percent of total billed charges,80% of total billed charges,254.88,38.8,,,percent of total billed charges,38.8% of total billed charges,558.37,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,624.06,
Strep A Confirmation Culture,40087081,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,56.2,44.96,,42.15,75,,,percent of total billed charges,75% of total billed charges,22.48,40,,,percent of total billed charges,40% of total billed charges,44.51,79.2,,,percent of total billed charges,79.2% of total billed charges,47.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,53.39,95,,,percent of total billed charges,95% of total billed charges,44.96,80,,,percent of total billed charges,80% of total billed charges,47.77,85,,,percent of total billed charges,85% of total billed charges,50.58,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,22.48,40,,,percent of total billed charges,40% of total billed charges,22.48,40,,,percent of total billed charges,40% of total billed charges,50.58,90,,,percent of total billed charges,90% of total billed charges,42.71,76,,,percent of total billed charges,76% of total billed charges,22.48,40,,,percent of total billed charges,40% of total billed charges,47.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,44.96,80,,,percent of total billed charges,80% of total billed charges,21.81,38.8,,,percent of total billed charges,38.8% of total billed charges,47.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,53.39,
76641 US BREAST COMP BI-LAT,41576641,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,397.3,317.84,TC,297.98,75,,,percent of total billed charges,75% of total billed charges,158.92,40,,,percent of total billed charges,40% of total billed charges,314.66,79.2,,,percent of total billed charges,79.2% of total billed charges,337.71,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,377.44,95,,,percent of total billed charges,95% of total billed charges,317.84,80,,,percent of total billed charges,80% of total billed charges,337.71,85,,,percent of total billed charges,85% of total billed charges,357.57,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,158.92,40,,,percent of total billed charges,40% of total billed charges,158.92,40,,,percent of total billed charges,40% of total billed charges,357.57,90,,,percent of total billed charges,90% of total billed charges,301.95,76,,,percent of total billed charges,76% of total billed charges,158.92,40,,,percent of total billed charges,40% of total billed charges,337.71,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,317.84,80,,,percent of total billed charges,80% of total billed charges,154.15,38.8,,,percent of total billed charges,38.8% of total billed charges,337.71,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,377.44,
DUALOK LOCALIZATION WIRE,41252439,CDM,270,RC,,,OUTPATIENT,,,109.2,87.36,,81.9,75,,,percent of total billed charges,75% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,86.49,79.2,,,percent of total billed charges,79.2% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rates,103.74,95,,,percent of total billed charges,95% of total billed charges,87.36,80,,,percent of total billed charges,80% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rates,109.2,100,,,fee schedule,100% of CO APG rates,109.2,100,,,fee schedule,100% of NM fee schedule,43.68,40,,,percent of total billed charges,40% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,82.99,76,,,percent of total billed charges,76% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rate,87.36,80,,,percent of total billed charges,80% of total billed charges,42.37,38.8,,,percent of total billed charges,38.8% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,42.37,109.2,
"BREAST TISSUE MARKER, ULTRACLIP 17GX10CM",41252440,CDM,270,RC,,,OUTPATIENT,,,241.5,193.2,,181.13,75,,,percent of total billed charges,75% of total billed charges,96.6,40,,,percent of total billed charges,40% of total billed charges,191.27,79.2,,,percent of total billed charges,79.2% of total billed charges,205.28,85,,,percent of total billed charges,85% of total billed charges,241.5,100,,,fee schedule,100% of CO APG rates,229.43,95,,,percent of total billed charges,95% of total billed charges,193.2,80,,,percent of total billed charges,80% of total billed charges,205.28,85,,,percent of total billed charges,85% of total billed charges,217.35,90,,,percent of total billed charges,90% of total billed charges,241.5,100,,,fee schedule,100% of CO APG rates,241.5,100,,,fee schedule,100% of CO APG rates,241.5,100,,,fee schedule,100% of NM fee schedule,96.6,40,,,percent of total billed charges,40% of total billed charges,96.6,40,,,percent of total billed charges,40% of total billed charges,217.35,90,,,percent of total billed charges,90% of total billed charges,183.54,76,,,percent of total billed charges,76% of total billed charges,96.6,40,,,percent of total billed charges,40% of total billed charges,205.28,85,,,percent of total billed charges,85% of total billed charges,241.5,100,,,fee schedule,100% of CO APG rate,193.2,80,,,percent of total billed charges,80% of total billed charges,93.7,38.8,,,percent of total billed charges,38.8% of total billed charges,205.28,85,,,percent of total billed charges,85% of total billed charges,241.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,93.7,241.5,
TRU-GUIDE COAXIAL BIOPSY NEEDLE 13GX7.8CM,41252442,CDM,270,RC,,,OUTPATIENT,,,53.6,42.88,,40.2,75,,,percent of total billed charges,75% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,42.45,79.2,,,percent of total billed charges,79.2% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rates,50.92,95,,,percent of total billed charges,95% of total billed charges,42.88,80,,,percent of total billed charges,80% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,48.24,90,,,percent of total billed charges,90% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rates,53.6,100,,,fee schedule,100% of CO APG rates,53.6,100,,,fee schedule,100% of NM fee schedule,21.44,40,,,percent of total billed charges,40% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,48.24,90,,,percent of total billed charges,90% of total billed charges,40.74,76,,,percent of total billed charges,76% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rate,42.88,80,,,percent of total billed charges,80% of total billed charges,20.8,38.8,,,percent of total billed charges,38.8% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,20.8,53.6,
TENMO BIOPSY NEEDLE 20GX11CM,41252443,CDM,270,RC,,,OUTPATIENT,,,249.1,199.28,,186.83,75,,,percent of total billed charges,75% of total billed charges,99.64,40,,,percent of total billed charges,40% of total billed charges,197.29,79.2,,,percent of total billed charges,79.2% of total billed charges,211.74,85,,,percent of total billed charges,85% of total billed charges,249.1,100,,,fee schedule,100% of CO APG rates,236.65,95,,,percent of total billed charges,95% of total billed charges,199.28,80,,,percent of total billed charges,80% of total billed charges,211.74,85,,,percent of total billed charges,85% of total billed charges,224.19,90,,,percent of total billed charges,90% of total billed charges,249.1,100,,,fee schedule,100% of CO APG rates,249.1,100,,,fee schedule,100% of CO APG rates,249.1,100,,,fee schedule,100% of NM fee schedule,99.64,40,,,percent of total billed charges,40% of total billed charges,99.64,40,,,percent of total billed charges,40% of total billed charges,224.19,90,,,percent of total billed charges,90% of total billed charges,189.32,76,,,percent of total billed charges,76% of total billed charges,99.64,40,,,percent of total billed charges,40% of total billed charges,211.74,85,,,percent of total billed charges,85% of total billed charges,249.1,100,,,fee schedule,100% of CO APG rate,199.28,80,,,percent of total billed charges,80% of total billed charges,96.65,38.8,,,percent of total billed charges,38.8% of total billed charges,211.74,85,,,percent of total billed charges,85% of total billed charges,249.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,96.65,249.1,
"BREAST TISSUE MARKER, COIL SHAPE 17GX12CM",41252444,CDM,270,RC,,,OUTPATIENT,,,321.1,256.88,,240.83,75,,,percent of total billed charges,75% of total billed charges,128.44,40,,,percent of total billed charges,40% of total billed charges,254.31,79.2,,,percent of total billed charges,79.2% of total billed charges,272.94,85,,,percent of total billed charges,85% of total billed charges,321.1,100,,,fee schedule,100% of CO APG rates,305.05,95,,,percent of total billed charges,95% of total billed charges,256.88,80,,,percent of total billed charges,80% of total billed charges,272.94,85,,,percent of total billed charges,85% of total billed charges,288.99,90,,,percent of total billed charges,90% of total billed charges,321.1,100,,,fee schedule,100% of CO APG rates,321.1,100,,,fee schedule,100% of CO APG rates,321.1,100,,,fee schedule,100% of NM fee schedule,128.44,40,,,percent of total billed charges,40% of total billed charges,128.44,40,,,percent of total billed charges,40% of total billed charges,288.99,90,,,percent of total billed charges,90% of total billed charges,244.04,76,,,percent of total billed charges,76% of total billed charges,128.44,40,,,percent of total billed charges,40% of total billed charges,272.94,85,,,percent of total billed charges,85% of total billed charges,321.1,100,,,fee schedule,100% of CO APG rate,256.88,80,,,percent of total billed charges,80% of total billed charges,124.59,38.8,,,percent of total billed charges,38.8% of total billed charges,272.94,85,,,percent of total billed charges,85% of total billed charges,321.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,124.59,321.1,
MRSA Screening Culture LC,40087081,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,32.5,26,,24.38,75,,,percent of total billed charges,75% of total billed charges,13,40,,,percent of total billed charges,40% of total billed charges,25.74,79.2,,,percent of total billed charges,79.2% of total billed charges,27.63,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,30.88,95,,,percent of total billed charges,95% of total billed charges,26,80,,,percent of total billed charges,80% of total billed charges,27.63,85,,,percent of total billed charges,85% of total billed charges,29.25,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,13,40,,,percent of total billed charges,40% of total billed charges,13,40,,,percent of total billed charges,40% of total billed charges,29.25,90,,,percent of total billed charges,90% of total billed charges,24.7,76,,,percent of total billed charges,76% of total billed charges,13,40,,,percent of total billed charges,40% of total billed charges,27.63,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,26,80,,,percent of total billed charges,80% of total billed charges,12.61,38.8,,,percent of total billed charges,38.8% of total billed charges,27.63,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,33.1,
"TRANSPEC SPECIMEN DEVICE, SOLID COMPRESSION PLATE",46052445,CDM,270,RC,,,OUTPATIENT,,,78.8,63.04,,59.1,75,,,percent of total billed charges,75% of total billed charges,31.52,40,,,percent of total billed charges,40% of total billed charges,62.41,79.2,,,percent of total billed charges,79.2% of total billed charges,66.98,85,,,percent of total billed charges,85% of total billed charges,78.8,100,,,fee schedule,100% of CO APG rates,74.86,95,,,percent of total billed charges,95% of total billed charges,63.04,80,,,percent of total billed charges,80% of total billed charges,66.98,85,,,percent of total billed charges,85% of total billed charges,70.92,90,,,percent of total billed charges,90% of total billed charges,78.8,100,,,fee schedule,100% of CO APG rates,78.8,100,,,fee schedule,100% of CO APG rates,78.8,100,,,fee schedule,100% of NM fee schedule,31.52,40,,,percent of total billed charges,40% of total billed charges,31.52,40,,,percent of total billed charges,40% of total billed charges,70.92,90,,,percent of total billed charges,90% of total billed charges,59.89,76,,,percent of total billed charges,76% of total billed charges,31.52,40,,,percent of total billed charges,40% of total billed charges,66.98,85,,,percent of total billed charges,85% of total billed charges,78.8,100,,,fee schedule,100% of CO APG rate,63.04,80,,,percent of total billed charges,80% of total billed charges,30.57,38.8,,,percent of total billed charges,38.8% of total billed charges,66.98,85,,,percent of total billed charges,85% of total billed charges,78.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,30.57,78.8,
69000 DRAIN EXTERNAL EAR LESION,31069000,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,385.8,308.64,,289.35,75,,,percent of total billed charges,75% of total billed charges,154.32,40,,,percent of total billed charges,40% of total billed charges,305.55,79.2,,,percent of total billed charges,79.2% of total billed charges,327.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,366.51,95,,,percent of total billed charges,95% of total billed charges,308.64,80,,,percent of total billed charges,80% of total billed charges,327.93,85,,,percent of total billed charges,85% of total billed charges,347.22,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,154.32,40,,,percent of total billed charges,40% of total billed charges,154.32,40,,,percent of total billed charges,40% of total billed charges,347.22,90,,,percent of total billed charges,90% of total billed charges,293.21,76,,,percent of total billed charges,76% of total billed charges,154.32,40,,,percent of total billed charges,40% of total billed charges,327.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,308.64,80,,,percent of total billed charges,80% of total billed charges,149.69,38.8,,,percent of total billed charges,38.8% of total billed charges,327.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,149.69,366.51,
51720 BLADDER INSTILLATION ANTICARCINOGENIC AGENT,60000193,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,818.2,654.56,,613.65,75,,,percent of total billed charges,75% of total billed charges,327.28,40,,,percent of total billed charges,40% of total billed charges,648.01,79.2,,,percent of total billed charges,79.2% of total billed charges,695.47,85,,,percent of total billed charges,85% of total billed charges,818.2,100,,,fee schedule,100% of CO APG rates,777.29,95,,,percent of total billed charges,95% of total billed charges,654.56,80,,,percent of total billed charges,80% of total billed charges,695.47,85,,,percent of total billed charges,85% of total billed charges,736.38,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,818.2,100,,,fee schedule,100% of NM APC rate,327.28,40,,,percent of total billed charges,40% of total billed charges,327.28,40,,,percent of total billed charges,40% of total billed charges,736.38,90,,,percent of total billed charges,90% of total billed charges,621.83,76,,,percent of total billed charges,76% of total billed charges,327.28,40,,,percent of total billed charges,40% of total billed charges,695.47,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,654.56,80,,,percent of total billed charges,80% of total billed charges,317.46,38.8,,,percent of total billed charges,38.8% of total billed charges,695.47,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,317.46,2713.28,
"FORCE FIBER #2  W/B CO-BRAID, 1/2 CIRCLE TAPER",46052447,CDM,270,RC,,,OUTPATIENT,,,68.9,55.12,,51.68,75,,,percent of total billed charges,75% of total billed charges,27.56,40,,,percent of total billed charges,40% of total billed charges,54.57,79.2,,,percent of total billed charges,79.2% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,68.9,100,,,fee schedule,100% of CO APG rates,65.46,95,,,percent of total billed charges,95% of total billed charges,55.12,80,,,percent of total billed charges,80% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,62.01,90,,,percent of total billed charges,90% of total billed charges,68.9,100,,,fee schedule,100% of CO APG rates,68.9,100,,,fee schedule,100% of CO APG rates,68.9,100,,,fee schedule,100% of NM fee schedule,27.56,40,,,percent of total billed charges,40% of total billed charges,27.56,40,,,percent of total billed charges,40% of total billed charges,62.01,90,,,percent of total billed charges,90% of total billed charges,52.36,76,,,percent of total billed charges,76% of total billed charges,27.56,40,,,percent of total billed charges,40% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,68.9,100,,,fee schedule,100% of CO APG rate,55.12,80,,,percent of total billed charges,80% of total billed charges,26.73,38.8,,,percent of total billed charges,38.8% of total billed charges,58.57,85,,,percent of total billed charges,85% of total billed charges,68.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.73,68.9,
"Chemo Admin, each add, Patient Supplied Medication",60000781,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,317.3,253.84,,237.98,75,,,percent of total billed charges,75% of total billed charges,126.92,40,,,percent of total billed charges,40% of total billed charges,251.3,79.2,,,percent of total billed charges,79.2% of total billed charges,269.71,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,301.44,95,,,percent of total billed charges,95% of total billed charges,253.84,80,,,percent of total billed charges,80% of total billed charges,269.71,85,,,percent of total billed charges,85% of total billed charges,285.57,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,126.92,40,,,percent of total billed charges,40% of total billed charges,126.92,40,,,percent of total billed charges,40% of total billed charges,285.57,90,,,percent of total billed charges,90% of total billed charges,241.15,76,,,percent of total billed charges,76% of total billed charges,126.92,40,,,percent of total billed charges,40% of total billed charges,269.71,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,253.84,80,,,percent of total billed charges,80% of total billed charges,123.11,38.8,,,percent of total billed charges,38.8% of total billed charges,269.71,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,301.44,
TAMPONADE ANTERIOR/POSTERIOR 7.5cm  (RAPID RHINO BALLOON),31052454,CDM,270,RC,,,OUTPATIENT,,,168.2,134.56,,126.15,75,,,percent of total billed charges,75% of total billed charges,67.28,40,,,percent of total billed charges,40% of total billed charges,133.21,79.2,,,percent of total billed charges,79.2% of total billed charges,142.97,85,,,percent of total billed charges,85% of total billed charges,168.2,100,,,fee schedule,100% of CO APG rates,159.79,95,,,percent of total billed charges,95% of total billed charges,134.56,80,,,percent of total billed charges,80% of total billed charges,142.97,85,,,percent of total billed charges,85% of total billed charges,151.38,90,,,percent of total billed charges,90% of total billed charges,168.2,100,,,fee schedule,100% of CO APG rates,168.2,100,,,fee schedule,100% of CO APG rates,168.2,100,,,fee schedule,100% of NM fee schedule,67.28,40,,,percent of total billed charges,40% of total billed charges,67.28,40,,,percent of total billed charges,40% of total billed charges,151.38,90,,,percent of total billed charges,90% of total billed charges,127.83,76,,,percent of total billed charges,76% of total billed charges,67.28,40,,,percent of total billed charges,40% of total billed charges,142.97,85,,,percent of total billed charges,85% of total billed charges,168.2,100,,,fee schedule,100% of CO APG rate,134.56,80,,,percent of total billed charges,80% of total billed charges,65.26,38.8,,,percent of total billed charges,38.8% of total billed charges,142.97,85,,,percent of total billed charges,85% of total billed charges,168.2,100,,,fee schedule,100% of APG fee schedule,336.4,200,,,percent of total billed charges,200% of total billed charges,65.26,336.4,
TAMPONADE 4.5CM ANTERIOR (RAPID RHINO BALLOON),31052455,CDM,270,RC,,,OUTPATIENT,,,162.8,130.24,,122.1,75,,,percent of total billed charges,75% of total billed charges,65.12,40,,,percent of total billed charges,40% of total billed charges,128.94,79.2,,,percent of total billed charges,79.2% of total billed charges,138.38,85,,,percent of total billed charges,85% of total billed charges,162.8,100,,,fee schedule,100% of CO APG rates,154.66,95,,,percent of total billed charges,95% of total billed charges,130.24,80,,,percent of total billed charges,80% of total billed charges,138.38,85,,,percent of total billed charges,85% of total billed charges,146.52,90,,,percent of total billed charges,90% of total billed charges,162.8,100,,,fee schedule,100% of CO APG rates,162.8,100,,,fee schedule,100% of CO APG rates,162.8,100,,,fee schedule,100% of NM fee schedule,65.12,40,,,percent of total billed charges,40% of total billed charges,65.12,40,,,percent of total billed charges,40% of total billed charges,146.52,90,,,percent of total billed charges,90% of total billed charges,123.73,76,,,percent of total billed charges,76% of total billed charges,65.12,40,,,percent of total billed charges,40% of total billed charges,138.38,85,,,percent of total billed charges,85% of total billed charges,162.8,100,,,fee schedule,100% of CO APG rate,130.24,80,,,percent of total billed charges,80% of total billed charges,63.17,38.8,,,percent of total billed charges,38.8% of total billed charges,138.38,85,,,percent of total billed charges,85% of total billed charges,162.8,100,,,fee schedule,100% of APG fee schedule,325.6,200,,,percent of total billed charges,200% of total billed charges,63.17,325.6,
90685 INS Fluzone Quadrivalent Influenza Vaccine - 6-35 mos,49190685,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,34.3,27.44,,25.73,75,,,percent of total billed charges,75% of total billed charges,13.72,40,,,percent of total billed charges,40% of total billed charges,27.17,79.2,,,percent of total billed charges,79.2% of total billed charges,29.16,85,,,percent of total billed charges,85% of total billed charges,34.3,100,,,fee schedule,100% of CO APG rates,32.59,95,,,percent of total billed charges,95% of total billed charges,27.44,80,,,percent of total billed charges,80% of total billed charges,29.16,85,,,percent of total billed charges,85% of total billed charges,30.87,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,34.3,100,,,fee schedule,100% of NM fee schedule,13.72,40,,,percent of total billed charges,40% of total billed charges,13.72,40,,,percent of total billed charges,40% of total billed charges,30.87,90,,,percent of total billed charges,90% of total billed charges,26.07,76,,,percent of total billed charges,76% of total billed charges,13.72,40,,,percent of total billed charges,40% of total billed charges,29.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,27.44,80,,,percent of total billed charges,80% of total billed charges,13.31,38.8,,,percent of total billed charges,38.8% of total billed charges,29.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,13.31,35.65,
"VOLUMEN LHV CONTRAST MEDIA, 0.1% BARIUM SULFATE, 450ML",41352550,CDM,255,RC,,,OUTPATIENT,,,52.5,42,,39.38,75,,,percent of total billed charges,75% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,41.58,79.2,,,percent of total billed charges,79.2% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rates,49.88,95,,,percent of total billed charges,95% of total billed charges,42,80,,,percent of total billed charges,80% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,47.25,90,,,percent of total billed charges,90% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rates,52.5,100,,,fee schedule,100% of CO APG rates,52.5,100,,,fee schedule,100% of NM fee schedule,21,40,,,percent of total billed charges,40% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,47.25,90,,,percent of total billed charges,90% of total billed charges,39.9,76,,,percent of total billed charges,76% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rate,42,80,,,percent of total billed charges,80% of total billed charges,20.37,38.8,,,percent of total billed charges,38.8% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,20.37,52.5,
TRIATHLON 1/8'' DRILL BIT,46052463,CDM,270,RC,,,OUTPATIENT,,,292.8,234.24,,219.6,75,,,percent of total billed charges,75% of total billed charges,117.12,40,,,percent of total billed charges,40% of total billed charges,231.9,79.2,,,percent of total billed charges,79.2% of total billed charges,248.88,85,,,percent of total billed charges,85% of total billed charges,292.8,100,,,fee schedule,100% of CO APG rates,278.16,95,,,percent of total billed charges,95% of total billed charges,234.24,80,,,percent of total billed charges,80% of total billed charges,248.88,85,,,percent of total billed charges,85% of total billed charges,263.52,90,,,percent of total billed charges,90% of total billed charges,292.8,100,,,fee schedule,100% of CO APG rates,292.8,100,,,fee schedule,100% of CO APG rates,292.8,100,,,fee schedule,100% of NM fee schedule,117.12,40,,,percent of total billed charges,40% of total billed charges,117.12,40,,,percent of total billed charges,40% of total billed charges,263.52,90,,,percent of total billed charges,90% of total billed charges,222.53,76,,,percent of total billed charges,76% of total billed charges,117.12,40,,,percent of total billed charges,40% of total billed charges,248.88,85,,,percent of total billed charges,85% of total billed charges,292.8,100,,,fee schedule,100% of CO APG rate,234.24,80,,,percent of total billed charges,80% of total billed charges,113.61,38.8,,,percent of total billed charges,38.8% of total billed charges,248.88,85,,,percent of total billed charges,85% of total billed charges,292.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,113.61,292.8,
"GALACTOGRAPHY KIT, 30G W/ CURVED CANNULA",41252466,CDM,270,RC,,,OUTPATIENT,,,124.5,99.6,,93.38,75,,,percent of total billed charges,75% of total billed charges,49.8,40,,,percent of total billed charges,40% of total billed charges,98.6,79.2,,,percent of total billed charges,79.2% of total billed charges,105.83,85,,,percent of total billed charges,85% of total billed charges,124.5,100,,,fee schedule,100% of CO APG rates,118.28,95,,,percent of total billed charges,95% of total billed charges,99.6,80,,,percent of total billed charges,80% of total billed charges,105.83,85,,,percent of total billed charges,85% of total billed charges,112.05,90,,,percent of total billed charges,90% of total billed charges,124.5,100,,,fee schedule,100% of CO APG rates,124.5,100,,,fee schedule,100% of CO APG rates,124.5,100,,,fee schedule,100% of NM fee schedule,49.8,40,,,percent of total billed charges,40% of total billed charges,49.8,40,,,percent of total billed charges,40% of total billed charges,112.05,90,,,percent of total billed charges,90% of total billed charges,94.62,76,,,percent of total billed charges,76% of total billed charges,49.8,40,,,percent of total billed charges,40% of total billed charges,105.83,85,,,percent of total billed charges,85% of total billed charges,124.5,100,,,fee schedule,100% of CO APG rate,99.6,80,,,percent of total billed charges,80% of total billed charges,48.31,38.8,,,percent of total billed charges,38.8% of total billed charges,105.83,85,,,percent of total billed charges,85% of total billed charges,124.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,48.31,124.5,
"N-Telopeptide, Serum LC",40082523,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,193.6,154.88,,145.2,75,,,percent of total billed charges,75% of total billed charges,77.44,40,,,percent of total billed charges,40% of total billed charges,153.33,79.2,,,percent of total billed charges,79.2% of total billed charges,164.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,183.92,95,,,percent of total billed charges,95% of total billed charges,154.88,80,,,percent of total billed charges,80% of total billed charges,164.56,85,,,percent of total billed charges,85% of total billed charges,174.24,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,77.44,40,,,percent of total billed charges,40% of total billed charges,77.44,40,,,percent of total billed charges,40% of total billed charges,174.24,90,,,percent of total billed charges,90% of total billed charges,147.14,76,,,percent of total billed charges,76% of total billed charges,77.44,40,,,percent of total billed charges,40% of total billed charges,164.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,154.88,80,,,percent of total billed charges,80% of total billed charges,75.12,38.8,,,percent of total billed charges,38.8% of total billed charges,164.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,183.92,
Free T4 by Dialysis/Mass Spec LC,40084439,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,255.4,204.32,,191.55,75,,,percent of total billed charges,75% of total billed charges,102.16,40,,,percent of total billed charges,40% of total billed charges,202.28,79.2,,,percent of total billed charges,79.2% of total billed charges,217.09,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,242.63,95,,,percent of total billed charges,95% of total billed charges,204.32,80,,,percent of total billed charges,80% of total billed charges,217.09,85,,,percent of total billed charges,85% of total billed charges,229.86,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,102.16,40,,,percent of total billed charges,40% of total billed charges,102.16,40,,,percent of total billed charges,40% of total billed charges,229.86,90,,,percent of total billed charges,90% of total billed charges,194.1,76,,,percent of total billed charges,76% of total billed charges,102.16,40,,,percent of total billed charges,40% of total billed charges,217.09,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,204.32,80,,,percent of total billed charges,80% of total billed charges,99.1,38.8,,,percent of total billed charges,38.8% of total billed charges,217.09,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,242.63,
GUIDEWIRE 1.2MM X 18,460ECON0197,CDM,270,RC,,,OUTPATIENT,,,203.1,162.48,,152.33,75,,,percent of total billed charges,75% of total billed charges,81.24,40,,,percent of total billed charges,40% of total billed charges,160.86,79.2,,,percent of total billed charges,79.2% of total billed charges,172.64,85,,,percent of total billed charges,85% of total billed charges,203.1,100,,,fee schedule,100% of CO APG rates,192.95,95,,,percent of total billed charges,95% of total billed charges,162.48,80,,,percent of total billed charges,80% of total billed charges,172.64,85,,,percent of total billed charges,85% of total billed charges,182.79,90,,,percent of total billed charges,90% of total billed charges,203.1,100,,,fee schedule,100% of CO APG rates,203.1,100,,,fee schedule,100% of CO APG rates,203.1,100,,,fee schedule,100% of NM fee schedule,81.24,40,,,percent of total billed charges,40% of total billed charges,81.24,40,,,percent of total billed charges,40% of total billed charges,182.79,90,,,percent of total billed charges,90% of total billed charges,154.36,76,,,percent of total billed charges,76% of total billed charges,81.24,40,,,percent of total billed charges,40% of total billed charges,172.64,85,,,percent of total billed charges,85% of total billed charges,203.1,100,,,fee schedule,100% of CO APG rate,162.48,80,,,percent of total billed charges,80% of total billed charges,78.8,38.8,,,percent of total billed charges,38.8% of total billed charges,172.64,85,,,percent of total billed charges,85% of total billed charges,203.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,78.8,203.1,
Homocysteine Level,40083090,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,137.1,109.68,,102.83,75,,,percent of total billed charges,75% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,108.58,79.2,,,percent of total billed charges,79.2% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,130.25,95,,,percent of total billed charges,95% of total billed charges,109.68,80,,,percent of total billed charges,80% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,123.39,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,54.84,40,,,percent of total billed charges,40% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,123.39,90,,,percent of total billed charges,90% of total billed charges,104.2,76,,,percent of total billed charges,76% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,109.68,80,,,percent of total billed charges,80% of total billed charges,53.19,38.8,,,percent of total billed charges,38.8% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,130.25,
"81207 BCR-ABL1, CML/ALL, PCR Quant LC",40081207,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,339.6,271.68,,254.7,75,,,percent of total billed charges,75% of total billed charges,135.84,40,,,percent of total billed charges,40% of total billed charges,268.96,79.2,,,percent of total billed charges,79.2% of total billed charges,288.66,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,322.62,95,,,percent of total billed charges,95% of total billed charges,271.68,80,,,percent of total billed charges,80% of total billed charges,288.66,85,,,percent of total billed charges,85% of total billed charges,305.64,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,135.84,40,,,percent of total billed charges,40% of total billed charges,135.84,40,,,percent of total billed charges,40% of total billed charges,305.64,90,,,percent of total billed charges,90% of total billed charges,258.1,76,,,percent of total billed charges,76% of total billed charges,135.84,40,,,percent of total billed charges,40% of total billed charges,288.66,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,271.68,80,,,percent of total billed charges,80% of total billed charges,131.76,38.8,,,percent of total billed charges,38.8% of total billed charges,288.66,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,322.62,
43215 ESOPHAGOSCOPY FLEX REMOVE FB,46043215,CDM,360,RC,43215,HCPCS,OUTPATIENT,,,635.4,508.32,,476.55,75,,,percent of total billed charges,75% of total billed charges,254.16,40,,,percent of total billed charges,40% of total billed charges,503.24,79.2,,,percent of total billed charges,79.2% of total billed charges,540.09,85,,,percent of total billed charges,85% of total billed charges,635.4,100,,,fee schedule,100% of CO APG rates,603.63,95,,,percent of total billed charges,95% of total billed charges,508.32,80,,,percent of total billed charges,80% of total billed charges,540.09,85,,,percent of total billed charges,85% of total billed charges,571.86,90,,,percent of total billed charges,90% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rates,1260.54,100,,,fee schedule,100% of CO APG rates,635.4,100,,,fee schedule,100% of NM APC rate,254.16,40,,,percent of total billed charges,40% of total billed charges,254.16,40,,,percent of total billed charges,40% of total billed charges,571.86,90,,,percent of total billed charges,90% of total billed charges,482.9,76,,,percent of total billed charges,76% of total billed charges,254.16,40,,,percent of total billed charges,40% of total billed charges,540.09,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of CO APG rate,508.32,80,,,percent of total billed charges,80% of total billed charges,246.54,38.8,,,percent of total billed charges,38.8% of total billed charges,540.09,85,,,percent of total billed charges,85% of total billed charges,1260.54,100,,,fee schedule,100% of APG fee schedule,281.54,200,,,fee schedule,200% of CMS fee schedule,246.54,1260.54,
23545 CLOSED TREATMENT OF ACROMIOCLAVICULAR DISLCATION W/MAN,46023545,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
28660 CLD TX IP JT DIS W/O ANES,31028660,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
23625 Closed treatment of greater humeral tuberosity frac,31023625,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1575.6,1260.48,,1181.7,75,,,percent of total billed charges,75% of total billed charges,630.24,40,,,percent of total billed charges,40% of total billed charges,1247.88,79.2,,,percent of total billed charges,79.2% of total billed charges,1339.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1496.82,95,,,percent of total billed charges,95% of total billed charges,1260.48,80,,,percent of total billed charges,80% of total billed charges,1339.26,85,,,percent of total billed charges,85% of total billed charges,1418.04,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,630.24,40,,,percent of total billed charges,40% of total billed charges,630.24,40,,,percent of total billed charges,40% of total billed charges,1418.04,90,,,percent of total billed charges,90% of total billed charges,1197.46,76,,,percent of total billed charges,76% of total billed charges,630.24,40,,,percent of total billed charges,40% of total billed charges,1339.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1260.48,80,,,percent of total billed charges,80% of total billed charges,611.33,38.8,,,percent of total billed charges,38.8% of total billed charges,1339.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1496.82,
36591 SPECIMEN COLL VIA CATH,31036591,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,368.2,294.56,,276.15,75,,,percent of total billed charges,75% of total billed charges,147.28,40,,,percent of total billed charges,40% of total billed charges,291.61,79.2,,,percent of total billed charges,79.2% of total billed charges,312.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,349.79,95,,,percent of total billed charges,95% of total billed charges,294.56,80,,,percent of total billed charges,80% of total billed charges,312.97,85,,,percent of total billed charges,85% of total billed charges,331.38,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,147.28,40,,,percent of total billed charges,40% of total billed charges,147.28,40,,,percent of total billed charges,40% of total billed charges,331.38,90,,,percent of total billed charges,90% of total billed charges,279.83,76,,,percent of total billed charges,76% of total billed charges,147.28,40,,,percent of total billed charges,40% of total billed charges,312.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,294.56,80,,,percent of total billed charges,80% of total billed charges,142.86,38.8,,,percent of total billed charges,38.8% of total billed charges,312.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,142.86,349.79,
64486 TAP BLOCK UNILATERAL; BY INJ(S); INC IMG GUID,46264486,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,1010.9,808.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64487 TAP BLOCK UNILATERAL; BY CONT INFUSION(S); INC IMG GUI,46264487,CDM,370,RC,99152,HCPCS,OUTPATIENT,,,361.25,289,,270.94,75,,,percent of total billed charges,75% of total billed charges,144.5,40,,,percent of total billed charges,40% of total billed charges,286.11,79.2,,,percent of total billed charges,79.2% of total billed charges,307.06,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rates,343.19,95,,,percent of total billed charges,95% of total billed charges,289,80,,,percent of total billed charges,80% of total billed charges,307.06,85,,,percent of total billed charges,85% of total billed charges,325.13,90,,,percent of total billed charges,90% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rates,31.51,100,,,fee schedule,100% of CO APG rates,361.25,100,,,fee schedule,100% of NM fee schedule,144.5,40,,,percent of total billed charges,40% of total billed charges,144.5,40,,,percent of total billed charges,40% of total billed charges,325.13,90,,,percent of total billed charges,90% of total billed charges,274.55,76,,,percent of total billed charges,76% of total billed charges,144.5,40,,,percent of total billed charges,40% of total billed charges,307.06,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rate,289,80,,,percent of total billed charges,80% of total billed charges,140.17,38.8,,,percent of total billed charges,38.8% of total billed charges,307.06,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of APG fee schedule,24.88,200,,,fee schedule,200% of CMS fee schedule,24.88,361.25,
64489 TAP BLOCK BILATERAL; BY CONT INFUSION(S); INC IMG GUID,46264489,CDM,370,RC,99152,HCPCS,OUTPATIENT,,,440,352,,330,75,,,percent of total billed charges,75% of total billed charges,176,40,,,percent of total billed charges,40% of total billed charges,348.48,79.2,,,percent of total billed charges,79.2% of total billed charges,374,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rates,418,95,,,percent of total billed charges,95% of total billed charges,352,80,,,percent of total billed charges,80% of total billed charges,374,85,,,percent of total billed charges,85% of total billed charges,396,90,,,percent of total billed charges,90% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rates,31.51,100,,,fee schedule,100% of CO APG rates,440,100,,,fee schedule,100% of NM fee schedule,176,40,,,percent of total billed charges,40% of total billed charges,176,40,,,percent of total billed charges,40% of total billed charges,396,90,,,percent of total billed charges,90% of total billed charges,334.4,76,,,percent of total billed charges,76% of total billed charges,176,40,,,percent of total billed charges,40% of total billed charges,374,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rate,352,80,,,percent of total billed charges,80% of total billed charges,170.72,38.8,,,percent of total billed charges,38.8% of total billed charges,374,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of APG fee schedule,24.88,200,,,fee schedule,200% of CMS fee schedule,24.88,440,
.Auto Diff 7,40085004,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,62.9,50.32,,47.18,75,,,percent of total billed charges,75% of total billed charges,25.16,40,,,percent of total billed charges,40% of total billed charges,49.82,79.2,,,percent of total billed charges,79.2% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,59.76,95,,,percent of total billed charges,95% of total billed charges,50.32,80,,,percent of total billed charges,80% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,56.61,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,25.16,40,,,percent of total billed charges,40% of total billed charges,25.16,40,,,percent of total billed charges,40% of total billed charges,56.61,90,,,percent of total billed charges,90% of total billed charges,47.8,76,,,percent of total billed charges,76% of total billed charges,25.16,40,,,percent of total billed charges,40% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,50.32,80,,,percent of total billed charges,80% of total billed charges,24.41,38.8,,,percent of total billed charges,38.8% of total billed charges,53.47,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,59.76,
CT Angio Head w/ Cont,41070496,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,779.1,623.28,TC,584.33,75,,,percent of total billed charges,75% of total billed charges,311.64,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,662.24,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,740.15,95,,,percent of total billed charges,95% of total billed charges,623.28,80,,,percent of total billed charges,80% of total billed charges,662.24,85,,,percent of total billed charges,85% of total billed charges,701.19,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,311.64,40,,,percent of total billed charges,40% of total billed charges,311.64,40,,,percent of total billed charges,40% of total billed charges,701.19,90,,,percent of total billed charges,90% of total billed charges,592.12,76,,,percent of total billed charges,76% of total billed charges,311.64,40,,,percent of total billed charges,40% of total billed charges,662.24,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,623.28,80,,,percent of total billed charges,80% of total billed charges,302.29,38.8,,,percent of total billed charges,38.8% of total billed charges,662.24,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,740.15,
Communication Order Blood Transfusion - PMHA,40536430,CDM,391,RC,36430,HCPCS,OUTPATIENT,,,1292.9,1034.32,,969.68,75,,,percent of total billed charges,75% of total billed charges,517.16,40,,,percent of total billed charges,40% of total billed charges,1023.98,79.2,,,percent of total billed charges,79.2% of total billed charges,1098.97,85,,,percent of total billed charges,85% of total billed charges,606.63,100,,,fee schedule,100% of CO APG rates,1228.26,95,,,percent of total billed charges,95% of total billed charges,1034.32,80,,,percent of total billed charges,80% of total billed charges,1098.97,85,,,percent of total billed charges,85% of total billed charges,1163.61,90,,,percent of total billed charges,90% of total billed charges,606.63,100,,,fee schedule,100% of CO APG rates,606.63,100,,,fee schedule,100% of CO APG rates,407.75,100,,,fee schedule,100% of NM APC rate,517.16,40,,,percent of total billed charges,40% of total billed charges,517.16,40,,,percent of total billed charges,40% of total billed charges,1163.61,90,,,percent of total billed charges,90% of total billed charges,982.6,76,,,percent of total billed charges,76% of total billed charges,517.16,40,,,percent of total billed charges,40% of total billed charges,1098.97,85,,,percent of total billed charges,85% of total billed charges,606.63,100,,,fee schedule,100% of CO APG rate,1034.32,80,,,percent of total billed charges,80% of total billed charges,501.65,38.8,,,percent of total billed charges,38.8% of total billed charges,1098.97,85,,,percent of total billed charges,85% of total billed charges,606.63,100,,,fee schedule,100% of APG fee schedule,82.9,200,,,fee schedule,200% of CMS fee schedule,82.9,1228.26,
Application of a modality to 1 or more areas; paraffin bath,42597018,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,41.6,33.28,GP,31.2,75,,,percent of total billed charges,75% of total billed charges,16.64,40,,,percent of total billed charges,40% of total billed charges,32.95,79.2,,,percent of total billed charges,79.2% of total billed charges,35.36,85,,,percent of total billed charges,85% of total billed charges,41.6,100,,,fee schedule,100% of CO APG rates,39.52,95,,,percent of total billed charges,95% of total billed charges,33.28,80,,,percent of total billed charges,80% of total billed charges,35.36,85,,,percent of total billed charges,85% of total billed charges,37.44,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,16.64,40,,,percent of total billed charges,40% of total billed charges,16.64,40,,,percent of total billed charges,40% of total billed charges,37.44,90,,,percent of total billed charges,90% of total billed charges,31.62,76,,,percent of total billed charges,76% of total billed charges,16.64,40,,,percent of total billed charges,40% of total billed charges,35.36,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,33.28,80,,,percent of total billed charges,80% of total billed charges,16.14,38.8,,,percent of total billed charges,38.8% of total billed charges,35.36,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,16.14,61.06,
"SUTURE 0-VICRYL UR-6, J603H",46052478,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.91,7.5,
MA Diag Breast Tomo Bil.,60001000,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,477.3,381.84,TC,357.98,75,,,percent of total billed charges,75% of total billed charges,190.92,40,,,percent of total billed charges,40% of total billed charges,378.02,79.2,,,percent of total billed charges,79.2% of total billed charges,405.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,453.44,95,,,percent of total billed charges,95% of total billed charges,381.84,80,,,percent of total billed charges,80% of total billed charges,405.71,85,,,percent of total billed charges,85% of total billed charges,429.57,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,190.92,40,,,percent of total billed charges,40% of total billed charges,190.92,40,,,percent of total billed charges,40% of total billed charges,429.57,90,,,percent of total billed charges,90% of total billed charges,362.75,76,,,percent of total billed charges,76% of total billed charges,190.92,40,,,percent of total billed charges,40% of total billed charges,405.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,381.84,80,,,percent of total billed charges,80% of total billed charges,185.19,38.8,,,percent of total billed charges,38.8% of total billed charges,405.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,453.44,
MA Diag Breast Tomo Lt.,60001001,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,373.1,298.48,TC,279.83,75,,,percent of total billed charges,75% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,295.5,79.2,,,percent of total billed charges,79.2% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,354.45,95,,,percent of total billed charges,95% of total billed charges,298.48,80,,,percent of total billed charges,80% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,335.79,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,149.24,40,,,percent of total billed charges,40% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,335.79,90,,,percent of total billed charges,90% of total billed charges,283.56,76,,,percent of total billed charges,76% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,298.48,80,,,percent of total billed charges,80% of total billed charges,144.76,38.8,,,percent of total billed charges,38.8% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,144.76,354.45,
MA Diag Breast Tomo Rt.,60001001,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,373.1,298.48,TC,279.83,75,,,percent of total billed charges,75% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,295.5,79.2,,,percent of total billed charges,79.2% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,354.45,95,,,percent of total billed charges,95% of total billed charges,298.48,80,,,percent of total billed charges,80% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,335.79,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,149.24,40,,,percent of total billed charges,40% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,335.79,90,,,percent of total billed charges,90% of total billed charges,283.56,76,,,percent of total billed charges,76% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,298.48,80,,,percent of total billed charges,80% of total billed charges,144.76,38.8,,,percent of total billed charges,38.8% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,144.76,354.45,
SUTURE 10-0 ETHILON CSM-6  9005G,46052479,CDM,270,RC,,,OUTPATIENT,,,52.5,42,,39.38,75,,,percent of total billed charges,75% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,41.58,79.2,,,percent of total billed charges,79.2% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rates,49.88,95,,,percent of total billed charges,95% of total billed charges,42,80,,,percent of total billed charges,80% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,47.25,90,,,percent of total billed charges,90% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rates,52.5,100,,,fee schedule,100% of CO APG rates,52.5,100,,,fee schedule,100% of NM fee schedule,21,40,,,percent of total billed charges,40% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,47.25,90,,,percent of total billed charges,90% of total billed charges,39.9,76,,,percent of total billed charges,76% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rate,42,80,,,percent of total billed charges,80% of total billed charges,20.37,38.8,,,percent of total billed charges,38.8% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,20.37,52.5,
HCV FibroSURE LC,40082172,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,240.3,192.24,,180.23,75,,,percent of total billed charges,75% of total billed charges,96.12,40,,,percent of total billed charges,40% of total billed charges,190.32,79.2,,,percent of total billed charges,79.2% of total billed charges,204.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,228.29,95,,,percent of total billed charges,95% of total billed charges,192.24,80,,,percent of total billed charges,80% of total billed charges,204.26,85,,,percent of total billed charges,85% of total billed charges,216.27,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,96.12,40,,,percent of total billed charges,40% of total billed charges,96.12,40,,,percent of total billed charges,40% of total billed charges,216.27,90,,,percent of total billed charges,90% of total billed charges,182.63,76,,,percent of total billed charges,76% of total billed charges,96.12,40,,,percent of total billed charges,40% of total billed charges,204.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,192.24,80,,,percent of total billed charges,80% of total billed charges,93.24,38.8,,,percent of total billed charges,38.8% of total billed charges,204.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,228.29,
93271 Holter Extended Cadiac Moitoring Services Technical,42293271,CDM,731,RC,93225,HCPCS,OUTPATIENT,,,700.4,560.32,,525.3,75,,,percent of total billed charges,75% of total billed charges,280.16,40,,,percent of total billed charges,40% of total billed charges,554.72,79.2,,,percent of total billed charges,79.2% of total billed charges,595.34,85,,,percent of total billed charges,85% of total billed charges,89.98,100,,,fee schedule,100% of CO APG rates,665.38,95,,,percent of total billed charges,95% of total billed charges,560.32,80,,,percent of total billed charges,80% of total billed charges,595.34,85,,,percent of total billed charges,85% of total billed charges,630.36,90,,,percent of total billed charges,90% of total billed charges,89.98,100,,,fee schedule,100% of CO APG rates,89.98,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,280.16,40,,,percent of total billed charges,40% of total billed charges,280.16,40,,,percent of total billed charges,40% of total billed charges,630.36,90,,,percent of total billed charges,90% of total billed charges,532.3,76,,,percent of total billed charges,76% of total billed charges,280.16,40,,,percent of total billed charges,40% of total billed charges,595.34,85,,,percent of total billed charges,85% of total billed charges,89.98,100,,,fee schedule,100% of CO APG rate,560.32,80,,,percent of total billed charges,80% of total billed charges,271.76,38.8,,,percent of total billed charges,38.8% of total billed charges,595.34,85,,,percent of total billed charges,85% of total billed charges,89.98,100,,,fee schedule,100% of APG fee schedule,38.96,200,,,fee schedule,200% of CMS fee schedule,38.96,665.38,
27760 Closed Treatment of medial malleous fracture; without manipulation,60000060,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1335.4,1068.32,,1001.55,75,,,percent of total billed charges,75% of total billed charges,534.16,40,,,percent of total billed charges,40% of total billed charges,1057.64,79.2,,,percent of total billed charges,79.2% of total billed charges,1135.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1268.63,95,,,percent of total billed charges,95% of total billed charges,1068.32,80,,,percent of total billed charges,80% of total billed charges,1135.09,85,,,percent of total billed charges,85% of total billed charges,1201.86,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,534.16,40,,,percent of total billed charges,40% of total billed charges,534.16,40,,,percent of total billed charges,40% of total billed charges,1201.86,90,,,percent of total billed charges,90% of total billed charges,1014.9,76,,,percent of total billed charges,76% of total billed charges,534.16,40,,,percent of total billed charges,40% of total billed charges,1135.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1068.32,80,,,percent of total billed charges,80% of total billed charges,518.14,38.8,,,percent of total billed charges,38.8% of total billed charges,1135.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1268.63,
"32555 Thoracentesis, needle or catheter, aspiration of the p",60000075,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2429.4,1943.52,,1822.05,75,,,percent of total billed charges,75% of total billed charges,971.76,40,,,percent of total billed charges,40% of total billed charges,1924.08,79.2,,,percent of total billed charges,79.2% of total billed charges,2064.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2307.93,95,,,percent of total billed charges,95% of total billed charges,1943.52,80,,,percent of total billed charges,80% of total billed charges,2064.99,85,,,percent of total billed charges,85% of total billed charges,2186.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,971.76,40,,,percent of total billed charges,40% of total billed charges,971.76,40,,,percent of total billed charges,40% of total billed charges,2186.46,90,,,percent of total billed charges,90% of total billed charges,1846.34,76,,,percent of total billed charges,76% of total billed charges,971.76,40,,,percent of total billed charges,40% of total billed charges,2064.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1943.52,80,,,percent of total billed charges,80% of total billed charges,942.61,38.8,,,percent of total billed charges,38.8% of total billed charges,2064.99,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2307.93,
82247 Bilirubin; total,40082287,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
"82977 Glutamyltransferase, gamma (GGT)",40082977,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,79.6,63.68,,59.7,75,,,percent of total billed charges,75% of total billed charges,31.84,40,,,percent of total billed charges,40% of total billed charges,63.04,79.2,,,percent of total billed charges,79.2% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,75.62,95,,,percent of total billed charges,95% of total billed charges,63.68,80,,,percent of total billed charges,80% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,71.64,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,31.84,40,,,percent of total billed charges,40% of total billed charges,31.84,40,,,percent of total billed charges,40% of total billed charges,71.64,90,,,percent of total billed charges,90% of total billed charges,60.5,76,,,percent of total billed charges,76% of total billed charges,31.84,40,,,percent of total billed charges,40% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,63.68,80,,,percent of total billed charges,80% of total billed charges,30.88,38.8,,,percent of total billed charges,38.8% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,75.62,
83010 Haptoglobin; quantitative,40083010,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,148.6,118.88,,111.45,75,,,percent of total billed charges,75% of total billed charges,59.44,40,,,percent of total billed charges,40% of total billed charges,117.69,79.2,,,percent of total billed charges,79.2% of total billed charges,126.31,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,141.17,95,,,percent of total billed charges,95% of total billed charges,118.88,80,,,percent of total billed charges,80% of total billed charges,126.31,85,,,percent of total billed charges,85% of total billed charges,133.74,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,59.44,40,,,percent of total billed charges,40% of total billed charges,59.44,40,,,percent of total billed charges,40% of total billed charges,133.74,90,,,percent of total billed charges,90% of total billed charges,112.94,76,,,percent of total billed charges,76% of total billed charges,59.44,40,,,percent of total billed charges,40% of total billed charges,126.31,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,118.88,80,,,percent of total billed charges,80% of total billed charges,57.66,38.8,,,percent of total billed charges,38.8% of total billed charges,126.31,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,141.17,
"Nephelometry, each analyte not elsewhere specified",40083883,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,106.2,84.96,,79.65,75,,,percent of total billed charges,75% of total billed charges,42.48,40,,,percent of total billed charges,40% of total billed charges,84.11,79.2,,,percent of total billed charges,79.2% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,100.89,95,,,percent of total billed charges,95% of total billed charges,84.96,80,,,percent of total billed charges,80% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,95.58,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,42.48,40,,,percent of total billed charges,40% of total billed charges,42.48,40,,,percent of total billed charges,40% of total billed charges,95.58,90,,,percent of total billed charges,90% of total billed charges,80.71,76,,,percent of total billed charges,76% of total billed charges,42.48,40,,,percent of total billed charges,40% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,84.96,80,,,percent of total billed charges,80% of total billed charges,41.21,38.8,,,percent of total billed charges,38.8% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,100.89,
84460 Transferase; alanine amino (ALT) (SGPT),40084460,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,62.5,50,,46.88,75,,,percent of total billed charges,75% of total billed charges,25,40,,,percent of total billed charges,40% of total billed charges,49.5,79.2,,,percent of total billed charges,79.2% of total billed charges,53.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,59.38,95,,,percent of total billed charges,95% of total billed charges,50,80,,,percent of total billed charges,80% of total billed charges,53.13,85,,,percent of total billed charges,85% of total billed charges,56.25,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,25,40,,,percent of total billed charges,40% of total billed charges,25,40,,,percent of total billed charges,40% of total billed charges,56.25,90,,,percent of total billed charges,90% of total billed charges,47.5,76,,,percent of total billed charges,76% of total billed charges,25,40,,,percent of total billed charges,40% of total billed charges,53.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,50,80,,,percent of total billed charges,80% of total billed charges,24.25,38.8,,,percent of total billed charges,38.8% of total billed charges,53.13,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,59.38,
BEADED CABLE AND SLEEVE,46052481,CDM,278,RC,,,OUTPATIENT,,,1465.3,1172.24,,1098.98,75,,,percent of total billed charges,75% of total billed charges,586.12,40,,,percent of total billed charges,40% of total billed charges,1160.52,79.2,,,percent of total billed charges,79.2% of total billed charges,1245.51,85,,,percent of total billed charges,85% of total billed charges,1465.3,100,,,fee schedule,100% of CO APG rates,1392.04,95,,,percent of total billed charges,95% of total billed charges,1172.24,80,,,percent of total billed charges,80% of total billed charges,1245.51,85,,,percent of total billed charges,85% of total billed charges,1318.77,90,,,percent of total billed charges,90% of total billed charges,1465.3,100,,,fee schedule,100% of CO APG rates,1465.3,100,,,fee schedule,100% of CO APG rates,1465.3,100,,,fee schedule,100% of NM fee schedule,586.12,40,,,percent of total billed charges,40% of total billed charges,586.12,40,,,percent of total billed charges,40% of total billed charges,1318.77,90,,,percent of total billed charges,90% of total billed charges,1113.63,76,,,percent of total billed charges,76% of total billed charges,586.12,40,,,percent of total billed charges,40% of total billed charges,1245.51,85,,,percent of total billed charges,85% of total billed charges,1465.3,100,,,fee schedule,100% of CO APG rate,1172.24,80,,,percent of total billed charges,80% of total billed charges,568.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1245.51,85,,,percent of total billed charges,85% of total billed charges,1465.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,568.54,1465.3,
"TROCH GRIP W/ 2 CABLES, MD",46052482,CDM,278,RC,,,OUTPATIENT,,,2986.3,2389.04,,2239.73,75,,,percent of total billed charges,75% of total billed charges,1194.52,40,,,percent of total billed charges,40% of total billed charges,2365.15,79.2,,,percent of total billed charges,79.2% of total billed charges,2538.36,85,,,percent of total billed charges,85% of total billed charges,2986.3,100,,,fee schedule,100% of CO APG rates,2836.99,95,,,percent of total billed charges,95% of total billed charges,2389.04,80,,,percent of total billed charges,80% of total billed charges,2538.36,85,,,percent of total billed charges,85% of total billed charges,2687.67,90,,,percent of total billed charges,90% of total billed charges,2986.3,100,,,fee schedule,100% of CO APG rates,2986.3,100,,,fee schedule,100% of CO APG rates,2986.3,100,,,fee schedule,100% of NM fee schedule,1194.52,40,,,percent of total billed charges,40% of total billed charges,1194.52,40,,,percent of total billed charges,40% of total billed charges,2687.67,90,,,percent of total billed charges,90% of total billed charges,2269.59,76,,,percent of total billed charges,76% of total billed charges,1194.52,40,,,percent of total billed charges,40% of total billed charges,2538.36,85,,,percent of total billed charges,85% of total billed charges,2986.3,100,,,fee schedule,100% of CO APG rate,2389.04,80,,,percent of total billed charges,80% of total billed charges,1158.68,38.8,,,percent of total billed charges,38.8% of total billed charges,2538.36,85,,,percent of total billed charges,85% of total billed charges,2986.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1158.68,2986.3,
"Spirometry including graphic record, total and timed vital c",42294010,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,358.8,287.04,,269.1,75,,,percent of total billed charges,75% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,284.17,79.2,,,percent of total billed charges,79.2% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,340.86,95,,,percent of total billed charges,95% of total billed charges,287.04,80,,,percent of total billed charges,80% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,143.52,40,,,percent of total billed charges,40% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,272.69,76,,,percent of total billed charges,76% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,287.04,80,,,percent of total billed charges,80% of total billed charges,139.21,38.8,,,percent of total billed charges,38.8% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,340.86,
"Closed Treatment of Humeral Condylar Fracture, Medial or Lat",60000040,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2810.1,2248.08,,2107.58,75,,,percent of total billed charges,75% of total billed charges,1124.04,40,,,percent of total billed charges,40% of total billed charges,2225.6,79.2,,,percent of total billed charges,79.2% of total billed charges,2388.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2669.6,95,,,percent of total billed charges,95% of total billed charges,2248.08,80,,,percent of total billed charges,80% of total billed charges,2388.59,85,,,percent of total billed charges,85% of total billed charges,2529.09,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1124.04,40,,,percent of total billed charges,40% of total billed charges,1124.04,40,,,percent of total billed charges,40% of total billed charges,2529.09,90,,,percent of total billed charges,90% of total billed charges,2135.68,76,,,percent of total billed charges,76% of total billed charges,1124.04,40,,,percent of total billed charges,40% of total billed charges,2388.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,2248.08,80,,,percent of total billed charges,80% of total billed charges,1090.32,38.8,,,percent of total billed charges,38.8% of total billed charges,2388.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2669.6,
"Ostectomy, Partial, Exostectomy or Condylectomy, Metatarsal",24628288,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,218.4,174.72,,163.8,75,,,percent of total billed charges,75% of total billed charges,87.36,40,,,percent of total billed charges,40% of total billed charges,172.97,79.2,,,percent of total billed charges,79.2% of total billed charges,185.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,207.48,95,,,percent of total billed charges,95% of total billed charges,174.72,80,,,percent of total billed charges,80% of total billed charges,185.64,85,,,percent of total billed charges,85% of total billed charges,196.56,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,218.4,100,,,fee schedule,100% of NM APC rate,87.36,40,,,percent of total billed charges,40% of total billed charges,87.36,40,,,percent of total billed charges,40% of total billed charges,196.56,90,,,percent of total billed charges,90% of total billed charges,165.98,76,,,percent of total billed charges,76% of total billed charges,87.36,40,,,percent of total billed charges,40% of total billed charges,185.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,174.72,80,,,percent of total billed charges,80% of total billed charges,84.74,38.8,,,percent of total billed charges,38.8% of total billed charges,185.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,84.74,218.4,
"10121 Incision And Removal Foreign Body, Subcut; Complicated",46010121,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4753.8,3803.04,,3565.35,75,,,percent of total billed charges,75% of total billed charges,1901.52,40,,,percent of total billed charges,40% of total billed charges,3765.01,79.2,,,percent of total billed charges,79.2% of total billed charges,4040.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4516.11,95,,,percent of total billed charges,95% of total billed charges,3803.04,80,,,percent of total billed charges,80% of total billed charges,4040.73,85,,,percent of total billed charges,85% of total billed charges,4278.42,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1901.52,40,,,percent of total billed charges,40% of total billed charges,1901.52,40,,,percent of total billed charges,40% of total billed charges,4278.42,90,,,percent of total billed charges,90% of total billed charges,3612.89,76,,,percent of total billed charges,76% of total billed charges,1901.52,40,,,percent of total billed charges,40% of total billed charges,4040.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3803.04,80,,,percent of total billed charges,80% of total billed charges,1844.47,38.8,,,percent of total billed charges,38.8% of total billed charges,4040.73,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4516.11,
"10160 Puncture Aspiration Of Abscess, Hematoma, Bulla, Or Cy",46010160,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1125.3,900.24,,843.98,75,,,percent of total billed charges,75% of total billed charges,450.12,40,,,percent of total billed charges,40% of total billed charges,891.24,79.2,,,percent of total billed charges,79.2% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1069.04,95,,,percent of total billed charges,95% of total billed charges,900.24,80,,,percent of total billed charges,80% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,1012.77,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,450.12,40,,,percent of total billed charges,40% of total billed charges,450.12,40,,,percent of total billed charges,40% of total billed charges,1012.77,90,,,percent of total billed charges,90% of total billed charges,855.23,76,,,percent of total billed charges,76% of total billed charges,450.12,40,,,percent of total billed charges,40% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,900.24,80,,,percent of total billed charges,80% of total billed charges,436.62,38.8,,,percent of total billed charges,38.8% of total billed charges,956.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1069.04,
"11045 Debridement, Subcutaneous Tissue; each Add 20 Sq cm",46011045,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,172.65,138.12,,129.49,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,136.74,79.2,,,percent of total billed charges,79.2% of total billed charges,146.75,85,,,percent of total billed charges,85% of total billed charges,172.65,100,,,fee schedule,100% of CO APG rates,164.02,95,,,percent of total billed charges,95% of total billed charges,138.12,80,,,percent of total billed charges,80% of total billed charges,146.75,85,,,percent of total billed charges,85% of total billed charges,155.39,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,172.65,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,155.39,90,,,percent of total billed charges,90% of total billed charges,131.21,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,146.75,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,138.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,146.75,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,727.5,100,,,case rate,pays based on per visit rate,129.49,727.5,
12020 Treatment Of Superficial Wound Dehiscence; Simple Clos,46012020,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1741,1392.8,,1305.75,75,,,percent of total billed charges,75% of total billed charges,696.4,40,,,percent of total billed charges,40% of total billed charges,1378.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1479.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1653.95,95,,,percent of total billed charges,95% of total billed charges,1392.8,80,,,percent of total billed charges,80% of total billed charges,1479.85,85,,,percent of total billed charges,85% of total billed charges,1566.9,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,696.4,40,,,percent of total billed charges,40% of total billed charges,696.4,40,,,percent of total billed charges,40% of total billed charges,1566.9,90,,,percent of total billed charges,90% of total billed charges,1323.16,76,,,percent of total billed charges,76% of total billed charges,696.4,40,,,percent of total billed charges,40% of total billed charges,1479.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1392.8,80,,,percent of total billed charges,80% of total billed charges,675.51,38.8,,,percent of total billed charges,38.8% of total billed charges,1479.85,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1653.95,
12021 Treatment Of Superficial Wound Dehiscence; With Packin,46012021,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1212.6,970.08,,909.45,75,,,percent of total billed charges,75% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,960.38,79.2,,,percent of total billed charges,79.2% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1151.97,95,,,percent of total billed charges,95% of total billed charges,970.08,80,,,percent of total billed charges,80% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,485.04,40,,,percent of total billed charges,40% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,921.58,76,,,percent of total billed charges,76% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,970.08,80,,,percent of total billed charges,80% of total billed charges,470.49,38.8,,,percent of total billed charges,38.8% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1151.97,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012037,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,10382.3,8305.84,,7786.73,75,,,percent of total billed charges,75% of total billed charges,4152.92,40,,,percent of total billed charges,40% of total billed charges,8222.78,79.2,,,percent of total billed charges,79.2% of total billed charges,8824.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,9863.19,95,,,percent of total billed charges,95% of total billed charges,8305.84,80,,,percent of total billed charges,80% of total billed charges,8824.96,85,,,percent of total billed charges,85% of total billed charges,9344.07,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,5213.72,100,,,fee schedule,100% of NM APC rate,4152.92,40,,,percent of total billed charges,40% of total billed charges,4152.92,40,,,percent of total billed charges,40% of total billed charges,9344.07,90,,,percent of total billed charges,90% of total billed charges,7890.55,76,,,percent of total billed charges,76% of total billed charges,4152.92,40,,,percent of total billed charges,40% of total billed charges,8824.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,8305.84,80,,,percent of total billed charges,80% of total billed charges,4028.33,38.8,,,percent of total billed charges,38.8% of total billed charges,8824.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,215.49,9863.19,
"Repair, intermediate, wounds of scalp, axillae, trunk and/or",46012036,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2023.8,1619.04,,1517.85,75,,,percent of total billed charges,75% of total billed charges,809.52,40,,,percent of total billed charges,40% of total billed charges,1602.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1720.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1922.61,95,,,percent of total billed charges,95% of total billed charges,1619.04,80,,,percent of total billed charges,80% of total billed charges,1720.23,85,,,percent of total billed charges,85% of total billed charges,1821.42,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,809.52,40,,,percent of total billed charges,40% of total billed charges,809.52,40,,,percent of total billed charges,40% of total billed charges,1821.42,90,,,percent of total billed charges,90% of total billed charges,1538.09,76,,,percent of total billed charges,76% of total billed charges,809.52,40,,,percent of total billed charges,40% of total billed charges,1720.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1619.04,80,,,percent of total billed charges,80% of total billed charges,785.23,38.8,,,percent of total billed charges,38.8% of total billed charges,1720.23,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1922.61,
"Repair, intermediate, wounds of neck, hands, feet, and/or ex",46012041,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1212.6,970.08,,909.45,75,,,percent of total billed charges,75% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,960.38,79.2,,,percent of total billed charges,79.2% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1151.97,95,,,percent of total billed charges,95% of total billed charges,970.08,80,,,percent of total billed charges,80% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,485.04,40,,,percent of total billed charges,40% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,921.58,76,,,percent of total billed charges,76% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,970.08,80,,,percent of total billed charges,80% of total billed charges,470.49,38.8,,,percent of total billed charges,38.8% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1151.97,
"Repair, intermediate, wounds of neck, hands, feet, and/or ex",46012044,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1775.3,1420.24,,1331.48,75,,,percent of total billed charges,75% of total billed charges,710.12,40,,,percent of total billed charges,40% of total billed charges,1406.04,79.2,,,percent of total billed charges,79.2% of total billed charges,1509.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1686.54,95,,,percent of total billed charges,95% of total billed charges,1420.24,80,,,percent of total billed charges,80% of total billed charges,1509.01,85,,,percent of total billed charges,85% of total billed charges,1597.77,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,710.12,40,,,percent of total billed charges,40% of total billed charges,710.12,40,,,percent of total billed charges,40% of total billed charges,1597.77,90,,,percent of total billed charges,90% of total billed charges,1349.23,76,,,percent of total billed charges,76% of total billed charges,710.12,40,,,percent of total billed charges,40% of total billed charges,1509.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1420.24,80,,,percent of total billed charges,80% of total billed charges,688.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1509.01,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1686.54,
"Repair, intermediate, wounds of neck, hands, feet, and/or ex",46012045,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1878.2,1502.56,,1408.65,75,,,percent of total billed charges,75% of total billed charges,751.28,40,,,percent of total billed charges,40% of total billed charges,1487.53,79.2,,,percent of total billed charges,79.2% of total billed charges,1596.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1784.29,95,,,percent of total billed charges,95% of total billed charges,1502.56,80,,,percent of total billed charges,80% of total billed charges,1596.47,85,,,percent of total billed charges,85% of total billed charges,1690.38,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,751.28,40,,,percent of total billed charges,40% of total billed charges,751.28,40,,,percent of total billed charges,40% of total billed charges,1690.38,90,,,percent of total billed charges,90% of total billed charges,1427.43,76,,,percent of total billed charges,76% of total billed charges,751.28,40,,,percent of total billed charges,40% of total billed charges,1596.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1502.56,80,,,percent of total billed charges,80% of total billed charges,728.74,38.8,,,percent of total billed charges,38.8% of total billed charges,1596.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1784.29,
"Repair, intermediate, wounds of neck, hands, feet, and/or ex",46012046,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1212.6,970.08,,909.45,75,,,percent of total billed charges,75% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,960.38,79.2,,,percent of total billed charges,79.2% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1151.97,95,,,percent of total billed charges,95% of total billed charges,970.08,80,,,percent of total billed charges,80% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,485.04,40,,,percent of total billed charges,40% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,921.58,76,,,percent of total billed charges,76% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,970.08,80,,,percent of total billed charges,80% of total billed charges,470.49,38.8,,,percent of total billed charges,38.8% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1151.97,
"Repair, intermediate, wounds of neck, hands, feet, and/or ex",46012047,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,5917.6,4734.08,,4438.2,75,,,percent of total billed charges,75% of total billed charges,2367.04,40,,,percent of total billed charges,40% of total billed charges,4686.74,79.2,,,percent of total billed charges,79.2% of total billed charges,5029.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,5621.72,95,,,percent of total billed charges,95% of total billed charges,4734.08,80,,,percent of total billed charges,80% of total billed charges,5029.96,85,,,percent of total billed charges,85% of total billed charges,5325.84,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,2981.37,100,,,fee schedule,100% of NM APC rate,2367.04,40,,,percent of total billed charges,40% of total billed charges,2367.04,40,,,percent of total billed charges,40% of total billed charges,5325.84,90,,,percent of total billed charges,90% of total billed charges,4497.38,76,,,percent of total billed charges,76% of total billed charges,2367.04,40,,,percent of total billed charges,40% of total billed charges,5029.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,4734.08,80,,,percent of total billed charges,80% of total billed charges,2296.03,38.8,,,percent of total billed charges,38.8% of total billed charges,5029.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,215.49,5621.72,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012054,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1212.6,970.08,,909.45,75,,,percent of total billed charges,75% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,960.38,79.2,,,percent of total billed charges,79.2% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1151.97,95,,,percent of total billed charges,95% of total billed charges,970.08,80,,,percent of total billed charges,80% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,485.04,40,,,percent of total billed charges,40% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,921.58,76,,,percent of total billed charges,76% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,970.08,80,,,percent of total billed charges,80% of total billed charges,470.49,38.8,,,percent of total billed charges,38.8% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1151.97,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012055,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1212.6,970.08,,909.45,75,,,percent of total billed charges,75% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,960.38,79.2,,,percent of total billed charges,79.2% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1151.97,95,,,percent of total billed charges,95% of total billed charges,970.08,80,,,percent of total billed charges,80% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,485.04,40,,,percent of total billed charges,40% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,921.58,76,,,percent of total billed charges,76% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,970.08,80,,,percent of total billed charges,80% of total billed charges,470.49,38.8,,,percent of total billed charges,38.8% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1151.97,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012056,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1212.6,970.08,,909.45,75,,,percent of total billed charges,75% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,960.38,79.2,,,percent of total billed charges,79.2% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1151.97,95,,,percent of total billed charges,95% of total billed charges,970.08,80,,,percent of total billed charges,80% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,485.04,40,,,percent of total billed charges,40% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1091.34,90,,,percent of total billed charges,90% of total billed charges,921.58,76,,,percent of total billed charges,76% of total billed charges,485.04,40,,,percent of total billed charges,40% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,970.08,80,,,percent of total billed charges,80% of total billed charges,470.49,38.8,,,percent of total billed charges,38.8% of total billed charges,1030.71,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1151.97,
"Repair, intermediate, wounds of face, ears, eyelids, nose, l",46012057,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1285.4,1028.32,,964.05,75,,,percent of total billed charges,75% of total billed charges,514.16,40,,,percent of total billed charges,40% of total billed charges,1018.04,79.2,,,percent of total billed charges,79.2% of total billed charges,1092.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1221.13,95,,,percent of total billed charges,95% of total billed charges,1028.32,80,,,percent of total billed charges,80% of total billed charges,1092.59,85,,,percent of total billed charges,85% of total billed charges,1156.86,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,514.16,40,,,percent of total billed charges,40% of total billed charges,514.16,40,,,percent of total billed charges,40% of total billed charges,1156.86,90,,,percent of total billed charges,90% of total billed charges,976.9,76,,,percent of total billed charges,76% of total billed charges,514.16,40,,,percent of total billed charges,40% of total billed charges,1092.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1028.32,80,,,percent of total billed charges,80% of total billed charges,498.74,38.8,,,percent of total billed charges,38.8% of total billed charges,1092.59,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1221.13,
"13100 Repair, Complex, Trunk; 1.1 Cm To 2.5 Cm",46013100,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2270.3,1816.24,,1702.73,75,,,percent of total billed charges,75% of total billed charges,908.12,40,,,percent of total billed charges,40% of total billed charges,1798.08,79.2,,,percent of total billed charges,79.2% of total billed charges,1929.76,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2156.79,95,,,percent of total billed charges,95% of total billed charges,1816.24,80,,,percent of total billed charges,80% of total billed charges,1929.76,85,,,percent of total billed charges,85% of total billed charges,2043.27,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,908.12,40,,,percent of total billed charges,40% of total billed charges,908.12,40,,,percent of total billed charges,40% of total billed charges,2043.27,90,,,percent of total billed charges,90% of total billed charges,1725.43,76,,,percent of total billed charges,76% of total billed charges,908.12,40,,,percent of total billed charges,40% of total billed charges,1929.76,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1816.24,80,,,percent of total billed charges,80% of total billed charges,880.88,38.8,,,percent of total billed charges,38.8% of total billed charges,1929.76,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2156.79,
"13101 Repair, Complex, Trunk; 2.6 Cm To 7.5 Cm",46013101,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1361.6,1089.28,,1021.2,75,,,percent of total billed charges,75% of total billed charges,544.64,40,,,percent of total billed charges,40% of total billed charges,1078.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1157.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1293.52,95,,,percent of total billed charges,95% of total billed charges,1089.28,80,,,percent of total billed charges,80% of total billed charges,1157.36,85,,,percent of total billed charges,85% of total billed charges,1225.44,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,544.64,40,,,percent of total billed charges,40% of total billed charges,544.64,40,,,percent of total billed charges,40% of total billed charges,1225.44,90,,,percent of total billed charges,90% of total billed charges,1034.82,76,,,percent of total billed charges,76% of total billed charges,544.64,40,,,percent of total billed charges,40% of total billed charges,1157.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1089.28,80,,,percent of total billed charges,80% of total billed charges,528.3,38.8,,,percent of total billed charges,38.8% of total billed charges,1157.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1293.52,
13120 CMPLX RPR S/A/L 1.1-2.5 CM,60000393,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1913.6,1530.88,,1435.2,75,,,percent of total billed charges,75% of total billed charges,765.44,40,,,percent of total billed charges,40% of total billed charges,1515.57,79.2,,,percent of total billed charges,79.2% of total billed charges,1626.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1817.92,95,,,percent of total billed charges,95% of total billed charges,1530.88,80,,,percent of total billed charges,80% of total billed charges,1626.56,85,,,percent of total billed charges,85% of total billed charges,1722.24,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,765.44,40,,,percent of total billed charges,40% of total billed charges,765.44,40,,,percent of total billed charges,40% of total billed charges,1722.24,90,,,percent of total billed charges,90% of total billed charges,1454.34,76,,,percent of total billed charges,76% of total billed charges,765.44,40,,,percent of total billed charges,40% of total billed charges,1626.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1530.88,80,,,percent of total billed charges,80% of total billed charges,742.48,38.8,,,percent of total billed charges,38.8% of total billed charges,1626.56,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1817.92,
"Bile Acids, Fractionated LCMS LC",40082542,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,439.1,351.28,,329.33,75,,,percent of total billed charges,75% of total billed charges,175.64,40,,,percent of total billed charges,40% of total billed charges,347.77,79.2,,,percent of total billed charges,79.2% of total billed charges,373.24,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,417.15,95,,,percent of total billed charges,95% of total billed charges,351.28,80,,,percent of total billed charges,80% of total billed charges,373.24,85,,,percent of total billed charges,85% of total billed charges,395.19,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,175.64,40,,,percent of total billed charges,40% of total billed charges,175.64,40,,,percent of total billed charges,40% of total billed charges,395.19,90,,,percent of total billed charges,90% of total billed charges,333.72,76,,,percent of total billed charges,76% of total billed charges,175.64,40,,,percent of total billed charges,40% of total billed charges,373.24,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,351.28,80,,,percent of total billed charges,80% of total billed charges,170.37,38.8,,,percent of total billed charges,38.8% of total billed charges,373.24,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,417.15,
"Cyclosporine, Blood LC",40080158,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,47.1,37.68,,35.33,75,,,percent of total billed charges,75% of total billed charges,18.84,40,,,percent of total billed charges,40% of total billed charges,37.3,79.2,,,percent of total billed charges,79.2% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,44.75,95,,,percent of total billed charges,95% of total billed charges,37.68,80,,,percent of total billed charges,80% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,42.39,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,18.84,40,,,percent of total billed charges,40% of total billed charges,18.84,40,,,percent of total billed charges,40% of total billed charges,42.39,90,,,percent of total billed charges,90% of total billed charges,35.8,76,,,percent of total billed charges,76% of total billed charges,18.84,40,,,percent of total billed charges,40% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,37.68,80,,,percent of total billed charges,80% of total billed charges,18.27,38.8,,,percent of total billed charges,38.8% of total billed charges,40.04,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,44.75,
"TORQ-FLEX GUIDE WIRE, 60CM",46052484,CDM,270,RC,,,OUTPATIENT,,,177.1,141.68,,132.83,75,,,percent of total billed charges,75% of total billed charges,70.84,40,,,percent of total billed charges,40% of total billed charges,140.26,79.2,,,percent of total billed charges,79.2% of total billed charges,150.54,85,,,percent of total billed charges,85% of total billed charges,177.1,100,,,fee schedule,100% of CO APG rates,168.25,95,,,percent of total billed charges,95% of total billed charges,141.68,80,,,percent of total billed charges,80% of total billed charges,150.54,85,,,percent of total billed charges,85% of total billed charges,159.39,90,,,percent of total billed charges,90% of total billed charges,177.1,100,,,fee schedule,100% of CO APG rates,177.1,100,,,fee schedule,100% of CO APG rates,177.1,100,,,fee schedule,100% of NM fee schedule,70.84,40,,,percent of total billed charges,40% of total billed charges,70.84,40,,,percent of total billed charges,40% of total billed charges,159.39,90,,,percent of total billed charges,90% of total billed charges,134.6,76,,,percent of total billed charges,76% of total billed charges,70.84,40,,,percent of total billed charges,40% of total billed charges,150.54,85,,,percent of total billed charges,85% of total billed charges,177.1,100,,,fee schedule,100% of CO APG rate,141.68,80,,,percent of total billed charges,80% of total billed charges,68.71,38.8,,,percent of total billed charges,38.8% of total billed charges,150.54,85,,,percent of total billed charges,85% of total billed charges,177.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,68.71,177.1,
51701 Insertion of non dwelling bladder catheter (e.g. straight cath for residua,60000092,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,392.1,313.68,,294.08,75,,,percent of total billed charges,75% of total billed charges,156.84,40,,,percent of total billed charges,40% of total billed charges,310.54,79.2,,,percent of total billed charges,79.2% of total billed charges,333.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,372.5,95,,,percent of total billed charges,95% of total billed charges,313.68,80,,,percent of total billed charges,80% of total billed charges,333.29,85,,,percent of total billed charges,85% of total billed charges,352.89,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,156.84,40,,,percent of total billed charges,40% of total billed charges,156.84,40,,,percent of total billed charges,40% of total billed charges,352.89,90,,,percent of total billed charges,90% of total billed charges,298,76,,,percent of total billed charges,76% of total billed charges,156.84,40,,,percent of total billed charges,40% of total billed charges,333.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,313.68,80,,,percent of total billed charges,80% of total billed charges,152.13,38.8,,,percent of total billed charges,38.8% of total billed charges,333.29,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,152.13,372.5,
"SUTURE VICRYL 4-0, ANTIBAC, RB-1, VCP304H",46052485,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.91,7.5,
HPV,40087624,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,151.24,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
CT,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
NG,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
TV,40087661,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
HSV 1,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
HSV 2,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
US Aorta Screening,41276706,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,349.9,279.92,,262.43,75,,,percent of total billed charges,75% of total billed charges,139.96,40,,,percent of total billed charges,40% of total billed charges,277.12,79.2,,,percent of total billed charges,79.2% of total billed charges,297.42,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,332.41,95,,,percent of total billed charges,95% of total billed charges,279.92,80,,,percent of total billed charges,80% of total billed charges,297.42,85,,,percent of total billed charges,85% of total billed charges,314.91,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,139.96,40,,,percent of total billed charges,40% of total billed charges,139.96,40,,,percent of total billed charges,40% of total billed charges,314.91,90,,,percent of total billed charges,90% of total billed charges,265.92,76,,,percent of total billed charges,76% of total billed charges,139.96,40,,,percent of total billed charges,40% of total billed charges,297.42,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,279.92,80,,,percent of total billed charges,80% of total billed charges,135.76,38.8,,,percent of total billed charges,38.8% of total billed charges,297.42,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,332.41,
Infrared Charge,47297026,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,22.5,18,GO,16.88,75,,,percent of total billed charges,75% of total billed charges,9,40,,,percent of total billed charges,40% of total billed charges,17.82,79.2,,,percent of total billed charges,79.2% of total billed charges,19.13,85,,,percent of total billed charges,85% of total billed charges,22.5,100,,,fee schedule,100% of CO APG rates,21.38,95,,,percent of total billed charges,95% of total billed charges,18,80,,,percent of total billed charges,80% of total billed charges,19.13,85,,,percent of total billed charges,85% of total billed charges,20.25,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,9,40,,,percent of total billed charges,40% of total billed charges,9,40,,,percent of total billed charges,40% of total billed charges,20.25,90,,,percent of total billed charges,90% of total billed charges,17.1,76,,,percent of total billed charges,76% of total billed charges,9,40,,,percent of total billed charges,40% of total billed charges,19.13,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,18,80,,,percent of total billed charges,80% of total billed charges,8.73,38.8,,,percent of total billed charges,38.8% of total billed charges,19.13,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,8.73,65.96,
TENMO BIOPSY NEEDLE 18GX15CM,41252488,CDM,270,RC,,,OUTPATIENT,,,191.1,152.88,,143.33,75,,,percent of total billed charges,75% of total billed charges,76.44,40,,,percent of total billed charges,40% of total billed charges,151.35,79.2,,,percent of total billed charges,79.2% of total billed charges,162.44,85,,,percent of total billed charges,85% of total billed charges,191.1,100,,,fee schedule,100% of CO APG rates,181.55,95,,,percent of total billed charges,95% of total billed charges,152.88,80,,,percent of total billed charges,80% of total billed charges,162.44,85,,,percent of total billed charges,85% of total billed charges,171.99,90,,,percent of total billed charges,90% of total billed charges,191.1,100,,,fee schedule,100% of CO APG rates,191.1,100,,,fee schedule,100% of CO APG rates,191.1,100,,,fee schedule,100% of NM fee schedule,76.44,40,,,percent of total billed charges,40% of total billed charges,76.44,40,,,percent of total billed charges,40% of total billed charges,171.99,90,,,percent of total billed charges,90% of total billed charges,145.24,76,,,percent of total billed charges,76% of total billed charges,76.44,40,,,percent of total billed charges,40% of total billed charges,162.44,85,,,percent of total billed charges,85% of total billed charges,191.1,100,,,fee schedule,100% of CO APG rate,152.88,80,,,percent of total billed charges,80% of total billed charges,74.15,38.8,,,percent of total billed charges,38.8% of total billed charges,162.44,85,,,percent of total billed charges,85% of total billed charges,191.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,74.15,191.1,
Clinitest Urine 2,40084376,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,66,52.8,,49.5,75,,,percent of total billed charges,75% of total billed charges,26.4,40,,,percent of total billed charges,40% of total billed charges,52.27,79.2,,,percent of total billed charges,79.2% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,62.7,95,,,percent of total billed charges,95% of total billed charges,52.8,80,,,percent of total billed charges,80% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,59.4,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,26.4,40,,,percent of total billed charges,40% of total billed charges,26.4,40,,,percent of total billed charges,40% of total billed charges,59.4,90,,,percent of total billed charges,90% of total billed charges,50.16,76,,,percent of total billed charges,76% of total billed charges,26.4,40,,,percent of total billed charges,40% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,52.8,80,,,percent of total billed charges,80% of total billed charges,25.61,38.8,,,percent of total billed charges,38.8% of total billed charges,56.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,62.7,
Whirlpool Extremity Charge,42707022,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,66.4,53.12,GO,49.8,75,,,percent of total billed charges,75% of total billed charges,26.56,40,,,percent of total billed charges,40% of total billed charges,52.59,79.2,,,percent of total billed charges,79.2% of total billed charges,56.44,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,63.08,95,,,percent of total billed charges,95% of total billed charges,53.12,80,,,percent of total billed charges,80% of total billed charges,56.44,85,,,percent of total billed charges,85% of total billed charges,59.76,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,26.56,40,,,percent of total billed charges,40% of total billed charges,26.56,40,,,percent of total billed charges,40% of total billed charges,59.76,90,,,percent of total billed charges,90% of total billed charges,50.46,76,,,percent of total billed charges,76% of total billed charges,26.56,40,,,percent of total billed charges,40% of total billed charges,56.44,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,53.12,80,,,percent of total billed charges,80% of total billed charges,25.76,38.8,,,percent of total billed charges,38.8% of total billed charges,56.44,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,25.76,65.96,
"CCK (CHOLECYSTOKININ), KINEVAC 5MCG",41152491,CDM,255,RC,,,OUTPATIENT,,,339.3,271.44,,254.48,75,,,percent of total billed charges,75% of total billed charges,135.72,40,,,percent of total billed charges,40% of total billed charges,268.73,79.2,,,percent of total billed charges,79.2% of total billed charges,288.41,85,,,percent of total billed charges,85% of total billed charges,339.3,100,,,fee schedule,100% of CO APG rates,322.34,95,,,percent of total billed charges,95% of total billed charges,271.44,80,,,percent of total billed charges,80% of total billed charges,288.41,85,,,percent of total billed charges,85% of total billed charges,305.37,90,,,percent of total billed charges,90% of total billed charges,339.3,100,,,fee schedule,100% of CO APG rates,339.3,100,,,fee schedule,100% of CO APG rates,339.3,100,,,fee schedule,100% of NM fee schedule,135.72,40,,,percent of total billed charges,40% of total billed charges,135.72,40,,,percent of total billed charges,40% of total billed charges,305.37,90,,,percent of total billed charges,90% of total billed charges,257.87,76,,,percent of total billed charges,76% of total billed charges,135.72,40,,,percent of total billed charges,40% of total billed charges,288.41,85,,,percent of total billed charges,85% of total billed charges,339.3,100,,,fee schedule,100% of CO APG rate,271.44,80,,,percent of total billed charges,80% of total billed charges,131.65,38.8,,,percent of total billed charges,38.8% of total billed charges,288.41,85,,,percent of total billed charges,85% of total billed charges,339.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,131.65,339.3,
Removal of Foreign Body from Pharynx,49142809,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1268.8,1015.04,,951.6,75,,,percent of total billed charges,75% of total billed charges,507.52,40,,,percent of total billed charges,40% of total billed charges,1004.89,79.2,,,percent of total billed charges,79.2% of total billed charges,1078.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1205.36,95,,,percent of total billed charges,95% of total billed charges,1015.04,80,,,percent of total billed charges,80% of total billed charges,1078.48,85,,,percent of total billed charges,85% of total billed charges,1141.92,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,507.52,40,,,percent of total billed charges,40% of total billed charges,507.52,40,,,percent of total billed charges,40% of total billed charges,1141.92,90,,,percent of total billed charges,90% of total billed charges,964.29,76,,,percent of total billed charges,76% of total billed charges,507.52,40,,,percent of total billed charges,40% of total billed charges,1078.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1015.04,80,,,percent of total billed charges,80% of total billed charges,492.29,38.8,,,percent of total billed charges,38.8% of total billed charges,1078.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1205.36,
"SUTURE 2-0, COATED VICRYL, PLUS ABSORBABLE, VCP333H",46052496,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.91,7.5,
Vancomycin Random Level,40080202,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
"INJECTION MANOMETER, B-SMART",46252498,CDM,270,RC,,,OUTPATIENT,,,51.2,40.96,,38.4,75,,,percent of total billed charges,75% of total billed charges,20.48,40,,,percent of total billed charges,40% of total billed charges,40.55,79.2,,,percent of total billed charges,79.2% of total billed charges,43.52,85,,,percent of total billed charges,85% of total billed charges,51.2,100,,,fee schedule,100% of CO APG rates,48.64,95,,,percent of total billed charges,95% of total billed charges,40.96,80,,,percent of total billed charges,80% of total billed charges,43.52,85,,,percent of total billed charges,85% of total billed charges,46.08,90,,,percent of total billed charges,90% of total billed charges,51.2,100,,,fee schedule,100% of CO APG rates,51.2,100,,,fee schedule,100% of CO APG rates,51.2,100,,,fee schedule,100% of NM fee schedule,20.48,40,,,percent of total billed charges,40% of total billed charges,20.48,40,,,percent of total billed charges,40% of total billed charges,46.08,90,,,percent of total billed charges,90% of total billed charges,38.91,76,,,percent of total billed charges,76% of total billed charges,20.48,40,,,percent of total billed charges,40% of total billed charges,43.52,85,,,percent of total billed charges,85% of total billed charges,51.2,100,,,fee schedule,100% of CO APG rate,40.96,80,,,percent of total billed charges,80% of total billed charges,19.87,38.8,,,percent of total billed charges,38.8% of total billed charges,43.52,85,,,percent of total billed charges,85% of total billed charges,51.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,19.87,51.2,
Pap IG,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
HPV,40087624,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,151.24,
Urine Microalbumin 24 Hour 1,40082043,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,76.4,61.12,,57.3,75,,,percent of total billed charges,75% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,60.51,79.2,,,percent of total billed charges,79.2% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,72.58,95,,,percent of total billed charges,95% of total billed charges,61.12,80,,,percent of total billed charges,80% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,30.56,40,,,percent of total billed charges,40% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,68.76,90,,,percent of total billed charges,90% of total billed charges,58.06,76,,,percent of total billed charges,76% of total billed charges,30.56,40,,,percent of total billed charges,40% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,61.12,80,,,percent of total billed charges,80% of total billed charges,29.64,38.8,,,percent of total billed charges,38.8% of total billed charges,64.94,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,72.58,
"SUTURE 3-0 COATED VICRYL SH1, J772D",46052500,CDM,270,RC,,,OUTPATIENT,,,36.1,28.88,,27.08,75,,,percent of total billed charges,75% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,28.59,79.2,,,percent of total billed charges,79.2% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,36.1,100,,,fee schedule,100% of CO APG rates,34.3,95,,,percent of total billed charges,95% of total billed charges,28.88,80,,,percent of total billed charges,80% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,32.49,90,,,percent of total billed charges,90% of total billed charges,36.1,100,,,fee schedule,100% of CO APG rates,36.1,100,,,fee schedule,100% of CO APG rates,36.1,100,,,fee schedule,100% of NM fee schedule,14.44,40,,,percent of total billed charges,40% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,32.49,90,,,percent of total billed charges,90% of total billed charges,27.44,76,,,percent of total billed charges,76% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,36.1,100,,,fee schedule,100% of CO APG rate,28.88,80,,,percent of total billed charges,80% of total billed charges,14.01,38.8,,,percent of total billed charges,38.8% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,36.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,14.01,36.1,
"SUTURE 4-0 MONCRYL PLUS PS-2, MCP426H",46052501,CDM,270,RC,,,OUTPATIENT,,,20.8,16.64,,15.6,75,,,percent of total billed charges,75% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,16.47,79.2,,,percent of total billed charges,79.2% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rates,19.76,95,,,percent of total billed charges,95% of total billed charges,16.64,80,,,percent of total billed charges,80% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rates,20.8,100,,,fee schedule,100% of CO APG rates,20.8,100,,,fee schedule,100% of NM fee schedule,8.32,40,,,percent of total billed charges,40% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,15.81,76,,,percent of total billed charges,76% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rate,16.64,80,,,percent of total billed charges,80% of total billed charges,8.07,38.8,,,percent of total billed charges,38.8% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.07,20.8,
77012 - Computer tomography guidance for needle placement (e,46077012,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,252.4,201.92,,189.3,75,,,percent of total billed charges,75% of total billed charges,100.96,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,214.54,85,,,percent of total billed charges,85% of total billed charges,252.4,100,,,fee schedule,100% of CO APG rates,239.78,95,,,percent of total billed charges,95% of total billed charges,201.92,80,,,percent of total billed charges,80% of total billed charges,214.54,85,,,percent of total billed charges,85% of total billed charges,227.16,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,100.96,40,,,percent of total billed charges,40% of total billed charges,100.96,40,,,percent of total billed charges,40% of total billed charges,227.16,90,,,percent of total billed charges,90% of total billed charges,191.82,76,,,percent of total billed charges,76% of total billed charges,100.96,40,,,percent of total billed charges,40% of total billed charges,214.54,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,201.92,80,,,percent of total billed charges,80% of total billed charges,97.93,38.8,,,percent of total billed charges,38.8% of total billed charges,214.54,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,97.93,514,
"FLUTED HEADLESS 1/8 PIN, WICKED",46052503,CDM,270,RC,,,OUTPATIENT,,,601.9,481.52,,451.43,75,,,percent of total billed charges,75% of total billed charges,240.76,40,,,percent of total billed charges,40% of total billed charges,476.7,79.2,,,percent of total billed charges,79.2% of total billed charges,511.62,85,,,percent of total billed charges,85% of total billed charges,601.9,100,,,fee schedule,100% of CO APG rates,571.81,95,,,percent of total billed charges,95% of total billed charges,481.52,80,,,percent of total billed charges,80% of total billed charges,511.62,85,,,percent of total billed charges,85% of total billed charges,541.71,90,,,percent of total billed charges,90% of total billed charges,601.9,100,,,fee schedule,100% of CO APG rates,601.9,100,,,fee schedule,100% of CO APG rates,601.9,100,,,fee schedule,100% of NM fee schedule,240.76,40,,,percent of total billed charges,40% of total billed charges,240.76,40,,,percent of total billed charges,40% of total billed charges,541.71,90,,,percent of total billed charges,90% of total billed charges,457.44,76,,,percent of total billed charges,76% of total billed charges,240.76,40,,,percent of total billed charges,40% of total billed charges,511.62,85,,,percent of total billed charges,85% of total billed charges,601.9,100,,,fee schedule,100% of CO APG rate,481.52,80,,,percent of total billed charges,80% of total billed charges,233.54,38.8,,,percent of total billed charges,38.8% of total billed charges,511.62,85,,,percent of total billed charges,85% of total billed charges,601.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,233.54,601.9,
YEUH CENTESIS CATHETER 6FR X10CM,52505,CDM,270,RC,,,OUTPATIENT,,,97.2,77.76,,72.9,75,,,percent of total billed charges,75% of total billed charges,38.88,40,,,percent of total billed charges,40% of total billed charges,76.98,79.2,,,percent of total billed charges,79.2% of total billed charges,82.62,85,,,percent of total billed charges,85% of total billed charges,97.2,100,,,fee schedule,100% of CO APG rates,92.34,95,,,percent of total billed charges,95% of total billed charges,77.76,80,,,percent of total billed charges,80% of total billed charges,82.62,85,,,percent of total billed charges,85% of total billed charges,87.48,90,,,percent of total billed charges,90% of total billed charges,97.2,100,,,fee schedule,100% of CO APG rates,97.2,100,,,fee schedule,100% of CO APG rates,97.2,100,,,fee schedule,100% of NM fee schedule,38.88,40,,,percent of total billed charges,40% of total billed charges,38.88,40,,,percent of total billed charges,40% of total billed charges,87.48,90,,,percent of total billed charges,90% of total billed charges,73.87,76,,,percent of total billed charges,76% of total billed charges,38.88,40,,,percent of total billed charges,40% of total billed charges,82.62,85,,,percent of total billed charges,85% of total billed charges,97.2,100,,,fee schedule,100% of CO APG rate,77.76,80,,,percent of total billed charges,80% of total billed charges,37.71,38.8,,,percent of total billed charges,38.8% of total billed charges,82.62,85,,,percent of total billed charges,85% of total billed charges,97.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,37.71,97.2,
von Willebrand Factor Activity LC,40085240,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,331.2,264.96,,248.4,75,,,percent of total billed charges,75% of total billed charges,132.48,40,,,percent of total billed charges,40% of total billed charges,262.31,79.2,,,percent of total billed charges,79.2% of total billed charges,281.52,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,314.64,95,,,percent of total billed charges,95% of total billed charges,264.96,80,,,percent of total billed charges,80% of total billed charges,281.52,85,,,percent of total billed charges,85% of total billed charges,298.08,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,132.48,40,,,percent of total billed charges,40% of total billed charges,132.48,40,,,percent of total billed charges,40% of total billed charges,298.08,90,,,percent of total billed charges,90% of total billed charges,251.71,76,,,percent of total billed charges,76% of total billed charges,132.48,40,,,percent of total billed charges,40% of total billed charges,281.52,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,264.96,80,,,percent of total billed charges,80% of total billed charges,128.51,38.8,,,percent of total billed charges,38.8% of total billed charges,281.52,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,314.64,
aPTT LC,40085730,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,85.1,68.08,,63.83,75,,,percent of total billed charges,75% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,67.4,79.2,,,percent of total billed charges,79.2% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,80.85,95,,,percent of total billed charges,95% of total billed charges,68.08,80,,,percent of total billed charges,80% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,34.04,40,,,percent of total billed charges,40% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,64.68,76,,,percent of total billed charges,76% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,68.08,80,,,percent of total billed charges,80% of total billed charges,33.02,38.8,,,percent of total billed charges,38.8% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,80.85,
Factor VIII Activity LC,40085240,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,126.6,101.28,,94.95,75,,,percent of total billed charges,75% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,100.27,79.2,,,percent of total billed charges,79.2% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,120.27,95,,,percent of total billed charges,95% of total billed charges,101.28,80,,,percent of total billed charges,80% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,50.64,40,,,percent of total billed charges,40% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,96.22,76,,,percent of total billed charges,76% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,101.28,80,,,percent of total billed charges,80% of total billed charges,49.12,38.8,,,percent of total billed charges,38.8% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,120.27,
von Willebrand Factor Activity LC,40085245,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,190.3,152.24,,142.73,75,,,percent of total billed charges,75% of total billed charges,76.12,40,,,percent of total billed charges,40% of total billed charges,150.72,79.2,,,percent of total billed charges,79.2% of total billed charges,161.76,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,180.79,95,,,percent of total billed charges,95% of total billed charges,152.24,80,,,percent of total billed charges,80% of total billed charges,161.76,85,,,percent of total billed charges,85% of total billed charges,171.27,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,76.12,40,,,percent of total billed charges,40% of total billed charges,76.12,40,,,percent of total billed charges,40% of total billed charges,171.27,90,,,percent of total billed charges,90% of total billed charges,144.63,76,,,percent of total billed charges,76% of total billed charges,76.12,40,,,percent of total billed charges,40% of total billed charges,161.76,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,152.24,80,,,percent of total billed charges,80% of total billed charges,73.84,38.8,,,percent of total billed charges,38.8% of total billed charges,161.76,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,180.79,
von Willebrand Factor Antigen LC,40085246,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,126.6,101.28,,94.95,75,,,percent of total billed charges,75% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,100.27,79.2,,,percent of total billed charges,79.2% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,120.27,95,,,percent of total billed charges,95% of total billed charges,101.28,80,,,percent of total billed charges,80% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,50.64,40,,,percent of total billed charges,40% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,96.22,76,,,percent of total billed charges,76% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,101.28,80,,,percent of total billed charges,80% of total billed charges,49.12,38.8,,,percent of total billed charges,38.8% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,120.27,
vWF Collagen Binding LC,40083520,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,68.2,54.56,,51.15,75,,,percent of total billed charges,75% of total billed charges,27.28,40,,,percent of total billed charges,40% of total billed charges,54.01,79.2,,,percent of total billed charges,79.2% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,64.79,95,,,percent of total billed charges,95% of total billed charges,54.56,80,,,percent of total billed charges,80% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,61.38,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,27.28,40,,,percent of total billed charges,40% of total billed charges,27.28,40,,,percent of total billed charges,40% of total billed charges,61.38,90,,,percent of total billed charges,90% of total billed charges,51.83,76,,,percent of total billed charges,76% of total billed charges,27.28,40,,,percent of total billed charges,40% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,54.56,80,,,percent of total billed charges,80% of total billed charges,26.46,38.8,,,percent of total billed charges,38.8% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,64.79,
UDS out,40099001,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,40.8,32.64,,30.6,75,,,percent of total billed charges,75% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,32.31,79.2,,,percent of total billed charges,79.2% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,38.76,95,,,percent of total billed charges,95% of total billed charges,32.64,80,,,percent of total billed charges,80% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,16.32,40,,,percent of total billed charges,40% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,31.01,76,,,percent of total billed charges,76% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,32.64,80,,,percent of total billed charges,80% of total billed charges,15.83,38.8,,,percent of total billed charges,38.8% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,38.76,
SURGICAL BRA MEDIUM,52507,CDM,270,RC,,,OUTPATIENT,,,148.5,118.8,,111.38,75,,,percent of total billed charges,75% of total billed charges,59.4,40,,,percent of total billed charges,40% of total billed charges,117.61,79.2,,,percent of total billed charges,79.2% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,148.5,100,,,fee schedule,100% of CO APG rates,141.08,95,,,percent of total billed charges,95% of total billed charges,118.8,80,,,percent of total billed charges,80% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,133.65,90,,,percent of total billed charges,90% of total billed charges,148.5,100,,,fee schedule,100% of CO APG rates,148.5,100,,,fee schedule,100% of CO APG rates,148.5,100,,,fee schedule,100% of NM fee schedule,59.4,40,,,percent of total billed charges,40% of total billed charges,59.4,40,,,percent of total billed charges,40% of total billed charges,133.65,90,,,percent of total billed charges,90% of total billed charges,112.86,76,,,percent of total billed charges,76% of total billed charges,59.4,40,,,percent of total billed charges,40% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,148.5,100,,,fee schedule,100% of CO APG rate,118.8,80,,,percent of total billed charges,80% of total billed charges,57.62,38.8,,,percent of total billed charges,38.8% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,148.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,57.62,148.5,
SURGICAL BRA LARGE,52508,CDM,270,RC,,,OUTPATIENT,,,148.5,118.8,,111.38,75,,,percent of total billed charges,75% of total billed charges,59.4,40,,,percent of total billed charges,40% of total billed charges,117.61,79.2,,,percent of total billed charges,79.2% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,148.5,100,,,fee schedule,100% of CO APG rates,141.08,95,,,percent of total billed charges,95% of total billed charges,118.8,80,,,percent of total billed charges,80% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,133.65,90,,,percent of total billed charges,90% of total billed charges,148.5,100,,,fee schedule,100% of CO APG rates,148.5,100,,,fee schedule,100% of CO APG rates,148.5,100,,,fee schedule,100% of NM fee schedule,59.4,40,,,percent of total billed charges,40% of total billed charges,59.4,40,,,percent of total billed charges,40% of total billed charges,133.65,90,,,percent of total billed charges,90% of total billed charges,112.86,76,,,percent of total billed charges,76% of total billed charges,59.4,40,,,percent of total billed charges,40% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,148.5,100,,,fee schedule,100% of CO APG rate,118.8,80,,,percent of total billed charges,80% of total billed charges,57.62,38.8,,,percent of total billed charges,38.8% of total billed charges,126.23,85,,,percent of total billed charges,85% of total billed charges,148.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,57.62,148.5,
"TRIDENT HIP DRILL BIT, 4.0MM X 25MM",460ECON0200,CDM,270,RC,,,OUTPATIENT,,,481.8,385.44,,361.35,75,,,percent of total billed charges,75% of total billed charges,192.72,40,,,percent of total billed charges,40% of total billed charges,381.59,79.2,,,percent of total billed charges,79.2% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,481.8,100,,,fee schedule,100% of CO APG rates,457.71,95,,,percent of total billed charges,95% of total billed charges,385.44,80,,,percent of total billed charges,80% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,433.62,90,,,percent of total billed charges,90% of total billed charges,481.8,100,,,fee schedule,100% of CO APG rates,481.8,100,,,fee schedule,100% of CO APG rates,481.8,100,,,fee schedule,100% of NM fee schedule,192.72,40,,,percent of total billed charges,40% of total billed charges,192.72,40,,,percent of total billed charges,40% of total billed charges,433.62,90,,,percent of total billed charges,90% of total billed charges,366.17,76,,,percent of total billed charges,76% of total billed charges,192.72,40,,,percent of total billed charges,40% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,481.8,100,,,fee schedule,100% of CO APG rate,385.44,80,,,percent of total billed charges,80% of total billed charges,186.94,38.8,,,percent of total billed charges,38.8% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,481.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,186.94,481.8,
"TRIDENT HIP DRILL BIT, 4.0MM X 40MM",460ECON0201,CDM,270,RC,,,OUTPATIENT,,,481.8,385.44,,361.35,75,,,percent of total billed charges,75% of total billed charges,192.72,40,,,percent of total billed charges,40% of total billed charges,381.59,79.2,,,percent of total billed charges,79.2% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,481.8,100,,,fee schedule,100% of CO APG rates,457.71,95,,,percent of total billed charges,95% of total billed charges,385.44,80,,,percent of total billed charges,80% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,433.62,90,,,percent of total billed charges,90% of total billed charges,481.8,100,,,fee schedule,100% of CO APG rates,481.8,100,,,fee schedule,100% of CO APG rates,481.8,100,,,fee schedule,100% of NM fee schedule,192.72,40,,,percent of total billed charges,40% of total billed charges,192.72,40,,,percent of total billed charges,40% of total billed charges,433.62,90,,,percent of total billed charges,90% of total billed charges,366.17,76,,,percent of total billed charges,76% of total billed charges,192.72,40,,,percent of total billed charges,40% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,481.8,100,,,fee schedule,100% of CO APG rate,385.44,80,,,percent of total billed charges,80% of total billed charges,186.94,38.8,,,percent of total billed charges,38.8% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,481.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,186.94,481.8,
"TRIDENT HIP DRILL BIT, 4.0MM X 60MM",460ECON0202,CDM,270,RC,,,OUTPATIENT,,,481.8,385.44,,361.35,75,,,percent of total billed charges,75% of total billed charges,192.72,40,,,percent of total billed charges,40% of total billed charges,381.59,79.2,,,percent of total billed charges,79.2% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,481.8,100,,,fee schedule,100% of CO APG rates,457.71,95,,,percent of total billed charges,95% of total billed charges,385.44,80,,,percent of total billed charges,80% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,433.62,90,,,percent of total billed charges,90% of total billed charges,481.8,100,,,fee schedule,100% of CO APG rates,481.8,100,,,fee schedule,100% of CO APG rates,481.8,100,,,fee schedule,100% of NM fee schedule,192.72,40,,,percent of total billed charges,40% of total billed charges,192.72,40,,,percent of total billed charges,40% of total billed charges,433.62,90,,,percent of total billed charges,90% of total billed charges,366.17,76,,,percent of total billed charges,76% of total billed charges,192.72,40,,,percent of total billed charges,40% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,481.8,100,,,fee schedule,100% of CO APG rate,385.44,80,,,percent of total billed charges,80% of total billed charges,186.94,38.8,,,percent of total billed charges,38.8% of total billed charges,409.53,85,,,percent of total billed charges,85% of total billed charges,481.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,186.94,481.8,
"SUTURE, ETHI-PACK SURGICAL STEEL 18GA",46052511,CDM,270,RC,,,OUTPATIENT,,,3.4,2.72,,2.55,75,,,percent of total billed charges,75% of total billed charges,1.36,40,,,percent of total billed charges,40% of total billed charges,2.69,79.2,,,percent of total billed charges,79.2% of total billed charges,2.89,85,,,percent of total billed charges,85% of total billed charges,3.4,100,,,fee schedule,100% of CO APG rates,3.23,95,,,percent of total billed charges,95% of total billed charges,2.72,80,,,percent of total billed charges,80% of total billed charges,2.89,85,,,percent of total billed charges,85% of total billed charges,3.06,90,,,percent of total billed charges,90% of total billed charges,3.4,100,,,fee schedule,100% of CO APG rates,3.4,100,,,fee schedule,100% of CO APG rates,3.4,100,,,fee schedule,100% of NM fee schedule,1.36,40,,,percent of total billed charges,40% of total billed charges,1.36,40,,,percent of total billed charges,40% of total billed charges,3.06,90,,,percent of total billed charges,90% of total billed charges,2.58,76,,,percent of total billed charges,76% of total billed charges,1.36,40,,,percent of total billed charges,40% of total billed charges,2.89,85,,,percent of total billed charges,85% of total billed charges,3.4,100,,,fee schedule,100% of CO APG rate,2.72,80,,,percent of total billed charges,80% of total billed charges,1.32,38.8,,,percent of total billed charges,38.8% of total billed charges,2.89,85,,,percent of total billed charges,85% of total billed charges,3.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1.32,3.4,
"SUTURE, ETHI-PACK SURGICAL STEEL 20GA",46052512,CDM,270,RC,,,OUTPATIENT,,,3.6,2.88,,2.7,75,,,percent of total billed charges,75% of total billed charges,1.44,40,,,percent of total billed charges,40% of total billed charges,2.85,79.2,,,percent of total billed charges,79.2% of total billed charges,3.06,85,,,percent of total billed charges,85% of total billed charges,3.6,100,,,fee schedule,100% of CO APG rates,3.42,95,,,percent of total billed charges,95% of total billed charges,2.88,80,,,percent of total billed charges,80% of total billed charges,3.06,85,,,percent of total billed charges,85% of total billed charges,3.24,90,,,percent of total billed charges,90% of total billed charges,3.6,100,,,fee schedule,100% of CO APG rates,3.6,100,,,fee schedule,100% of CO APG rates,3.6,100,,,fee schedule,100% of NM fee schedule,1.44,40,,,percent of total billed charges,40% of total billed charges,1.44,40,,,percent of total billed charges,40% of total billed charges,3.24,90,,,percent of total billed charges,90% of total billed charges,2.74,76,,,percent of total billed charges,76% of total billed charges,1.44,40,,,percent of total billed charges,40% of total billed charges,3.06,85,,,percent of total billed charges,85% of total billed charges,3.6,100,,,fee schedule,100% of CO APG rate,2.88,80,,,percent of total billed charges,80% of total billed charges,1.4,38.8,,,percent of total billed charges,38.8% of total billed charges,3.06,85,,,percent of total billed charges,85% of total billed charges,3.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1.4,3.6,
CT Dual Head Syringe 200ml,41152465,CDM,270,RC,,,OUTPATIENT,,,136.5,109.2,,102.38,75,,,percent of total billed charges,75% of total billed charges,54.6,40,,,percent of total billed charges,40% of total billed charges,108.11,79.2,,,percent of total billed charges,79.2% of total billed charges,116.03,85,,,percent of total billed charges,85% of total billed charges,136.5,100,,,fee schedule,100% of CO APG rates,129.68,95,,,percent of total billed charges,95% of total billed charges,109.2,80,,,percent of total billed charges,80% of total billed charges,116.03,85,,,percent of total billed charges,85% of total billed charges,122.85,90,,,percent of total billed charges,90% of total billed charges,136.5,100,,,fee schedule,100% of CO APG rates,136.5,100,,,fee schedule,100% of CO APG rates,136.5,100,,,fee schedule,100% of NM fee schedule,54.6,40,,,percent of total billed charges,40% of total billed charges,54.6,40,,,percent of total billed charges,40% of total billed charges,122.85,90,,,percent of total billed charges,90% of total billed charges,103.74,76,,,percent of total billed charges,76% of total billed charges,54.6,40,,,percent of total billed charges,40% of total billed charges,116.03,85,,,percent of total billed charges,85% of total billed charges,136.5,100,,,fee schedule,100% of CO APG rate,109.2,80,,,percent of total billed charges,80% of total billed charges,52.96,38.8,,,percent of total billed charges,38.8% of total billed charges,116.03,85,,,percent of total billed charges,85% of total billed charges,136.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,52.96,136.5,
PSMC Eovist,30588,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,69.8,55.84,,52.35,75,,,percent of total billed charges,75% of total billed charges,27.92,40,,,percent of total billed charges,40% of total billed charges,55.28,79.2,,,percent of total billed charges,79.2% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,66.31,95,,,percent of total billed charges,95% of total billed charges,55.84,80,,,percent of total billed charges,80% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,62.82,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,69.8,100,,,fee schedule,100% of NM fee schedule,27.92,40,,,percent of total billed charges,40% of total billed charges,27.92,40,,,percent of total billed charges,40% of total billed charges,62.82,90,,,percent of total billed charges,90% of total billed charges,53.05,76,,,percent of total billed charges,76% of total billed charges,27.92,40,,,percent of total billed charges,40% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,55.84,80,,,percent of total billed charges,80% of total billed charges,27.08,38.8,,,percent of total billed charges,38.8% of total billed charges,59.33,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,27.08,69.8,
"CCK (CHOLECYSTOKININ), KINEVAC 5MCG",41152491,CDM,255,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
PSMC Tech-99,30601,CDM,255,RC,,,OUTPATIENT,,,59.9,47.92,,44.93,75,,,percent of total billed charges,75% of total billed charges,23.96,40,,,percent of total billed charges,40% of total billed charges,47.44,79.2,,,percent of total billed charges,79.2% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,59.9,100,,,fee schedule,100% of CO APG rates,56.91,95,,,percent of total billed charges,95% of total billed charges,47.92,80,,,percent of total billed charges,80% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,53.91,90,,,percent of total billed charges,90% of total billed charges,59.9,100,,,fee schedule,100% of CO APG rates,59.9,100,,,fee schedule,100% of CO APG rates,59.9,100,,,fee schedule,100% of NM fee schedule,23.96,40,,,percent of total billed charges,40% of total billed charges,23.96,40,,,percent of total billed charges,40% of total billed charges,53.91,90,,,percent of total billed charges,90% of total billed charges,45.52,76,,,percent of total billed charges,76% of total billed charges,23.96,40,,,percent of total billed charges,40% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,59.9,100,,,fee schedule,100% of CO APG rate,47.92,80,,,percent of total billed charges,80% of total billed charges,23.24,38.8,,,percent of total billed charges,38.8% of total billed charges,50.92,85,,,percent of total billed charges,85% of total billed charges,59.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,23.24,59.9,
PSMC I-123,30604,CDM,343,RC,,,OUTPATIENT,,,900.3,720.24,,675.23,75,,,percent of total billed charges,75% of total billed charges,360.12,40,,,percent of total billed charges,40% of total billed charges,713.04,79.2,,,percent of total billed charges,79.2% of total billed charges,765.26,85,,,percent of total billed charges,85% of total billed charges,900.3,100,,,fee schedule,100% of CO APG rates,855.29,95,,,percent of total billed charges,95% of total billed charges,720.24,80,,,percent of total billed charges,80% of total billed charges,765.26,85,,,percent of total billed charges,85% of total billed charges,810.27,90,,,percent of total billed charges,90% of total billed charges,900.3,100,,,fee schedule,100% of CO APG rates,900.3,100,,,fee schedule,100% of CO APG rates,900.3,100,,,fee schedule,100% of NM fee schedule,360.12,40,,,percent of total billed charges,40% of total billed charges,360.12,40,,,percent of total billed charges,40% of total billed charges,810.27,90,,,percent of total billed charges,90% of total billed charges,684.23,76,,,percent of total billed charges,76% of total billed charges,360.12,40,,,percent of total billed charges,40% of total billed charges,765.26,85,,,percent of total billed charges,85% of total billed charges,900.3,100,,,fee schedule,100% of CO APG rate,720.24,80,,,percent of total billed charges,80% of total billed charges,349.32,38.8,,,percent of total billed charges,38.8% of total billed charges,765.26,85,,,percent of total billed charges,85% of total billed charges,900.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,349.32,900.3,
"ON-Q, SINGLE SHOT PREP KIT- TBT02",52516,CDM,270,RC,,,OUTPATIENT,,,152.9,122.32,,114.68,75,,,percent of total billed charges,75% of total billed charges,61.16,40,,,percent of total billed charges,40% of total billed charges,121.1,79.2,,,percent of total billed charges,79.2% of total billed charges,129.97,85,,,percent of total billed charges,85% of total billed charges,152.9,100,,,fee schedule,100% of CO APG rates,145.26,95,,,percent of total billed charges,95% of total billed charges,122.32,80,,,percent of total billed charges,80% of total billed charges,129.97,85,,,percent of total billed charges,85% of total billed charges,137.61,90,,,percent of total billed charges,90% of total billed charges,152.9,100,,,fee schedule,100% of CO APG rates,152.9,100,,,fee schedule,100% of CO APG rates,152.9,100,,,fee schedule,100% of NM fee schedule,61.16,40,,,percent of total billed charges,40% of total billed charges,61.16,40,,,percent of total billed charges,40% of total billed charges,137.61,90,,,percent of total billed charges,90% of total billed charges,116.2,76,,,percent of total billed charges,76% of total billed charges,61.16,40,,,percent of total billed charges,40% of total billed charges,129.97,85,,,percent of total billed charges,85% of total billed charges,152.9,100,,,fee schedule,100% of CO APG rate,122.32,80,,,percent of total billed charges,80% of total billed charges,59.33,38.8,,,percent of total billed charges,38.8% of total billed charges,129.97,85,,,percent of total billed charges,85% of total billed charges,152.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,59.33,152.9,
EMERGENCY PNEUMOTHORAX SET,52517,CDM,270,RC,,,OUTPATIENT,,,432.6,346.08,,324.45,75,,,percent of total billed charges,75% of total billed charges,173.04,40,,,percent of total billed charges,40% of total billed charges,342.62,79.2,,,percent of total billed charges,79.2% of total billed charges,367.71,85,,,percent of total billed charges,85% of total billed charges,432.6,100,,,fee schedule,100% of CO APG rates,410.97,95,,,percent of total billed charges,95% of total billed charges,346.08,80,,,percent of total billed charges,80% of total billed charges,367.71,85,,,percent of total billed charges,85% of total billed charges,389.34,90,,,percent of total billed charges,90% of total billed charges,432.6,100,,,fee schedule,100% of CO APG rates,432.6,100,,,fee schedule,100% of CO APG rates,432.6,100,,,fee schedule,100% of NM fee schedule,173.04,40,,,percent of total billed charges,40% of total billed charges,173.04,40,,,percent of total billed charges,40% of total billed charges,389.34,90,,,percent of total billed charges,90% of total billed charges,328.78,76,,,percent of total billed charges,76% of total billed charges,173.04,40,,,percent of total billed charges,40% of total billed charges,367.71,85,,,percent of total billed charges,85% of total billed charges,432.6,100,,,fee schedule,100% of CO APG rate,346.08,80,,,percent of total billed charges,80% of total billed charges,167.85,38.8,,,percent of total billed charges,38.8% of total billed charges,367.71,85,,,percent of total billed charges,85% of total billed charges,432.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,167.85,432.6,
90686 Fluzone 0.5mL Single dose syringe; Quadrivalent Influe,49190686,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,51.5,41.2,,38.63,75,,,percent of total billed charges,75% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,40.79,79.2,,,percent of total billed charges,79.2% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,48.93,95,,,percent of total billed charges,95% of total billed charges,41.2,80,,,percent of total billed charges,80% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,46.35,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,51.5,100,,,fee schedule,100% of NM fee schedule,20.6,40,,,percent of total billed charges,40% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,46.35,90,,,percent of total billed charges,90% of total billed charges,39.14,76,,,percent of total billed charges,76% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,41.2,80,,,percent of total billed charges,80% of total billed charges,19.98,38.8,,,percent of total billed charges,38.8% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,19.98,51.5,
MA Stereotactic Biopsy Bil.,60001041,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,4817.3,3853.84,TC,3612.98,75,,,percent of total billed charges,75% of total billed charges,1926.92,40,,,percent of total billed charges,40% of total billed charges,3815.3,79.2,,,percent of total billed charges,79.2% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,4576.44,95,,,percent of total billed charges,95% of total billed charges,3853.84,80,,,percent of total billed charges,80% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,4335.57,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,1926.92,40,,,percent of total billed charges,40% of total billed charges,1926.92,40,,,percent of total billed charges,40% of total billed charges,4335.57,90,,,percent of total billed charges,90% of total billed charges,3661.15,76,,,percent of total billed charges,76% of total billed charges,1926.92,40,,,percent of total billed charges,40% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,3853.84,80,,,percent of total billed charges,80% of total billed charges,1869.11,38.8,,,percent of total billed charges,38.8% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,4576.44,
MA Stereotactic Biopsy Lt.,60001042,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,4817.3,3853.84,TC,3612.98,75,,,percent of total billed charges,75% of total billed charges,1926.92,40,,,percent of total billed charges,40% of total billed charges,3815.3,79.2,,,percent of total billed charges,79.2% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,4576.44,95,,,percent of total billed charges,95% of total billed charges,3853.84,80,,,percent of total billed charges,80% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,4335.57,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,1926.92,40,,,percent of total billed charges,40% of total billed charges,1926.92,40,,,percent of total billed charges,40% of total billed charges,4335.57,90,,,percent of total billed charges,90% of total billed charges,3661.15,76,,,percent of total billed charges,76% of total billed charges,1926.92,40,,,percent of total billed charges,40% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,3853.84,80,,,percent of total billed charges,80% of total billed charges,1869.11,38.8,,,percent of total billed charges,38.8% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,4576.44,
MA Stereotactic Biopsy Rt.,60001043,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,4817.3,3853.84,TC,3612.98,75,,,percent of total billed charges,75% of total billed charges,1926.92,40,,,percent of total billed charges,40% of total billed charges,3815.3,79.2,,,percent of total billed charges,79.2% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,4576.44,95,,,percent of total billed charges,95% of total billed charges,3853.84,80,,,percent of total billed charges,80% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,4335.57,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,1926.92,40,,,percent of total billed charges,40% of total billed charges,1926.92,40,,,percent of total billed charges,40% of total billed charges,4335.57,90,,,percent of total billed charges,90% of total billed charges,3661.15,76,,,percent of total billed charges,76% of total billed charges,1926.92,40,,,percent of total billed charges,40% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,3853.84,80,,,percent of total billed charges,80% of total billed charges,1869.11,38.8,,,percent of total billed charges,38.8% of total billed charges,4094.71,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,4576.44,
"27372 - Removal of foreign body deep, thigh or knee",60000397,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,8615.4,6892.32,,6461.55,75,,,percent of total billed charges,75% of total billed charges,3446.16,40,,,percent of total billed charges,40% of total billed charges,6823.4,79.2,,,percent of total billed charges,79.2% of total billed charges,7323.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,8184.63,95,,,percent of total billed charges,95% of total billed charges,6892.32,80,,,percent of total billed charges,80% of total billed charges,7323.09,85,,,percent of total billed charges,85% of total billed charges,7753.86,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,4330.27,100,,,fee schedule,100% of NM APC rate,3446.16,40,,,percent of total billed charges,40% of total billed charges,3446.16,40,,,percent of total billed charges,40% of total billed charges,7753.86,90,,,percent of total billed charges,90% of total billed charges,6547.7,76,,,percent of total billed charges,76% of total billed charges,3446.16,40,,,percent of total billed charges,40% of total billed charges,7323.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,6892.32,80,,,percent of total billed charges,80% of total billed charges,3342.78,38.8,,,percent of total billed charges,38.8% of total billed charges,7323.09,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,215.49,8184.63,
MA Stereotactic Biopsy Addl Lt.,60001045,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,2408.6,1926.88,TC,1806.45,75,,,percent of total billed charges,75% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,1907.61,79.2,,,percent of total billed charges,79.2% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,2288.17,95,,,percent of total billed charges,95% of total billed charges,1926.88,80,,,percent of total billed charges,80% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,2167.74,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,963.44,40,,,percent of total billed charges,40% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,2167.74,90,,,percent of total billed charges,90% of total billed charges,1830.54,76,,,percent of total billed charges,76% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,1926.88,80,,,percent of total billed charges,80% of total billed charges,934.54,38.8,,,percent of total billed charges,38.8% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,2288.17,
MA Stereotactic Biopsy Addl Rt.,60001046,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,2408.6,1926.88,TC,1806.45,75,,,percent of total billed charges,75% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,1907.61,79.2,,,percent of total billed charges,79.2% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,2288.17,95,,,percent of total billed charges,95% of total billed charges,1926.88,80,,,percent of total billed charges,80% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,2167.74,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,963.44,40,,,percent of total billed charges,40% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,2167.74,90,,,percent of total billed charges,90% of total billed charges,1830.54,76,,,percent of total billed charges,76% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,1926.88,80,,,percent of total billed charges,80% of total billed charges,934.54,38.8,,,percent of total billed charges,38.8% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,2288.17,
MA Stereotactic Biopsy Addl Bil.,60001044,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,2408.6,1926.88,TC,1806.45,75,,,percent of total billed charges,75% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,1907.61,79.2,,,percent of total billed charges,79.2% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,2288.17,95,,,percent of total billed charges,95% of total billed charges,1926.88,80,,,percent of total billed charges,80% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,2167.74,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,963.44,40,,,percent of total billed charges,40% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,2167.74,90,,,percent of total billed charges,90% of total billed charges,1830.54,76,,,percent of total billed charges,76% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,1926.88,80,,,percent of total billed charges,80% of total billed charges,934.54,38.8,,,percent of total billed charges,38.8% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,2288.17,
ECHOGENIC 150MM SINGLE SHOT STIMULATING NEEDLE,46252520,CDM,270,RC,,,OUTPATIENT,,,64.5,51.6,,48.38,75,,,percent of total billed charges,75% of total billed charges,25.8,40,,,percent of total billed charges,40% of total billed charges,51.08,79.2,,,percent of total billed charges,79.2% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,64.5,100,,,fee schedule,100% of CO APG rates,61.28,95,,,percent of total billed charges,95% of total billed charges,51.6,80,,,percent of total billed charges,80% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,58.05,90,,,percent of total billed charges,90% of total billed charges,64.5,100,,,fee schedule,100% of CO APG rates,64.5,100,,,fee schedule,100% of CO APG rates,64.5,100,,,fee schedule,100% of NM fee schedule,25.8,40,,,percent of total billed charges,40% of total billed charges,25.8,40,,,percent of total billed charges,40% of total billed charges,58.05,90,,,percent of total billed charges,90% of total billed charges,49.02,76,,,percent of total billed charges,76% of total billed charges,25.8,40,,,percent of total billed charges,40% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,64.5,100,,,fee schedule,100% of CO APG rate,51.6,80,,,percent of total billed charges,80% of total billed charges,25.03,38.8,,,percent of total billed charges,38.8% of total billed charges,54.83,85,,,percent of total billed charges,85% of total billed charges,64.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,25.03,64.5,
4X90 APEX S/D HALF PIN 20 THR,46052521,CDM,278,RC,,,OUTPATIENT,,,355,284,,266.25,75,,,percent of total billed charges,75% of total billed charges,142,40,,,percent of total billed charges,40% of total billed charges,281.16,79.2,,,percent of total billed charges,79.2% of total billed charges,301.75,85,,,percent of total billed charges,85% of total billed charges,355,100,,,fee schedule,100% of CO APG rates,337.25,95,,,percent of total billed charges,95% of total billed charges,284,80,,,percent of total billed charges,80% of total billed charges,301.75,85,,,percent of total billed charges,85% of total billed charges,319.5,90,,,percent of total billed charges,90% of total billed charges,355,100,,,fee schedule,100% of CO APG rates,355,100,,,fee schedule,100% of CO APG rates,355,100,,,fee schedule,100% of NM fee schedule,142,40,,,percent of total billed charges,40% of total billed charges,142,40,,,percent of total billed charges,40% of total billed charges,319.5,90,,,percent of total billed charges,90% of total billed charges,269.8,76,,,percent of total billed charges,76% of total billed charges,142,40,,,percent of total billed charges,40% of total billed charges,301.75,85,,,percent of total billed charges,85% of total billed charges,355,100,,,fee schedule,100% of CO APG rate,284,80,,,percent of total billed charges,80% of total billed charges,137.74,38.8,,,percent of total billed charges,38.8% of total billed charges,301.75,85,,,percent of total billed charges,85% of total billed charges,355,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.74,355,
HOFFMANN3 5 HOLE PIN CLAMP DIA 4/5/6mm,46052522,CDM,270,RC,,,OUTPATIENT,,,1896.4,1517.12,,1422.3,75,,,percent of total billed charges,75% of total billed charges,758.56,40,,,percent of total billed charges,40% of total billed charges,1501.95,79.2,,,percent of total billed charges,79.2% of total billed charges,1611.94,85,,,percent of total billed charges,85% of total billed charges,1896.4,100,,,fee schedule,100% of CO APG rates,1801.58,95,,,percent of total billed charges,95% of total billed charges,1517.12,80,,,percent of total billed charges,80% of total billed charges,1611.94,85,,,percent of total billed charges,85% of total billed charges,1706.76,90,,,percent of total billed charges,90% of total billed charges,1896.4,100,,,fee schedule,100% of CO APG rates,1896.4,100,,,fee schedule,100% of CO APG rates,1896.4,100,,,fee schedule,100% of NM fee schedule,758.56,40,,,percent of total billed charges,40% of total billed charges,758.56,40,,,percent of total billed charges,40% of total billed charges,1706.76,90,,,percent of total billed charges,90% of total billed charges,1441.26,76,,,percent of total billed charges,76% of total billed charges,758.56,40,,,percent of total billed charges,40% of total billed charges,1611.94,85,,,percent of total billed charges,85% of total billed charges,1896.4,100,,,fee schedule,100% of CO APG rate,1517.12,80,,,percent of total billed charges,80% of total billed charges,735.8,38.8,,,percent of total billed charges,38.8% of total billed charges,1611.94,85,,,percent of total billed charges,85% of total billed charges,1896.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,735.8,1896.4,
HOFFMANN3 PIN TO ROD COUPLING DIA 4/5/6mm DIA5/8/11mm,46052523,CDM,270,RC,,,OUTPATIENT,,,1888.9,1511.12,,1416.68,75,,,percent of total billed charges,75% of total billed charges,755.56,40,,,percent of total billed charges,40% of total billed charges,1496.01,79.2,,,percent of total billed charges,79.2% of total billed charges,1605.57,85,,,percent of total billed charges,85% of total billed charges,1888.9,100,,,fee schedule,100% of CO APG rates,1794.46,95,,,percent of total billed charges,95% of total billed charges,1511.12,80,,,percent of total billed charges,80% of total billed charges,1605.57,85,,,percent of total billed charges,85% of total billed charges,1700.01,90,,,percent of total billed charges,90% of total billed charges,1888.9,100,,,fee schedule,100% of CO APG rates,1888.9,100,,,fee schedule,100% of CO APG rates,1888.9,100,,,fee schedule,100% of NM fee schedule,755.56,40,,,percent of total billed charges,40% of total billed charges,755.56,40,,,percent of total billed charges,40% of total billed charges,1700.01,90,,,percent of total billed charges,90% of total billed charges,1435.56,76,,,percent of total billed charges,76% of total billed charges,755.56,40,,,percent of total billed charges,40% of total billed charges,1605.57,85,,,percent of total billed charges,85% of total billed charges,1888.9,100,,,fee schedule,100% of CO APG rate,1511.12,80,,,percent of total billed charges,80% of total billed charges,732.89,38.8,,,percent of total billed charges,38.8% of total billed charges,1605.57,85,,,percent of total billed charges,85% of total billed charges,1888.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,732.89,1888.9,
HOFFMANN3 POST 30 DEG ANGLED DIA 11mm,46052524,CDM,270,RC,,,OUTPATIENT,,,466.4,373.12,,349.8,75,,,percent of total billed charges,75% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,369.39,79.2,,,percent of total billed charges,79.2% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,443.08,95,,,percent of total billed charges,95% of total billed charges,373.12,80,,,percent of total billed charges,80% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of CO APG rates,466.4,100,,,fee schedule,100% of NM fee schedule,186.56,40,,,percent of total billed charges,40% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,419.76,90,,,percent of total billed charges,90% of total billed charges,354.46,76,,,percent of total billed charges,76% of total billed charges,186.56,40,,,percent of total billed charges,40% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of CO APG rate,373.12,80,,,percent of total billed charges,80% of total billed charges,180.96,38.8,,,percent of total billed charges,38.8% of total billed charges,396.44,85,,,percent of total billed charges,85% of total billed charges,466.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,180.96,466.4,
HOFFMANN3 CONNECTING ROD DIA 11X250mm,46052525,CDM,270,RC,,,OUTPATIENT,,,705.6,564.48,,529.2,75,,,percent of total billed charges,75% of total billed charges,282.24,40,,,percent of total billed charges,40% of total billed charges,558.84,79.2,,,percent of total billed charges,79.2% of total billed charges,599.76,85,,,percent of total billed charges,85% of total billed charges,705.6,100,,,fee schedule,100% of CO APG rates,670.32,95,,,percent of total billed charges,95% of total billed charges,564.48,80,,,percent of total billed charges,80% of total billed charges,599.76,85,,,percent of total billed charges,85% of total billed charges,635.04,90,,,percent of total billed charges,90% of total billed charges,705.6,100,,,fee schedule,100% of CO APG rates,705.6,100,,,fee schedule,100% of CO APG rates,705.6,100,,,fee schedule,100% of NM fee schedule,282.24,40,,,percent of total billed charges,40% of total billed charges,282.24,40,,,percent of total billed charges,40% of total billed charges,635.04,90,,,percent of total billed charges,90% of total billed charges,536.26,76,,,percent of total billed charges,76% of total billed charges,282.24,40,,,percent of total billed charges,40% of total billed charges,599.76,85,,,percent of total billed charges,85% of total billed charges,705.6,100,,,fee schedule,100% of CO APG rate,564.48,80,,,percent of total billed charges,80% of total billed charges,273.77,38.8,,,percent of total billed charges,38.8% of total billed charges,599.76,85,,,percent of total billed charges,85% of total billed charges,705.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,273.77,705.6,
HOFFMANN3 ROD TO ROD COUPLING DIA 5/8/11mm,46052526,CDM,270,RC,,,OUTPATIENT,,,1806.7,1445.36,,1355.03,75,,,percent of total billed charges,75% of total billed charges,722.68,40,,,percent of total billed charges,40% of total billed charges,1430.91,79.2,,,percent of total billed charges,79.2% of total billed charges,1535.7,85,,,percent of total billed charges,85% of total billed charges,1806.7,100,,,fee schedule,100% of CO APG rates,1716.37,95,,,percent of total billed charges,95% of total billed charges,1445.36,80,,,percent of total billed charges,80% of total billed charges,1535.7,85,,,percent of total billed charges,85% of total billed charges,1626.03,90,,,percent of total billed charges,90% of total billed charges,1806.7,100,,,fee schedule,100% of CO APG rates,1806.7,100,,,fee schedule,100% of CO APG rates,1806.7,100,,,fee schedule,100% of NM fee schedule,722.68,40,,,percent of total billed charges,40% of total billed charges,722.68,40,,,percent of total billed charges,40% of total billed charges,1626.03,90,,,percent of total billed charges,90% of total billed charges,1373.09,76,,,percent of total billed charges,76% of total billed charges,722.68,40,,,percent of total billed charges,40% of total billed charges,1535.7,85,,,percent of total billed charges,85% of total billed charges,1806.7,100,,,fee schedule,100% of CO APG rate,1445.36,80,,,percent of total billed charges,80% of total billed charges,701,38.8,,,percent of total billed charges,38.8% of total billed charges,1535.7,85,,,percent of total billed charges,85% of total billed charges,1806.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,701,1806.7,
5X150 APEX S/D HALF PIN 40 THR,46052527,CDM,270,RC,,,OUTPATIENT,,,433.7,346.96,,325.28,75,,,percent of total billed charges,75% of total billed charges,173.48,40,,,percent of total billed charges,40% of total billed charges,343.49,79.2,,,percent of total billed charges,79.2% of total billed charges,368.65,85,,,percent of total billed charges,85% of total billed charges,433.7,100,,,fee schedule,100% of CO APG rates,412.02,95,,,percent of total billed charges,95% of total billed charges,346.96,80,,,percent of total billed charges,80% of total billed charges,368.65,85,,,percent of total billed charges,85% of total billed charges,390.33,90,,,percent of total billed charges,90% of total billed charges,433.7,100,,,fee schedule,100% of CO APG rates,433.7,100,,,fee schedule,100% of CO APG rates,433.7,100,,,fee schedule,100% of NM fee schedule,173.48,40,,,percent of total billed charges,40% of total billed charges,173.48,40,,,percent of total billed charges,40% of total billed charges,390.33,90,,,percent of total billed charges,90% of total billed charges,329.61,76,,,percent of total billed charges,76% of total billed charges,173.48,40,,,percent of total billed charges,40% of total billed charges,368.65,85,,,percent of total billed charges,85% of total billed charges,433.7,100,,,fee schedule,100% of CO APG rate,346.96,80,,,percent of total billed charges,80% of total billed charges,168.28,38.8,,,percent of total billed charges,38.8% of total billed charges,368.65,85,,,percent of total billed charges,85% of total billed charges,433.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,168.28,433.7,
5X120 APEX S/D HALF PIN 35 THR,46052528,CDM,278,RC,,,OUTPATIENT,,,417,333.6,,312.75,75,,,percent of total billed charges,75% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,330.26,79.2,,,percent of total billed charges,79.2% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of CO APG rates,396.15,95,,,percent of total billed charges,95% of total billed charges,333.6,80,,,percent of total billed charges,80% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,375.3,90,,,percent of total billed charges,90% of total billed charges,417,100,,,fee schedule,100% of CO APG rates,417,100,,,fee schedule,100% of CO APG rates,417,100,,,fee schedule,100% of NM fee schedule,166.8,40,,,percent of total billed charges,40% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,375.3,90,,,percent of total billed charges,90% of total billed charges,316.92,76,,,percent of total billed charges,76% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of CO APG rate,333.6,80,,,percent of total billed charges,80% of total billed charges,161.8,38.8,,,percent of total billed charges,38.8% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,161.8,417,
HOFFMANN3 5 HOLE PIN CLAMP 2 POSTS 30 DEG DIA 4/5/6mm,46052529,CDM,270,RC,,,OUTPATIENT,,,2065.7,1652.56,,1549.28,75,,,percent of total billed charges,75% of total billed charges,826.28,40,,,percent of total billed charges,40% of total billed charges,1636.03,79.2,,,percent of total billed charges,79.2% of total billed charges,1755.85,85,,,percent of total billed charges,85% of total billed charges,2065.7,100,,,fee schedule,100% of CO APG rates,1962.42,95,,,percent of total billed charges,95% of total billed charges,1652.56,80,,,percent of total billed charges,80% of total billed charges,1755.85,85,,,percent of total billed charges,85% of total billed charges,1859.13,90,,,percent of total billed charges,90% of total billed charges,2065.7,100,,,fee schedule,100% of CO APG rates,2065.7,100,,,fee schedule,100% of CO APG rates,2065.7,100,,,fee schedule,100% of NM fee schedule,826.28,40,,,percent of total billed charges,40% of total billed charges,826.28,40,,,percent of total billed charges,40% of total billed charges,1859.13,90,,,percent of total billed charges,90% of total billed charges,1569.93,76,,,percent of total billed charges,76% of total billed charges,826.28,40,,,percent of total billed charges,40% of total billed charges,1755.85,85,,,percent of total billed charges,85% of total billed charges,2065.7,100,,,fee schedule,100% of CO APG rate,1652.56,80,,,percent of total billed charges,80% of total billed charges,801.49,38.8,,,percent of total billed charges,38.8% of total billed charges,1755.85,85,,,percent of total billed charges,85% of total billed charges,2065.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,801.49,2065.7,
HII MRI 10 HOLE PIN CLAMP,46052530,CDM,270,RC,,,OUTPATIENT,,,2161.9,1729.52,,1621.43,75,,,percent of total billed charges,75% of total billed charges,864.76,40,,,percent of total billed charges,40% of total billed charges,1712.22,79.2,,,percent of total billed charges,79.2% of total billed charges,1837.62,85,,,percent of total billed charges,85% of total billed charges,2161.9,100,,,fee schedule,100% of CO APG rates,2053.81,95,,,percent of total billed charges,95% of total billed charges,1729.52,80,,,percent of total billed charges,80% of total billed charges,1837.62,85,,,percent of total billed charges,85% of total billed charges,1945.71,90,,,percent of total billed charges,90% of total billed charges,2161.9,100,,,fee schedule,100% of CO APG rates,2161.9,100,,,fee schedule,100% of CO APG rates,2161.9,100,,,fee schedule,100% of NM fee schedule,864.76,40,,,percent of total billed charges,40% of total billed charges,864.76,40,,,percent of total billed charges,40% of total billed charges,1945.71,90,,,percent of total billed charges,90% of total billed charges,1643.04,76,,,percent of total billed charges,76% of total billed charges,864.76,40,,,percent of total billed charges,40% of total billed charges,1837.62,85,,,percent of total billed charges,85% of total billed charges,2161.9,100,,,fee schedule,100% of CO APG rate,1729.52,80,,,percent of total billed charges,80% of total billed charges,838.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1837.62,85,,,percent of total billed charges,85% of total billed charges,2161.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,838.82,2161.9,
HOFFMANN3 POST STRAIGHT DIA 11mm,46052531,CDM,270,RC,,,OUTPATIENT,,,520,416,,390,75,,,percent of total billed charges,75% of total billed charges,208,40,,,percent of total billed charges,40% of total billed charges,411.84,79.2,,,percent of total billed charges,79.2% of total billed charges,442,85,,,percent of total billed charges,85% of total billed charges,520,100,,,fee schedule,100% of CO APG rates,494,95,,,percent of total billed charges,95% of total billed charges,416,80,,,percent of total billed charges,80% of total billed charges,442,85,,,percent of total billed charges,85% of total billed charges,468,90,,,percent of total billed charges,90% of total billed charges,520,100,,,fee schedule,100% of CO APG rates,520,100,,,fee schedule,100% of CO APG rates,520,100,,,fee schedule,100% of NM fee schedule,208,40,,,percent of total billed charges,40% of total billed charges,208,40,,,percent of total billed charges,40% of total billed charges,468,90,,,percent of total billed charges,90% of total billed charges,395.2,76,,,percent of total billed charges,76% of total billed charges,208,40,,,percent of total billed charges,40% of total billed charges,442,85,,,percent of total billed charges,85% of total billed charges,520,100,,,fee schedule,100% of CO APG rate,416,80,,,percent of total billed charges,80% of total billed charges,201.76,38.8,,,percent of total billed charges,38.8% of total billed charges,442,85,,,percent of total billed charges,85% of total billed charges,520,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,201.76,520,
HOFFMANN3 POST 90 DEG ANGLED DIA 11mm,46052532,CDM,270,RC,,,OUTPATIENT,,,617.2,493.76,,462.9,75,,,percent of total billed charges,75% of total billed charges,246.88,40,,,percent of total billed charges,40% of total billed charges,488.82,79.2,,,percent of total billed charges,79.2% of total billed charges,524.62,85,,,percent of total billed charges,85% of total billed charges,617.2,100,,,fee schedule,100% of CO APG rates,586.34,95,,,percent of total billed charges,95% of total billed charges,493.76,80,,,percent of total billed charges,80% of total billed charges,524.62,85,,,percent of total billed charges,85% of total billed charges,555.48,90,,,percent of total billed charges,90% of total billed charges,617.2,100,,,fee schedule,100% of CO APG rates,617.2,100,,,fee schedule,100% of CO APG rates,617.2,100,,,fee schedule,100% of NM fee schedule,246.88,40,,,percent of total billed charges,40% of total billed charges,246.88,40,,,percent of total billed charges,40% of total billed charges,555.48,90,,,percent of total billed charges,90% of total billed charges,469.07,76,,,percent of total billed charges,76% of total billed charges,246.88,40,,,percent of total billed charges,40% of total billed charges,524.62,85,,,percent of total billed charges,85% of total billed charges,617.2,100,,,fee schedule,100% of CO APG rate,493.76,80,,,percent of total billed charges,80% of total billed charges,239.47,38.8,,,percent of total billed charges,38.8% of total billed charges,524.62,85,,,percent of total billed charges,85% of total billed charges,617.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,239.47,617.2,
5X180 APEX S/D HALF PIN 50 THR,46052535,CDM,278,RC,,,OUTPATIENT,,,417,333.6,,312.75,75,,,percent of total billed charges,75% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,330.26,79.2,,,percent of total billed charges,79.2% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of CO APG rates,396.15,95,,,percent of total billed charges,95% of total billed charges,333.6,80,,,percent of total billed charges,80% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,375.3,90,,,percent of total billed charges,90% of total billed charges,417,100,,,fee schedule,100% of CO APG rates,417,100,,,fee schedule,100% of CO APG rates,417,100,,,fee schedule,100% of NM fee schedule,166.8,40,,,percent of total billed charges,40% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,375.3,90,,,percent of total billed charges,90% of total billed charges,316.92,76,,,percent of total billed charges,76% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of CO APG rate,333.6,80,,,percent of total billed charges,80% of total billed charges,161.8,38.8,,,percent of total billed charges,38.8% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,161.8,417,
HOFFMANN3 CONNECTING ROD DIA 11X150mm,46052537,CDM,270,RC,,,OUTPATIENT,,,665.3,532.24,,498.98,75,,,percent of total billed charges,75% of total billed charges,266.12,40,,,percent of total billed charges,40% of total billed charges,526.92,79.2,,,percent of total billed charges,79.2% of total billed charges,565.51,85,,,percent of total billed charges,85% of total billed charges,665.3,100,,,fee schedule,100% of CO APG rates,632.04,95,,,percent of total billed charges,95% of total billed charges,532.24,80,,,percent of total billed charges,80% of total billed charges,565.51,85,,,percent of total billed charges,85% of total billed charges,598.77,90,,,percent of total billed charges,90% of total billed charges,665.3,100,,,fee schedule,100% of CO APG rates,665.3,100,,,fee schedule,100% of CO APG rates,665.3,100,,,fee schedule,100% of NM fee schedule,266.12,40,,,percent of total billed charges,40% of total billed charges,266.12,40,,,percent of total billed charges,40% of total billed charges,598.77,90,,,percent of total billed charges,90% of total billed charges,505.63,76,,,percent of total billed charges,76% of total billed charges,266.12,40,,,percent of total billed charges,40% of total billed charges,565.51,85,,,percent of total billed charges,85% of total billed charges,665.3,100,,,fee schedule,100% of CO APG rate,532.24,80,,,percent of total billed charges,80% of total billed charges,258.14,38.8,,,percent of total billed charges,38.8% of total billed charges,565.51,85,,,percent of total billed charges,85% of total billed charges,665.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,258.14,665.3,
HOFFMANN3 CONNECTING ROD DIA 11X300mm,46052538,CDM,270,RC,,,OUTPATIENT,,,800.8,640.64,,600.6,75,,,percent of total billed charges,75% of total billed charges,320.32,40,,,percent of total billed charges,40% of total billed charges,634.23,79.2,,,percent of total billed charges,79.2% of total billed charges,680.68,85,,,percent of total billed charges,85% of total billed charges,800.8,100,,,fee schedule,100% of CO APG rates,760.76,95,,,percent of total billed charges,95% of total billed charges,640.64,80,,,percent of total billed charges,80% of total billed charges,680.68,85,,,percent of total billed charges,85% of total billed charges,720.72,90,,,percent of total billed charges,90% of total billed charges,800.8,100,,,fee schedule,100% of CO APG rates,800.8,100,,,fee schedule,100% of CO APG rates,800.8,100,,,fee schedule,100% of NM fee schedule,320.32,40,,,percent of total billed charges,40% of total billed charges,320.32,40,,,percent of total billed charges,40% of total billed charges,720.72,90,,,percent of total billed charges,90% of total billed charges,608.61,76,,,percent of total billed charges,76% of total billed charges,320.32,40,,,percent of total billed charges,40% of total billed charges,680.68,85,,,percent of total billed charges,85% of total billed charges,800.8,100,,,fee schedule,100% of CO APG rate,640.64,80,,,percent of total billed charges,80% of total billed charges,310.71,38.8,,,percent of total billed charges,38.8% of total billed charges,680.68,85,,,percent of total billed charges,85% of total billed charges,800.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,310.71,800.8,
HOFFMANN3 CONNECTING ROD DIA 11X350mm,46052539,CDM,270,RC,,,OUTPATIENT,,,962.5,770,,721.88,75,,,percent of total billed charges,75% of total billed charges,385,40,,,percent of total billed charges,40% of total billed charges,762.3,79.2,,,percent of total billed charges,79.2% of total billed charges,818.13,85,,,percent of total billed charges,85% of total billed charges,962.5,100,,,fee schedule,100% of CO APG rates,914.38,95,,,percent of total billed charges,95% of total billed charges,770,80,,,percent of total billed charges,80% of total billed charges,818.13,85,,,percent of total billed charges,85% of total billed charges,866.25,90,,,percent of total billed charges,90% of total billed charges,962.5,100,,,fee schedule,100% of CO APG rates,962.5,100,,,fee schedule,100% of CO APG rates,962.5,100,,,fee schedule,100% of NM fee schedule,385,40,,,percent of total billed charges,40% of total billed charges,385,40,,,percent of total billed charges,40% of total billed charges,866.25,90,,,percent of total billed charges,90% of total billed charges,731.5,76,,,percent of total billed charges,76% of total billed charges,385,40,,,percent of total billed charges,40% of total billed charges,818.13,85,,,percent of total billed charges,85% of total billed charges,962.5,100,,,fee schedule,100% of CO APG rate,770,80,,,percent of total billed charges,80% of total billed charges,373.45,38.8,,,percent of total billed charges,38.8% of total billed charges,818.13,85,,,percent of total billed charges,85% of total billed charges,962.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,373.45,962.5,
Reticulocyte Count.,40085045,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,55.4,44.32,,41.55,75,,,percent of total billed charges,75% of total billed charges,22.16,40,,,percent of total billed charges,40% of total billed charges,43.88,79.2,,,percent of total billed charges,79.2% of total billed charges,47.09,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,52.63,95,,,percent of total billed charges,95% of total billed charges,44.32,80,,,percent of total billed charges,80% of total billed charges,47.09,85,,,percent of total billed charges,85% of total billed charges,49.86,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,22.16,40,,,percent of total billed charges,40% of total billed charges,22.16,40,,,percent of total billed charges,40% of total billed charges,49.86,90,,,percent of total billed charges,90% of total billed charges,42.1,76,,,percent of total billed charges,76% of total billed charges,22.16,40,,,percent of total billed charges,40% of total billed charges,47.09,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,44.32,80,,,percent of total billed charges,80% of total billed charges,21.5,38.8,,,percent of total billed charges,38.8% of total billed charges,47.09,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,52.63,
Direct TIBC,40083550,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,82,65.6,,61.5,75,,,percent of total billed charges,75% of total billed charges,32.8,40,,,percent of total billed charges,40% of total billed charges,64.94,79.2,,,percent of total billed charges,79.2% of total billed charges,69.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,77.9,95,,,percent of total billed charges,95% of total billed charges,65.6,80,,,percent of total billed charges,80% of total billed charges,69.7,85,,,percent of total billed charges,85% of total billed charges,73.8,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,32.8,40,,,percent of total billed charges,40% of total billed charges,32.8,40,,,percent of total billed charges,40% of total billed charges,73.8,90,,,percent of total billed charges,90% of total billed charges,62.32,76,,,percent of total billed charges,76% of total billed charges,32.8,40,,,percent of total billed charges,40% of total billed charges,69.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,65.6,80,,,percent of total billed charges,80% of total billed charges,31.82,38.8,,,percent of total billed charges,38.8% of total billed charges,69.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,77.9,
Hepatitis A IgM,40086709,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,134,107.2,,100.5,75,,,percent of total billed charges,75% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,106.13,79.2,,,percent of total billed charges,79.2% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,127.3,95,,,percent of total billed charges,95% of total billed charges,107.2,80,,,percent of total billed charges,80% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,53.6,40,,,percent of total billed charges,40% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,120.6,90,,,percent of total billed charges,90% of total billed charges,101.84,76,,,percent of total billed charges,76% of total billed charges,53.6,40,,,percent of total billed charges,40% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,107.2,80,,,percent of total billed charges,80% of total billed charges,51.99,38.8,,,percent of total billed charges,38.8% of total billed charges,113.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,127.3,
Hep B IgM,40086705,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,127.5,102,,95.63,75,,,percent of total billed charges,75% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,100.98,79.2,,,percent of total billed charges,79.2% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,121.13,95,,,percent of total billed charges,95% of total billed charges,102,80,,,percent of total billed charges,80% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,51,40,,,percent of total billed charges,40% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,114.75,90,,,percent of total billed charges,90% of total billed charges,96.9,76,,,percent of total billed charges,76% of total billed charges,51,40,,,percent of total billed charges,40% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,102,80,,,percent of total billed charges,80% of total billed charges,49.47,38.8,,,percent of total billed charges,38.8% of total billed charges,108.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,121.13,
MA Ductogram or Galactogram Inj,41519030,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,662,529.6,TC,496.5,75,,,percent of total billed charges,75% of total billed charges,264.8,40,,,percent of total billed charges,40% of total billed charges,524.3,79.2,,,percent of total billed charges,79.2% of total billed charges,562.7,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,628.9,95,,,percent of total billed charges,95% of total billed charges,529.6,80,,,percent of total billed charges,80% of total billed charges,562.7,85,,,percent of total billed charges,85% of total billed charges,595.8,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,264.8,40,,,percent of total billed charges,40% of total billed charges,264.8,40,,,percent of total billed charges,40% of total billed charges,595.8,90,,,percent of total billed charges,90% of total billed charges,503.12,76,,,percent of total billed charges,76% of total billed charges,264.8,40,,,percent of total billed charges,40% of total billed charges,562.7,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,529.6,80,,,percent of total billed charges,80% of total billed charges,256.86,38.8,,,percent of total billed charges,38.8% of total billed charges,562.7,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,628.9,
Tx of Speech/Lang/Voice/Comm/Auditory Chg Medicaid,42692507,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,523.5,418.8,GN,392.63,75,,,percent of total billed charges,75% of total billed charges,209.4,40,,,percent of total billed charges,40% of total billed charges,414.61,79.2,,,percent of total billed charges,79.2% of total billed charges,444.98,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,497.33,95,,,percent of total billed charges,95% of total billed charges,418.8,80,,,percent of total billed charges,80% of total billed charges,444.98,85,,,percent of total billed charges,85% of total billed charges,471.15,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,209.4,40,,,percent of total billed charges,40% of total billed charges,209.4,40,,,percent of total billed charges,40% of total billed charges,471.15,90,,,percent of total billed charges,90% of total billed charges,397.86,76,,,percent of total billed charges,76% of total billed charges,209.4,40,,,percent of total billed charges,40% of total billed charges,444.98,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,418.8,80,,,percent of total billed charges,80% of total billed charges,203.12,38.8,,,percent of total billed charges,38.8% of total billed charges,444.98,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,497.33,
"92522 Evaluation of speech sound production (eg, articulatio",42692522,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,372.3,297.84,GN,279.23,75,,,percent of total billed charges,75% of total billed charges,148.92,40,,,percent of total billed charges,40% of total billed charges,294.86,79.2,,,percent of total billed charges,79.2% of total billed charges,316.46,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,353.69,95,,,percent of total billed charges,95% of total billed charges,297.84,80,,,percent of total billed charges,80% of total billed charges,316.46,85,,,percent of total billed charges,85% of total billed charges,335.07,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,148.92,40,,,percent of total billed charges,40% of total billed charges,148.92,40,,,percent of total billed charges,40% of total billed charges,335.07,90,,,percent of total billed charges,90% of total billed charges,282.95,76,,,percent of total billed charges,76% of total billed charges,148.92,40,,,percent of total billed charges,40% of total billed charges,316.46,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,297.84,80,,,percent of total billed charges,80% of total billed charges,144.45,38.8,,,percent of total billed charges,38.8% of total billed charges,316.46,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,353.69,
27825 Closed tx of fx of weight bearing articular portion of,46027825,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4771.5,3817.2,,3578.63,75,,,percent of total billed charges,75% of total billed charges,1908.6,40,,,percent of total billed charges,40% of total billed charges,3779.03,79.2,,,percent of total billed charges,79.2% of total billed charges,4055.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4532.93,95,,,percent of total billed charges,95% of total billed charges,3817.2,80,,,percent of total billed charges,80% of total billed charges,4055.78,85,,,percent of total billed charges,85% of total billed charges,4294.35,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1908.6,40,,,percent of total billed charges,40% of total billed charges,1908.6,40,,,percent of total billed charges,40% of total billed charges,4294.35,90,,,percent of total billed charges,90% of total billed charges,3626.34,76,,,percent of total billed charges,76% of total billed charges,1908.6,40,,,percent of total billed charges,40% of total billed charges,4055.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3817.2,80,,,percent of total billed charges,80% of total billed charges,1851.34,38.8,,,percent of total billed charges,38.8% of total billed charges,4055.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4532.93,
Urea Nitrogen Body Fluid,40084520,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,60.5,48.4,,45.38,75,,,percent of total billed charges,75% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,47.92,79.2,,,percent of total billed charges,79.2% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,57.48,95,,,percent of total billed charges,95% of total billed charges,48.4,80,,,percent of total billed charges,80% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,24.2,40,,,percent of total billed charges,40% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,54.45,90,,,percent of total billed charges,90% of total billed charges,45.98,76,,,percent of total billed charges,76% of total billed charges,24.2,40,,,percent of total billed charges,40% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,48.4,80,,,percent of total billed charges,80% of total billed charges,23.47,38.8,,,percent of total billed charges,38.8% of total billed charges,51.43,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,57.48,
51702 - Facility Fee - Insertion of temp bladder cathete,60000093,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,370.2,296.16,,277.65,75,,,percent of total billed charges,75% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,293.2,79.2,,,percent of total billed charges,79.2% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,351.69,95,,,percent of total billed charges,95% of total billed charges,296.16,80,,,percent of total billed charges,80% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,148.08,40,,,percent of total billed charges,40% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,281.35,76,,,percent of total billed charges,76% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,296.16,80,,,percent of total billed charges,80% of total billed charges,143.64,38.8,,,percent of total billed charges,38.8% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,143.64,351.69,
27503- Closed treatment of supracondylar or transcondylar fe,46027503,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4998.2,3998.56,,3748.65,75,,,percent of total billed charges,75% of total billed charges,1999.28,40,,,percent of total billed charges,40% of total billed charges,3958.57,79.2,,,percent of total billed charges,79.2% of total billed charges,4248.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4748.29,95,,,percent of total billed charges,95% of total billed charges,3998.56,80,,,percent of total billed charges,80% of total billed charges,4248.47,85,,,percent of total billed charges,85% of total billed charges,4498.38,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1999.28,40,,,percent of total billed charges,40% of total billed charges,1999.28,40,,,percent of total billed charges,40% of total billed charges,4498.38,90,,,percent of total billed charges,90% of total billed charges,3798.63,76,,,percent of total billed charges,76% of total billed charges,1999.28,40,,,percent of total billed charges,40% of total billed charges,4248.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3998.56,80,,,percent of total billed charges,80% of total billed charges,1939.3,38.8,,,percent of total billed charges,38.8% of total billed charges,4248.47,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4748.29,
Thiopurine Metabolites LC,40003800,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,378.8,303.04,,284.1,75,,,percent of total billed charges,75% of total billed charges,151.52,40,,,percent of total billed charges,40% of total billed charges,300.01,79.2,,,percent of total billed charges,79.2% of total billed charges,321.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,359.86,95,,,percent of total billed charges,95% of total billed charges,303.04,80,,,percent of total billed charges,80% of total billed charges,321.98,85,,,percent of total billed charges,85% of total billed charges,340.92,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,151.52,40,,,percent of total billed charges,40% of total billed charges,151.52,40,,,percent of total billed charges,40% of total billed charges,340.92,90,,,percent of total billed charges,90% of total billed charges,287.89,76,,,percent of total billed charges,76% of total billed charges,151.52,40,,,percent of total billed charges,40% of total billed charges,321.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,303.04,80,,,percent of total billed charges,80% of total billed charges,146.97,38.8,,,percent of total billed charges,38.8% of total billed charges,321.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,359.86,
Cystatin C LC,40082610,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,40.3,32.24,,30.23,75,,,percent of total billed charges,75% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,31.92,79.2,,,percent of total billed charges,79.2% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,38.29,95,,,percent of total billed charges,95% of total billed charges,32.24,80,,,percent of total billed charges,80% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,16.12,40,,,percent of total billed charges,40% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,36.27,90,,,percent of total billed charges,90% of total billed charges,30.63,76,,,percent of total billed charges,76% of total billed charges,16.12,40,,,percent of total billed charges,40% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,32.24,80,,,percent of total billed charges,80% of total billed charges,15.64,38.8,,,percent of total billed charges,38.8% of total billed charges,34.26,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,38.29,
Insulin Antibodies LC,40086337,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,53,42.4,,39.75,75,,,percent of total billed charges,75% of total billed charges,21.2,40,,,percent of total billed charges,40% of total billed charges,41.98,79.2,,,percent of total billed charges,79.2% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,50.35,95,,,percent of total billed charges,95% of total billed charges,42.4,80,,,percent of total billed charges,80% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,47.7,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,21.2,40,,,percent of total billed charges,40% of total billed charges,21.2,40,,,percent of total billed charges,40% of total billed charges,47.7,90,,,percent of total billed charges,90% of total billed charges,40.28,76,,,percent of total billed charges,76% of total billed charges,21.2,40,,,percent of total billed charges,40% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,42.4,80,,,percent of total billed charges,80% of total billed charges,20.56,38.8,,,percent of total billed charges,38.8% of total billed charges,45.05,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,50.35,
Transitional Care Management 99495 Charge,49699495,CDM,510,RC,99495,HCPCS,OUTPATIENT,,,419.7,335.76,,314.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,332.4,79.2,,,percent of total billed charges,79.2% of total billed charges,356.75,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rates,398.72,95,,,percent of total billed charges,95% of total billed charges,335.76,80,,,percent of total billed charges,80% of total billed charges,356.75,85,,,percent of total billed charges,85% of total billed charges,377.73,90,,,percent of total billed charges,90% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rates,136.55,100,,,fee schedule,100% of CO APG rates,120.86,100,,,fee schedule,100% of NM APC rate,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,377.73,90,,,percent of total billed charges,90% of total billed charges,318.97,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,356.75,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rate,335.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,356.75,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of APG fee schedule,664.52,100,,,case rate,pays based on per visit rate,120.86,664.52,
Transitional Care Management 99496 Charge,49699496,CDM,510,RC,99495,HCPCS,OUTPATIENT,,,606.5,485.2,,454.88,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,480.35,79.2,,,percent of total billed charges,79.2% of total billed charges,515.53,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rates,576.18,95,,,percent of total billed charges,95% of total billed charges,485.2,80,,,percent of total billed charges,80% of total billed charges,515.53,85,,,percent of total billed charges,85% of total billed charges,545.85,90,,,percent of total billed charges,90% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rates,136.55,100,,,fee schedule,100% of CO APG rates,120.86,100,,,fee schedule,100% of NM APC rate,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,545.85,90,,,percent of total billed charges,90% of total billed charges,460.94,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,515.53,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rate,485.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,515.53,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of APG fee schedule,664.52,100,,,case rate,pays based on per visit rate,120.86,664.52,
Advance Care Planning 99497 Charge,49699497,CDM,510,RC,99495,HCPCS,OUTPATIENT,,,308.8,247.04,,231.6,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,244.57,79.2,,,percent of total billed charges,79.2% of total billed charges,262.48,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rates,293.36,95,,,percent of total billed charges,95% of total billed charges,247.04,80,,,percent of total billed charges,80% of total billed charges,262.48,85,,,percent of total billed charges,85% of total billed charges,277.92,90,,,percent of total billed charges,90% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rates,136.55,100,,,fee schedule,100% of CO APG rates,120.86,100,,,fee schedule,100% of NM APC rate,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,277.92,90,,,percent of total billed charges,90% of total billed charges,234.69,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,262.48,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rate,247.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,262.48,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of APG fee schedule,664.52,100,,,case rate,pays based on per visit rate,120.86,664.52,
Advance Care Planning 99498 Charge,49699498,CDM,510,RC,99495,HCPCS,OUTPATIENT,,,288.6,230.88,,216.45,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,228.57,79.2,,,percent of total billed charges,79.2% of total billed charges,245.31,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rates,274.17,95,,,percent of total billed charges,95% of total billed charges,230.88,80,,,percent of total billed charges,80% of total billed charges,245.31,85,,,percent of total billed charges,85% of total billed charges,259.74,90,,,percent of total billed charges,90% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rates,136.55,100,,,fee schedule,100% of CO APG rates,120.86,100,,,fee schedule,100% of NM APC rate,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,259.74,90,,,percent of total billed charges,90% of total billed charges,219.34,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,245.31,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rate,230.88,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,245.31,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of APG fee schedule,664.52,100,,,case rate,pays based on per visit rate,120.86,664.52,
Evaluation of swallowing function,60000309,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,410.6,328.48,GN,307.95,75,,,percent of total billed charges,75% of total billed charges,164.24,40,,,percent of total billed charges,40% of total billed charges,325.2,79.2,,,percent of total billed charges,79.2% of total billed charges,349.01,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,390.07,95,,,percent of total billed charges,95% of total billed charges,328.48,80,,,percent of total billed charges,80% of total billed charges,349.01,85,,,percent of total billed charges,85% of total billed charges,369.54,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,164.24,40,,,percent of total billed charges,40% of total billed charges,164.24,40,,,percent of total billed charges,40% of total billed charges,369.54,90,,,percent of total billed charges,90% of total billed charges,312.06,76,,,percent of total billed charges,76% of total billed charges,164.24,40,,,percent of total billed charges,40% of total billed charges,349.01,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,328.48,80,,,percent of total billed charges,80% of total billed charges,159.31,38.8,,,percent of total billed charges,38.8% of total billed charges,349.01,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,390.07,
PSMC Volumen,41352550,CDM,255,RC,,,OUTPATIENT,,,52.5,42,,39.38,75,,,percent of total billed charges,75% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,41.58,79.2,,,percent of total billed charges,79.2% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rates,49.88,95,,,percent of total billed charges,95% of total billed charges,42,80,,,percent of total billed charges,80% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,47.25,90,,,percent of total billed charges,90% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rates,52.5,100,,,fee schedule,100% of CO APG rates,52.5,100,,,fee schedule,100% of NM fee schedule,21,40,,,percent of total billed charges,40% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,47.25,90,,,percent of total billed charges,90% of total billed charges,39.9,76,,,percent of total billed charges,76% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rate,42,80,,,percent of total billed charges,80% of total billed charges,20.37,38.8,,,percent of total billed charges,38.8% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,20.37,52.5,
"19083 Biopsy breast w/placement of localization device, including ultrasound gui",60019083,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2698.1,2158.48,,2023.58,75,,,percent of total billed charges,75% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2136.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,2698.1,100,,,fee schedule,100% of CO APG rates,2563.2,95,,,percent of total billed charges,95% of total billed charges,2158.48,80,,,percent of total billed charges,80% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,2428.29,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,1079.24,40,,,percent of total billed charges,40% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2428.29,90,,,percent of total billed charges,90% of total billed charges,2050.56,76,,,percent of total billed charges,76% of total billed charges,1079.24,40,,,percent of total billed charges,40% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,2158.48,80,,,percent of total billed charges,80% of total billed charges,1046.86,38.8,,,percent of total billed charges,38.8% of total billed charges,2293.39,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
LONG MEDIUM AGGRESSIVE BLADE (31.0MM X 9.0MM),46052551,CDM,270,RC,,,OUTPATIENT,,,161.7,129.36,,121.28,75,,,percent of total billed charges,75% of total billed charges,64.68,40,,,percent of total billed charges,40% of total billed charges,128.07,79.2,,,percent of total billed charges,79.2% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,161.7,100,,,fee schedule,100% of CO APG rates,153.62,95,,,percent of total billed charges,95% of total billed charges,129.36,80,,,percent of total billed charges,80% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,145.53,90,,,percent of total billed charges,90% of total billed charges,161.7,100,,,fee schedule,100% of CO APG rates,161.7,100,,,fee schedule,100% of CO APG rates,161.7,100,,,fee schedule,100% of NM fee schedule,64.68,40,,,percent of total billed charges,40% of total billed charges,64.68,40,,,percent of total billed charges,40% of total billed charges,145.53,90,,,percent of total billed charges,90% of total billed charges,122.89,76,,,percent of total billed charges,76% of total billed charges,64.68,40,,,percent of total billed charges,40% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,161.7,100,,,fee schedule,100% of CO APG rate,129.36,80,,,percent of total billed charges,80% of total billed charges,62.74,38.8,,,percent of total billed charges,38.8% of total billed charges,137.45,85,,,percent of total billed charges,85% of total billed charges,161.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,62.74,161.7,
GI Panel by PCR,40087507,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,849,679.2,,636.75,75,,,percent of total billed charges,75% of total billed charges,339.6,40,,,percent of total billed charges,40% of total billed charges,672.41,79.2,,,percent of total billed charges,79.2% of total billed charges,721.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,806.55,95,,,percent of total billed charges,95% of total billed charges,679.2,80,,,percent of total billed charges,80% of total billed charges,721.65,85,,,percent of total billed charges,85% of total billed charges,764.1,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,339.6,40,,,percent of total billed charges,40% of total billed charges,339.6,40,,,percent of total billed charges,40% of total billed charges,764.1,90,,,percent of total billed charges,90% of total billed charges,645.24,76,,,percent of total billed charges,76% of total billed charges,339.6,40,,,percent of total billed charges,40% of total billed charges,721.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,679.2,80,,,percent of total billed charges,80% of total billed charges,329.41,38.8,,,percent of total billed charges,38.8% of total billed charges,721.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,806.55,
Blood ID Panel by PCR,4008150,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,60.42,
Respiratory Panel by PCR,40087633,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,990,792,,742.5,75,,,percent of total billed charges,75% of total billed charges,396,40,,,percent of total billed charges,40% of total billed charges,784.08,79.2,,,percent of total billed charges,79.2% of total billed charges,841.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,940.5,95,,,percent of total billed charges,95% of total billed charges,792,80,,,percent of total billed charges,80% of total billed charges,841.5,85,,,percent of total billed charges,85% of total billed charges,891,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,396,40,,,percent of total billed charges,40% of total billed charges,396,40,,,percent of total billed charges,40% of total billed charges,891,90,,,percent of total billed charges,90% of total billed charges,752.4,76,,,percent of total billed charges,76% of total billed charges,396,40,,,percent of total billed charges,40% of total billed charges,841.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,792,80,,,percent of total billed charges,80% of total billed charges,384.12,38.8,,,percent of total billed charges,38.8% of total billed charges,841.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,940.5,
"STOCKINGS  KNEE-HIGH LARGE, REGULAR WHITE",52880,CDM,270,RC,,,OUTPATIENT,,,28.3,22.64,,21.23,75,,,percent of total billed charges,75% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,22.41,79.2,,,percent of total billed charges,79.2% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,28.3,100,,,fee schedule,100% of CO APG rates,26.89,95,,,percent of total billed charges,95% of total billed charges,22.64,80,,,percent of total billed charges,80% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,25.47,90,,,percent of total billed charges,90% of total billed charges,28.3,100,,,fee schedule,100% of CO APG rates,28.3,100,,,fee schedule,100% of CO APG rates,28.3,100,,,fee schedule,100% of NM fee schedule,11.32,40,,,percent of total billed charges,40% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,25.47,90,,,percent of total billed charges,90% of total billed charges,21.51,76,,,percent of total billed charges,76% of total billed charges,11.32,40,,,percent of total billed charges,40% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,28.3,100,,,fee schedule,100% of CO APG rate,22.64,80,,,percent of total billed charges,80% of total billed charges,10.98,38.8,,,percent of total billed charges,38.8% of total billed charges,24.06,85,,,percent of total billed charges,85% of total billed charges,28.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,10.98,28.3,
CHAMPION SLINGSHOT-45 LEFT,46052554,CDM,278,RC,,,OUTPATIENT,,,1269.9,1015.92,,952.43,75,,,percent of total billed charges,75% of total billed charges,507.96,40,,,percent of total billed charges,40% of total billed charges,1005.76,79.2,,,percent of total billed charges,79.2% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1269.9,100,,,fee schedule,100% of CO APG rates,1206.41,95,,,percent of total billed charges,95% of total billed charges,1015.92,80,,,percent of total billed charges,80% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1142.91,90,,,percent of total billed charges,90% of total billed charges,1269.9,100,,,fee schedule,100% of CO APG rates,1269.9,100,,,fee schedule,100% of CO APG rates,1269.9,100,,,fee schedule,100% of NM fee schedule,507.96,40,,,percent of total billed charges,40% of total billed charges,507.96,40,,,percent of total billed charges,40% of total billed charges,1142.91,90,,,percent of total billed charges,90% of total billed charges,965.12,76,,,percent of total billed charges,76% of total billed charges,507.96,40,,,percent of total billed charges,40% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1269.9,100,,,fee schedule,100% of CO APG rate,1015.92,80,,,percent of total billed charges,80% of total billed charges,492.72,38.8,,,percent of total billed charges,38.8% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1269.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,492.72,1269.9,
CHAMPION SLINGSHOT-45 RIGHT,46052555,CDM,278,RC,,,OUTPATIENT,,,1269.9,1015.92,,952.43,75,,,percent of total billed charges,75% of total billed charges,507.96,40,,,percent of total billed charges,40% of total billed charges,1005.76,79.2,,,percent of total billed charges,79.2% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1269.9,100,,,fee schedule,100% of CO APG rates,1206.41,95,,,percent of total billed charges,95% of total billed charges,1015.92,80,,,percent of total billed charges,80% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1142.91,90,,,percent of total billed charges,90% of total billed charges,1269.9,100,,,fee schedule,100% of CO APG rates,1269.9,100,,,fee schedule,100% of CO APG rates,1269.9,100,,,fee schedule,100% of NM fee schedule,507.96,40,,,percent of total billed charges,40% of total billed charges,507.96,40,,,percent of total billed charges,40% of total billed charges,1142.91,90,,,percent of total billed charges,90% of total billed charges,965.12,76,,,percent of total billed charges,76% of total billed charges,507.96,40,,,percent of total billed charges,40% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1269.9,100,,,fee schedule,100% of CO APG rate,1015.92,80,,,percent of total billed charges,80% of total billed charges,492.72,38.8,,,percent of total billed charges,38.8% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1269.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,492.72,1269.9,
ACL DISPOSABLE PACK- BONE TENDON BONE,46052553,CDM,278,RC,,,OUTPATIENT,,,1716.4,1373.12,,1287.3,75,,,percent of total billed charges,75% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1359.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1630.58,95,,,percent of total billed charges,95% of total billed charges,1373.12,80,,,percent of total billed charges,80% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of CO APG rates,1716.4,100,,,fee schedule,100% of NM fee schedule,686.56,40,,,percent of total billed charges,40% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1544.76,90,,,percent of total billed charges,90% of total billed charges,1304.46,76,,,percent of total billed charges,76% of total billed charges,686.56,40,,,percent of total billed charges,40% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of CO APG rate,1373.12,80,,,percent of total billed charges,80% of total billed charges,665.96,38.8,,,percent of total billed charges,38.8% of total billed charges,1458.94,85,,,percent of total billed charges,85% of total billed charges,1716.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,665.96,1716.4,
CHAMPION SLINGSHOT-70 UP,46052556,CDM,278,RC,,,OUTPATIENT,,,1269.9,1015.92,,952.43,75,,,percent of total billed charges,75% of total billed charges,507.96,40,,,percent of total billed charges,40% of total billed charges,1005.76,79.2,,,percent of total billed charges,79.2% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1269.9,100,,,fee schedule,100% of CO APG rates,1206.41,95,,,percent of total billed charges,95% of total billed charges,1015.92,80,,,percent of total billed charges,80% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1142.91,90,,,percent of total billed charges,90% of total billed charges,1269.9,100,,,fee schedule,100% of CO APG rates,1269.9,100,,,fee schedule,100% of CO APG rates,1269.9,100,,,fee schedule,100% of NM fee schedule,507.96,40,,,percent of total billed charges,40% of total billed charges,507.96,40,,,percent of total billed charges,40% of total billed charges,1142.91,90,,,percent of total billed charges,90% of total billed charges,965.12,76,,,percent of total billed charges,76% of total billed charges,507.96,40,,,percent of total billed charges,40% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1269.9,100,,,fee schedule,100% of CO APG rate,1015.92,80,,,percent of total billed charges,80% of total billed charges,492.72,38.8,,,percent of total billed charges,38.8% of total billed charges,1079.42,85,,,percent of total billed charges,85% of total billed charges,1269.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,492.72,1269.9,
BIOSTEON INTERFERENCE SCREW- 6X28MM,460ECON0208,CDM,278,RC,,,OUTPATIENT,,,1032.5,826,,774.38,75,,,percent of total billed charges,75% of total billed charges,413,40,,,percent of total billed charges,40% of total billed charges,817.74,79.2,,,percent of total billed charges,79.2% of total billed charges,877.63,85,,,percent of total billed charges,85% of total billed charges,1032.5,100,,,fee schedule,100% of CO APG rates,980.88,95,,,percent of total billed charges,95% of total billed charges,826,80,,,percent of total billed charges,80% of total billed charges,877.63,85,,,percent of total billed charges,85% of total billed charges,929.25,90,,,percent of total billed charges,90% of total billed charges,1032.5,100,,,fee schedule,100% of CO APG rates,1032.5,100,,,fee schedule,100% of CO APG rates,1032.5,100,,,fee schedule,100% of NM fee schedule,413,40,,,percent of total billed charges,40% of total billed charges,413,40,,,percent of total billed charges,40% of total billed charges,929.25,90,,,percent of total billed charges,90% of total billed charges,784.7,76,,,percent of total billed charges,76% of total billed charges,413,40,,,percent of total billed charges,40% of total billed charges,877.63,85,,,percent of total billed charges,85% of total billed charges,1032.5,100,,,fee schedule,100% of CO APG rate,826,80,,,percent of total billed charges,80% of total billed charges,400.61,38.8,,,percent of total billed charges,38.8% of total billed charges,877.63,85,,,percent of total billed charges,85% of total billed charges,1032.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,400.61,1032.5,
BIOSTEON INTERFERENCE SCREW- 7X28MM,460ECON0209,CDM,278,RC,,,OUTPATIENT,,,1055.7,844.56,,791.78,75,,,percent of total billed charges,75% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,836.11,79.2,,,percent of total billed charges,79.2% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rates,1002.92,95,,,percent of total billed charges,95% of total billed charges,844.56,80,,,percent of total billed charges,80% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,950.13,90,,,percent of total billed charges,90% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rates,1055.7,100,,,fee schedule,100% of CO APG rates,1055.7,100,,,fee schedule,100% of NM fee schedule,422.28,40,,,percent of total billed charges,40% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,950.13,90,,,percent of total billed charges,90% of total billed charges,802.33,76,,,percent of total billed charges,76% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rate,844.56,80,,,percent of total billed charges,80% of total billed charges,409.61,38.8,,,percent of total billed charges,38.8% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,409.61,1055.7,
BIOSTEON INTERFERENCE SCREW- 9X28MM,460ECON0211,CDM,278,RC,,,OUTPATIENT,,,1055.7,844.56,,791.78,75,,,percent of total billed charges,75% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,836.11,79.2,,,percent of total billed charges,79.2% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rates,1002.92,95,,,percent of total billed charges,95% of total billed charges,844.56,80,,,percent of total billed charges,80% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,950.13,90,,,percent of total billed charges,90% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rates,1055.7,100,,,fee schedule,100% of CO APG rates,1055.7,100,,,fee schedule,100% of NM fee schedule,422.28,40,,,percent of total billed charges,40% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,950.13,90,,,percent of total billed charges,90% of total billed charges,802.33,76,,,percent of total billed charges,76% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rate,844.56,80,,,percent of total billed charges,80% of total billed charges,409.61,38.8,,,percent of total billed charges,38.8% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,409.61,1055.7,
BIOSTEON INTERFERENCE SCREW- 10X28MM,460ECON0212,CDM,278,RC,,,OUTPATIENT,,,1055.7,844.56,,791.78,75,,,percent of total billed charges,75% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,836.11,79.2,,,percent of total billed charges,79.2% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rates,1002.92,95,,,percent of total billed charges,95% of total billed charges,844.56,80,,,percent of total billed charges,80% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,950.13,90,,,percent of total billed charges,90% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rates,1055.7,100,,,fee schedule,100% of CO APG rates,1055.7,100,,,fee schedule,100% of NM fee schedule,422.28,40,,,percent of total billed charges,40% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,950.13,90,,,percent of total billed charges,90% of total billed charges,802.33,76,,,percent of total billed charges,76% of total billed charges,422.28,40,,,percent of total billed charges,40% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of CO APG rate,844.56,80,,,percent of total billed charges,80% of total billed charges,409.61,38.8,,,percent of total billed charges,38.8% of total billed charges,897.35,85,,,percent of total billed charges,85% of total billed charges,1055.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,409.61,1055.7,
Influenza Vaccine Admin,77100008,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.8,50.67,
Aerosol Equipment Instruction,60000313,CDM,412,RC,94640,HCPCS,OUTPATIENT,,,135,108,,101.25,75,,,percent of total billed charges,75% of total billed charges,54,40,,,percent of total billed charges,40% of total billed charges,106.92,79.2,,,percent of total billed charges,79.2% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,128.25,95,,,percent of total billed charges,95% of total billed charges,108,80,,,percent of total billed charges,80% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,121.5,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,135,100,,,fee schedule,100% of NM APC rate,54,40,,,percent of total billed charges,40% of total billed charges,54,40,,,percent of total billed charges,40% of total billed charges,121.5,90,,,percent of total billed charges,90% of total billed charges,102.6,76,,,percent of total billed charges,76% of total billed charges,54,40,,,percent of total billed charges,40% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,108,80,,,percent of total billed charges,80% of total billed charges,52.38,38.8,,,percent of total billed charges,38.8% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,135,
"96365 - IV tx, first hour",31096365,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,305.9,244.72,,229.43,75,,,percent of total billed charges,75% of total billed charges,122.36,40,,,percent of total billed charges,40% of total billed charges,242.27,79.2,,,percent of total billed charges,79.2% of total billed charges,260.02,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,290.61,95,,,percent of total billed charges,95% of total billed charges,244.72,80,,,percent of total billed charges,80% of total billed charges,260.02,85,,,percent of total billed charges,85% of total billed charges,275.31,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,122.36,40,,,percent of total billed charges,40% of total billed charges,122.36,40,,,percent of total billed charges,40% of total billed charges,275.31,90,,,percent of total billed charges,90% of total billed charges,232.48,76,,,percent of total billed charges,76% of total billed charges,122.36,40,,,percent of total billed charges,40% of total billed charges,260.02,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,244.72,80,,,percent of total billed charges,80% of total billed charges,118.69,38.8,,,percent of total billed charges,38.8% of total billed charges,260.02,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,290.61,
"96366 - IV tx, each additional hour",31096366,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,83.5,66.8,,62.63,75,,,percent of total billed charges,75% of total billed charges,33.4,40,,,percent of total billed charges,40% of total billed charges,66.13,79.2,,,percent of total billed charges,79.2% of total billed charges,70.98,85,,,percent of total billed charges,85% of total billed charges,83.5,100,,,fee schedule,100% of CO APG rates,79.33,95,,,percent of total billed charges,95% of total billed charges,66.8,80,,,percent of total billed charges,80% of total billed charges,70.98,85,,,percent of total billed charges,85% of total billed charges,75.15,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,83.5,100,,,fee schedule,100% of NM APC rate,33.4,40,,,percent of total billed charges,40% of total billed charges,33.4,40,,,percent of total billed charges,40% of total billed charges,75.15,90,,,percent of total billed charges,90% of total billed charges,63.46,76,,,percent of total billed charges,76% of total billed charges,33.4,40,,,percent of total billed charges,40% of total billed charges,70.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,66.8,80,,,percent of total billed charges,80% of total billed charges,32.4,38.8,,,percent of total billed charges,38.8% of total billed charges,70.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,167,200,,,fee schedule,200% of CMS fee schedule,32.4,215.49,
"96367 - IV tx, sequential infusion",31096367,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,223.6,178.88,,167.7,75,,,percent of total billed charges,75% of total billed charges,89.44,40,,,percent of total billed charges,40% of total billed charges,177.09,79.2,,,percent of total billed charges,79.2% of total billed charges,190.06,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,212.42,95,,,percent of total billed charges,95% of total billed charges,178.88,80,,,percent of total billed charges,80% of total billed charges,190.06,85,,,percent of total billed charges,85% of total billed charges,201.24,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,89.44,40,,,percent of total billed charges,40% of total billed charges,89.44,40,,,percent of total billed charges,40% of total billed charges,201.24,90,,,percent of total billed charges,90% of total billed charges,169.94,76,,,percent of total billed charges,76% of total billed charges,89.44,40,,,percent of total billed charges,40% of total billed charges,190.06,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,178.88,80,,,percent of total billed charges,80% of total billed charges,86.76,38.8,,,percent of total billed charges,38.8% of total billed charges,190.06,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,212.42,
"96368 - IV tx, concurrent infusion",31096368,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,77.6,62.08,,58.2,75,,,percent of total billed charges,75% of total billed charges,31.04,40,,,percent of total billed charges,40% of total billed charges,61.46,79.2,,,percent of total billed charges,79.2% of total billed charges,65.96,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,73.72,95,,,percent of total billed charges,95% of total billed charges,62.08,80,,,percent of total billed charges,80% of total billed charges,65.96,85,,,percent of total billed charges,85% of total billed charges,69.84,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,77.6,100,,,fee schedule,100% of NM APC rate,31.04,40,,,percent of total billed charges,40% of total billed charges,31.04,40,,,percent of total billed charges,40% of total billed charges,69.84,90,,,percent of total billed charges,90% of total billed charges,58.98,76,,,percent of total billed charges,76% of total billed charges,31.04,40,,,percent of total billed charges,40% of total billed charges,65.96,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,62.08,80,,,percent of total billed charges,80% of total billed charges,30.11,38.8,,,percent of total billed charges,38.8% of total billed charges,65.96,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,30.11,77.6,
96372 - Subq/IM Injection,46596372,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,111.2,88.96,,83.4,75,,,percent of total billed charges,75% of total billed charges,44.48,40,,,percent of total billed charges,40% of total billed charges,88.07,79.2,,,percent of total billed charges,79.2% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,105.64,95,,,percent of total billed charges,95% of total billed charges,88.96,80,,,percent of total billed charges,80% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,100.08,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,111.2,100,,,fee schedule,100% of NM APC rate,44.48,40,,,percent of total billed charges,40% of total billed charges,44.48,40,,,percent of total billed charges,40% of total billed charges,100.08,90,,,percent of total billed charges,90% of total billed charges,84.51,76,,,percent of total billed charges,76% of total billed charges,44.48,40,,,percent of total billed charges,40% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,88.96,80,,,percent of total billed charges,80% of total billed charges,43.15,38.8,,,percent of total billed charges,38.8% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,43.15,111.2,
"96374 - IV Injection, single/initial",31096374,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,265.3,212.24,,198.98,75,,,percent of total billed charges,75% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,210.12,79.2,,,percent of total billed charges,79.2% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,252.04,95,,,percent of total billed charges,95% of total billed charges,212.24,80,,,percent of total billed charges,80% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,106.12,40,,,percent of total billed charges,40% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,238.77,90,,,percent of total billed charges,90% of total billed charges,201.63,76,,,percent of total billed charges,76% of total billed charges,106.12,40,,,percent of total billed charges,40% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,212.24,80,,,percent of total billed charges,80% of total billed charges,102.94,38.8,,,percent of total billed charges,38.8% of total billed charges,225.51,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,252.04,
"96375 - IV Injection, add new drug",31096375,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,108.9,87.12,,81.68,75,,,percent of total billed charges,75% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,86.25,79.2,,,percent of total billed charges,79.2% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,103.46,95,,,percent of total billed charges,95% of total billed charges,87.12,80,,,percent of total billed charges,80% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,98.01,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,108.9,100,,,fee schedule,100% of NM APC rate,43.56,40,,,percent of total billed charges,40% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,98.01,90,,,percent of total billed charges,90% of total billed charges,82.76,76,,,percent of total billed charges,76% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,87.12,80,,,percent of total billed charges,80% of total billed charges,42.25,38.8,,,percent of total billed charges,38.8% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,42.25,108.9,
"96376 - IV Injection, add same drug",31096376,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,108.9,87.12,,81.68,75,,,percent of total billed charges,75% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,86.25,79.2,,,percent of total billed charges,79.2% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,103.46,95,,,percent of total billed charges,95% of total billed charges,87.12,80,,,percent of total billed charges,80% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,98.01,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,108.9,100,,,fee schedule,100% of NM APC rate,43.56,40,,,percent of total billed charges,40% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,98.01,90,,,percent of total billed charges,90% of total billed charges,82.76,76,,,percent of total billed charges,76% of total billed charges,43.56,40,,,percent of total billed charges,40% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,87.12,80,,,percent of total billed charges,80% of total billed charges,42.25,38.8,,,percent of total billed charges,38.8% of total billed charges,92.57,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,42.25,108.9,
99281 - Level 1,31099281,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,412.9,330.32,,309.68,75,,,percent of total billed charges,75% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,327.02,79.2,,,percent of total billed charges,79.2% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,392.26,95,,,percent of total billed charges,95% of total billed charges,330.32,80,,,percent of total billed charges,80% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,371.61,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,165.16,40,,,percent of total billed charges,40% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,371.61,90,,,percent of total billed charges,90% of total billed charges,313.8,76,,,percent of total billed charges,76% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,330.32,80,,,percent of total billed charges,80% of total billed charges,160.21,38.8,,,percent of total billed charges,38.8% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,160.21,392.26,
99282 - Level 2,31099282,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,412.9,330.32,,309.68,75,,,percent of total billed charges,75% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,327.02,79.2,,,percent of total billed charges,79.2% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,392.26,95,,,percent of total billed charges,95% of total billed charges,330.32,80,,,percent of total billed charges,80% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,371.61,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,165.16,40,,,percent of total billed charges,40% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,371.61,90,,,percent of total billed charges,90% of total billed charges,313.8,76,,,percent of total billed charges,76% of total billed charges,165.16,40,,,percent of total billed charges,40% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,330.32,80,,,percent of total billed charges,80% of total billed charges,160.21,38.8,,,percent of total billed charges,38.8% of total billed charges,350.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,160.21,392.26,
99283 - Level 3,31099283,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1003.6,802.88,,752.7,75,,,percent of total billed charges,75% of total billed charges,401.44,40,,,percent of total billed charges,40% of total billed charges,794.85,79.2,,,percent of total billed charges,79.2% of total billed charges,853.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,953.42,95,,,percent of total billed charges,95% of total billed charges,802.88,80,,,percent of total billed charges,80% of total billed charges,853.06,85,,,percent of total billed charges,85% of total billed charges,903.24,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,401.44,40,,,percent of total billed charges,40% of total billed charges,401.44,40,,,percent of total billed charges,40% of total billed charges,903.24,90,,,percent of total billed charges,90% of total billed charges,762.74,76,,,percent of total billed charges,76% of total billed charges,401.44,40,,,percent of total billed charges,40% of total billed charges,853.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,802.88,80,,,percent of total billed charges,80% of total billed charges,389.4,38.8,,,percent of total billed charges,38.8% of total billed charges,853.06,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,953.42,
99284 - Level 4,31099284,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1455,1164,,1091.25,75,,,percent of total billed charges,75% of total billed charges,582,40,,,percent of total billed charges,40% of total billed charges,1152.36,79.2,,,percent of total billed charges,79.2% of total billed charges,1236.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1382.25,95,,,percent of total billed charges,95% of total billed charges,1164,80,,,percent of total billed charges,80% of total billed charges,1236.75,85,,,percent of total billed charges,85% of total billed charges,1309.5,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,582,40,,,percent of total billed charges,40% of total billed charges,582,40,,,percent of total billed charges,40% of total billed charges,1309.5,90,,,percent of total billed charges,90% of total billed charges,1105.8,76,,,percent of total billed charges,76% of total billed charges,582,40,,,percent of total billed charges,40% of total billed charges,1236.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1164,80,,,percent of total billed charges,80% of total billed charges,564.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1236.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1382.25,
99285 - Level 5,31099285,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2048.8,1639.04,,1536.6,75,,,percent of total billed charges,75% of total billed charges,819.52,40,,,percent of total billed charges,40% of total billed charges,1622.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1741.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1946.36,95,,,percent of total billed charges,95% of total billed charges,1639.04,80,,,percent of total billed charges,80% of total billed charges,1741.48,85,,,percent of total billed charges,85% of total billed charges,1843.92,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,819.52,40,,,percent of total billed charges,40% of total billed charges,819.52,40,,,percent of total billed charges,40% of total billed charges,1843.92,90,,,percent of total billed charges,90% of total billed charges,1557.09,76,,,percent of total billed charges,76% of total billed charges,819.52,40,,,percent of total billed charges,40% of total billed charges,1741.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1639.04,80,,,percent of total billed charges,80% of total billed charges,794.93,38.8,,,percent of total billed charges,38.8% of total billed charges,1741.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1946.36,
99291 - Critical Care,31099291,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,3177.2,2541.76,,2382.9,75,,,percent of total billed charges,75% of total billed charges,1270.88,40,,,percent of total billed charges,40% of total billed charges,2516.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2700.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,3018.34,95,,,percent of total billed charges,95% of total billed charges,2541.76,80,,,percent of total billed charges,80% of total billed charges,2700.62,85,,,percent of total billed charges,85% of total billed charges,2859.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1270.88,40,,,percent of total billed charges,40% of total billed charges,1270.88,40,,,percent of total billed charges,40% of total billed charges,2859.48,90,,,percent of total billed charges,90% of total billed charges,2414.67,76,,,percent of total billed charges,76% of total billed charges,1270.88,40,,,percent of total billed charges,40% of total billed charges,2700.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,2541.76,80,,,percent of total billed charges,80% of total billed charges,1232.75,38.8,,,percent of total billed charges,38.8% of total billed charges,2700.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,3018.34,
"99292 - Critical Care, each 30 min",31099292,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,747.8,598.24,,560.85,75,,,percent of total billed charges,75% of total billed charges,299.12,40,,,percent of total billed charges,40% of total billed charges,592.26,79.2,,,percent of total billed charges,79.2% of total billed charges,635.63,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,710.41,95,,,percent of total billed charges,95% of total billed charges,598.24,80,,,percent of total billed charges,80% of total billed charges,635.63,85,,,percent of total billed charges,85% of total billed charges,673.02,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,299.12,40,,,percent of total billed charges,40% of total billed charges,299.12,40,,,percent of total billed charges,40% of total billed charges,673.02,90,,,percent of total billed charges,90% of total billed charges,568.33,76,,,percent of total billed charges,76% of total billed charges,299.12,40,,,percent of total billed charges,40% of total billed charges,635.63,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,598.24,80,,,percent of total billed charges,80% of total billed charges,290.15,38.8,,,percent of total billed charges,38.8% of total billed charges,635.63,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,710.41,
Body Fluid Cell Count 4,40089051,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,75.4,60.32,,56.55,75,,,percent of total billed charges,75% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,59.72,79.2,,,percent of total billed charges,79.2% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,71.63,95,,,percent of total billed charges,95% of total billed charges,60.32,80,,,percent of total billed charges,80% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,30.16,40,,,percent of total billed charges,40% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,57.3,76,,,percent of total billed charges,76% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,60.32,80,,,percent of total billed charges,80% of total billed charges,29.26,38.8,,,percent of total billed charges,38.8% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,71.63,
CSF Cell Count 4,40089051,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,75.4,60.32,,56.55,75,,,percent of total billed charges,75% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,59.72,79.2,,,percent of total billed charges,79.2% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,71.63,95,,,percent of total billed charges,95% of total billed charges,60.32,80,,,percent of total billed charges,80% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,30.16,40,,,percent of total billed charges,40% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,57.3,76,,,percent of total billed charges,76% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,60.32,80,,,percent of total billed charges,80% of total billed charges,29.26,38.8,,,percent of total billed charges,38.8% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,71.63,
PROCINCH ADJUSTABLE LOOP- STANDARD,46052803,CDM,270,RC,,,OUTPATIENT,,,1833,1466.4,,1374.75,75,,,percent of total billed charges,75% of total billed charges,733.2,40,,,percent of total billed charges,40% of total billed charges,1451.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1558.05,85,,,percent of total billed charges,85% of total billed charges,1833,100,,,fee schedule,100% of CO APG rates,1741.35,95,,,percent of total billed charges,95% of total billed charges,1466.4,80,,,percent of total billed charges,80% of total billed charges,1558.05,85,,,percent of total billed charges,85% of total billed charges,1649.7,90,,,percent of total billed charges,90% of total billed charges,1833,100,,,fee schedule,100% of CO APG rates,1833,100,,,fee schedule,100% of CO APG rates,1833,100,,,fee schedule,100% of NM fee schedule,733.2,40,,,percent of total billed charges,40% of total billed charges,733.2,40,,,percent of total billed charges,40% of total billed charges,1649.7,90,,,percent of total billed charges,90% of total billed charges,1393.08,76,,,percent of total billed charges,76% of total billed charges,733.2,40,,,percent of total billed charges,40% of total billed charges,1558.05,85,,,percent of total billed charges,85% of total billed charges,1833,100,,,fee schedule,100% of CO APG rate,1466.4,80,,,percent of total billed charges,80% of total billed charges,711.2,38.8,,,percent of total billed charges,38.8% of total billed charges,1558.05,85,,,percent of total billed charges,85% of total billed charges,1833,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,711.2,1833,
FLEXIBLE GUIDE PIN- NON-STERILE,46052559,CDM,270,RC,,,OUTPATIENT,,,1138.3,910.64,,853.73,75,,,percent of total billed charges,75% of total billed charges,455.32,40,,,percent of total billed charges,40% of total billed charges,901.53,79.2,,,percent of total billed charges,79.2% of total billed charges,967.56,85,,,percent of total billed charges,85% of total billed charges,1138.3,100,,,fee schedule,100% of CO APG rates,1081.39,95,,,percent of total billed charges,95% of total billed charges,910.64,80,,,percent of total billed charges,80% of total billed charges,967.56,85,,,percent of total billed charges,85% of total billed charges,1024.47,90,,,percent of total billed charges,90% of total billed charges,1138.3,100,,,fee schedule,100% of CO APG rates,1138.3,100,,,fee schedule,100% of CO APG rates,1138.3,100,,,fee schedule,100% of NM fee schedule,455.32,40,,,percent of total billed charges,40% of total billed charges,455.32,40,,,percent of total billed charges,40% of total billed charges,1024.47,90,,,percent of total billed charges,90% of total billed charges,865.11,76,,,percent of total billed charges,76% of total billed charges,455.32,40,,,percent of total billed charges,40% of total billed charges,967.56,85,,,percent of total billed charges,85% of total billed charges,1138.3,100,,,fee schedule,100% of CO APG rate,910.64,80,,,percent of total billed charges,80% of total billed charges,441.66,38.8,,,percent of total billed charges,38.8% of total billed charges,967.56,85,,,percent of total billed charges,85% of total billed charges,1138.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,441.66,1138.3,
UTERINE EXPLORA CURETTE,49152564,CDM,270,RC,,,OUTPATIENT,,,55.6,44.48,,41.7,75,,,percent of total billed charges,75% of total billed charges,22.24,40,,,percent of total billed charges,40% of total billed charges,44.04,79.2,,,percent of total billed charges,79.2% of total billed charges,47.26,85,,,percent of total billed charges,85% of total billed charges,55.6,100,,,fee schedule,100% of CO APG rates,52.82,95,,,percent of total billed charges,95% of total billed charges,44.48,80,,,percent of total billed charges,80% of total billed charges,47.26,85,,,percent of total billed charges,85% of total billed charges,50.04,90,,,percent of total billed charges,90% of total billed charges,55.6,100,,,fee schedule,100% of CO APG rates,55.6,100,,,fee schedule,100% of CO APG rates,55.6,100,,,fee schedule,100% of NM fee schedule,22.24,40,,,percent of total billed charges,40% of total billed charges,22.24,40,,,percent of total billed charges,40% of total billed charges,50.04,90,,,percent of total billed charges,90% of total billed charges,42.26,76,,,percent of total billed charges,76% of total billed charges,22.24,40,,,percent of total billed charges,40% of total billed charges,47.26,85,,,percent of total billed charges,85% of total billed charges,55.6,100,,,fee schedule,100% of CO APG rate,44.48,80,,,percent of total billed charges,80% of total billed charges,21.57,38.8,,,percent of total billed charges,38.8% of total billed charges,47.26,85,,,percent of total billed charges,85% of total billed charges,55.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,21.57,55.6,
Childhood Allergy Profile+IgE LC,40082785,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,723.9,579.12,,542.93,75,,,percent of total billed charges,75% of total billed charges,289.56,40,,,percent of total billed charges,40% of total billed charges,573.33,79.2,,,percent of total billed charges,79.2% of total billed charges,615.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,687.71,95,,,percent of total billed charges,95% of total billed charges,579.12,80,,,percent of total billed charges,80% of total billed charges,615.32,85,,,percent of total billed charges,85% of total billed charges,651.51,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,289.56,40,,,percent of total billed charges,40% of total billed charges,289.56,40,,,percent of total billed charges,40% of total billed charges,651.51,90,,,percent of total billed charges,90% of total billed charges,550.16,76,,,percent of total billed charges,76% of total billed charges,289.56,40,,,percent of total billed charges,40% of total billed charges,615.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,579.12,80,,,percent of total billed charges,80% of total billed charges,280.87,38.8,,,percent of total billed charges,38.8% of total billed charges,615.32,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,687.71,
86003 Childhood Allergy Profile+IgE LC,40086003,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,710.9,568.72,,533.18,75,,,percent of total billed charges,75% of total billed charges,284.36,40,,,percent of total billed charges,40% of total billed charges,563.03,79.2,,,percent of total billed charges,79.2% of total billed charges,604.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,675.36,95,,,percent of total billed charges,95% of total billed charges,568.72,80,,,percent of total billed charges,80% of total billed charges,604.27,85,,,percent of total billed charges,85% of total billed charges,639.81,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,284.36,40,,,percent of total billed charges,40% of total billed charges,284.36,40,,,percent of total billed charges,40% of total billed charges,639.81,90,,,percent of total billed charges,90% of total billed charges,540.28,76,,,percent of total billed charges,76% of total billed charges,284.36,40,,,percent of total billed charges,40% of total billed charges,604.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,568.72,80,,,percent of total billed charges,80% of total billed charges,275.83,38.8,,,percent of total billed charges,38.8% of total billed charges,604.27,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,675.36,
16020 DRESS/DEBRID P-THICK BURN S,60000018,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,280.8,224.64,,210.6,75,,,percent of total billed charges,75% of total billed charges,112.32,40,,,percent of total billed charges,40% of total billed charges,222.39,79.2,,,percent of total billed charges,79.2% of total billed charges,238.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,266.76,95,,,percent of total billed charges,95% of total billed charges,224.64,80,,,percent of total billed charges,80% of total billed charges,238.68,85,,,percent of total billed charges,85% of total billed charges,252.72,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,112.32,40,,,percent of total billed charges,40% of total billed charges,112.32,40,,,percent of total billed charges,40% of total billed charges,252.72,90,,,percent of total billed charges,90% of total billed charges,213.41,76,,,percent of total billed charges,76% of total billed charges,112.32,40,,,percent of total billed charges,40% of total billed charges,238.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,224.64,80,,,percent of total billed charges,80% of total billed charges,108.95,38.8,,,percent of total billed charges,38.8% of total billed charges,238.68,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,108.95,266.76,
PSMC MRI Dual Syringe,41352566,CDM,270,RC,,,OUTPATIENT,,,75.4,60.32,,56.55,75,,,percent of total billed charges,75% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,59.72,79.2,,,percent of total billed charges,79.2% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,75.4,100,,,fee schedule,100% of CO APG rates,71.63,95,,,percent of total billed charges,95% of total billed charges,60.32,80,,,percent of total billed charges,80% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,75.4,100,,,fee schedule,100% of CO APG rates,75.4,100,,,fee schedule,100% of CO APG rates,75.4,100,,,fee schedule,100% of NM fee schedule,30.16,40,,,percent of total billed charges,40% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,57.3,76,,,percent of total billed charges,76% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,75.4,100,,,fee schedule,100% of CO APG rate,60.32,80,,,percent of total billed charges,80% of total billed charges,29.26,38.8,,,percent of total billed charges,38.8% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,75.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,29.26,75.4,
"10120 Incision and removal of foreign body, subcutaneous tissue; simple",60000006,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1147.1,917.68,,860.33,75,,,percent of total billed charges,75% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,908.5,79.2,,,percent of total billed charges,79.2% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1089.75,95,,,percent of total billed charges,95% of total billed charges,917.68,80,,,percent of total billed charges,80% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,458.84,40,,,percent of total billed charges,40% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,1032.39,90,,,percent of total billed charges,90% of total billed charges,871.8,76,,,percent of total billed charges,76% of total billed charges,458.84,40,,,percent of total billed charges,40% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,917.68,80,,,percent of total billed charges,80% of total billed charges,445.07,38.8,,,percent of total billed charges,38.8% of total billed charges,975.04,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1089.75,
"11042 Debridement, Subcutaneous Tissue; First 20 Sq Cm Or Le",60000010,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,345.3,276.24,,258.98,75,,,percent of total billed charges,75% of total billed charges,138.12,40,,,percent of total billed charges,40% of total billed charges,273.48,79.2,,,percent of total billed charges,79.2% of total billed charges,293.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,328.04,95,,,percent of total billed charges,95% of total billed charges,276.24,80,,,percent of total billed charges,80% of total billed charges,293.51,85,,,percent of total billed charges,85% of total billed charges,310.77,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,138.12,40,,,percent of total billed charges,40% of total billed charges,138.12,40,,,percent of total billed charges,40% of total billed charges,310.77,90,,,percent of total billed charges,90% of total billed charges,262.43,76,,,percent of total billed charges,76% of total billed charges,138.12,40,,,percent of total billed charges,40% of total billed charges,293.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,276.24,80,,,percent of total billed charges,80% of total billed charges,133.98,38.8,,,percent of total billed charges,38.8% of total billed charges,293.51,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,133.98,328.04,
31028435 Closed treatment of talus fracture; with manipulation,31028435,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1183.5,946.8,,887.63,75,,,percent of total billed charges,75% of total billed charges,473.4,40,,,percent of total billed charges,40% of total billed charges,937.33,79.2,,,percent of total billed charges,79.2% of total billed charges,1005.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1124.33,95,,,percent of total billed charges,95% of total billed charges,946.8,80,,,percent of total billed charges,80% of total billed charges,1005.98,85,,,percent of total billed charges,85% of total billed charges,1065.15,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,473.4,40,,,percent of total billed charges,40% of total billed charges,473.4,40,,,percent of total billed charges,40% of total billed charges,1065.15,90,,,percent of total billed charges,90% of total billed charges,899.46,76,,,percent of total billed charges,76% of total billed charges,473.4,40,,,percent of total billed charges,40% of total billed charges,1005.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,946.8,80,,,percent of total billed charges,80% of total billed charges,459.2,38.8,,,percent of total billed charges,38.8% of total billed charges,1005.98,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1124.33,
31055100 Drainage of scrotal wall abscess,31055100,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4898.4,3918.72,,3673.8,75,,,percent of total billed charges,75% of total billed charges,1959.36,40,,,percent of total billed charges,40% of total billed charges,3879.53,79.2,,,percent of total billed charges,79.2% of total billed charges,4163.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4653.48,95,,,percent of total billed charges,95% of total billed charges,3918.72,80,,,percent of total billed charges,80% of total billed charges,4163.64,85,,,percent of total billed charges,85% of total billed charges,4408.56,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1959.36,40,,,percent of total billed charges,40% of total billed charges,1959.36,40,,,percent of total billed charges,40% of total billed charges,4408.56,90,,,percent of total billed charges,90% of total billed charges,3722.78,76,,,percent of total billed charges,76% of total billed charges,1959.36,40,,,percent of total billed charges,40% of total billed charges,4163.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3918.72,80,,,percent of total billed charges,80% of total billed charges,1900.58,38.8,,,percent of total billed charges,38.8% of total billed charges,4163.64,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4653.48,
"SPIROL CLOSED CATHETER 20G X 24IN, EPIMED",46252570,CDM,270,RC,,,OUTPATIENT,,,110.2,88.16,,82.65,75,,,percent of total billed charges,75% of total billed charges,44.08,40,,,percent of total billed charges,40% of total billed charges,87.28,79.2,,,percent of total billed charges,79.2% of total billed charges,93.67,85,,,percent of total billed charges,85% of total billed charges,110.2,100,,,fee schedule,100% of CO APG rates,104.69,95,,,percent of total billed charges,95% of total billed charges,88.16,80,,,percent of total billed charges,80% of total billed charges,93.67,85,,,percent of total billed charges,85% of total billed charges,99.18,90,,,percent of total billed charges,90% of total billed charges,110.2,100,,,fee schedule,100% of CO APG rates,110.2,100,,,fee schedule,100% of CO APG rates,110.2,100,,,fee schedule,100% of NM fee schedule,44.08,40,,,percent of total billed charges,40% of total billed charges,44.08,40,,,percent of total billed charges,40% of total billed charges,99.18,90,,,percent of total billed charges,90% of total billed charges,83.75,76,,,percent of total billed charges,76% of total billed charges,44.08,40,,,percent of total billed charges,40% of total billed charges,93.67,85,,,percent of total billed charges,85% of total billed charges,110.2,100,,,fee schedule,100% of CO APG rate,88.16,80,,,percent of total billed charges,80% of total billed charges,42.76,38.8,,,percent of total billed charges,38.8% of total billed charges,93.67,85,,,percent of total billed charges,85% of total billed charges,110.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,42.76,110.2,
"11770 - Excision of pilonidal cyst or sinus, simple",46011770,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,8421.9,6737.52,,6316.43,75,,,percent of total billed charges,75% of total billed charges,3368.76,40,,,percent of total billed charges,40% of total billed charges,6670.14,79.2,,,percent of total billed charges,79.2% of total billed charges,7158.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,8000.81,95,,,percent of total billed charges,95% of total billed charges,6737.52,80,,,percent of total billed charges,80% of total billed charges,7158.62,85,,,percent of total billed charges,85% of total billed charges,7579.71,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,4233.52,100,,,fee schedule,100% of NM APC rate,3368.76,40,,,percent of total billed charges,40% of total billed charges,3368.76,40,,,percent of total billed charges,40% of total billed charges,7579.71,90,,,percent of total billed charges,90% of total billed charges,6400.64,76,,,percent of total billed charges,76% of total billed charges,3368.76,40,,,percent of total billed charges,40% of total billed charges,7158.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,6737.52,80,,,percent of total billed charges,80% of total billed charges,3267.7,38.8,,,percent of total billed charges,38.8% of total billed charges,7158.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,215.49,8000.81,
"46050 - Incision and drainage, perineal abscess,superficial",46046050,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2426.3,1941.04,,1819.73,75,,,percent of total billed charges,75% of total billed charges,970.52,40,,,percent of total billed charges,40% of total billed charges,1921.63,79.2,,,percent of total billed charges,79.2% of total billed charges,2062.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2304.99,95,,,percent of total billed charges,95% of total billed charges,1941.04,80,,,percent of total billed charges,80% of total billed charges,2062.36,85,,,percent of total billed charges,85% of total billed charges,2183.67,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,970.52,40,,,percent of total billed charges,40% of total billed charges,970.52,40,,,percent of total billed charges,40% of total billed charges,2183.67,90,,,percent of total billed charges,90% of total billed charges,1843.99,76,,,percent of total billed charges,76% of total billed charges,970.52,40,,,percent of total billed charges,40% of total billed charges,2062.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1941.04,80,,,percent of total billed charges,80% of total billed charges,941.4,38.8,,,percent of total billed charges,38.8% of total billed charges,2062.36,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2304.99,
11983 Removal with reinsertion of Nexplanon drug delivery im,60000379,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,979.7,783.76,,734.78,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,775.92,79.2,,,percent of total billed charges,79.2% of total billed charges,832.75,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,930.72,95,,,percent of total billed charges,95% of total billed charges,783.76,80,,,percent of total billed charges,80% of total billed charges,832.75,85,,,percent of total billed charges,85% of total billed charges,881.73,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,979.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,881.73,90,,,percent of total billed charges,90% of total billed charges,744.57,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,832.75,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,783.76,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,832.75,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
Complex Chronic Care Management 99487 Charge,49699487,CDM,510,RC,99495,HCPCS,OUTPATIENT,,,116.3,93.04,,87.23,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,92.11,79.2,,,percent of total billed charges,79.2% of total billed charges,98.86,85,,,percent of total billed charges,85% of total billed charges,116.3,100,,,fee schedule,100% of CO APG rates,110.49,95,,,percent of total billed charges,95% of total billed charges,93.04,80,,,percent of total billed charges,80% of total billed charges,98.86,85,,,percent of total billed charges,85% of total billed charges,104.67,90,,,percent of total billed charges,90% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rates,136.55,100,,,fee schedule,100% of CO APG rates,116.3,100,,,fee schedule,100% of NM APC rate,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,104.67,90,,,percent of total billed charges,90% of total billed charges,88.39,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,98.86,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rate,93.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,98.86,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of APG fee schedule,614.8,100,,,case rate,pays based on per visit rate,87.23,614.8,
Complex Chronic Care Management 99489 Charge,49699489,CDM,510,RC,99495,HCPCS,OUTPATIENT,,,64.1,51.28,,48.08,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,50.77,79.2,,,percent of total billed charges,79.2% of total billed charges,54.49,85,,,percent of total billed charges,85% of total billed charges,64.1,100,,,fee schedule,100% of CO APG rates,60.9,95,,,percent of total billed charges,95% of total billed charges,51.28,80,,,percent of total billed charges,80% of total billed charges,54.49,85,,,percent of total billed charges,85% of total billed charges,57.69,90,,,percent of total billed charges,90% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rates,136.55,100,,,fee schedule,100% of CO APG rates,64.1,100,,,fee schedule,100% of NM APC rate,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,57.69,90,,,percent of total billed charges,90% of total billed charges,48.72,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,54.49,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of CO APG rate,51.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,54.49,85,,,percent of total billed charges,85% of total billed charges,136.55,100,,,fee schedule,100% of APG fee schedule,510.4,100,,,case rate,pays based on per visit rate,48.08,510.4,
Cryptococcus Antigen  CSF LC,40183016,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,27.9,22.32,,20.93,75,,,percent of total billed charges,75% of total billed charges,11.16,40,,,percent of total billed charges,40% of total billed charges,22.1,79.2,,,percent of total billed charges,79.2% of total billed charges,23.72,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,26.51,95,,,percent of total billed charges,95% of total billed charges,22.32,80,,,percent of total billed charges,80% of total billed charges,23.72,85,,,percent of total billed charges,85% of total billed charges,25.11,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,11.16,40,,,percent of total billed charges,40% of total billed charges,11.16,40,,,percent of total billed charges,40% of total billed charges,25.11,90,,,percent of total billed charges,90% of total billed charges,21.2,76,,,percent of total billed charges,76% of total billed charges,11.16,40,,,percent of total billed charges,40% of total billed charges,23.72,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,22.32,80,,,percent of total billed charges,80% of total billed charges,10.83,38.8,,,percent of total billed charges,38.8% of total billed charges,23.72,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,33.1,
"TWIST DRILL W/AO, 4.0MM CANNULATED",46052572,CDM,270,RC,,,OUTPATIENT,,,972.1,777.68,,729.08,75,,,percent of total billed charges,75% of total billed charges,388.84,40,,,percent of total billed charges,40% of total billed charges,769.9,79.2,,,percent of total billed charges,79.2% of total billed charges,826.29,85,,,percent of total billed charges,85% of total billed charges,972.1,100,,,fee schedule,100% of CO APG rates,923.5,95,,,percent of total billed charges,95% of total billed charges,777.68,80,,,percent of total billed charges,80% of total billed charges,826.29,85,,,percent of total billed charges,85% of total billed charges,874.89,90,,,percent of total billed charges,90% of total billed charges,972.1,100,,,fee schedule,100% of CO APG rates,972.1,100,,,fee schedule,100% of CO APG rates,972.1,100,,,fee schedule,100% of NM fee schedule,388.84,40,,,percent of total billed charges,40% of total billed charges,388.84,40,,,percent of total billed charges,40% of total billed charges,874.89,90,,,percent of total billed charges,90% of total billed charges,738.8,76,,,percent of total billed charges,76% of total billed charges,388.84,40,,,percent of total billed charges,40% of total billed charges,826.29,85,,,percent of total billed charges,85% of total billed charges,972.1,100,,,fee schedule,100% of CO APG rate,777.68,80,,,percent of total billed charges,80% of total billed charges,377.17,38.8,,,percent of total billed charges,38.8% of total billed charges,826.29,85,,,percent of total billed charges,85% of total billed charges,972.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,377.17,972.1,
"K-WIRE, SMOOTH, 1.4MMX100MM",46052573,CDM,278,RC,,,OUTPATIENT,,,70.4,56.32,,52.8,75,,,percent of total billed charges,75% of total billed charges,28.16,40,,,percent of total billed charges,40% of total billed charges,55.76,79.2,,,percent of total billed charges,79.2% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,70.4,100,,,fee schedule,100% of CO APG rates,66.88,95,,,percent of total billed charges,95% of total billed charges,56.32,80,,,percent of total billed charges,80% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,63.36,90,,,percent of total billed charges,90% of total billed charges,70.4,100,,,fee schedule,100% of CO APG rates,70.4,100,,,fee schedule,100% of CO APG rates,70.4,100,,,fee schedule,100% of NM fee schedule,28.16,40,,,percent of total billed charges,40% of total billed charges,28.16,40,,,percent of total billed charges,40% of total billed charges,63.36,90,,,percent of total billed charges,90% of total billed charges,53.5,76,,,percent of total billed charges,76% of total billed charges,28.16,40,,,percent of total billed charges,40% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,70.4,100,,,fee schedule,100% of CO APG rate,56.32,80,,,percent of total billed charges,80% of total billed charges,27.32,38.8,,,percent of total billed charges,38.8% of total billed charges,59.84,85,,,percent of total billed charges,85% of total billed charges,70.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,27.32,70.4,
K-WIRE FULLY THREADED 1.6MMX200MM,46052575,CDM,278,RC,,,OUTPATIENT,,,109.2,87.36,,81.9,75,,,percent of total billed charges,75% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,86.49,79.2,,,percent of total billed charges,79.2% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rates,103.74,95,,,percent of total billed charges,95% of total billed charges,87.36,80,,,percent of total billed charges,80% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rates,109.2,100,,,fee schedule,100% of CO APG rates,109.2,100,,,fee schedule,100% of NM fee schedule,43.68,40,,,percent of total billed charges,40% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,82.99,76,,,percent of total billed charges,76% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rate,87.36,80,,,percent of total billed charges,80% of total billed charges,42.37,38.8,,,percent of total billed charges,38.8% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,42.37,109.2,
"TAP, 2.7MM SCREW AO 50MM",46052576,CDM,270,RC,,,OUTPATIENT,,,227.2,181.76,,170.4,75,,,percent of total billed charges,75% of total billed charges,90.88,40,,,percent of total billed charges,40% of total billed charges,179.94,79.2,,,percent of total billed charges,79.2% of total billed charges,193.12,85,,,percent of total billed charges,85% of total billed charges,227.2,100,,,fee schedule,100% of CO APG rates,215.84,95,,,percent of total billed charges,95% of total billed charges,181.76,80,,,percent of total billed charges,80% of total billed charges,193.12,85,,,percent of total billed charges,85% of total billed charges,204.48,90,,,percent of total billed charges,90% of total billed charges,227.2,100,,,fee schedule,100% of CO APG rates,227.2,100,,,fee schedule,100% of CO APG rates,227.2,100,,,fee schedule,100% of NM fee schedule,90.88,40,,,percent of total billed charges,40% of total billed charges,90.88,40,,,percent of total billed charges,40% of total billed charges,204.48,90,,,percent of total billed charges,90% of total billed charges,172.67,76,,,percent of total billed charges,76% of total billed charges,90.88,40,,,percent of total billed charges,40% of total billed charges,193.12,85,,,percent of total billed charges,85% of total billed charges,227.2,100,,,fee schedule,100% of CO APG rate,181.76,80,,,percent of total billed charges,80% of total billed charges,88.15,38.8,,,percent of total billed charges,38.8% of total billed charges,193.12,85,,,percent of total billed charges,85% of total billed charges,227.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,88.15,227.2,
"TAP, 3.5MM SCREWS AO 70MM",46052577,CDM,270,RC,,,OUTPATIENT,,,267.5,214,,200.63,75,,,percent of total billed charges,75% of total billed charges,107,40,,,percent of total billed charges,40% of total billed charges,211.86,79.2,,,percent of total billed charges,79.2% of total billed charges,227.38,85,,,percent of total billed charges,85% of total billed charges,267.5,100,,,fee schedule,100% of CO APG rates,254.13,95,,,percent of total billed charges,95% of total billed charges,214,80,,,percent of total billed charges,80% of total billed charges,227.38,85,,,percent of total billed charges,85% of total billed charges,240.75,90,,,percent of total billed charges,90% of total billed charges,267.5,100,,,fee schedule,100% of CO APG rates,267.5,100,,,fee schedule,100% of CO APG rates,267.5,100,,,fee schedule,100% of NM fee schedule,107,40,,,percent of total billed charges,40% of total billed charges,107,40,,,percent of total billed charges,40% of total billed charges,240.75,90,,,percent of total billed charges,90% of total billed charges,203.3,76,,,percent of total billed charges,76% of total billed charges,107,40,,,percent of total billed charges,40% of total billed charges,227.38,85,,,percent of total billed charges,85% of total billed charges,267.5,100,,,fee schedule,100% of CO APG rate,214,80,,,percent of total billed charges,80% of total billed charges,103.79,38.8,,,percent of total billed charges,38.8% of total billed charges,227.38,85,,,percent of total billed charges,85% of total billed charges,267.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.79,267.5,
STEINMANN PIN TROCAR PT 1 END PLN,46052581,CDM,270,RC,,,OUTPATIENT,,,56.7,45.36,,42.53,75,,,percent of total billed charges,75% of total billed charges,22.68,40,,,percent of total billed charges,40% of total billed charges,44.91,79.2,,,percent of total billed charges,79.2% of total billed charges,48.2,85,,,percent of total billed charges,85% of total billed charges,56.7,100,,,fee schedule,100% of CO APG rates,53.87,95,,,percent of total billed charges,95% of total billed charges,45.36,80,,,percent of total billed charges,80% of total billed charges,48.2,85,,,percent of total billed charges,85% of total billed charges,51.03,90,,,percent of total billed charges,90% of total billed charges,56.7,100,,,fee schedule,100% of CO APG rates,56.7,100,,,fee schedule,100% of CO APG rates,56.7,100,,,fee schedule,100% of NM fee schedule,22.68,40,,,percent of total billed charges,40% of total billed charges,22.68,40,,,percent of total billed charges,40% of total billed charges,51.03,90,,,percent of total billed charges,90% of total billed charges,43.09,76,,,percent of total billed charges,76% of total billed charges,22.68,40,,,percent of total billed charges,40% of total billed charges,48.2,85,,,percent of total billed charges,85% of total billed charges,56.7,100,,,fee schedule,100% of CO APG rate,45.36,80,,,percent of total billed charges,80% of total billed charges,22,38.8,,,percent of total billed charges,38.8% of total billed charges,48.2,85,,,percent of total billed charges,85% of total billed charges,56.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,22,56.7,
TAP 3.5MM/L180MM AO FITTING,46052582,CDM,270,RC,,,OUTPATIENT,,,607.4,485.92,,455.55,75,,,percent of total billed charges,75% of total billed charges,242.96,40,,,percent of total billed charges,40% of total billed charges,481.06,79.2,,,percent of total billed charges,79.2% of total billed charges,516.29,85,,,percent of total billed charges,85% of total billed charges,607.4,100,,,fee schedule,100% of CO APG rates,577.03,95,,,percent of total billed charges,95% of total billed charges,485.92,80,,,percent of total billed charges,80% of total billed charges,516.29,85,,,percent of total billed charges,85% of total billed charges,546.66,90,,,percent of total billed charges,90% of total billed charges,607.4,100,,,fee schedule,100% of CO APG rates,607.4,100,,,fee schedule,100% of CO APG rates,607.4,100,,,fee schedule,100% of NM fee schedule,242.96,40,,,percent of total billed charges,40% of total billed charges,242.96,40,,,percent of total billed charges,40% of total billed charges,546.66,90,,,percent of total billed charges,90% of total billed charges,461.62,76,,,percent of total billed charges,76% of total billed charges,242.96,40,,,percent of total billed charges,40% of total billed charges,516.29,85,,,percent of total billed charges,85% of total billed charges,607.4,100,,,fee schedule,100% of CO APG rate,485.92,80,,,percent of total billed charges,80% of total billed charges,235.67,38.8,,,percent of total billed charges,38.8% of total billed charges,516.29,85,,,percent of total billed charges,85% of total billed charges,607.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,235.67,607.4,
TAP 4.0X180MM AO-QUICK COUPLING,46052583,CDM,270,RC,,,OUTPATIENT,,,554.8,443.84,,416.1,75,,,percent of total billed charges,75% of total billed charges,221.92,40,,,percent of total billed charges,40% of total billed charges,439.4,79.2,,,percent of total billed charges,79.2% of total billed charges,471.58,85,,,percent of total billed charges,85% of total billed charges,554.8,100,,,fee schedule,100% of CO APG rates,527.06,95,,,percent of total billed charges,95% of total billed charges,443.84,80,,,percent of total billed charges,80% of total billed charges,471.58,85,,,percent of total billed charges,85% of total billed charges,499.32,90,,,percent of total billed charges,90% of total billed charges,554.8,100,,,fee schedule,100% of CO APG rates,554.8,100,,,fee schedule,100% of CO APG rates,554.8,100,,,fee schedule,100% of NM fee schedule,221.92,40,,,percent of total billed charges,40% of total billed charges,221.92,40,,,percent of total billed charges,40% of total billed charges,499.32,90,,,percent of total billed charges,90% of total billed charges,421.65,76,,,percent of total billed charges,76% of total billed charges,221.92,40,,,percent of total billed charges,40% of total billed charges,471.58,85,,,percent of total billed charges,85% of total billed charges,554.8,100,,,fee schedule,100% of CO APG rate,443.84,80,,,percent of total billed charges,80% of total billed charges,215.26,38.8,,,percent of total billed charges,38.8% of total billed charges,471.58,85,,,percent of total billed charges,85% of total billed charges,554.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,215.26,554.8,
"CHIBA SPINAL NEEDLE, 22X3.5",46252584,CDM,270,RC,,,OUTPATIENT,,,53.6,42.88,,40.2,75,,,percent of total billed charges,75% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,42.45,79.2,,,percent of total billed charges,79.2% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rates,50.92,95,,,percent of total billed charges,95% of total billed charges,42.88,80,,,percent of total billed charges,80% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,48.24,90,,,percent of total billed charges,90% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rates,53.6,100,,,fee schedule,100% of CO APG rates,53.6,100,,,fee schedule,100% of NM fee schedule,21.44,40,,,percent of total billed charges,40% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,48.24,90,,,percent of total billed charges,90% of total billed charges,40.74,76,,,percent of total billed charges,76% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rate,42.88,80,,,percent of total billed charges,80% of total billed charges,20.8,38.8,,,percent of total billed charges,38.8% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,20.8,53.6,
"VECTRAN COATED CARBON FIBER ROD, 11X400MM",46052585,CDM,270,RC,,,OUTPATIENT,,,1100.1,880.08,,825.08,75,,,percent of total billed charges,75% of total billed charges,440.04,40,,,percent of total billed charges,40% of total billed charges,871.28,79.2,,,percent of total billed charges,79.2% of total billed charges,935.09,85,,,percent of total billed charges,85% of total billed charges,1100.1,100,,,fee schedule,100% of CO APG rates,1045.1,95,,,percent of total billed charges,95% of total billed charges,880.08,80,,,percent of total billed charges,80% of total billed charges,935.09,85,,,percent of total billed charges,85% of total billed charges,990.09,90,,,percent of total billed charges,90% of total billed charges,1100.1,100,,,fee schedule,100% of CO APG rates,1100.1,100,,,fee schedule,100% of CO APG rates,1100.1,100,,,fee schedule,100% of NM fee schedule,440.04,40,,,percent of total billed charges,40% of total billed charges,440.04,40,,,percent of total billed charges,40% of total billed charges,990.09,90,,,percent of total billed charges,90% of total billed charges,836.08,76,,,percent of total billed charges,76% of total billed charges,440.04,40,,,percent of total billed charges,40% of total billed charges,935.09,85,,,percent of total billed charges,85% of total billed charges,1100.1,100,,,fee schedule,100% of CO APG rate,880.08,80,,,percent of total billed charges,80% of total billed charges,426.84,38.8,,,percent of total billed charges,38.8% of total billed charges,935.09,85,,,percent of total billed charges,85% of total billed charges,1100.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,426.84,1100.1,
"VECTRAN COATED CARBON FIBER ROD, 11X450MM",46052586,CDM,270,RC,,,OUTPATIENT,,,1100.1,880.08,,825.08,75,,,percent of total billed charges,75% of total billed charges,440.04,40,,,percent of total billed charges,40% of total billed charges,871.28,79.2,,,percent of total billed charges,79.2% of total billed charges,935.09,85,,,percent of total billed charges,85% of total billed charges,1100.1,100,,,fee schedule,100% of CO APG rates,1045.1,95,,,percent of total billed charges,95% of total billed charges,880.08,80,,,percent of total billed charges,80% of total billed charges,935.09,85,,,percent of total billed charges,85% of total billed charges,990.09,90,,,percent of total billed charges,90% of total billed charges,1100.1,100,,,fee schedule,100% of CO APG rates,1100.1,100,,,fee schedule,100% of CO APG rates,1100.1,100,,,fee schedule,100% of NM fee schedule,440.04,40,,,percent of total billed charges,40% of total billed charges,440.04,40,,,percent of total billed charges,40% of total billed charges,990.09,90,,,percent of total billed charges,90% of total billed charges,836.08,76,,,percent of total billed charges,76% of total billed charges,440.04,40,,,percent of total billed charges,40% of total billed charges,935.09,85,,,percent of total billed charges,85% of total billed charges,1100.1,100,,,fee schedule,100% of CO APG rate,880.08,80,,,percent of total billed charges,80% of total billed charges,426.84,38.8,,,percent of total billed charges,38.8% of total billed charges,935.09,85,,,percent of total billed charges,85% of total billed charges,1100.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,426.84,1100.1,
"TRANSFIXING PIN APEX 4/5MM, 250X50MM",46052587,CDM,278,RC,,,OUTPATIENT,,,438,350.4,,328.5,75,,,percent of total billed charges,75% of total billed charges,175.2,40,,,percent of total billed charges,40% of total billed charges,346.9,79.2,,,percent of total billed charges,79.2% of total billed charges,372.3,85,,,percent of total billed charges,85% of total billed charges,438,100,,,fee schedule,100% of CO APG rates,416.1,95,,,percent of total billed charges,95% of total billed charges,350.4,80,,,percent of total billed charges,80% of total billed charges,372.3,85,,,percent of total billed charges,85% of total billed charges,394.2,90,,,percent of total billed charges,90% of total billed charges,438,100,,,fee schedule,100% of CO APG rates,438,100,,,fee schedule,100% of CO APG rates,438,100,,,fee schedule,100% of NM fee schedule,175.2,40,,,percent of total billed charges,40% of total billed charges,175.2,40,,,percent of total billed charges,40% of total billed charges,394.2,90,,,percent of total billed charges,90% of total billed charges,332.88,76,,,percent of total billed charges,76% of total billed charges,175.2,40,,,percent of total billed charges,40% of total billed charges,372.3,85,,,percent of total billed charges,85% of total billed charges,438,100,,,fee schedule,100% of CO APG rate,350.4,80,,,percent of total billed charges,80% of total billed charges,169.94,38.8,,,percent of total billed charges,38.8% of total billed charges,372.3,85,,,percent of total billed charges,85% of total billed charges,438,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,169.94,438,
"SELF-DRILLING HALF PIN APEX 5MM, 200X60MM",46052588,CDM,278,RC,,,OUTPATIENT,,,417,333.6,,312.75,75,,,percent of total billed charges,75% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,330.26,79.2,,,percent of total billed charges,79.2% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of CO APG rates,396.15,95,,,percent of total billed charges,95% of total billed charges,333.6,80,,,percent of total billed charges,80% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,375.3,90,,,percent of total billed charges,90% of total billed charges,417,100,,,fee schedule,100% of CO APG rates,417,100,,,fee schedule,100% of CO APG rates,417,100,,,fee schedule,100% of NM fee schedule,166.8,40,,,percent of total billed charges,40% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,375.3,90,,,percent of total billed charges,90% of total billed charges,316.92,76,,,percent of total billed charges,76% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of CO APG rate,333.6,80,,,percent of total billed charges,80% of total billed charges,161.8,38.8,,,percent of total billed charges,38.8% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,161.8,417,
"SELF-DRILLING HALF PIN APEX 5MM, 250X70MM",46052589,CDM,278,RC,,,OUTPATIENT,,,417,333.6,,312.75,75,,,percent of total billed charges,75% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,330.26,79.2,,,percent of total billed charges,79.2% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of CO APG rates,396.15,95,,,percent of total billed charges,95% of total billed charges,333.6,80,,,percent of total billed charges,80% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,375.3,90,,,percent of total billed charges,90% of total billed charges,417,100,,,fee schedule,100% of CO APG rates,417,100,,,fee schedule,100% of CO APG rates,417,100,,,fee schedule,100% of NM fee schedule,166.8,40,,,percent of total billed charges,40% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,375.3,90,,,percent of total billed charges,90% of total billed charges,316.92,76,,,percent of total billed charges,76% of total billed charges,166.8,40,,,percent of total billed charges,40% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of CO APG rate,333.6,80,,,percent of total billed charges,80% of total billed charges,161.8,38.8,,,percent of total billed charges,38.8% of total billed charges,354.45,85,,,percent of total billed charges,85% of total billed charges,417,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,161.8,417,
SEMI CIRCULAR ROD 8X174MM,46052590,CDM,270,RC,,,OUTPATIENT,,,1028,822.4,,771,75,,,percent of total billed charges,75% of total billed charges,411.2,40,,,percent of total billed charges,40% of total billed charges,814.18,79.2,,,percent of total billed charges,79.2% of total billed charges,873.8,85,,,percent of total billed charges,85% of total billed charges,1028,100,,,fee schedule,100% of CO APG rates,976.6,95,,,percent of total billed charges,95% of total billed charges,822.4,80,,,percent of total billed charges,80% of total billed charges,873.8,85,,,percent of total billed charges,85% of total billed charges,925.2,90,,,percent of total billed charges,90% of total billed charges,1028,100,,,fee schedule,100% of CO APG rates,1028,100,,,fee schedule,100% of CO APG rates,1028,100,,,fee schedule,100% of NM fee schedule,411.2,40,,,percent of total billed charges,40% of total billed charges,411.2,40,,,percent of total billed charges,40% of total billed charges,925.2,90,,,percent of total billed charges,90% of total billed charges,781.28,76,,,percent of total billed charges,76% of total billed charges,411.2,40,,,percent of total billed charges,40% of total billed charges,873.8,85,,,percent of total billed charges,85% of total billed charges,1028,100,,,fee schedule,100% of CO APG rate,822.4,80,,,percent of total billed charges,80% of total billed charges,398.86,38.8,,,percent of total billed charges,38.8% of total billed charges,873.8,85,,,percent of total billed charges,85% of total billed charges,1028,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,398.86,1028,
"2.3MM TWIST DRILL, AO",46052591,CDM,270,RC,,,OUTPATIENT,,,450.1,360.08,,337.58,75,,,percent of total billed charges,75% of total billed charges,180.04,40,,,percent of total billed charges,40% of total billed charges,356.48,79.2,,,percent of total billed charges,79.2% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,450.1,100,,,fee schedule,100% of CO APG rates,427.6,95,,,percent of total billed charges,95% of total billed charges,360.08,80,,,percent of total billed charges,80% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,405.09,90,,,percent of total billed charges,90% of total billed charges,450.1,100,,,fee schedule,100% of CO APG rates,450.1,100,,,fee schedule,100% of CO APG rates,450.1,100,,,fee schedule,100% of NM fee schedule,180.04,40,,,percent of total billed charges,40% of total billed charges,180.04,40,,,percent of total billed charges,40% of total billed charges,405.09,90,,,percent of total billed charges,90% of total billed charges,342.08,76,,,percent of total billed charges,76% of total billed charges,180.04,40,,,percent of total billed charges,40% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,450.1,100,,,fee schedule,100% of CO APG rate,360.08,80,,,percent of total billed charges,80% of total billed charges,174.64,38.8,,,percent of total billed charges,38.8% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,450.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.64,450.1,
G-LOK XL,460ECON0215,CDM,270,RC,,,OUTPATIENT,,,943.8,755.04,,707.85,75,,,percent of total billed charges,75% of total billed charges,377.52,40,,,percent of total billed charges,40% of total billed charges,747.49,79.2,,,percent of total billed charges,79.2% of total billed charges,802.23,85,,,percent of total billed charges,85% of total billed charges,943.8,100,,,fee schedule,100% of CO APG rates,896.61,95,,,percent of total billed charges,95% of total billed charges,755.04,80,,,percent of total billed charges,80% of total billed charges,802.23,85,,,percent of total billed charges,85% of total billed charges,849.42,90,,,percent of total billed charges,90% of total billed charges,943.8,100,,,fee schedule,100% of CO APG rates,943.8,100,,,fee schedule,100% of CO APG rates,943.8,100,,,fee schedule,100% of NM fee schedule,377.52,40,,,percent of total billed charges,40% of total billed charges,377.52,40,,,percent of total billed charges,40% of total billed charges,849.42,90,,,percent of total billed charges,90% of total billed charges,717.29,76,,,percent of total billed charges,76% of total billed charges,377.52,40,,,percent of total billed charges,40% of total billed charges,802.23,85,,,percent of total billed charges,85% of total billed charges,943.8,100,,,fee schedule,100% of CO APG rate,755.04,80,,,percent of total billed charges,80% of total billed charges,366.19,38.8,,,percent of total billed charges,38.8% of total billed charges,802.23,85,,,percent of total billed charges,85% of total billed charges,943.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,366.19,943.8,
LACTATED RINGER 3000ML,46052597,CDM,270,RC,,,OUTPATIENT,,,67.6,54.08,,50.7,75,,,percent of total billed charges,75% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,53.54,79.2,,,percent of total billed charges,79.2% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rates,64.22,95,,,percent of total billed charges,95% of total billed charges,54.08,80,,,percent of total billed charges,80% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,60.84,90,,,percent of total billed charges,90% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rates,67.6,100,,,fee schedule,100% of CO APG rates,67.6,100,,,fee schedule,100% of NM fee schedule,27.04,40,,,percent of total billed charges,40% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,60.84,90,,,percent of total billed charges,90% of total billed charges,51.38,76,,,percent of total billed charges,76% of total billed charges,27.04,40,,,percent of total billed charges,40% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of CO APG rate,54.08,80,,,percent of total billed charges,80% of total billed charges,26.23,38.8,,,percent of total billed charges,38.8% of total billed charges,57.46,85,,,percent of total billed charges,85% of total billed charges,67.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.23,67.6,
MICROFX OCD UNIVERSAL DRILL,460ECON0216,CDM,270,RC,,,OUTPATIENT,,,1700.9,1360.72,,1275.68,75,,,percent of total billed charges,75% of total billed charges,680.36,40,,,percent of total billed charges,40% of total billed charges,1347.11,79.2,,,percent of total billed charges,79.2% of total billed charges,1445.77,85,,,percent of total billed charges,85% of total billed charges,1700.9,100,,,fee schedule,100% of CO APG rates,1615.86,95,,,percent of total billed charges,95% of total billed charges,1360.72,80,,,percent of total billed charges,80% of total billed charges,1445.77,85,,,percent of total billed charges,85% of total billed charges,1530.81,90,,,percent of total billed charges,90% of total billed charges,1700.9,100,,,fee schedule,100% of CO APG rates,1700.9,100,,,fee schedule,100% of CO APG rates,1700.9,100,,,fee schedule,100% of NM fee schedule,680.36,40,,,percent of total billed charges,40% of total billed charges,680.36,40,,,percent of total billed charges,40% of total billed charges,1530.81,90,,,percent of total billed charges,90% of total billed charges,1292.68,76,,,percent of total billed charges,76% of total billed charges,680.36,40,,,percent of total billed charges,40% of total billed charges,1445.77,85,,,percent of total billed charges,85% of total billed charges,1700.9,100,,,fee schedule,100% of CO APG rate,1360.72,80,,,percent of total billed charges,80% of total billed charges,659.95,38.8,,,percent of total billed charges,38.8% of total billed charges,1445.77,85,,,percent of total billed charges,85% of total billed charges,1700.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,659.95,1700.9,
64450 Block Peripheral Nerve,60000114,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2129.9,1703.92,,1597.43,75,,,percent of total billed charges,75% of total billed charges,851.96,40,,,percent of total billed charges,40% of total billed charges,1686.88,79.2,,,percent of total billed charges,79.2% of total billed charges,1810.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2023.41,95,,,percent of total billed charges,95% of total billed charges,1703.92,80,,,percent of total billed charges,80% of total billed charges,1810.42,85,,,percent of total billed charges,85% of total billed charges,1916.91,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,851.96,40,,,percent of total billed charges,40% of total billed charges,851.96,40,,,percent of total billed charges,40% of total billed charges,1916.91,90,,,percent of total billed charges,90% of total billed charges,1618.72,76,,,percent of total billed charges,76% of total billed charges,851.96,40,,,percent of total billed charges,40% of total billed charges,1810.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1703.92,80,,,percent of total billed charges,80% of total billed charges,826.4,38.8,,,percent of total billed charges,38.8% of total billed charges,1810.42,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2023.41,
"32554 Thoracentesis, needle or catheter, aspiration of the p",46532554,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2268.2,1814.56,,1701.15,75,,,percent of total billed charges,75% of total billed charges,907.28,40,,,percent of total billed charges,40% of total billed charges,1796.41,79.2,,,percent of total billed charges,79.2% of total billed charges,1927.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2154.79,95,,,percent of total billed charges,95% of total billed charges,1814.56,80,,,percent of total billed charges,80% of total billed charges,1927.97,85,,,percent of total billed charges,85% of total billed charges,2041.38,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,907.28,40,,,percent of total billed charges,40% of total billed charges,907.28,40,,,percent of total billed charges,40% of total billed charges,2041.38,90,,,percent of total billed charges,90% of total billed charges,1723.83,76,,,percent of total billed charges,76% of total billed charges,907.28,40,,,percent of total billed charges,40% of total billed charges,1927.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1814.56,80,,,percent of total billed charges,80% of total billed charges,880.06,38.8,,,percent of total billed charges,38.8% of total billed charges,1927.97,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2154.79,
"69209 Removal impacted cerumen using irrigation/lavage, unil",49169209,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,199.7,159.76,,149.78,75,,,percent of total billed charges,75% of total billed charges,79.88,40,,,percent of total billed charges,40% of total billed charges,158.16,79.2,,,percent of total billed charges,79.2% of total billed charges,169.75,85,,,percent of total billed charges,85% of total billed charges,199.7,100,,,fee schedule,100% of CO APG rates,189.72,95,,,percent of total billed charges,95% of total billed charges,159.76,80,,,percent of total billed charges,80% of total billed charges,169.75,85,,,percent of total billed charges,85% of total billed charges,179.73,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,79.88,40,,,percent of total billed charges,40% of total billed charges,79.88,40,,,percent of total billed charges,40% of total billed charges,179.73,90,,,percent of total billed charges,90% of total billed charges,151.77,76,,,percent of total billed charges,76% of total billed charges,79.88,40,,,percent of total billed charges,40% of total billed charges,169.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,159.76,80,,,percent of total billed charges,80% of total billed charges,77.48,38.8,,,percent of total billed charges,38.8% of total billed charges,169.75,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,77.48,217.66,
25520 Closed treatment of radial shaft fracture,31025520,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2214.2,1771.36,,1660.65,75,,,percent of total billed charges,75% of total billed charges,885.68,40,,,percent of total billed charges,40% of total billed charges,1753.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1882.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2103.49,95,,,percent of total billed charges,95% of total billed charges,1771.36,80,,,percent of total billed charges,80% of total billed charges,1882.07,85,,,percent of total billed charges,85% of total billed charges,1992.78,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,885.68,40,,,percent of total billed charges,40% of total billed charges,885.68,40,,,percent of total billed charges,40% of total billed charges,1992.78,90,,,percent of total billed charges,90% of total billed charges,1682.79,76,,,percent of total billed charges,76% of total billed charges,885.68,40,,,percent of total billed charges,40% of total billed charges,1882.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1771.36,80,,,percent of total billed charges,80% of total billed charges,859.11,38.8,,,percent of total billed charges,38.8% of total billed charges,1882.07,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2103.49,
"SUTURE NEEDLE ANCHOR, 1/2 CIRCLE TAPER PT, DAVIS TONSIL",46052599,CDM,270,RC,,,OUTPATIENT,,,16.4,13.12,,12.3,75,,,percent of total billed charges,75% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,12.99,79.2,,,percent of total billed charges,79.2% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,15.58,95,,,percent of total billed charges,95% of total billed charges,13.12,80,,,percent of total billed charges,80% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of NM fee schedule,6.56,40,,,percent of total billed charges,40% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,12.46,76,,,percent of total billed charges,76% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rate,13.12,80,,,percent of total billed charges,80% of total billed charges,6.36,38.8,,,percent of total billed charges,38.8% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.36,16.4,
"Neonatal Resus, Complete Charge",60000321,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1844.2,1475.36,,1383.15,75,,,percent of total billed charges,75% of total billed charges,737.68,40,,,percent of total billed charges,40% of total billed charges,1460.61,79.2,,,percent of total billed charges,79.2% of total billed charges,1567.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1751.99,95,,,percent of total billed charges,95% of total billed charges,1475.36,80,,,percent of total billed charges,80% of total billed charges,1567.57,85,,,percent of total billed charges,85% of total billed charges,1659.78,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,737.68,40,,,percent of total billed charges,40% of total billed charges,737.68,40,,,percent of total billed charges,40% of total billed charges,1659.78,90,,,percent of total billed charges,90% of total billed charges,1401.59,76,,,percent of total billed charges,76% of total billed charges,737.68,40,,,percent of total billed charges,40% of total billed charges,1567.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1475.36,80,,,percent of total billed charges,80% of total billed charges,715.55,38.8,,,percent of total billed charges,38.8% of total billed charges,1567.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1751.99,
CHAMPION SLIDER NEEDLE 45 DEG. RIGHT,46052804,CDM,270,RC,,,OUTPATIENT,,,1066.3,853.04,,799.73,75,,,percent of total billed charges,75% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,844.51,79.2,,,percent of total billed charges,79.2% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rates,1012.99,95,,,percent of total billed charges,95% of total billed charges,853.04,80,,,percent of total billed charges,80% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,959.67,90,,,percent of total billed charges,90% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rates,1066.3,100,,,fee schedule,100% of CO APG rates,1066.3,100,,,fee schedule,100% of NM fee schedule,426.52,40,,,percent of total billed charges,40% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,959.67,90,,,percent of total billed charges,90% of total billed charges,810.39,76,,,percent of total billed charges,76% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rate,853.04,80,,,percent of total billed charges,80% of total billed charges,413.72,38.8,,,percent of total billed charges,38.8% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,413.72,1066.3,
CHAMPION SLIDER NEEDLE 45 DEG. LEFT,46052805,CDM,270,RC,,,OUTPATIENT,,,1066.3,853.04,,799.73,75,,,percent of total billed charges,75% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,844.51,79.2,,,percent of total billed charges,79.2% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rates,1012.99,95,,,percent of total billed charges,95% of total billed charges,853.04,80,,,percent of total billed charges,80% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,959.67,90,,,percent of total billed charges,90% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rates,1066.3,100,,,fee schedule,100% of CO APG rates,1066.3,100,,,fee schedule,100% of NM fee schedule,426.52,40,,,percent of total billed charges,40% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,959.67,90,,,percent of total billed charges,90% of total billed charges,810.39,76,,,percent of total billed charges,76% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rate,853.04,80,,,percent of total billed charges,80% of total billed charges,413.72,38.8,,,percent of total billed charges,38.8% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,413.72,1066.3,
CHAMPION NITINOL SHUTTLE,46052602,CDM,270,RC,,,OUTPATIENT,,,372.6,298.08,,279.45,75,,,percent of total billed charges,75% of total billed charges,149.04,40,,,percent of total billed charges,40% of total billed charges,295.1,79.2,,,percent of total billed charges,79.2% of total billed charges,316.71,85,,,percent of total billed charges,85% of total billed charges,372.6,100,,,fee schedule,100% of CO APG rates,353.97,95,,,percent of total billed charges,95% of total billed charges,298.08,80,,,percent of total billed charges,80% of total billed charges,316.71,85,,,percent of total billed charges,85% of total billed charges,335.34,90,,,percent of total billed charges,90% of total billed charges,372.6,100,,,fee schedule,100% of CO APG rates,372.6,100,,,fee schedule,100% of CO APG rates,372.6,100,,,fee schedule,100% of NM fee schedule,149.04,40,,,percent of total billed charges,40% of total billed charges,149.04,40,,,percent of total billed charges,40% of total billed charges,335.34,90,,,percent of total billed charges,90% of total billed charges,283.18,76,,,percent of total billed charges,76% of total billed charges,149.04,40,,,percent of total billed charges,40% of total billed charges,316.71,85,,,percent of total billed charges,85% of total billed charges,372.6,100,,,fee schedule,100% of CO APG rate,298.08,80,,,percent of total billed charges,80% of total billed charges,144.57,38.8,,,percent of total billed charges,38.8% of total billed charges,316.71,85,,,percent of total billed charges,85% of total billed charges,372.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,144.57,372.6,
3000 ml SALINE 0.9%,46052603,CDM,270,RC,,,OUTPATIENT,,,59,47.2,,44.25,75,,,percent of total billed charges,75% of total billed charges,23.6,40,,,percent of total billed charges,40% of total billed charges,46.73,79.2,,,percent of total billed charges,79.2% of total billed charges,50.15,85,,,percent of total billed charges,85% of total billed charges,59,100,,,fee schedule,100% of CO APG rates,56.05,95,,,percent of total billed charges,95% of total billed charges,47.2,80,,,percent of total billed charges,80% of total billed charges,50.15,85,,,percent of total billed charges,85% of total billed charges,53.1,90,,,percent of total billed charges,90% of total billed charges,59,100,,,fee schedule,100% of CO APG rates,59,100,,,fee schedule,100% of CO APG rates,59,100,,,fee schedule,100% of NM fee schedule,23.6,40,,,percent of total billed charges,40% of total billed charges,23.6,40,,,percent of total billed charges,40% of total billed charges,53.1,90,,,percent of total billed charges,90% of total billed charges,44.84,76,,,percent of total billed charges,76% of total billed charges,23.6,40,,,percent of total billed charges,40% of total billed charges,50.15,85,,,percent of total billed charges,85% of total billed charges,59,100,,,fee schedule,100% of CO APG rate,47.2,80,,,percent of total billed charges,80% of total billed charges,22.89,38.8,,,percent of total billed charges,38.8% of total billed charges,50.15,85,,,percent of total billed charges,85% of total billed charges,59,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,22.89,59,
Amnisure 1,40084112,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,293.2,234.56,,219.9,75,,,percent of total billed charges,75% of total billed charges,117.28,40,,,percent of total billed charges,40% of total billed charges,232.21,79.2,,,percent of total billed charges,79.2% of total billed charges,249.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,278.54,95,,,percent of total billed charges,95% of total billed charges,234.56,80,,,percent of total billed charges,80% of total billed charges,249.22,85,,,percent of total billed charges,85% of total billed charges,263.88,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,117.28,40,,,percent of total billed charges,40% of total billed charges,117.28,40,,,percent of total billed charges,40% of total billed charges,263.88,90,,,percent of total billed charges,90% of total billed charges,222.83,76,,,percent of total billed charges,76% of total billed charges,117.28,40,,,percent of total billed charges,40% of total billed charges,249.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,234.56,80,,,percent of total billed charges,80% of total billed charges,113.76,38.8,,,percent of total billed charges,38.8% of total billed charges,249.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,278.54,
PSMC US Gel Pad Aquaflex Transmission,41252600,CDM,270,RC,,,OUTPATIENT,,,38.2,30.56,,28.65,75,,,percent of total billed charges,75% of total billed charges,15.28,40,,,percent of total billed charges,40% of total billed charges,30.25,79.2,,,percent of total billed charges,79.2% of total billed charges,32.47,85,,,percent of total billed charges,85% of total billed charges,38.2,100,,,fee schedule,100% of CO APG rates,36.29,95,,,percent of total billed charges,95% of total billed charges,30.56,80,,,percent of total billed charges,80% of total billed charges,32.47,85,,,percent of total billed charges,85% of total billed charges,34.38,90,,,percent of total billed charges,90% of total billed charges,38.2,100,,,fee schedule,100% of CO APG rates,38.2,100,,,fee schedule,100% of CO APG rates,38.2,100,,,fee schedule,100% of NM fee schedule,15.28,40,,,percent of total billed charges,40% of total billed charges,15.28,40,,,percent of total billed charges,40% of total billed charges,34.38,90,,,percent of total billed charges,90% of total billed charges,29.03,76,,,percent of total billed charges,76% of total billed charges,15.28,40,,,percent of total billed charges,40% of total billed charges,32.47,85,,,percent of total billed charges,85% of total billed charges,38.2,100,,,fee schedule,100% of CO APG rate,30.56,80,,,percent of total billed charges,80% of total billed charges,14.82,38.8,,,percent of total billed charges,38.8% of total billed charges,32.47,85,,,percent of total billed charges,85% of total billed charges,38.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,14.82,38.2,
"MONOTUBE TRIAX STERILE WRIST KIT, 15MM X 200MM",460ECON0225,CDM,270,RC,,,OUTPATIENT,,,3792.9,3034.32,,2844.68,75,,,percent of total billed charges,75% of total billed charges,1517.16,40,,,percent of total billed charges,40% of total billed charges,3003.98,79.2,,,percent of total billed charges,79.2% of total billed charges,3223.97,85,,,percent of total billed charges,85% of total billed charges,3792.9,100,,,fee schedule,100% of CO APG rates,3603.26,95,,,percent of total billed charges,95% of total billed charges,3034.32,80,,,percent of total billed charges,80% of total billed charges,3223.97,85,,,percent of total billed charges,85% of total billed charges,3413.61,90,,,percent of total billed charges,90% of total billed charges,3792.9,100,,,fee schedule,100% of CO APG rates,3792.9,100,,,fee schedule,100% of CO APG rates,3792.9,100,,,fee schedule,100% of NM fee schedule,1517.16,40,,,percent of total billed charges,40% of total billed charges,1517.16,40,,,percent of total billed charges,40% of total billed charges,3413.61,90,,,percent of total billed charges,90% of total billed charges,2882.6,76,,,percent of total billed charges,76% of total billed charges,1517.16,40,,,percent of total billed charges,40% of total billed charges,3223.97,85,,,percent of total billed charges,85% of total billed charges,3792.9,100,,,fee schedule,100% of CO APG rate,3034.32,80,,,percent of total billed charges,80% of total billed charges,1471.65,38.8,,,percent of total billed charges,38.8% of total billed charges,3223.97,85,,,percent of total billed charges,85% of total billed charges,3792.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1471.65,3792.9,
"69020 - Drainage external auditory canal, abscess",31069020,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,598,478.4,,448.5,75,,,percent of total billed charges,75% of total billed charges,239.2,40,,,percent of total billed charges,40% of total billed charges,473.62,79.2,,,percent of total billed charges,79.2% of total billed charges,508.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,568.1,95,,,percent of total billed charges,95% of total billed charges,478.4,80,,,percent of total billed charges,80% of total billed charges,508.3,85,,,percent of total billed charges,85% of total billed charges,538.2,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,239.2,40,,,percent of total billed charges,40% of total billed charges,239.2,40,,,percent of total billed charges,40% of total billed charges,538.2,90,,,percent of total billed charges,90% of total billed charges,454.48,76,,,percent of total billed charges,76% of total billed charges,239.2,40,,,percent of total billed charges,40% of total billed charges,508.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,478.4,80,,,percent of total billed charges,80% of total billed charges,232.02,38.8,,,percent of total billed charges,38.8% of total billed charges,508.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,568.1,
"40650 Repair lip, full thickness; vermilion only",46040650,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1589.1,1271.28,,1191.83,75,,,percent of total billed charges,75% of total billed charges,635.64,40,,,percent of total billed charges,40% of total billed charges,1258.57,79.2,,,percent of total billed charges,79.2% of total billed charges,1350.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1509.65,95,,,percent of total billed charges,95% of total billed charges,1271.28,80,,,percent of total billed charges,80% of total billed charges,1350.74,85,,,percent of total billed charges,85% of total billed charges,1430.19,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,635.64,40,,,percent of total billed charges,40% of total billed charges,635.64,40,,,percent of total billed charges,40% of total billed charges,1430.19,90,,,percent of total billed charges,90% of total billed charges,1207.72,76,,,percent of total billed charges,76% of total billed charges,635.64,40,,,percent of total billed charges,40% of total billed charges,1350.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1271.28,80,,,percent of total billed charges,80% of total billed charges,616.57,38.8,,,percent of total billed charges,38.8% of total billed charges,1350.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1509.65,
"40652 Repair lip, full thickness; up to half vertical height",46040652,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1589.1,1271.28,,1191.83,75,,,percent of total billed charges,75% of total billed charges,635.64,40,,,percent of total billed charges,40% of total billed charges,1258.57,79.2,,,percent of total billed charges,79.2% of total billed charges,1350.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1509.65,95,,,percent of total billed charges,95% of total billed charges,1271.28,80,,,percent of total billed charges,80% of total billed charges,1350.74,85,,,percent of total billed charges,85% of total billed charges,1430.19,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,635.64,40,,,percent of total billed charges,40% of total billed charges,635.64,40,,,percent of total billed charges,40% of total billed charges,1430.19,90,,,percent of total billed charges,90% of total billed charges,1207.72,76,,,percent of total billed charges,76% of total billed charges,635.64,40,,,percent of total billed charges,40% of total billed charges,1350.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1271.28,80,,,percent of total billed charges,80% of total billed charges,616.57,38.8,,,percent of total billed charges,38.8% of total billed charges,1350.74,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1509.65,
"40654 Repair lip, full thickness; over one-half vertical height, or complex",46040654,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1557.9,1246.32,,1168.43,75,,,percent of total billed charges,75% of total billed charges,623.16,40,,,percent of total billed charges,40% of total billed charges,1233.86,79.2,,,percent of total billed charges,79.2% of total billed charges,1324.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1480.01,95,,,percent of total billed charges,95% of total billed charges,1246.32,80,,,percent of total billed charges,80% of total billed charges,1324.22,85,,,percent of total billed charges,85% of total billed charges,1402.11,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,623.16,40,,,percent of total billed charges,40% of total billed charges,623.16,40,,,percent of total billed charges,40% of total billed charges,1402.11,90,,,percent of total billed charges,90% of total billed charges,1184,76,,,percent of total billed charges,76% of total billed charges,623.16,40,,,percent of total billed charges,40% of total billed charges,1324.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1246.32,80,,,percent of total billed charges,80% of total billed charges,604.47,38.8,,,percent of total billed charges,38.8% of total billed charges,1324.22,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1480.01,
"40831 Closure of laceration, vestibule of mouth; over 2.5 cm",46040831,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,1527.7,1222.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"PAJUNK TUOHY SONO CANNULA, 17ga x 90mm",46252604,CDM,270,RC,,,OUTPATIENT,,,61.1,48.88,,45.83,75,,,percent of total billed charges,75% of total billed charges,24.44,40,,,percent of total billed charges,40% of total billed charges,48.39,79.2,,,percent of total billed charges,79.2% of total billed charges,51.94,85,,,percent of total billed charges,85% of total billed charges,61.1,100,,,fee schedule,100% of CO APG rates,58.05,95,,,percent of total billed charges,95% of total billed charges,48.88,80,,,percent of total billed charges,80% of total billed charges,51.94,85,,,percent of total billed charges,85% of total billed charges,54.99,90,,,percent of total billed charges,90% of total billed charges,61.1,100,,,fee schedule,100% of CO APG rates,61.1,100,,,fee schedule,100% of CO APG rates,61.1,100,,,fee schedule,100% of NM fee schedule,24.44,40,,,percent of total billed charges,40% of total billed charges,24.44,40,,,percent of total billed charges,40% of total billed charges,54.99,90,,,percent of total billed charges,90% of total billed charges,46.44,76,,,percent of total billed charges,76% of total billed charges,24.44,40,,,percent of total billed charges,40% of total billed charges,51.94,85,,,percent of total billed charges,85% of total billed charges,61.1,100,,,fee schedule,100% of CO APG rate,48.88,80,,,percent of total billed charges,80% of total billed charges,23.71,38.8,,,percent of total billed charges,38.8% of total billed charges,51.94,85,,,percent of total billed charges,85% of total billed charges,61.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,23.71,61.1,
"JEJUNAL FEEDING TUBE MIC 16FR, SILICONE",46052605,CDM,270,RC,,,OUTPATIENT,,,489.3,391.44,,366.98,75,,,percent of total billed charges,75% of total billed charges,195.72,40,,,percent of total billed charges,40% of total billed charges,387.53,79.2,,,percent of total billed charges,79.2% of total billed charges,415.91,85,,,percent of total billed charges,85% of total billed charges,489.3,100,,,fee schedule,100% of CO APG rates,464.84,95,,,percent of total billed charges,95% of total billed charges,391.44,80,,,percent of total billed charges,80% of total billed charges,415.91,85,,,percent of total billed charges,85% of total billed charges,440.37,90,,,percent of total billed charges,90% of total billed charges,489.3,100,,,fee schedule,100% of CO APG rates,489.3,100,,,fee schedule,100% of CO APG rates,489.3,100,,,fee schedule,100% of NM fee schedule,195.72,40,,,percent of total billed charges,40% of total billed charges,195.72,40,,,percent of total billed charges,40% of total billed charges,440.37,90,,,percent of total billed charges,90% of total billed charges,371.87,76,,,percent of total billed charges,76% of total billed charges,195.72,40,,,percent of total billed charges,40% of total billed charges,415.91,85,,,percent of total billed charges,85% of total billed charges,489.3,100,,,fee schedule,100% of CO APG rate,391.44,80,,,percent of total billed charges,80% of total billed charges,189.85,38.8,,,percent of total billed charges,38.8% of total billed charges,415.91,85,,,percent of total billed charges,85% of total billed charges,489.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,189.85,489.3,
PLEURX DRAINAGE KIT W/ BOTTLES,52607,CDM,270,RC,,,OUTPATIENT,,,2315.8,1852.64,,1736.85,75,,,percent of total billed charges,75% of total billed charges,926.32,40,,,percent of total billed charges,40% of total billed charges,1834.11,79.2,,,percent of total billed charges,79.2% of total billed charges,1968.43,85,,,percent of total billed charges,85% of total billed charges,2315.8,100,,,fee schedule,100% of CO APG rates,2200.01,95,,,percent of total billed charges,95% of total billed charges,1852.64,80,,,percent of total billed charges,80% of total billed charges,1968.43,85,,,percent of total billed charges,85% of total billed charges,2084.22,90,,,percent of total billed charges,90% of total billed charges,2315.8,100,,,fee schedule,100% of CO APG rates,2315.8,100,,,fee schedule,100% of CO APG rates,2315.8,100,,,fee schedule,100% of NM fee schedule,926.32,40,,,percent of total billed charges,40% of total billed charges,926.32,40,,,percent of total billed charges,40% of total billed charges,2084.22,90,,,percent of total billed charges,90% of total billed charges,1760.01,76,,,percent of total billed charges,76% of total billed charges,926.32,40,,,percent of total billed charges,40% of total billed charges,1968.43,85,,,percent of total billed charges,85% of total billed charges,2315.8,100,,,fee schedule,100% of CO APG rate,1852.64,80,,,percent of total billed charges,80% of total billed charges,898.53,38.8,,,percent of total billed charges,38.8% of total billed charges,1968.43,85,,,percent of total billed charges,85% of total billed charges,2315.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,898.53,2315.8,
"SUTURE 0 CHROMIC GUT UNDYED, CT-2, 844H",46052609,CDM,270,RC,,,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.04,13,
77003 - Fluoroguide For Spine Inject,60000708,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,694.2,555.36,,520.65,75,,,percent of total billed charges,75% of total billed charges,277.68,40,,,percent of total billed charges,40% of total billed charges,549.81,79.2,,,percent of total billed charges,79.2% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,659.49,95,,,percent of total billed charges,95% of total billed charges,555.36,80,,,percent of total billed charges,80% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,624.78,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,277.68,40,,,percent of total billed charges,40% of total billed charges,277.68,40,,,percent of total billed charges,40% of total billed charges,624.78,90,,,percent of total billed charges,90% of total billed charges,527.59,76,,,percent of total billed charges,76% of total billed charges,277.68,40,,,percent of total billed charges,40% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,555.36,80,,,percent of total billed charges,80% of total billed charges,269.35,38.8,,,percent of total billed charges,38.8% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,659.49,
"3mm WEDGE ANCHOR, NO. 2 FORCE FIBER",46052610,CDM,278,RC,,,OUTPATIENT,,,1023.1,818.48,,767.33,75,,,percent of total billed charges,75% of total billed charges,409.24,40,,,percent of total billed charges,40% of total billed charges,810.3,79.2,,,percent of total billed charges,79.2% of total billed charges,869.64,85,,,percent of total billed charges,85% of total billed charges,1023.1,100,,,fee schedule,100% of CO APG rates,971.95,95,,,percent of total billed charges,95% of total billed charges,818.48,80,,,percent of total billed charges,80% of total billed charges,869.64,85,,,percent of total billed charges,85% of total billed charges,920.79,90,,,percent of total billed charges,90% of total billed charges,1023.1,100,,,fee schedule,100% of CO APG rates,1023.1,100,,,fee schedule,100% of CO APG rates,1023.1,100,,,fee schedule,100% of NM fee schedule,409.24,40,,,percent of total billed charges,40% of total billed charges,409.24,40,,,percent of total billed charges,40% of total billed charges,920.79,90,,,percent of total billed charges,90% of total billed charges,777.56,76,,,percent of total billed charges,76% of total billed charges,409.24,40,,,percent of total billed charges,40% of total billed charges,869.64,85,,,percent of total billed charges,85% of total billed charges,1023.1,100,,,fee schedule,100% of CO APG rate,818.48,80,,,percent of total billed charges,80% of total billed charges,396.96,38.8,,,percent of total billed charges,38.8% of total billed charges,869.64,85,,,percent of total billed charges,85% of total billed charges,1023.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,396.96,1023.1,
32550 Insertion of indwelling tunneled pleural catheter w/cu,46032550,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,11047.9,8838.32,,8285.93,75,,,percent of total billed charges,75% of total billed charges,4419.16,40,,,percent of total billed charges,40% of total billed charges,8749.94,79.2,,,percent of total billed charges,79.2% of total billed charges,9390.72,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,10495.51,95,,,percent of total billed charges,95% of total billed charges,8838.32,80,,,percent of total billed charges,80% of total billed charges,9390.72,85,,,percent of total billed charges,85% of total billed charges,9943.11,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,5755.81,100,,,fee schedule,100% of NM APC rate,4419.16,40,,,percent of total billed charges,40% of total billed charges,4419.16,40,,,percent of total billed charges,40% of total billed charges,9943.11,90,,,percent of total billed charges,90% of total billed charges,8396.4,76,,,percent of total billed charges,76% of total billed charges,4419.16,40,,,percent of total billed charges,40% of total billed charges,9390.72,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,8838.32,80,,,percent of total billed charges,80% of total billed charges,4286.59,38.8,,,percent of total billed charges,38.8% of total billed charges,9390.72,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,10495.51,
99195 Therapeutic Phlebotomy INFUSION,42199195,CDM,940,RC,99195,HCPCS,OUTPATIENT,,,402.6,322.08,,301.95,75,,,percent of total billed charges,75% of total billed charges,161.04,40,,,percent of total billed charges,40% of total billed charges,318.86,79.2,,,percent of total billed charges,79.2% of total billed charges,342.21,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,382.47,95,,,percent of total billed charges,95% of total billed charges,322.08,80,,,percent of total billed charges,80% of total billed charges,342.21,85,,,percent of total billed charges,85% of total billed charges,362.34,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,161.04,40,,,percent of total billed charges,40% of total billed charges,161.04,40,,,percent of total billed charges,40% of total billed charges,362.34,90,,,percent of total billed charges,90% of total billed charges,305.98,76,,,percent of total billed charges,76% of total billed charges,161.04,40,,,percent of total billed charges,40% of total billed charges,342.21,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,322.08,80,,,percent of total billed charges,80% of total billed charges,156.21,38.8,,,percent of total billed charges,38.8% of total billed charges,342.21,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,205.34,200,,,fee schedule,200% of CMS fee schedule,77.32,382.47,
36415 Venipuncture INFUSION,42136415,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,11.05,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,11.05,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,408.2,100,,,case rate,pays based on per visit rate,9.75,408.2,
Antibody; Borrelia burgdorferi (Lyme disease),40086618,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,137.1,109.68,,102.83,75,,,percent of total billed charges,75% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,108.58,79.2,,,percent of total billed charges,79.2% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,130.25,95,,,percent of total billed charges,95% of total billed charges,109.68,80,,,percent of total billed charges,80% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,123.39,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,54.84,40,,,percent of total billed charges,40% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,123.39,90,,,percent of total billed charges,90% of total billed charges,104.2,76,,,percent of total billed charges,76% of total billed charges,54.84,40,,,percent of total billed charges,40% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,109.68,80,,,percent of total billed charges,80% of total billed charges,53.19,38.8,,,percent of total billed charges,38.8% of total billed charges,116.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,130.25,
Antibody; Borrelia burgdorferi (Lyme disease),40086618,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,261.3,209.04,,195.98,75,,,percent of total billed charges,75% of total billed charges,104.52,40,,,percent of total billed charges,40% of total billed charges,206.95,79.2,,,percent of total billed charges,79.2% of total billed charges,222.11,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,248.24,95,,,percent of total billed charges,95% of total billed charges,209.04,80,,,percent of total billed charges,80% of total billed charges,222.11,85,,,percent of total billed charges,85% of total billed charges,235.17,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,104.52,40,,,percent of total billed charges,40% of total billed charges,104.52,40,,,percent of total billed charges,40% of total billed charges,235.17,90,,,percent of total billed charges,90% of total billed charges,198.59,76,,,percent of total billed charges,76% of total billed charges,104.52,40,,,percent of total billed charges,40% of total billed charges,222.11,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,209.04,80,,,percent of total billed charges,80% of total billed charges,101.38,38.8,,,percent of total billed charges,38.8% of total billed charges,222.11,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,248.24,
Antibody; Borrelia burgdorferi (Lyme disease),40086618,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,141.4,113.12,,106.05,75,,,percent of total billed charges,75% of total billed charges,56.56,40,,,percent of total billed charges,40% of total billed charges,111.99,79.2,,,percent of total billed charges,79.2% of total billed charges,120.19,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,134.33,95,,,percent of total billed charges,95% of total billed charges,113.12,80,,,percent of total billed charges,80% of total billed charges,120.19,85,,,percent of total billed charges,85% of total billed charges,127.26,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,56.56,40,,,percent of total billed charges,40% of total billed charges,56.56,40,,,percent of total billed charges,40% of total billed charges,127.26,90,,,percent of total billed charges,90% of total billed charges,107.46,76,,,percent of total billed charges,76% of total billed charges,56.56,40,,,percent of total billed charges,40% of total billed charges,120.19,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,113.12,80,,,percent of total billed charges,80% of total billed charges,54.86,38.8,,,percent of total billed charges,38.8% of total billed charges,120.19,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,134.33,
TENCKOFF ACUTE PERITENEAL DIALYSIS CATHETER,46052612,CDM,270,RC,,,OUTPATIENT,,,559.3,447.44,,419.48,75,,,percent of total billed charges,75% of total billed charges,223.72,40,,,percent of total billed charges,40% of total billed charges,442.97,79.2,,,percent of total billed charges,79.2% of total billed charges,475.41,85,,,percent of total billed charges,85% of total billed charges,559.3,100,,,fee schedule,100% of CO APG rates,531.34,95,,,percent of total billed charges,95% of total billed charges,447.44,80,,,percent of total billed charges,80% of total billed charges,475.41,85,,,percent of total billed charges,85% of total billed charges,503.37,90,,,percent of total billed charges,90% of total billed charges,559.3,100,,,fee schedule,100% of CO APG rates,559.3,100,,,fee schedule,100% of CO APG rates,559.3,100,,,fee schedule,100% of NM fee schedule,223.72,40,,,percent of total billed charges,40% of total billed charges,223.72,40,,,percent of total billed charges,40% of total billed charges,503.37,90,,,percent of total billed charges,90% of total billed charges,425.07,76,,,percent of total billed charges,76% of total billed charges,223.72,40,,,percent of total billed charges,40% of total billed charges,475.41,85,,,percent of total billed charges,85% of total billed charges,559.3,100,,,fee schedule,100% of CO APG rate,447.44,80,,,percent of total billed charges,80% of total billed charges,217.01,38.8,,,percent of total billed charges,38.8% of total billed charges,475.41,85,,,percent of total billed charges,85% of total billed charges,559.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,217.01,559.3,
6.5x30mm Cancellous Screw 16mm T/L,46052613,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x35mm Cancellous Screw 16mm T/L,46052614,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x40mm Cancellous Screw 16mm T/L,46052615,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x45mm Cancellous Screw 16mm T/L,46052616,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x50mm Cancellous Screw 16mm T/L,46052617,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x55mm Cancellous Screw 16mm T/L,46052618,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x45mm Cancellous Screw 32mm T/L,46052619,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x50mm Cancellous Screw 32mm T/L,46052620,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x55mm Cancellous Screw 32mm T/L,46052621,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
Nut for 4.5mm Cortical Screw,46052622,CDM,270,RC,,,OUTPATIENT,,,118,94.4,,88.5,75,,,percent of total billed charges,75% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,93.46,79.2,,,percent of total billed charges,79.2% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,118,100,,,fee schedule,100% of CO APG rates,112.1,95,,,percent of total billed charges,95% of total billed charges,94.4,80,,,percent of total billed charges,80% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,118,100,,,fee schedule,100% of CO APG rates,118,100,,,fee schedule,100% of CO APG rates,118,100,,,fee schedule,100% of NM fee schedule,47.2,40,,,percent of total billed charges,40% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,106.2,90,,,percent of total billed charges,90% of total billed charges,89.68,76,,,percent of total billed charges,76% of total billed charges,47.2,40,,,percent of total billed charges,40% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,118,100,,,fee schedule,100% of CO APG rate,94.4,80,,,percent of total billed charges,80% of total billed charges,45.78,38.8,,,percent of total billed charges,38.8% of total billed charges,100.3,85,,,percent of total billed charges,85% of total billed charges,118,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,45.78,118,
6.5x25mm Cancellous Screw F/T,4605623,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x20mm Cancellous Screw F/T,46052624,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x35mm Cancellous Screw F/T,46052625,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x30mm Cancellous Screw F/T,46052626,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x40mm Cancellous Screw F/T,46052627,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x45mm Cancellous Screw F/T,46052628,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x50mm Cancellous Screw F/T,46052629,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
6.5x55mm Cancellous Screw F/T,46052670,CDM,278,RC,,,OUTPATIENT,,,113.4,90.72,,85.05,75,,,percent of total billed charges,75% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,89.81,79.2,,,percent of total billed charges,79.2% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,107.73,95,,,percent of total billed charges,95% of total billed charges,90.72,80,,,percent of total billed charges,80% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of CO APG rates,113.4,100,,,fee schedule,100% of NM fee schedule,45.36,40,,,percent of total billed charges,40% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,102.06,90,,,percent of total billed charges,90% of total billed charges,86.18,76,,,percent of total billed charges,76% of total billed charges,45.36,40,,,percent of total billed charges,40% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of CO APG rate,90.72,80,,,percent of total billed charges,80% of total billed charges,44,38.8,,,percent of total billed charges,38.8% of total billed charges,96.39,85,,,percent of total billed charges,85% of total billed charges,113.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44,113.4,
Self Tap Cortical Screw 4.5x56mm,46052671,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
Self Tap Cortical Screw 4.5x58mm,46052672,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
Self Tap Cortical Screw 4.5x62mm,46052673,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
Self Tap Cortical Screw 4.5x64mm,46052674,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
Self Tap Cortical Screw 4.5x66mm,46052675,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
Self Tap Cortical Screw 4.5x68mm,46052676,CDM,278,RC,,,OUTPATIENT,,,67.2,53.76,,50.4,75,,,percent of total billed charges,75% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,53.22,79.2,,,percent of total billed charges,79.2% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,63.84,95,,,percent of total billed charges,95% of total billed charges,53.76,80,,,percent of total billed charges,80% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of CO APG rates,67.2,100,,,fee schedule,100% of NM fee schedule,26.88,40,,,percent of total billed charges,40% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,60.48,90,,,percent of total billed charges,90% of total billed charges,51.07,76,,,percent of total billed charges,76% of total billed charges,26.88,40,,,percent of total billed charges,40% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of CO APG rate,53.76,80,,,percent of total billed charges,80% of total billed charges,26.07,38.8,,,percent of total billed charges,38.8% of total billed charges,57.12,85,,,percent of total billed charges,85% of total billed charges,67.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.07,67.2,
L Buttress Plate 4 Hole Left,46052681,CDM,278,RC,,,OUTPATIENT,,,782.6,626.08,,586.95,75,,,percent of total billed charges,75% of total billed charges,313.04,40,,,percent of total billed charges,40% of total billed charges,619.82,79.2,,,percent of total billed charges,79.2% of total billed charges,665.21,85,,,percent of total billed charges,85% of total billed charges,782.6,100,,,fee schedule,100% of CO APG rates,743.47,95,,,percent of total billed charges,95% of total billed charges,626.08,80,,,percent of total billed charges,80% of total billed charges,665.21,85,,,percent of total billed charges,85% of total billed charges,704.34,90,,,percent of total billed charges,90% of total billed charges,782.6,100,,,fee schedule,100% of CO APG rates,782.6,100,,,fee schedule,100% of CO APG rates,782.6,100,,,fee schedule,100% of NM fee schedule,313.04,40,,,percent of total billed charges,40% of total billed charges,313.04,40,,,percent of total billed charges,40% of total billed charges,704.34,90,,,percent of total billed charges,90% of total billed charges,594.78,76,,,percent of total billed charges,76% of total billed charges,313.04,40,,,percent of total billed charges,40% of total billed charges,665.21,85,,,percent of total billed charges,85% of total billed charges,782.6,100,,,fee schedule,100% of CO APG rate,626.08,80,,,percent of total billed charges,80% of total billed charges,303.65,38.8,,,percent of total billed charges,38.8% of total billed charges,665.21,85,,,percent of total billed charges,85% of total billed charges,782.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,303.65,782.6,
L Buttress Plate 6 Hole Left,46052682,CDM,278,RC,,,OUTPATIENT,,,963.2,770.56,,722.4,75,,,percent of total billed charges,75% of total billed charges,385.28,40,,,percent of total billed charges,40% of total billed charges,762.85,79.2,,,percent of total billed charges,79.2% of total billed charges,818.72,85,,,percent of total billed charges,85% of total billed charges,963.2,100,,,fee schedule,100% of CO APG rates,915.04,95,,,percent of total billed charges,95% of total billed charges,770.56,80,,,percent of total billed charges,80% of total billed charges,818.72,85,,,percent of total billed charges,85% of total billed charges,866.88,90,,,percent of total billed charges,90% of total billed charges,963.2,100,,,fee schedule,100% of CO APG rates,963.2,100,,,fee schedule,100% of CO APG rates,963.2,100,,,fee schedule,100% of NM fee schedule,385.28,40,,,percent of total billed charges,40% of total billed charges,385.28,40,,,percent of total billed charges,40% of total billed charges,866.88,90,,,percent of total billed charges,90% of total billed charges,732.03,76,,,percent of total billed charges,76% of total billed charges,385.28,40,,,percent of total billed charges,40% of total billed charges,818.72,85,,,percent of total billed charges,85% of total billed charges,963.2,100,,,fee schedule,100% of CO APG rate,770.56,80,,,percent of total billed charges,80% of total billed charges,373.72,38.8,,,percent of total billed charges,38.8% of total billed charges,818.72,85,,,percent of total billed charges,85% of total billed charges,963.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,373.72,963.2,
L Buttress Plate 4 Hole Right,46052683,CDM,278,RC,,,OUTPATIENT,,,782.6,626.08,,586.95,75,,,percent of total billed charges,75% of total billed charges,313.04,40,,,percent of total billed charges,40% of total billed charges,619.82,79.2,,,percent of total billed charges,79.2% of total billed charges,665.21,85,,,percent of total billed charges,85% of total billed charges,782.6,100,,,fee schedule,100% of CO APG rates,743.47,95,,,percent of total billed charges,95% of total billed charges,626.08,80,,,percent of total billed charges,80% of total billed charges,665.21,85,,,percent of total billed charges,85% of total billed charges,704.34,90,,,percent of total billed charges,90% of total billed charges,782.6,100,,,fee schedule,100% of CO APG rates,782.6,100,,,fee schedule,100% of CO APG rates,782.6,100,,,fee schedule,100% of NM fee schedule,313.04,40,,,percent of total billed charges,40% of total billed charges,313.04,40,,,percent of total billed charges,40% of total billed charges,704.34,90,,,percent of total billed charges,90% of total billed charges,594.78,76,,,percent of total billed charges,76% of total billed charges,313.04,40,,,percent of total billed charges,40% of total billed charges,665.21,85,,,percent of total billed charges,85% of total billed charges,782.6,100,,,fee schedule,100% of CO APG rate,626.08,80,,,percent of total billed charges,80% of total billed charges,303.65,38.8,,,percent of total billed charges,38.8% of total billed charges,665.21,85,,,percent of total billed charges,85% of total billed charges,782.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,303.65,782.6,
L Buttress Plate 6 Hole Right,46052684,CDM,278,RC,,,OUTPATIENT,,,963.2,770.56,,722.4,75,,,percent of total billed charges,75% of total billed charges,385.28,40,,,percent of total billed charges,40% of total billed charges,762.85,79.2,,,percent of total billed charges,79.2% of total billed charges,818.72,85,,,percent of total billed charges,85% of total billed charges,963.2,100,,,fee schedule,100% of CO APG rates,915.04,95,,,percent of total billed charges,95% of total billed charges,770.56,80,,,percent of total billed charges,80% of total billed charges,818.72,85,,,percent of total billed charges,85% of total billed charges,866.88,90,,,percent of total billed charges,90% of total billed charges,963.2,100,,,fee schedule,100% of CO APG rates,963.2,100,,,fee schedule,100% of CO APG rates,963.2,100,,,fee schedule,100% of NM fee schedule,385.28,40,,,percent of total billed charges,40% of total billed charges,385.28,40,,,percent of total billed charges,40% of total billed charges,866.88,90,,,percent of total billed charges,90% of total billed charges,732.03,76,,,percent of total billed charges,76% of total billed charges,385.28,40,,,percent of total billed charges,40% of total billed charges,818.72,85,,,percent of total billed charges,85% of total billed charges,963.2,100,,,fee schedule,100% of CO APG rate,770.56,80,,,percent of total billed charges,80% of total billed charges,373.72,38.8,,,percent of total billed charges,38.8% of total billed charges,818.72,85,,,percent of total billed charges,85% of total billed charges,963.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,373.72,963.2,
T-Plate 4 Hole L 79mm,46052685,CDM,278,RC,,,OUTPATIENT,,,559.9,447.92,,419.93,75,,,percent of total billed charges,75% of total billed charges,223.96,40,,,percent of total billed charges,40% of total billed charges,443.44,79.2,,,percent of total billed charges,79.2% of total billed charges,475.92,85,,,percent of total billed charges,85% of total billed charges,559.9,100,,,fee schedule,100% of CO APG rates,531.91,95,,,percent of total billed charges,95% of total billed charges,447.92,80,,,percent of total billed charges,80% of total billed charges,475.92,85,,,percent of total billed charges,85% of total billed charges,503.91,90,,,percent of total billed charges,90% of total billed charges,559.9,100,,,fee schedule,100% of CO APG rates,559.9,100,,,fee schedule,100% of CO APG rates,559.9,100,,,fee schedule,100% of NM fee schedule,223.96,40,,,percent of total billed charges,40% of total billed charges,223.96,40,,,percent of total billed charges,40% of total billed charges,503.91,90,,,percent of total billed charges,90% of total billed charges,425.52,76,,,percent of total billed charges,76% of total billed charges,223.96,40,,,percent of total billed charges,40% of total billed charges,475.92,85,,,percent of total billed charges,85% of total billed charges,559.9,100,,,fee schedule,100% of CO APG rate,447.92,80,,,percent of total billed charges,80% of total billed charges,217.24,38.8,,,percent of total billed charges,38.8% of total billed charges,475.92,85,,,percent of total billed charges,85% of total billed charges,559.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,217.24,559.9,
T-Plate 5 Hole L 95mm,46052686,CDM,278,RC,,,OUTPATIENT,,,600.8,480.64,,450.6,75,,,percent of total billed charges,75% of total billed charges,240.32,40,,,percent of total billed charges,40% of total billed charges,475.83,79.2,,,percent of total billed charges,79.2% of total billed charges,510.68,85,,,percent of total billed charges,85% of total billed charges,600.8,100,,,fee schedule,100% of CO APG rates,570.76,95,,,percent of total billed charges,95% of total billed charges,480.64,80,,,percent of total billed charges,80% of total billed charges,510.68,85,,,percent of total billed charges,85% of total billed charges,540.72,90,,,percent of total billed charges,90% of total billed charges,600.8,100,,,fee schedule,100% of CO APG rates,600.8,100,,,fee schedule,100% of CO APG rates,600.8,100,,,fee schedule,100% of NM fee schedule,240.32,40,,,percent of total billed charges,40% of total billed charges,240.32,40,,,percent of total billed charges,40% of total billed charges,540.72,90,,,percent of total billed charges,90% of total billed charges,456.61,76,,,percent of total billed charges,76% of total billed charges,240.32,40,,,percent of total billed charges,40% of total billed charges,510.68,85,,,percent of total billed charges,85% of total billed charges,600.8,100,,,fee schedule,100% of CO APG rate,480.64,80,,,percent of total billed charges,80% of total billed charges,233.11,38.8,,,percent of total billed charges,38.8% of total billed charges,510.68,85,,,percent of total billed charges,85% of total billed charges,600.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,233.11,600.8,
T-Plate 6 Hole L 111mm,46052687,CDM,278,RC,,,OUTPATIENT,,,641.8,513.44,,481.35,75,,,percent of total billed charges,75% of total billed charges,256.72,40,,,percent of total billed charges,40% of total billed charges,508.31,79.2,,,percent of total billed charges,79.2% of total billed charges,545.53,85,,,percent of total billed charges,85% of total billed charges,641.8,100,,,fee schedule,100% of CO APG rates,609.71,95,,,percent of total billed charges,95% of total billed charges,513.44,80,,,percent of total billed charges,80% of total billed charges,545.53,85,,,percent of total billed charges,85% of total billed charges,577.62,90,,,percent of total billed charges,90% of total billed charges,641.8,100,,,fee schedule,100% of CO APG rates,641.8,100,,,fee schedule,100% of CO APG rates,641.8,100,,,fee schedule,100% of NM fee schedule,256.72,40,,,percent of total billed charges,40% of total billed charges,256.72,40,,,percent of total billed charges,40% of total billed charges,577.62,90,,,percent of total billed charges,90% of total billed charges,487.77,76,,,percent of total billed charges,76% of total billed charges,256.72,40,,,percent of total billed charges,40% of total billed charges,545.53,85,,,percent of total billed charges,85% of total billed charges,641.8,100,,,fee schedule,100% of CO APG rate,513.44,80,,,percent of total billed charges,80% of total billed charges,249.02,38.8,,,percent of total billed charges,38.8% of total billed charges,545.53,85,,,percent of total billed charges,85% of total billed charges,641.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,249.02,641.8,
T Buttress Plate 4 Hole 81mm,46052688,CDM,278,RC,,,OUTPATIENT,,,732.1,585.68,,549.08,75,,,percent of total billed charges,75% of total billed charges,292.84,40,,,percent of total billed charges,40% of total billed charges,579.82,79.2,,,percent of total billed charges,79.2% of total billed charges,622.29,85,,,percent of total billed charges,85% of total billed charges,732.1,100,,,fee schedule,100% of CO APG rates,695.5,95,,,percent of total billed charges,95% of total billed charges,585.68,80,,,percent of total billed charges,80% of total billed charges,622.29,85,,,percent of total billed charges,85% of total billed charges,658.89,90,,,percent of total billed charges,90% of total billed charges,732.1,100,,,fee schedule,100% of CO APG rates,732.1,100,,,fee schedule,100% of CO APG rates,732.1,100,,,fee schedule,100% of NM fee schedule,292.84,40,,,percent of total billed charges,40% of total billed charges,292.84,40,,,percent of total billed charges,40% of total billed charges,658.89,90,,,percent of total billed charges,90% of total billed charges,556.4,76,,,percent of total billed charges,76% of total billed charges,292.84,40,,,percent of total billed charges,40% of total billed charges,622.29,85,,,percent of total billed charges,85% of total billed charges,732.1,100,,,fee schedule,100% of CO APG rate,585.68,80,,,percent of total billed charges,80% of total billed charges,284.05,38.8,,,percent of total billed charges,38.8% of total billed charges,622.29,85,,,percent of total billed charges,85% of total billed charges,732.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,284.05,732.1,
T Buttress Plate 6 Hole 113mm,46052689,CDM,278,RC,,,OUTPATIENT,,,789.9,631.92,,592.43,75,,,percent of total billed charges,75% of total billed charges,315.96,40,,,percent of total billed charges,40% of total billed charges,625.6,79.2,,,percent of total billed charges,79.2% of total billed charges,671.42,85,,,percent of total billed charges,85% of total billed charges,789.9,100,,,fee schedule,100% of CO APG rates,750.41,95,,,percent of total billed charges,95% of total billed charges,631.92,80,,,percent of total billed charges,80% of total billed charges,671.42,85,,,percent of total billed charges,85% of total billed charges,710.91,90,,,percent of total billed charges,90% of total billed charges,789.9,100,,,fee schedule,100% of CO APG rates,789.9,100,,,fee schedule,100% of CO APG rates,789.9,100,,,fee schedule,100% of NM fee schedule,315.96,40,,,percent of total billed charges,40% of total billed charges,315.96,40,,,percent of total billed charges,40% of total billed charges,710.91,90,,,percent of total billed charges,90% of total billed charges,600.32,76,,,percent of total billed charges,76% of total billed charges,315.96,40,,,percent of total billed charges,40% of total billed charges,671.42,85,,,percent of total billed charges,85% of total billed charges,789.9,100,,,fee schedule,100% of CO APG rate,631.92,80,,,percent of total billed charges,80% of total billed charges,306.48,38.8,,,percent of total billed charges,38.8% of total billed charges,671.42,85,,,percent of total billed charges,85% of total billed charges,789.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,306.48,789.9,
Oxygen Desaturation Study Ambulatory,60000320,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,354.3,283.44,,265.73,75,,,percent of total billed charges,75% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,280.61,79.2,,,percent of total billed charges,79.2% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,336.59,95,,,percent of total billed charges,95% of total billed charges,283.44,80,,,percent of total billed charges,80% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,141.72,40,,,percent of total billed charges,40% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,269.27,76,,,percent of total billed charges,76% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,283.44,80,,,percent of total billed charges,80% of total billed charges,137.47,38.8,,,percent of total billed charges,38.8% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,336.59,
OT Low Complex Units,60000296,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,302.9,242.32,GO,227.18,75,,,percent of total billed charges,75% of total billed charges,121.16,40,,,percent of total billed charges,40% of total billed charges,239.9,79.2,,,percent of total billed charges,79.2% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,287.76,95,,,percent of total billed charges,95% of total billed charges,242.32,80,,,percent of total billed charges,80% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,272.61,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,121.16,40,,,percent of total billed charges,40% of total billed charges,121.16,40,,,percent of total billed charges,40% of total billed charges,272.61,90,,,percent of total billed charges,90% of total billed charges,230.2,76,,,percent of total billed charges,76% of total billed charges,121.16,40,,,percent of total billed charges,40% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,242.32,80,,,percent of total billed charges,80% of total billed charges,117.53,38.8,,,percent of total billed charges,38.8% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,287.76,
OT Moderate Complex Units,60000295,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,302.9,242.32,GO,227.18,75,,,percent of total billed charges,75% of total billed charges,121.16,40,,,percent of total billed charges,40% of total billed charges,239.9,79.2,,,percent of total billed charges,79.2% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,287.76,95,,,percent of total billed charges,95% of total billed charges,242.32,80,,,percent of total billed charges,80% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,272.61,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,121.16,40,,,percent of total billed charges,40% of total billed charges,121.16,40,,,percent of total billed charges,40% of total billed charges,272.61,90,,,percent of total billed charges,90% of total billed charges,230.2,76,,,percent of total billed charges,76% of total billed charges,121.16,40,,,percent of total billed charges,40% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,242.32,80,,,percent of total billed charges,80% of total billed charges,117.53,38.8,,,percent of total billed charges,38.8% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,287.76,
OT High Complex Units,60000294,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,302.9,242.32,GO,227.18,75,,,percent of total billed charges,75% of total billed charges,121.16,40,,,percent of total billed charges,40% of total billed charges,239.9,79.2,,,percent of total billed charges,79.2% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,287.76,95,,,percent of total billed charges,95% of total billed charges,242.32,80,,,percent of total billed charges,80% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,272.61,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,121.16,40,,,percent of total billed charges,40% of total billed charges,121.16,40,,,percent of total billed charges,40% of total billed charges,272.61,90,,,percent of total billed charges,90% of total billed charges,230.2,76,,,percent of total billed charges,76% of total billed charges,121.16,40,,,percent of total billed charges,40% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,242.32,80,,,percent of total billed charges,80% of total billed charges,117.53,38.8,,,percent of total billed charges,38.8% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,287.76,
OT ReEval Units,60000293,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,206.6,165.28,GO,154.95,75,,,percent of total billed charges,75% of total billed charges,82.64,40,,,percent of total billed charges,40% of total billed charges,163.63,79.2,,,percent of total billed charges,79.2% of total billed charges,175.61,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,196.27,95,,,percent of total billed charges,95% of total billed charges,165.28,80,,,percent of total billed charges,80% of total billed charges,175.61,85,,,percent of total billed charges,85% of total billed charges,185.94,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,82.64,40,,,percent of total billed charges,40% of total billed charges,82.64,40,,,percent of total billed charges,40% of total billed charges,185.94,90,,,percent of total billed charges,90% of total billed charges,157.02,76,,,percent of total billed charges,76% of total billed charges,82.64,40,,,percent of total billed charges,40% of total billed charges,175.61,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,165.28,80,,,percent of total billed charges,80% of total billed charges,80.16,38.8,,,percent of total billed charges,38.8% of total billed charges,175.61,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,196.27,
PT Low Complex Units,42597161,CDM,424,RC,,,OUTPATIENT,,,290.3,232.24,GP,217.73,75,,,percent of total billed charges,75% of total billed charges,116.12,40,,,percent of total billed charges,40% of total billed charges,229.92,79.2,,,percent of total billed charges,79.2% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,290.3,100,,,fee schedule,100% of CO APG rates,275.79,95,,,percent of total billed charges,95% of total billed charges,232.24,80,,,percent of total billed charges,80% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,261.27,90,,,percent of total billed charges,90% of total billed charges,290.3,100,,,fee schedule,100% of CO APG rates,290.3,100,,,fee schedule,100% of CO APG rates,290.3,100,,,fee schedule,100% of NM fee schedule,116.12,40,,,percent of total billed charges,40% of total billed charges,116.12,40,,,percent of total billed charges,40% of total billed charges,261.27,90,,,percent of total billed charges,90% of total billed charges,220.63,76,,,percent of total billed charges,76% of total billed charges,116.12,40,,,percent of total billed charges,40% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,290.3,100,,,fee schedule,100% of CO APG rate,232.24,80,,,percent of total billed charges,80% of total billed charges,112.64,38.8,,,percent of total billed charges,38.8% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,290.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,112.64,290.3,
PT Moderate Complex Units,42597162,CDM,424,RC,,,OUTPATIENT,,,290.3,232.24,GP,217.73,75,,,percent of total billed charges,75% of total billed charges,116.12,40,,,percent of total billed charges,40% of total billed charges,229.92,79.2,,,percent of total billed charges,79.2% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,290.3,100,,,fee schedule,100% of CO APG rates,275.79,95,,,percent of total billed charges,95% of total billed charges,232.24,80,,,percent of total billed charges,80% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,261.27,90,,,percent of total billed charges,90% of total billed charges,290.3,100,,,fee schedule,100% of CO APG rates,290.3,100,,,fee schedule,100% of CO APG rates,290.3,100,,,fee schedule,100% of NM fee schedule,116.12,40,,,percent of total billed charges,40% of total billed charges,116.12,40,,,percent of total billed charges,40% of total billed charges,261.27,90,,,percent of total billed charges,90% of total billed charges,220.63,76,,,percent of total billed charges,76% of total billed charges,116.12,40,,,percent of total billed charges,40% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,290.3,100,,,fee schedule,100% of CO APG rate,232.24,80,,,percent of total billed charges,80% of total billed charges,112.64,38.8,,,percent of total billed charges,38.8% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,290.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,112.64,290.3,
PT High Complex Units,42597163,CDM,424,RC,,,OUTPATIENT,,,290.3,232.24,GP,217.73,75,,,percent of total billed charges,75% of total billed charges,116.12,40,,,percent of total billed charges,40% of total billed charges,229.92,79.2,,,percent of total billed charges,79.2% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,290.3,100,,,fee schedule,100% of CO APG rates,275.79,95,,,percent of total billed charges,95% of total billed charges,232.24,80,,,percent of total billed charges,80% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,261.27,90,,,percent of total billed charges,90% of total billed charges,290.3,100,,,fee schedule,100% of CO APG rates,290.3,100,,,fee schedule,100% of CO APG rates,290.3,100,,,fee schedule,100% of NM fee schedule,116.12,40,,,percent of total billed charges,40% of total billed charges,116.12,40,,,percent of total billed charges,40% of total billed charges,261.27,90,,,percent of total billed charges,90% of total billed charges,220.63,76,,,percent of total billed charges,76% of total billed charges,116.12,40,,,percent of total billed charges,40% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,290.3,100,,,fee schedule,100% of CO APG rate,232.24,80,,,percent of total billed charges,80% of total billed charges,112.64,38.8,,,percent of total billed charges,38.8% of total billed charges,246.76,85,,,percent of total billed charges,85% of total billed charges,290.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,112.64,290.3,
PT ReEval Units,42597164,CDM,424,RC,,,OUTPATIENT,,,198,158.4,GP,148.5,75,,,percent of total billed charges,75% of total billed charges,79.2,40,,,percent of total billed charges,40% of total billed charges,156.82,79.2,,,percent of total billed charges,79.2% of total billed charges,168.3,85,,,percent of total billed charges,85% of total billed charges,198,100,,,fee schedule,100% of CO APG rates,188.1,95,,,percent of total billed charges,95% of total billed charges,158.4,80,,,percent of total billed charges,80% of total billed charges,168.3,85,,,percent of total billed charges,85% of total billed charges,178.2,90,,,percent of total billed charges,90% of total billed charges,198,100,,,fee schedule,100% of CO APG rates,198,100,,,fee schedule,100% of CO APG rates,198,100,,,fee schedule,100% of NM fee schedule,79.2,40,,,percent of total billed charges,40% of total billed charges,79.2,40,,,percent of total billed charges,40% of total billed charges,178.2,90,,,percent of total billed charges,90% of total billed charges,150.48,76,,,percent of total billed charges,76% of total billed charges,79.2,40,,,percent of total billed charges,40% of total billed charges,168.3,85,,,percent of total billed charges,85% of total billed charges,198,100,,,fee schedule,100% of CO APG rate,158.4,80,,,percent of total billed charges,80% of total billed charges,76.82,38.8,,,percent of total billed charges,38.8% of total billed charges,168.3,85,,,percent of total billed charges,85% of total billed charges,198,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,76.82,198,
Q0091 - Pap Smear Collection for MEDICARE Patients,465Q0091,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,45.4,36.32,,34.05,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,35.96,79.2,,,percent of total billed charges,79.2% of total billed charges,38.59,85,,,percent of total billed charges,85% of total billed charges,45.4,100,,,fee schedule,100% of CO APG rates,43.13,95,,,percent of total billed charges,95% of total billed charges,36.32,80,,,percent of total billed charges,80% of total billed charges,38.59,85,,,percent of total billed charges,85% of total billed charges,40.86,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,45.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,40.86,90,,,percent of total billed charges,90% of total billed charges,34.5,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,38.59,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,36.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,38.59,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,473,100,,,case rate,pays based on per visit rate,34.05,473,
Soluble Transferrin Receptor LC,40084238,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,146.8,117.44,,110.1,75,,,percent of total billed charges,75% of total billed charges,58.72,40,,,percent of total billed charges,40% of total billed charges,116.27,79.2,,,percent of total billed charges,79.2% of total billed charges,124.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,139.46,95,,,percent of total billed charges,95% of total billed charges,117.44,80,,,percent of total billed charges,80% of total billed charges,124.78,85,,,percent of total billed charges,85% of total billed charges,132.12,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.72,40,,,percent of total billed charges,40% of total billed charges,58.72,40,,,percent of total billed charges,40% of total billed charges,132.12,90,,,percent of total billed charges,90% of total billed charges,111.57,76,,,percent of total billed charges,76% of total billed charges,58.72,40,,,percent of total billed charges,40% of total billed charges,124.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,117.44,80,,,percent of total billed charges,80% of total billed charges,56.96,38.8,,,percent of total billed charges,38.8% of total billed charges,124.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,139.46,
"EBV Ab VCA, IgM LC",40086665,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,155.2,124.16,,116.4,75,,,percent of total billed charges,75% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,122.92,79.2,,,percent of total billed charges,79.2% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,147.44,95,,,percent of total billed charges,95% of total billed charges,124.16,80,,,percent of total billed charges,80% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,62.08,40,,,percent of total billed charges,40% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,117.95,76,,,percent of total billed charges,76% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,124.16,80,,,percent of total billed charges,80% of total billed charges,60.22,38.8,,,percent of total billed charges,38.8% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,147.44,
BREAST BIOPSY BUNDLE,41252690,CDM,270,RC,,,OUTPATIENT,,,53.6,42.88,,40.2,75,,,percent of total billed charges,75% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,42.45,79.2,,,percent of total billed charges,79.2% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rates,50.92,95,,,percent of total billed charges,95% of total billed charges,42.88,80,,,percent of total billed charges,80% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,48.24,90,,,percent of total billed charges,90% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rates,53.6,100,,,fee schedule,100% of CO APG rates,53.6,100,,,fee schedule,100% of NM fee schedule,21.44,40,,,percent of total billed charges,40% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,48.24,90,,,percent of total billed charges,90% of total billed charges,40.74,76,,,percent of total billed charges,76% of total billed charges,21.44,40,,,percent of total billed charges,40% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of CO APG rate,42.88,80,,,percent of total billed charges,80% of total billed charges,20.8,38.8,,,percent of total billed charges,38.8% of total billed charges,45.56,85,,,percent of total billed charges,85% of total billed charges,53.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,20.8,53.6,
GHIATAS BEADED BREAST LOCALIZATION WIRE,41252691,CDM,270,RC,,,OUTPATIENT,,,89.7,71.76,,67.28,75,,,percent of total billed charges,75% of total billed charges,35.88,40,,,percent of total billed charges,40% of total billed charges,71.04,79.2,,,percent of total billed charges,79.2% of total billed charges,76.25,85,,,percent of total billed charges,85% of total billed charges,89.7,100,,,fee schedule,100% of CO APG rates,85.22,95,,,percent of total billed charges,95% of total billed charges,71.76,80,,,percent of total billed charges,80% of total billed charges,76.25,85,,,percent of total billed charges,85% of total billed charges,80.73,90,,,percent of total billed charges,90% of total billed charges,89.7,100,,,fee schedule,100% of CO APG rates,89.7,100,,,fee schedule,100% of CO APG rates,89.7,100,,,fee schedule,100% of NM fee schedule,35.88,40,,,percent of total billed charges,40% of total billed charges,35.88,40,,,percent of total billed charges,40% of total billed charges,80.73,90,,,percent of total billed charges,90% of total billed charges,68.17,76,,,percent of total billed charges,76% of total billed charges,35.88,40,,,percent of total billed charges,40% of total billed charges,76.25,85,,,percent of total billed charges,85% of total billed charges,89.7,100,,,fee schedule,100% of CO APG rate,71.76,80,,,percent of total billed charges,80% of total billed charges,34.8,38.8,,,percent of total billed charges,38.8% of total billed charges,76.25,85,,,percent of total billed charges,85% of total billed charges,89.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,34.8,89.7,
SENOMARK ULTRACORE 14G X 13cm MARKER,41252693,CDM,270,RC,,,OUTPATIENT,,,340.9,272.72,,255.68,75,,,percent of total billed charges,75% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,269.99,79.2,,,percent of total billed charges,79.2% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,340.9,100,,,fee schedule,100% of CO APG rates,323.86,95,,,percent of total billed charges,95% of total billed charges,272.72,80,,,percent of total billed charges,80% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,306.81,90,,,percent of total billed charges,90% of total billed charges,340.9,100,,,fee schedule,100% of CO APG rates,340.9,100,,,fee schedule,100% of CO APG rates,340.9,100,,,fee schedule,100% of NM fee schedule,136.36,40,,,percent of total billed charges,40% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,306.81,90,,,percent of total billed charges,90% of total billed charges,259.08,76,,,percent of total billed charges,76% of total billed charges,136.36,40,,,percent of total billed charges,40% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,340.9,100,,,fee schedule,100% of CO APG rate,272.72,80,,,percent of total billed charges,80% of total billed charges,132.27,38.8,,,percent of total billed charges,38.8% of total billed charges,289.77,85,,,percent of total billed charges,85% of total billed charges,340.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,132.27,340.9,
COLLECTION: Arterial Draw,42236600,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,130.9,104.72,,98.18,75,,,percent of total billed charges,75% of total billed charges,52.36,40,,,percent of total billed charges,40% of total billed charges,103.67,79.2,,,percent of total billed charges,79.2% of total billed charges,111.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,124.36,95,,,percent of total billed charges,95% of total billed charges,104.72,80,,,percent of total billed charges,80% of total billed charges,111.27,85,,,percent of total billed charges,85% of total billed charges,117.81,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,52.36,40,,,percent of total billed charges,40% of total billed charges,52.36,40,,,percent of total billed charges,40% of total billed charges,117.81,90,,,percent of total billed charges,90% of total billed charges,99.48,76,,,percent of total billed charges,76% of total billed charges,52.36,40,,,percent of total billed charges,40% of total billed charges,111.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,104.72,80,,,percent of total billed charges,80% of total billed charges,50.79,38.8,,,percent of total billed charges,38.8% of total billed charges,111.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,124.36,
"23665 Closed Treatment Of Shoulder Dislocation, With Fractur",31023665,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,4801,3840.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"92521 Evaluation of speech fluency (eg, stuttering, clutteri",42692521,CDM,444,RC,96105,HCPCS,OUTPATIENT,,,423.6,338.88,GN,317.7,75,,,percent of total billed charges,75% of total billed charges,169.44,40,,,percent of total billed charges,40% of total billed charges,335.49,79.2,,,percent of total billed charges,79.2% of total billed charges,360.06,85,,,percent of total billed charges,85% of total billed charges,423.6,100,,,fee schedule,100% of CO APG rates,402.42,95,,,percent of total billed charges,95% of total billed charges,338.88,80,,,percent of total billed charges,80% of total billed charges,360.06,85,,,percent of total billed charges,85% of total billed charges,381.24,90,,,percent of total billed charges,90% of total billed charges,763.08,100,,,fee schedule,100% of CO APG rates,763.08,100,,,fee schedule,100% of CO APG rates,58.84,100,,,fee schedule,100% of NM fee schedule,169.44,40,,,percent of total billed charges,40% of total billed charges,169.44,40,,,percent of total billed charges,40% of total billed charges,381.24,90,,,percent of total billed charges,90% of total billed charges,321.94,76,,,percent of total billed charges,76% of total billed charges,169.44,40,,,percent of total billed charges,40% of total billed charges,360.06,85,,,percent of total billed charges,85% of total billed charges,763.08,100,,,fee schedule,100% of CO APG rate,338.88,80,,,percent of total billed charges,80% of total billed charges,164.36,38.8,,,percent of total billed charges,38.8% of total billed charges,360.06,85,,,percent of total billed charges,85% of total billed charges,763.08,100,,,fee schedule,100% of APG fee schedule,199.32,200,,,fee schedule,200% of CMS fee schedule,58.84,763.08,
"92522 Evaluation of speech sound production (eg, articulatio",42692522,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,349.7,279.76,GN,262.28,75,,,percent of total billed charges,75% of total billed charges,139.88,40,,,percent of total billed charges,40% of total billed charges,276.96,79.2,,,percent of total billed charges,79.2% of total billed charges,297.25,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,332.22,95,,,percent of total billed charges,95% of total billed charges,279.76,80,,,percent of total billed charges,80% of total billed charges,297.25,85,,,percent of total billed charges,85% of total billed charges,314.73,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,139.88,40,,,percent of total billed charges,40% of total billed charges,139.88,40,,,percent of total billed charges,40% of total billed charges,314.73,90,,,percent of total billed charges,90% of total billed charges,265.77,76,,,percent of total billed charges,76% of total billed charges,139.88,40,,,percent of total billed charges,40% of total billed charges,297.25,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,279.76,80,,,percent of total billed charges,80% of total billed charges,135.68,38.8,,,percent of total billed charges,38.8% of total billed charges,297.25,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,332.22,
92523 Evaluation of speech sound production; with evaluation,42692523,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,747,597.6,GN,560.25,75,,,percent of total billed charges,75% of total billed charges,298.8,40,,,percent of total billed charges,40% of total billed charges,591.62,79.2,,,percent of total billed charges,79.2% of total billed charges,634.95,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,709.65,95,,,percent of total billed charges,95% of total billed charges,597.6,80,,,percent of total billed charges,80% of total billed charges,634.95,85,,,percent of total billed charges,85% of total billed charges,672.3,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,298.8,40,,,percent of total billed charges,40% of total billed charges,298.8,40,,,percent of total billed charges,40% of total billed charges,672.3,90,,,percent of total billed charges,90% of total billed charges,567.72,76,,,percent of total billed charges,76% of total billed charges,298.8,40,,,percent of total billed charges,40% of total billed charges,634.95,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,597.6,80,,,percent of total billed charges,80% of total billed charges,289.84,38.8,,,percent of total billed charges,38.8% of total billed charges,634.95,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,709.65,
92524 Behavioral and qualitative analysis of voice and reson,42692524,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,337.7,270.16,GN,253.28,75,,,percent of total billed charges,75% of total billed charges,135.08,40,,,percent of total billed charges,40% of total billed charges,267.46,79.2,,,percent of total billed charges,79.2% of total billed charges,287.05,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,320.82,95,,,percent of total billed charges,95% of total billed charges,270.16,80,,,percent of total billed charges,80% of total billed charges,287.05,85,,,percent of total billed charges,85% of total billed charges,303.93,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,135.08,40,,,percent of total billed charges,40% of total billed charges,135.08,40,,,percent of total billed charges,40% of total billed charges,303.93,90,,,percent of total billed charges,90% of total billed charges,256.65,76,,,percent of total billed charges,76% of total billed charges,135.08,40,,,percent of total billed charges,40% of total billed charges,287.05,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,270.16,80,,,percent of total billed charges,80% of total billed charges,131.03,38.8,,,percent of total billed charges,38.8% of total billed charges,287.05,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,320.82,
Chlamydia (CT),40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,256.2,204.96,,192.15,75,,,percent of total billed charges,75% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,202.91,79.2,,,percent of total billed charges,79.2% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,243.39,95,,,percent of total billed charges,95% of total billed charges,204.96,80,,,percent of total billed charges,80% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,230.58,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,102.48,40,,,percent of total billed charges,40% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,230.58,90,,,percent of total billed charges,90% of total billed charges,194.71,76,,,percent of total billed charges,76% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,204.96,80,,,percent of total billed charges,80% of total billed charges,99.41,38.8,,,percent of total billed charges,38.8% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,243.39,
Chlamydia (CT),40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,256.2,204.96,,192.15,75,,,percent of total billed charges,75% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,202.91,79.2,,,percent of total billed charges,79.2% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,243.39,95,,,percent of total billed charges,95% of total billed charges,204.96,80,,,percent of total billed charges,80% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,230.58,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,102.48,40,,,percent of total billed charges,40% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,230.58,90,,,percent of total billed charges,90% of total billed charges,194.71,76,,,percent of total billed charges,76% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,204.96,80,,,percent of total billed charges,80% of total billed charges,99.41,38.8,,,percent of total billed charges,38.8% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,243.39,
Neisseria (NG),40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,256.2,204.96,,192.15,75,,,percent of total billed charges,75% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,202.91,79.2,,,percent of total billed charges,79.2% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,243.39,95,,,percent of total billed charges,95% of total billed charges,204.96,80,,,percent of total billed charges,80% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,230.58,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,102.48,40,,,percent of total billed charges,40% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,230.58,90,,,percent of total billed charges,90% of total billed charges,194.71,76,,,percent of total billed charges,76% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,204.96,80,,,percent of total billed charges,80% of total billed charges,99.41,38.8,,,percent of total billed charges,38.8% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,243.39,
Neisseria (NG),40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,256.2,204.96,,192.15,75,,,percent of total billed charges,75% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,202.91,79.2,,,percent of total billed charges,79.2% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,243.39,95,,,percent of total billed charges,95% of total billed charges,204.96,80,,,percent of total billed charges,80% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,230.58,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,102.48,40,,,percent of total billed charges,40% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,230.58,90,,,percent of total billed charges,90% of total billed charges,194.71,76,,,percent of total billed charges,76% of total billed charges,102.48,40,,,percent of total billed charges,40% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,204.96,80,,,percent of total billed charges,80% of total billed charges,99.41,38.8,,,percent of total billed charges,38.8% of total billed charges,217.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,243.39,
QUICK PRESSURE MONITOR SET,46052694,CDM,270,RC,,,OUTPATIENT,,,496.1,396.88,,372.08,75,,,percent of total billed charges,75% of total billed charges,198.44,40,,,percent of total billed charges,40% of total billed charges,392.91,79.2,,,percent of total billed charges,79.2% of total billed charges,421.69,85,,,percent of total billed charges,85% of total billed charges,496.1,100,,,fee schedule,100% of CO APG rates,471.3,95,,,percent of total billed charges,95% of total billed charges,396.88,80,,,percent of total billed charges,80% of total billed charges,421.69,85,,,percent of total billed charges,85% of total billed charges,446.49,90,,,percent of total billed charges,90% of total billed charges,496.1,100,,,fee schedule,100% of CO APG rates,496.1,100,,,fee schedule,100% of CO APG rates,496.1,100,,,fee schedule,100% of NM fee schedule,198.44,40,,,percent of total billed charges,40% of total billed charges,198.44,40,,,percent of total billed charges,40% of total billed charges,446.49,90,,,percent of total billed charges,90% of total billed charges,377.04,76,,,percent of total billed charges,76% of total billed charges,198.44,40,,,percent of total billed charges,40% of total billed charges,421.69,85,,,percent of total billed charges,85% of total billed charges,496.1,100,,,fee schedule,100% of CO APG rate,396.88,80,,,percent of total billed charges,80% of total billed charges,192.49,38.8,,,percent of total billed charges,38.8% of total billed charges,421.69,85,,,percent of total billed charges,85% of total billed charges,496.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,192.49,496.1,
Therapeutic services for the use of speech-generating device,60000355,CDM,440,RC,97533,HCPCS,OUTPATIENT,,,326.3,261.04,GN,244.73,75,,,percent of total billed charges,75% of total billed charges,130.52,40,,,percent of total billed charges,40% of total billed charges,258.43,79.2,,,percent of total billed charges,79.2% of total billed charges,277.36,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,309.99,95,,,percent of total billed charges,95% of total billed charges,261.04,80,,,percent of total billed charges,80% of total billed charges,277.36,85,,,percent of total billed charges,85% of total billed charges,293.67,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,25.54,100,,,fee schedule,100% of NM fee schedule,130.52,40,,,percent of total billed charges,40% of total billed charges,130.52,40,,,percent of total billed charges,40% of total billed charges,293.67,90,,,percent of total billed charges,90% of total billed charges,247.99,76,,,percent of total billed charges,76% of total billed charges,130.52,40,,,percent of total billed charges,40% of total billed charges,277.36,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,261.04,80,,,percent of total billed charges,80% of total billed charges,126.6,38.8,,,percent of total billed charges,38.8% of total billed charges,277.36,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,133.56,200,,,fee schedule,200% of CMS fee schedule,25.54,309.99,
MA Routine Screen Bil.,41400001,CDM,403,RC,77067,HCPCS,OUTPATIENT,,,395.1,316.08,TC,296.33,75,,,percent of total billed charges,75% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,312.92,79.2,,,percent of total billed charges,79.2% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,375.35,95,,,percent of total billed charges,95% of total billed charges,316.08,80,,,percent of total billed charges,80% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,66.74,100,,,fee schedule,100% of CO APG rates,127.61,100,,,fee schedule,100% of NM fee schedule,158.04,40,,,percent of total billed charges,40% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,300.28,76,,,percent of total billed charges,76% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rate,316.08,80,,,percent of total billed charges,80% of total billed charges,153.3,38.8,,,percent of total billed charges,38.8% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of APG fee schedule,270.8,200,,,fee schedule,200% of CMS fee schedule,66.74,375.35,
64405 Injection; anesthetic agent; greater occipital nerve,46264405,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,848.6,678.88,,636.45,75,,,percent of total billed charges,75% of total billed charges,339.44,40,,,percent of total billed charges,40% of total billed charges,672.09,79.2,,,percent of total billed charges,79.2% of total billed charges,721.31,85,,,percent of total billed charges,85% of total billed charges,848.6,100,,,fee schedule,100% of CO APG rates,806.17,95,,,percent of total billed charges,95% of total billed charges,678.88,80,,,percent of total billed charges,80% of total billed charges,721.31,85,,,percent of total billed charges,85% of total billed charges,763.74,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,848.6,100,,,fee schedule,100% of NM APC rate,339.44,40,,,percent of total billed charges,40% of total billed charges,339.44,40,,,percent of total billed charges,40% of total billed charges,763.74,90,,,percent of total billed charges,90% of total billed charges,644.94,76,,,percent of total billed charges,76% of total billed charges,339.44,40,,,percent of total billed charges,40% of total billed charges,721.31,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,678.88,80,,,percent of total billed charges,80% of total billed charges,329.26,38.8,,,percent of total billed charges,38.8% of total billed charges,721.31,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,329.26,2713.28,
19084 Breast Biopsy w/placement of device and imaging of spe,46519084,CDM,402,RC,76700,HCPCS,OUTPATIENT,,,1396.7,1117.36,,1047.53,75,,,percent of total billed charges,75% of total billed charges,558.68,40,,,percent of total billed charges,40% of total billed charges,1106.19,79.2,,,percent of total billed charges,79.2% of total billed charges,1187.2,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,1326.87,95,,,percent of total billed charges,95% of total billed charges,1117.36,80,,,percent of total billed charges,80% of total billed charges,1187.2,85,,,percent of total billed charges,85% of total billed charges,1257.03,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,558.68,40,,,percent of total billed charges,40% of total billed charges,558.68,40,,,percent of total billed charges,40% of total billed charges,1257.03,90,,,percent of total billed charges,90% of total billed charges,1061.49,76,,,percent of total billed charges,76% of total billed charges,558.68,40,,,percent of total billed charges,40% of total billed charges,1187.2,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,1117.36,80,,,percent of total billed charges,80% of total billed charges,541.92,38.8,,,percent of total billed charges,38.8% of total billed charges,1187.2,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,246.44,200,,,fee schedule,200% of CMS fee schedule,106.88,1326.87,
19000 Puncture aspiration of cyst of breast,46519000,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2091.4,1673.12,,1568.55,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1656.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1777.69,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1986.83,95,,,percent of total billed charges,95% of total billed charges,1673.12,80,,,percent of total billed charges,80% of total billed charges,1777.69,85,,,percent of total billed charges,85% of total billed charges,1882.26,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2091.4,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1882.26,90,,,percent of total billed charges,90% of total billed charges,1589.46,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1777.69,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1673.12,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1777.69,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2091.4,
"JAK2 V617F Mutation Analysis, Quant LC",40081270,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,694.8,555.84,,521.1,75,,,percent of total billed charges,75% of total billed charges,277.92,40,,,percent of total billed charges,40% of total billed charges,550.28,79.2,,,percent of total billed charges,79.2% of total billed charges,590.58,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,660.06,95,,,percent of total billed charges,95% of total billed charges,555.84,80,,,percent of total billed charges,80% of total billed charges,590.58,85,,,percent of total billed charges,85% of total billed charges,625.32,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,277.92,40,,,percent of total billed charges,40% of total billed charges,277.92,40,,,percent of total billed charges,40% of total billed charges,625.32,90,,,percent of total billed charges,90% of total billed charges,528.05,76,,,percent of total billed charges,76% of total billed charges,277.92,40,,,percent of total billed charges,40% of total billed charges,590.58,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,555.84,80,,,percent of total billed charges,80% of total billed charges,269.58,38.8,,,percent of total billed charges,38.8% of total billed charges,590.58,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,660.06,
CT Chest Hi-Res w/o Contrast,41171250,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1668.6,1334.88,TC,1251.45,75,,,percent of total billed charges,75% of total billed charges,667.44,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1418.31,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1585.17,95,,,percent of total billed charges,95% of total billed charges,1334.88,80,,,percent of total billed charges,80% of total billed charges,1418.31,85,,,percent of total billed charges,85% of total billed charges,1501.74,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,667.44,40,,,percent of total billed charges,40% of total billed charges,667.44,40,,,percent of total billed charges,40% of total billed charges,1501.74,90,,,percent of total billed charges,90% of total billed charges,1268.14,76,,,percent of total billed charges,76% of total billed charges,667.44,40,,,percent of total billed charges,40% of total billed charges,1418.31,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1334.88,80,,,percent of total billed charges,80% of total billed charges,647.42,38.8,,,percent of total billed charges,38.8% of total billed charges,1418.31,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1585.17,
STRYKER AIR MENISCAL REPAIR DEVICE,46052697,CDM,278,RC,,,OUTPATIENT,,,1483.2,1186.56,,1112.4,75,,,percent of total billed charges,75% of total billed charges,593.28,40,,,percent of total billed charges,40% of total billed charges,1174.69,79.2,,,percent of total billed charges,79.2% of total billed charges,1260.72,85,,,percent of total billed charges,85% of total billed charges,1483.2,100,,,fee schedule,100% of CO APG rates,1409.04,95,,,percent of total billed charges,95% of total billed charges,1186.56,80,,,percent of total billed charges,80% of total billed charges,1260.72,85,,,percent of total billed charges,85% of total billed charges,1334.88,90,,,percent of total billed charges,90% of total billed charges,1483.2,100,,,fee schedule,100% of CO APG rates,1483.2,100,,,fee schedule,100% of CO APG rates,1483.2,100,,,fee schedule,100% of NM fee schedule,593.28,40,,,percent of total billed charges,40% of total billed charges,593.28,40,,,percent of total billed charges,40% of total billed charges,1334.88,90,,,percent of total billed charges,90% of total billed charges,1127.23,76,,,percent of total billed charges,76% of total billed charges,593.28,40,,,percent of total billed charges,40% of total billed charges,1260.72,85,,,percent of total billed charges,85% of total billed charges,1483.2,100,,,fee schedule,100% of CO APG rate,1186.56,80,,,percent of total billed charges,80% of total billed charges,575.48,38.8,,,percent of total billed charges,38.8% of total billed charges,1260.72,85,,,percent of total billed charges,85% of total billed charges,1483.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,575.48,1483.2,
HSV 1 NAA LC,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,128.4,102.72,,96.3,75,,,percent of total billed charges,75% of total billed charges,51.36,40,,,percent of total billed charges,40% of total billed charges,101.69,79.2,,,percent of total billed charges,79.2% of total billed charges,109.14,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,121.98,95,,,percent of total billed charges,95% of total billed charges,102.72,80,,,percent of total billed charges,80% of total billed charges,109.14,85,,,percent of total billed charges,85% of total billed charges,115.56,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,51.36,40,,,percent of total billed charges,40% of total billed charges,51.36,40,,,percent of total billed charges,40% of total billed charges,115.56,90,,,percent of total billed charges,90% of total billed charges,97.58,76,,,percent of total billed charges,76% of total billed charges,51.36,40,,,percent of total billed charges,40% of total billed charges,109.14,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,102.72,80,,,percent of total billed charges,80% of total billed charges,49.82,38.8,,,percent of total billed charges,38.8% of total billed charges,109.14,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,121.98,
HSV 2 NAA LC,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,128.8,103.04,,96.6,75,,,percent of total billed charges,75% of total billed charges,51.52,40,,,percent of total billed charges,40% of total billed charges,102.01,79.2,,,percent of total billed charges,79.2% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,122.36,95,,,percent of total billed charges,95% of total billed charges,103.04,80,,,percent of total billed charges,80% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,115.92,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,51.52,40,,,percent of total billed charges,40% of total billed charges,51.52,40,,,percent of total billed charges,40% of total billed charges,115.92,90,,,percent of total billed charges,90% of total billed charges,97.89,76,,,percent of total billed charges,76% of total billed charges,51.52,40,,,percent of total billed charges,40% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,103.04,80,,,percent of total billed charges,80% of total billed charges,49.97,38.8,,,percent of total billed charges,38.8% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,122.36,
Blood C/S w/Reflex,40087040,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,103.9,83.12,,77.93,75,,,percent of total billed charges,75% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,82.29,79.2,,,percent of total billed charges,79.2% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,98.71,95,,,percent of total billed charges,95% of total billed charges,83.12,80,,,percent of total billed charges,80% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,41.56,40,,,percent of total billed charges,40% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,78.96,76,,,percent of total billed charges,76% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,83.12,80,,,percent of total billed charges,80% of total billed charges,40.31,38.8,,,percent of total billed charges,38.8% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,98.71,
"ANTI-EMBOLISM STOCKING, THIGH SM LONG",52870,CDM,270,RC,,,OUTPATIENT,,,29.4,23.52,,22.05,75,,,percent of total billed charges,75% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,23.28,79.2,,,percent of total billed charges,79.2% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rates,27.93,95,,,percent of total billed charges,95% of total billed charges,23.52,80,,,percent of total billed charges,80% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,26.46,90,,,percent of total billed charges,90% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rates,29.4,100,,,fee schedule,100% of CO APG rates,29.4,100,,,fee schedule,100% of NM fee schedule,11.76,40,,,percent of total billed charges,40% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,26.46,90,,,percent of total billed charges,90% of total billed charges,22.34,76,,,percent of total billed charges,76% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rate,23.52,80,,,percent of total billed charges,80% of total billed charges,11.41,38.8,,,percent of total billed charges,38.8% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,11.41,29.4,
"ANTI-EMBOLISM STOCKING, THIGH SM REGULAR",52869,CDM,270,RC,,,OUTPATIENT,,,29.4,23.52,,22.05,75,,,percent of total billed charges,75% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,23.28,79.2,,,percent of total billed charges,79.2% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rates,27.93,95,,,percent of total billed charges,95% of total billed charges,23.52,80,,,percent of total billed charges,80% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,26.46,90,,,percent of total billed charges,90% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rates,29.4,100,,,fee schedule,100% of CO APG rates,29.4,100,,,fee schedule,100% of NM fee schedule,11.76,40,,,percent of total billed charges,40% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,26.46,90,,,percent of total billed charges,90% of total billed charges,22.34,76,,,percent of total billed charges,76% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rate,23.52,80,,,percent of total billed charges,80% of total billed charges,11.41,38.8,,,percent of total billed charges,38.8% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,11.41,29.4,
"ANTI-EMBOLISM STOCKING, THIGH MD LONG",52874,CDM,270,RC,,,OUTPATIENT,,,49.1,39.28,,36.83,75,,,percent of total billed charges,75% of total billed charges,19.64,40,,,percent of total billed charges,40% of total billed charges,38.89,79.2,,,percent of total billed charges,79.2% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,49.1,100,,,fee schedule,100% of CO APG rates,46.65,95,,,percent of total billed charges,95% of total billed charges,39.28,80,,,percent of total billed charges,80% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,44.19,90,,,percent of total billed charges,90% of total billed charges,49.1,100,,,fee schedule,100% of CO APG rates,49.1,100,,,fee schedule,100% of CO APG rates,49.1,100,,,fee schedule,100% of NM fee schedule,19.64,40,,,percent of total billed charges,40% of total billed charges,19.64,40,,,percent of total billed charges,40% of total billed charges,44.19,90,,,percent of total billed charges,90% of total billed charges,37.32,76,,,percent of total billed charges,76% of total billed charges,19.64,40,,,percent of total billed charges,40% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,49.1,100,,,fee schedule,100% of CO APG rate,39.28,80,,,percent of total billed charges,80% of total billed charges,19.05,38.8,,,percent of total billed charges,38.8% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,49.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,19.05,49.1,
"ANTI-EMBOLISM STOCKING, THIGH SM SHORT",52868,CDM,270,RC,,,OUTPATIENT,,,29.4,23.52,,22.05,75,,,percent of total billed charges,75% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,23.28,79.2,,,percent of total billed charges,79.2% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rates,27.93,95,,,percent of total billed charges,95% of total billed charges,23.52,80,,,percent of total billed charges,80% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,26.46,90,,,percent of total billed charges,90% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rates,29.4,100,,,fee schedule,100% of CO APG rates,29.4,100,,,fee schedule,100% of NM fee schedule,11.76,40,,,percent of total billed charges,40% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,26.46,90,,,percent of total billed charges,90% of total billed charges,22.34,76,,,percent of total billed charges,76% of total billed charges,11.76,40,,,percent of total billed charges,40% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of CO APG rate,23.52,80,,,percent of total billed charges,80% of total billed charges,11.41,38.8,,,percent of total billed charges,38.8% of total billed charges,24.99,85,,,percent of total billed charges,85% of total billed charges,29.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,11.41,29.4,
"ANTI-EMBOLISM STOCKING, THIGH MD REGULAR",52873,CDM,270,RC,,,OUTPATIENT,,,49.1,39.28,,36.83,75,,,percent of total billed charges,75% of total billed charges,19.64,40,,,percent of total billed charges,40% of total billed charges,38.89,79.2,,,percent of total billed charges,79.2% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,49.1,100,,,fee schedule,100% of CO APG rates,46.65,95,,,percent of total billed charges,95% of total billed charges,39.28,80,,,percent of total billed charges,80% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,44.19,90,,,percent of total billed charges,90% of total billed charges,49.1,100,,,fee schedule,100% of CO APG rates,49.1,100,,,fee schedule,100% of CO APG rates,49.1,100,,,fee schedule,100% of NM fee schedule,19.64,40,,,percent of total billed charges,40% of total billed charges,19.64,40,,,percent of total billed charges,40% of total billed charges,44.19,90,,,percent of total billed charges,90% of total billed charges,37.32,76,,,percent of total billed charges,76% of total billed charges,19.64,40,,,percent of total billed charges,40% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,49.1,100,,,fee schedule,100% of CO APG rate,39.28,80,,,percent of total billed charges,80% of total billed charges,19.05,38.8,,,percent of total billed charges,38.8% of total billed charges,41.74,85,,,percent of total billed charges,85% of total billed charges,49.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,19.05,49.1,
"ANTI-EMBOLISM STOCKING, THIGH LG LONG",52877,CDM,270,RC,,,OUTPATIENT,,,21.8,17.44,,16.35,75,,,percent of total billed charges,75% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,17.27,79.2,,,percent of total billed charges,79.2% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rates,20.71,95,,,percent of total billed charges,95% of total billed charges,17.44,80,,,percent of total billed charges,80% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,19.62,90,,,percent of total billed charges,90% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rates,21.8,100,,,fee schedule,100% of CO APG rates,21.8,100,,,fee schedule,100% of NM fee schedule,8.72,40,,,percent of total billed charges,40% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,19.62,90,,,percent of total billed charges,90% of total billed charges,16.57,76,,,percent of total billed charges,76% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rate,17.44,80,,,percent of total billed charges,80% of total billed charges,8.46,38.8,,,percent of total billed charges,38.8% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.46,21.8,
"ANTI-EMBOLISM STOCKING, THIGH LG SHORT",52875,CDM,270,RC,,,OUTPATIENT,,,27.3,21.84,,20.48,75,,,percent of total billed charges,75% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,21.62,79.2,,,percent of total billed charges,79.2% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,27.3,100,,,fee schedule,100% of CO APG rates,25.94,95,,,percent of total billed charges,95% of total billed charges,21.84,80,,,percent of total billed charges,80% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,24.57,90,,,percent of total billed charges,90% of total billed charges,27.3,100,,,fee schedule,100% of CO APG rates,27.3,100,,,fee schedule,100% of CO APG rates,27.3,100,,,fee schedule,100% of NM fee schedule,10.92,40,,,percent of total billed charges,40% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,24.57,90,,,percent of total billed charges,90% of total billed charges,20.75,76,,,percent of total billed charges,76% of total billed charges,10.92,40,,,percent of total billed charges,40% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,27.3,100,,,fee schedule,100% of CO APG rate,21.84,80,,,percent of total billed charges,80% of total billed charges,10.59,38.8,,,percent of total billed charges,38.8% of total billed charges,23.21,85,,,percent of total billed charges,85% of total billed charges,27.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,10.59,27.3,
"DRILL BIT, 2.6MM X 220MM, AO",460ECON0227,CDM,270,RC,,,OUTPATIENT,,,672.9,538.32,,504.68,75,,,percent of total billed charges,75% of total billed charges,269.16,40,,,percent of total billed charges,40% of total billed charges,532.94,79.2,,,percent of total billed charges,79.2% of total billed charges,571.97,85,,,percent of total billed charges,85% of total billed charges,672.9,100,,,fee schedule,100% of CO APG rates,639.26,95,,,percent of total billed charges,95% of total billed charges,538.32,80,,,percent of total billed charges,80% of total billed charges,571.97,85,,,percent of total billed charges,85% of total billed charges,605.61,90,,,percent of total billed charges,90% of total billed charges,672.9,100,,,fee schedule,100% of CO APG rates,672.9,100,,,fee schedule,100% of CO APG rates,672.9,100,,,fee schedule,100% of NM fee schedule,269.16,40,,,percent of total billed charges,40% of total billed charges,269.16,40,,,percent of total billed charges,40% of total billed charges,605.61,90,,,percent of total billed charges,90% of total billed charges,511.4,76,,,percent of total billed charges,76% of total billed charges,269.16,40,,,percent of total billed charges,40% of total billed charges,571.97,85,,,percent of total billed charges,85% of total billed charges,672.9,100,,,fee schedule,100% of CO APG rate,538.32,80,,,percent of total billed charges,80% of total billed charges,261.09,38.8,,,percent of total billed charges,38.8% of total billed charges,571.97,85,,,percent of total billed charges,85% of total billed charges,672.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,261.09,672.9,
"ANTERIOR MIDSHAFT PLATE, 6 HOLES, 75MM",460ECON0228,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"ANTERIOR MIDSHAFT PLATE, 7 HOLES, 86MM",460ECON0229,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"ANTERIOR MIDSHAFT PLATE, 8 HOLES, 97MM",460ECON0230,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"ANTERIOR MIDSHAFT PLATE, 10 HOLES, 118MM",460ECON0231,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"ANTERIOR LATERAL PLATE, 6 HOLES, 59MM",460ECON0232,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"ANTERIOR LATERAL PLATE, 7 HOLES, 72MM",460ECON0233,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"ANTERIOR LATERAL PLATE, 8 HOLES, 83MM",460ECON0234,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"SUPERIOR MIDSHAFT PLATE, DECREASED CURVATRUE, 7 HOLE- LEFT,",460ECON0236,CDM,278,RC,,,OUTPATIENT,,,2105,1684,,1578.75,75,,,percent of total billed charges,75% of total billed charges,842,40,,,percent of total billed charges,40% of total billed charges,1667.16,79.2,,,percent of total billed charges,79.2% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,2105,100,,,fee schedule,100% of CO APG rates,1999.75,95,,,percent of total billed charges,95% of total billed charges,1684,80,,,percent of total billed charges,80% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,1894.5,90,,,percent of total billed charges,90% of total billed charges,2105,100,,,fee schedule,100% of CO APG rates,2105,100,,,fee schedule,100% of CO APG rates,2105,100,,,fee schedule,100% of NM fee schedule,842,40,,,percent of total billed charges,40% of total billed charges,842,40,,,percent of total billed charges,40% of total billed charges,1894.5,90,,,percent of total billed charges,90% of total billed charges,1599.8,76,,,percent of total billed charges,76% of total billed charges,842,40,,,percent of total billed charges,40% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,2105,100,,,fee schedule,100% of CO APG rate,1684,80,,,percent of total billed charges,80% of total billed charges,816.74,38.8,,,percent of total billed charges,38.8% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,2105,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,816.74,2105,
"SUPERIOR MIDSHAFT PLATE, DECREASED CURVATRUE, 8 HOLE- LEFT,",460ECON0237,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"SUPERIOR MIDSHAFT PLATE, DECREASED CURVATRUE, 10 HOLE- LEFT,",460ECON0238,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"SUPERIOR PLATE DECREASED, 6 HOLE BRIDGE- LEFT",460ECON0239,CDM,278,RC,,,OUTPATIENT,,,2572.4,2057.92,,1929.3,75,,,percent of total billed charges,75% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2037.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2443.78,95,,,percent of total billed charges,95% of total billed charges,2057.92,80,,,percent of total billed charges,80% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of NM fee schedule,1028.96,40,,,percent of total billed charges,40% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,1955.02,76,,,percent of total billed charges,76% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rate,2057.92,80,,,percent of total billed charges,80% of total billed charges,998.09,38.8,,,percent of total billed charges,38.8% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of APG fee schedule,5144.8,200,,,percent of total billed charges,200% of total billed charges,998.09,5144.8,
"SUPERIOR PLATE DECREASED, 8 HOLE BRIDGE- LEFT",460ECON0240,CDM,278,RC,,,OUTPATIENT,,,2572.4,2057.92,,1929.3,75,,,percent of total billed charges,75% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2037.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2443.78,95,,,percent of total billed charges,95% of total billed charges,2057.92,80,,,percent of total billed charges,80% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of NM fee schedule,1028.96,40,,,percent of total billed charges,40% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,1955.02,76,,,percent of total billed charges,76% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rate,2057.92,80,,,percent of total billed charges,80% of total billed charges,998.09,38.8,,,percent of total billed charges,38.8% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of APG fee schedule,5144.8,200,,,percent of total billed charges,200% of total billed charges,998.09,5144.8,
"SUPERIOR PLATE DECREASED, 6 HOLE- RIGHT",ECON0241,CDM,278,RC,,,OUTPATIENT,,,2105,1684,,1578.75,75,,,percent of total billed charges,75% of total billed charges,842,40,,,percent of total billed charges,40% of total billed charges,1667.16,79.2,,,percent of total billed charges,79.2% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,2105,100,,,fee schedule,100% of CO APG rates,1999.75,95,,,percent of total billed charges,95% of total billed charges,1684,80,,,percent of total billed charges,80% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,1894.5,90,,,percent of total billed charges,90% of total billed charges,2105,100,,,fee schedule,100% of CO APG rates,2105,100,,,fee schedule,100% of CO APG rates,2105,100,,,fee schedule,100% of NM fee schedule,842,40,,,percent of total billed charges,40% of total billed charges,842,40,,,percent of total billed charges,40% of total billed charges,1894.5,90,,,percent of total billed charges,90% of total billed charges,1599.8,76,,,percent of total billed charges,76% of total billed charges,842,40,,,percent of total billed charges,40% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,2105,100,,,fee schedule,100% of CO APG rate,1684,80,,,percent of total billed charges,80% of total billed charges,816.74,38.8,,,percent of total billed charges,38.8% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,2105,100,,,fee schedule,100% of APG fee schedule,4210,200,,,percent of total billed charges,200% of total billed charges,816.74,4210,
"SUPERIOR PLATE DECREASED, 7 HOLE- RIGHT",460ECON0242,CDM,278,RC,,,OUTPATIENT,,,2105,1684,,1578.75,75,,,percent of total billed charges,75% of total billed charges,842,40,,,percent of total billed charges,40% of total billed charges,1667.16,79.2,,,percent of total billed charges,79.2% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,2105,100,,,fee schedule,100% of CO APG rates,1999.75,95,,,percent of total billed charges,95% of total billed charges,1684,80,,,percent of total billed charges,80% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,1894.5,90,,,percent of total billed charges,90% of total billed charges,2105,100,,,fee schedule,100% of CO APG rates,2105,100,,,fee schedule,100% of CO APG rates,2105,100,,,fee schedule,100% of NM fee schedule,842,40,,,percent of total billed charges,40% of total billed charges,842,40,,,percent of total billed charges,40% of total billed charges,1894.5,90,,,percent of total billed charges,90% of total billed charges,1599.8,76,,,percent of total billed charges,76% of total billed charges,842,40,,,percent of total billed charges,40% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,2105,100,,,fee schedule,100% of CO APG rate,1684,80,,,percent of total billed charges,80% of total billed charges,816.74,38.8,,,percent of total billed charges,38.8% of total billed charges,1789.25,85,,,percent of total billed charges,85% of total billed charges,2105,100,,,fee schedule,100% of APG fee schedule,4210,200,,,percent of total billed charges,200% of total billed charges,816.74,4210,
"SUPERIOR PLATE DECREASED, 8 HOLE- RIGHT",460ECON0243,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,4676.4,200,,,percent of total billed charges,200% of total billed charges,907.22,4676.4,
"SUPERIOR PLATE DECREASED, 10 HOLE- RIGHT",460ECON0244,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,4676.4,200,,,percent of total billed charges,200% of total billed charges,907.22,4676.4,
"SUPERIOR PLATE DECREASED, 6 HOLE BRIDGE- RIGHT",460ECON0245,CDM,278,RC,,,OUTPATIENT,,,2572.4,2057.92,,1929.3,75,,,percent of total billed charges,75% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2037.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2443.78,95,,,percent of total billed charges,95% of total billed charges,2057.92,80,,,percent of total billed charges,80% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of NM fee schedule,1028.96,40,,,percent of total billed charges,40% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,1955.02,76,,,percent of total billed charges,76% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rate,2057.92,80,,,percent of total billed charges,80% of total billed charges,998.09,38.8,,,percent of total billed charges,38.8% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of APG fee schedule,5144.8,200,,,percent of total billed charges,200% of total billed charges,998.09,5144.8,
"SUPERIOR PLATE DECREASED, 8 HOLE BRIDGE- RIGHT",460ECON0246,CDM,278,RC,,,OUTPATIENT,,,2572.4,2057.92,,1929.3,75,,,percent of total billed charges,75% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2037.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2443.78,95,,,percent of total billed charges,95% of total billed charges,2057.92,80,,,percent of total billed charges,80% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of NM fee schedule,1028.96,40,,,percent of total billed charges,40% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,1955.02,76,,,percent of total billed charges,76% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rate,2057.92,80,,,percent of total billed charges,80% of total billed charges,998.09,38.8,,,percent of total billed charges,38.8% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of APG fee schedule,5144.8,200,,,percent of total billed charges,200% of total billed charges,998.09,5144.8,
"SUPERIOR PLACE INCREASED, 8 HOLE- LEFT",460ECON0247,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,4676.4,200,,,percent of total billed charges,200% of total billed charges,907.22,4676.4,
"SUPERIOR PLACE INCREASED, 10 HOLE- LEFT",460ECON0248,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,4676.4,200,,,percent of total billed charges,200% of total billed charges,907.22,4676.4,
"SUPERIOR PLACE INCREASED, 8 HOLE- RIGHT",460ECON0249,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,4676.4,200,,,percent of total billed charges,200% of total billed charges,907.22,4676.4,
"SUPERIOR PLATE INCREASED, 10 HOLE- RIGHT",460ECON0250,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,4676.4,200,,,percent of total billed charges,200% of total billed charges,907.22,4676.4,
"SUPERIOR PLATE INCREASED, 6 HOLE BRIDGE- LEFT",460ECON0251,CDM,278,RC,,,OUTPATIENT,,,2572.4,2057.92,,1929.3,75,,,percent of total billed charges,75% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2037.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2443.78,95,,,percent of total billed charges,95% of total billed charges,2057.92,80,,,percent of total billed charges,80% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of NM fee schedule,1028.96,40,,,percent of total billed charges,40% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,1955.02,76,,,percent of total billed charges,76% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rate,2057.92,80,,,percent of total billed charges,80% of total billed charges,998.09,38.8,,,percent of total billed charges,38.8% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of APG fee schedule,5144.8,200,,,percent of total billed charges,200% of total billed charges,998.09,5144.8,
"SUPERIOR PLATE INCREASED, 8 HOLE BRIDGE- LEFT",460ECON0252,CDM,278,RC,,,OUTPATIENT,,,2572.4,2057.92,,1929.3,75,,,percent of total billed charges,75% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2037.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2443.78,95,,,percent of total billed charges,95% of total billed charges,2057.92,80,,,percent of total billed charges,80% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of NM fee schedule,1028.96,40,,,percent of total billed charges,40% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,1955.02,76,,,percent of total billed charges,76% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rate,2057.92,80,,,percent of total billed charges,80% of total billed charges,998.09,38.8,,,percent of total billed charges,38.8% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of APG fee schedule,5144.8,200,,,percent of total billed charges,200% of total billed charges,998.09,5144.8,
"SUPERIOR PLATE INCREASED, 6 HOLE BRIDGE- RIGHT",460ECON0253,CDM,278,RC,,,OUTPATIENT,,,2572.4,2057.92,,1929.3,75,,,percent of total billed charges,75% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2037.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2443.78,95,,,percent of total billed charges,95% of total billed charges,2057.92,80,,,percent of total billed charges,80% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of NM fee schedule,1028.96,40,,,percent of total billed charges,40% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,1955.02,76,,,percent of total billed charges,76% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rate,2057.92,80,,,percent of total billed charges,80% of total billed charges,998.09,38.8,,,percent of total billed charges,38.8% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,998.09,2572.4,
"SUPERIOR PLATE INCREASED, 8 HOLE BRIDGE- RIGHT",460ECON0254,CDM,278,RC,,,OUTPATIENT,,,2572.4,2057.92,,1929.3,75,,,percent of total billed charges,75% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2037.34,79.2,,,percent of total billed charges,79.2% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2443.78,95,,,percent of total billed charges,95% of total billed charges,2057.92,80,,,percent of total billed charges,80% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of CO APG rates,2572.4,100,,,fee schedule,100% of NM fee schedule,1028.96,40,,,percent of total billed charges,40% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2315.16,90,,,percent of total billed charges,90% of total billed charges,1955.02,76,,,percent of total billed charges,76% of total billed charges,1028.96,40,,,percent of total billed charges,40% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of CO APG rate,2057.92,80,,,percent of total billed charges,80% of total billed charges,998.09,38.8,,,percent of total billed charges,38.8% of total billed charges,2186.54,85,,,percent of total billed charges,85% of total billed charges,2572.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,998.09,2572.4,
"SUPERIOR LATERAL PLATE, 3 HOLE- LEFT",460ECON0255,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"SUPERIOR LATERAL PLATE, 4 HOLE- LEFT",460ECON0256,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"SUPERIOR LATERAL PLATE, 5 HOLE- LEFT",460ECON0257,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"SUPERIOR LATERAL PLATE, 7 HOLE- LEFT",460ECON0258,CDM,278,RC,,,OUTPATIENT,,,2884.4,2307.52,,2163.3,75,,,percent of total billed charges,75% of total billed charges,1153.76,40,,,percent of total billed charges,40% of total billed charges,2284.44,79.2,,,percent of total billed charges,79.2% of total billed charges,2451.74,85,,,percent of total billed charges,85% of total billed charges,2884.4,100,,,fee schedule,100% of CO APG rates,2740.18,95,,,percent of total billed charges,95% of total billed charges,2307.52,80,,,percent of total billed charges,80% of total billed charges,2451.74,85,,,percent of total billed charges,85% of total billed charges,2595.96,90,,,percent of total billed charges,90% of total billed charges,2884.4,100,,,fee schedule,100% of CO APG rates,2884.4,100,,,fee schedule,100% of CO APG rates,2884.4,100,,,fee schedule,100% of NM fee schedule,1153.76,40,,,percent of total billed charges,40% of total billed charges,1153.76,40,,,percent of total billed charges,40% of total billed charges,2595.96,90,,,percent of total billed charges,90% of total billed charges,2192.14,76,,,percent of total billed charges,76% of total billed charges,1153.76,40,,,percent of total billed charges,40% of total billed charges,2451.74,85,,,percent of total billed charges,85% of total billed charges,2884.4,100,,,fee schedule,100% of CO APG rate,2307.52,80,,,percent of total billed charges,80% of total billed charges,1119.15,38.8,,,percent of total billed charges,38.8% of total billed charges,2451.74,85,,,percent of total billed charges,85% of total billed charges,2884.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1119.15,2884.4,
"SUPERIOR LATERAL PLATE, 7 HOLE- RIGHT",460ECON0262,CDM,278,RC,,,OUTPATIENT,,,2884.4,2307.52,,2163.3,75,,,percent of total billed charges,75% of total billed charges,1153.76,40,,,percent of total billed charges,40% of total billed charges,2284.44,79.2,,,percent of total billed charges,79.2% of total billed charges,2451.74,85,,,percent of total billed charges,85% of total billed charges,2884.4,100,,,fee schedule,100% of CO APG rates,2740.18,95,,,percent of total billed charges,95% of total billed charges,2307.52,80,,,percent of total billed charges,80% of total billed charges,2451.74,85,,,percent of total billed charges,85% of total billed charges,2595.96,90,,,percent of total billed charges,90% of total billed charges,2884.4,100,,,fee schedule,100% of CO APG rates,2884.4,100,,,fee schedule,100% of CO APG rates,2884.4,100,,,fee schedule,100% of NM fee schedule,1153.76,40,,,percent of total billed charges,40% of total billed charges,1153.76,40,,,percent of total billed charges,40% of total billed charges,2595.96,90,,,percent of total billed charges,90% of total billed charges,2192.14,76,,,percent of total billed charges,76% of total billed charges,1153.76,40,,,percent of total billed charges,40% of total billed charges,2451.74,85,,,percent of total billed charges,85% of total billed charges,2884.4,100,,,fee schedule,100% of CO APG rate,2307.52,80,,,percent of total billed charges,80% of total billed charges,1119.15,38.8,,,percent of total billed charges,38.8% of total billed charges,2451.74,85,,,percent of total billed charges,85% of total billed charges,2884.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1119.15,2884.4,
"SUPERIOR LATERAL PLATE, 5 HOLE- RIGHT",460ECON0261,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"SUPERIOR LATERAL PLATE, 4 HOLE- RIGHT",460ECON0260,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
"SUPERIOR LATERAL PLATE, 3 HOLE- RIGHT",460ECON0259,CDM,278,RC,,,OUTPATIENT,,,2338.2,1870.56,,1753.65,75,,,percent of total billed charges,75% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1851.85,79.2,,,percent of total billed charges,79.2% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2221.29,95,,,percent of total billed charges,95% of total billed charges,1870.56,80,,,percent of total billed charges,80% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of CO APG rates,2338.2,100,,,fee schedule,100% of NM fee schedule,935.28,40,,,percent of total billed charges,40% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,2104.38,90,,,percent of total billed charges,90% of total billed charges,1777.03,76,,,percent of total billed charges,76% of total billed charges,935.28,40,,,percent of total billed charges,40% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of CO APG rate,1870.56,80,,,percent of total billed charges,80% of total billed charges,907.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1987.47,85,,,percent of total billed charges,85% of total billed charges,2338.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,907.22,2338.2,
AIR PUSHER/CUTTER WITH SLED,46052701,CDM,270,RC,,,OUTPATIENT,,,742.8,594.24,,557.1,75,,,percent of total billed charges,75% of total billed charges,297.12,40,,,percent of total billed charges,40% of total billed charges,588.3,79.2,,,percent of total billed charges,79.2% of total billed charges,631.38,85,,,percent of total billed charges,85% of total billed charges,742.8,100,,,fee schedule,100% of CO APG rates,705.66,95,,,percent of total billed charges,95% of total billed charges,594.24,80,,,percent of total billed charges,80% of total billed charges,631.38,85,,,percent of total billed charges,85% of total billed charges,668.52,90,,,percent of total billed charges,90% of total billed charges,742.8,100,,,fee schedule,100% of CO APG rates,742.8,100,,,fee schedule,100% of CO APG rates,742.8,100,,,fee schedule,100% of NM fee schedule,297.12,40,,,percent of total billed charges,40% of total billed charges,297.12,40,,,percent of total billed charges,40% of total billed charges,668.52,90,,,percent of total billed charges,90% of total billed charges,564.53,76,,,percent of total billed charges,76% of total billed charges,297.12,40,,,percent of total billed charges,40% of total billed charges,631.38,85,,,percent of total billed charges,85% of total billed charges,742.8,100,,,fee schedule,100% of CO APG rate,594.24,80,,,percent of total billed charges,80% of total billed charges,288.21,38.8,,,percent of total billed charges,38.8% of total billed charges,631.38,85,,,percent of total billed charges,85% of total billed charges,742.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,288.21,742.8,
"DRILL BIT, AO DIA 2.0mm x 135mm, SCALED",460ECON0263,CDM,270,RC,,,OUTPATIENT,,,589.9,471.92,,442.43,75,,,percent of total billed charges,75% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,467.2,79.2,,,percent of total billed charges,79.2% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rates,560.41,95,,,percent of total billed charges,95% of total billed charges,471.92,80,,,percent of total billed charges,80% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,530.91,90,,,percent of total billed charges,90% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rates,589.9,100,,,fee schedule,100% of CO APG rates,589.9,100,,,fee schedule,100% of NM fee schedule,235.96,40,,,percent of total billed charges,40% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,530.91,90,,,percent of total billed charges,90% of total billed charges,448.32,76,,,percent of total billed charges,76% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rate,471.92,80,,,percent of total billed charges,80% of total billed charges,228.88,38.8,,,percent of total billed charges,38.8% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.88,589.9,
"DRILL BIT, AO DIA 2.6mm x 135mm, SCALED",460ECON0264,CDM,270,RC,,,OUTPATIENT,,,589.9,471.92,,442.43,75,,,percent of total billed charges,75% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,467.2,79.2,,,percent of total billed charges,79.2% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rates,560.41,95,,,percent of total billed charges,95% of total billed charges,471.92,80,,,percent of total billed charges,80% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,530.91,90,,,percent of total billed charges,90% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rates,589.9,100,,,fee schedule,100% of CO APG rates,589.9,100,,,fee schedule,100% of NM fee schedule,235.96,40,,,percent of total billed charges,40% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,530.91,90,,,percent of total billed charges,90% of total billed charges,448.32,76,,,percent of total billed charges,76% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rate,471.92,80,,,percent of total billed charges,80% of total billed charges,228.88,38.8,,,percent of total billed charges,38.8% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.88,589.9,
"OVERDRILL AO, DIA 3.5mm x 122mm",460ECON0265,CDM,270,RC,,,OUTPATIENT,,,589.9,471.92,,442.43,75,,,percent of total billed charges,75% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,467.2,79.2,,,percent of total billed charges,79.2% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rates,560.41,95,,,percent of total billed charges,95% of total billed charges,471.92,80,,,percent of total billed charges,80% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,530.91,90,,,percent of total billed charges,90% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rates,589.9,100,,,fee schedule,100% of CO APG rates,589.9,100,,,fee schedule,100% of NM fee schedule,235.96,40,,,percent of total billed charges,40% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,530.91,90,,,percent of total billed charges,90% of total billed charges,448.32,76,,,percent of total billed charges,76% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rate,471.92,80,,,percent of total billed charges,80% of total billed charges,228.88,38.8,,,percent of total billed charges,38.8% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.88,589.9,
"OVERDRILL AO, DIA 2.7mm x 122mm",460ECON0266,CDM,270,RC,,,OUTPATIENT,,,589.9,471.92,,442.43,75,,,percent of total billed charges,75% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,467.2,79.2,,,percent of total billed charges,79.2% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rates,560.41,95,,,percent of total billed charges,95% of total billed charges,471.92,80,,,percent of total billed charges,80% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,530.91,90,,,percent of total billed charges,90% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rates,589.9,100,,,fee schedule,100% of CO APG rates,589.9,100,,,fee schedule,100% of NM fee schedule,235.96,40,,,percent of total billed charges,40% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,530.91,90,,,percent of total billed charges,90% of total billed charges,448.32,76,,,percent of total billed charges,76% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of CO APG rate,471.92,80,,,percent of total billed charges,80% of total billed charges,228.88,38.8,,,percent of total billed charges,38.8% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,589.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.88,589.9,
"SPEEDGUIDE DRILL AO, DIA 2.0mm (L = 30mm)",460ECON0267,CDM,270,RC,,,OUTPATIENT,,,660.9,528.72,,495.68,75,,,percent of total billed charges,75% of total billed charges,264.36,40,,,percent of total billed charges,40% of total billed charges,523.43,79.2,,,percent of total billed charges,79.2% of total billed charges,561.77,85,,,percent of total billed charges,85% of total billed charges,660.9,100,,,fee schedule,100% of CO APG rates,627.86,95,,,percent of total billed charges,95% of total billed charges,528.72,80,,,percent of total billed charges,80% of total billed charges,561.77,85,,,percent of total billed charges,85% of total billed charges,594.81,90,,,percent of total billed charges,90% of total billed charges,660.9,100,,,fee schedule,100% of CO APG rates,660.9,100,,,fee schedule,100% of CO APG rates,660.9,100,,,fee schedule,100% of NM fee schedule,264.36,40,,,percent of total billed charges,40% of total billed charges,264.36,40,,,percent of total billed charges,40% of total billed charges,594.81,90,,,percent of total billed charges,90% of total billed charges,502.28,76,,,percent of total billed charges,76% of total billed charges,264.36,40,,,percent of total billed charges,40% of total billed charges,561.77,85,,,percent of total billed charges,85% of total billed charges,660.9,100,,,fee schedule,100% of CO APG rate,528.72,80,,,percent of total billed charges,80% of total billed charges,256.43,38.8,,,percent of total billed charges,38.8% of total billed charges,561.77,85,,,percent of total billed charges,85% of total billed charges,660.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,256.43,660.9,
"SPEEDGUIDE DRILL AO, DIA 2.6mm (L = 30mm)",460ECON0268,CDM,270,RC,,,OUTPATIENT,,,660.9,528.72,,495.68,75,,,percent of total billed charges,75% of total billed charges,264.36,40,,,percent of total billed charges,40% of total billed charges,523.43,79.2,,,percent of total billed charges,79.2% of total billed charges,561.77,85,,,percent of total billed charges,85% of total billed charges,660.9,100,,,fee schedule,100% of CO APG rates,627.86,95,,,percent of total billed charges,95% of total billed charges,528.72,80,,,percent of total billed charges,80% of total billed charges,561.77,85,,,percent of total billed charges,85% of total billed charges,594.81,90,,,percent of total billed charges,90% of total billed charges,660.9,100,,,fee schedule,100% of CO APG rates,660.9,100,,,fee schedule,100% of CO APG rates,660.9,100,,,fee schedule,100% of NM fee schedule,264.36,40,,,percent of total billed charges,40% of total billed charges,264.36,40,,,percent of total billed charges,40% of total billed charges,594.81,90,,,percent of total billed charges,90% of total billed charges,502.28,76,,,percent of total billed charges,76% of total billed charges,264.36,40,,,percent of total billed charges,40% of total billed charges,561.77,85,,,percent of total billed charges,85% of total billed charges,660.9,100,,,fee schedule,100% of CO APG rate,528.72,80,,,percent of total billed charges,80% of total billed charges,256.43,38.8,,,percent of total billed charges,38.8% of total billed charges,561.77,85,,,percent of total billed charges,85% of total billed charges,660.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,256.43,660.9,
"TAP AO, FOR 3.5mm SCREWS",460ECON0269,CDM,270,RC,,,OUTPATIENT,,,1114.4,891.52,,835.8,75,,,percent of total billed charges,75% of total billed charges,445.76,40,,,percent of total billed charges,40% of total billed charges,882.6,79.2,,,percent of total billed charges,79.2% of total billed charges,947.24,85,,,percent of total billed charges,85% of total billed charges,1114.4,100,,,fee schedule,100% of CO APG rates,1058.68,95,,,percent of total billed charges,95% of total billed charges,891.52,80,,,percent of total billed charges,80% of total billed charges,947.24,85,,,percent of total billed charges,85% of total billed charges,1002.96,90,,,percent of total billed charges,90% of total billed charges,1114.4,100,,,fee schedule,100% of CO APG rates,1114.4,100,,,fee schedule,100% of CO APG rates,1114.4,100,,,fee schedule,100% of NM fee schedule,445.76,40,,,percent of total billed charges,40% of total billed charges,445.76,40,,,percent of total billed charges,40% of total billed charges,1002.96,90,,,percent of total billed charges,90% of total billed charges,846.94,76,,,percent of total billed charges,76% of total billed charges,445.76,40,,,percent of total billed charges,40% of total billed charges,947.24,85,,,percent of total billed charges,85% of total billed charges,1114.4,100,,,fee schedule,100% of CO APG rate,891.52,80,,,percent of total billed charges,80% of total billed charges,432.39,38.8,,,percent of total billed charges,38.8% of total billed charges,947.24,85,,,percent of total billed charges,85% of total billed charges,1114.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,432.39,1114.4,
"TAP AO, FOR 2.7mm SCREWS",460ECON0270,CDM,270,RC,,,OUTPATIENT,,,1114.4,891.52,,835.8,75,,,percent of total billed charges,75% of total billed charges,445.76,40,,,percent of total billed charges,40% of total billed charges,882.6,79.2,,,percent of total billed charges,79.2% of total billed charges,947.24,85,,,percent of total billed charges,85% of total billed charges,1114.4,100,,,fee schedule,100% of CO APG rates,1058.68,95,,,percent of total billed charges,95% of total billed charges,891.52,80,,,percent of total billed charges,80% of total billed charges,947.24,85,,,percent of total billed charges,85% of total billed charges,1002.96,90,,,percent of total billed charges,90% of total billed charges,1114.4,100,,,fee schedule,100% of CO APG rates,1114.4,100,,,fee schedule,100% of CO APG rates,1114.4,100,,,fee schedule,100% of NM fee schedule,445.76,40,,,percent of total billed charges,40% of total billed charges,445.76,40,,,percent of total billed charges,40% of total billed charges,1002.96,90,,,percent of total billed charges,90% of total billed charges,846.94,76,,,percent of total billed charges,76% of total billed charges,445.76,40,,,percent of total billed charges,40% of total billed charges,947.24,85,,,percent of total billed charges,85% of total billed charges,1114.4,100,,,fee schedule,100% of CO APG rate,891.52,80,,,percent of total billed charges,80% of total billed charges,432.39,38.8,,,percent of total billed charges,38.8% of total billed charges,947.24,85,,,percent of total billed charges,85% of total billed charges,1114.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,432.39,1114.4,
WASHER T8  T10 SCREWS 2.4mm / 2.7mm / 3.5mm,460ECON0271,CDM,270,RC,,,OUTPATIENT,,,140.9,112.72,,105.68,75,,,percent of total billed charges,75% of total billed charges,56.36,40,,,percent of total billed charges,40% of total billed charges,111.59,79.2,,,percent of total billed charges,79.2% of total billed charges,119.77,85,,,percent of total billed charges,85% of total billed charges,140.9,100,,,fee schedule,100% of CO APG rates,133.86,95,,,percent of total billed charges,95% of total billed charges,112.72,80,,,percent of total billed charges,80% of total billed charges,119.77,85,,,percent of total billed charges,85% of total billed charges,126.81,90,,,percent of total billed charges,90% of total billed charges,140.9,100,,,fee schedule,100% of CO APG rates,140.9,100,,,fee schedule,100% of CO APG rates,140.9,100,,,fee schedule,100% of NM fee schedule,56.36,40,,,percent of total billed charges,40% of total billed charges,56.36,40,,,percent of total billed charges,40% of total billed charges,126.81,90,,,percent of total billed charges,90% of total billed charges,107.08,76,,,percent of total billed charges,76% of total billed charges,56.36,40,,,percent of total billed charges,40% of total billed charges,119.77,85,,,percent of total billed charges,85% of total billed charges,140.9,100,,,fee schedule,100% of CO APG rate,112.72,80,,,percent of total billed charges,80% of total billed charges,54.67,38.8,,,percent of total billed charges,38.8% of total billed charges,119.77,85,,,percent of total billed charges,85% of total billed charges,140.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,54.67,140.9,
LOCKING SCREW T10 FULL THREAD 2.7mm / L8mm,460ECON0272,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
ASNIS III CANNULATED DRILL 5.6MM LG AO,46052702,CDM,270,RC,,,OUTPATIENT,,,140.9,112.72,,105.68,75,,,percent of total billed charges,75% of total billed charges,56.36,40,,,percent of total billed charges,40% of total billed charges,111.59,79.2,,,percent of total billed charges,79.2% of total billed charges,119.77,85,,,percent of total billed charges,85% of total billed charges,140.9,100,,,fee schedule,100% of CO APG rates,133.86,95,,,percent of total billed charges,95% of total billed charges,112.72,80,,,percent of total billed charges,80% of total billed charges,119.77,85,,,percent of total billed charges,85% of total billed charges,126.81,90,,,percent of total billed charges,90% of total billed charges,140.9,100,,,fee schedule,100% of CO APG rates,140.9,100,,,fee schedule,100% of CO APG rates,140.9,100,,,fee schedule,100% of NM fee schedule,56.36,40,,,percent of total billed charges,40% of total billed charges,56.36,40,,,percent of total billed charges,40% of total billed charges,126.81,90,,,percent of total billed charges,90% of total billed charges,107.08,76,,,percent of total billed charges,76% of total billed charges,56.36,40,,,percent of total billed charges,40% of total billed charges,119.77,85,,,percent of total billed charges,85% of total billed charges,140.9,100,,,fee schedule,100% of CO APG rate,112.72,80,,,percent of total billed charges,80% of total billed charges,54.67,38.8,,,percent of total billed charges,38.8% of total billed charges,119.77,85,,,percent of total billed charges,85% of total billed charges,140.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,54.67,140.9,
29505 Application Of Long Leg Splint,60000071,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,454.5,363.6,,340.88,75,,,percent of total billed charges,75% of total billed charges,181.8,40,,,percent of total billed charges,40% of total billed charges,359.96,79.2,,,percent of total billed charges,79.2% of total billed charges,386.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,431.78,95,,,percent of total billed charges,95% of total billed charges,363.6,80,,,percent of total billed charges,80% of total billed charges,386.33,85,,,percent of total billed charges,85% of total billed charges,409.05,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,181.8,40,,,percent of total billed charges,40% of total billed charges,181.8,40,,,percent of total billed charges,40% of total billed charges,409.05,90,,,percent of total billed charges,90% of total billed charges,345.42,76,,,percent of total billed charges,76% of total billed charges,181.8,40,,,percent of total billed charges,40% of total billed charges,386.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,363.6,80,,,percent of total billed charges,80% of total billed charges,176.35,38.8,,,percent of total billed charges,38.8% of total billed charges,386.33,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,176.35,431.78,
82570 Creatinine; other source,40082570,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,65.8,52.64,,49.35,75,,,percent of total billed charges,75% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,52.11,79.2,,,percent of total billed charges,79.2% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,62.51,95,,,percent of total billed charges,95% of total billed charges,52.64,80,,,percent of total billed charges,80% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,26.32,40,,,percent of total billed charges,40% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,50.01,76,,,percent of total billed charges,76% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,52.64,80,,,percent of total billed charges,80% of total billed charges,25.53,38.8,,,percent of total billed charges,38.8% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,62.51,
82533 Cortisol; total,40082533,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,158.1,126.48,,118.58,75,,,percent of total billed charges,75% of total billed charges,63.24,40,,,percent of total billed charges,40% of total billed charges,125.22,79.2,,,percent of total billed charges,79.2% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,150.2,95,,,percent of total billed charges,95% of total billed charges,126.48,80,,,percent of total billed charges,80% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,142.29,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,63.24,40,,,percent of total billed charges,40% of total billed charges,63.24,40,,,percent of total billed charges,40% of total billed charges,142.29,90,,,percent of total billed charges,90% of total billed charges,120.16,76,,,percent of total billed charges,76% of total billed charges,63.24,40,,,percent of total billed charges,40% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,126.48,80,,,percent of total billed charges,80% of total billed charges,61.34,38.8,,,percent of total billed charges,38.8% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,150.2,
82746 Folic acid; serum,40082746,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,130.5,104.4,,97.88,75,,,percent of total billed charges,75% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,103.36,79.2,,,percent of total billed charges,79.2% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,123.98,95,,,percent of total billed charges,95% of total billed charges,104.4,80,,,percent of total billed charges,80% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,117.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,52.2,40,,,percent of total billed charges,40% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,117.45,90,,,percent of total billed charges,90% of total billed charges,99.18,76,,,percent of total billed charges,76% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,104.4,80,,,percent of total billed charges,80% of total billed charges,50.63,38.8,,,percent of total billed charges,38.8% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,123.98,
"87150 Culture, typing; identification by nucleic acid (DNA o",4008150,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,65.8,52.64,,49.35,75,,,percent of total billed charges,75% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,52.11,79.2,,,percent of total billed charges,79.2% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,62.51,95,,,percent of total billed charges,95% of total billed charges,52.64,80,,,percent of total billed charges,80% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,26.32,40,,,percent of total billed charges,40% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,50.01,76,,,percent of total billed charges,76% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,52.64,80,,,percent of total billed charges,80% of total billed charges,25.53,38.8,,,percent of total billed charges,38.8% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,62.51,
82105 Alpha-fetoprotein (AFP); serum,40082105,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,139,111.2,,104.25,75,,,percent of total billed charges,75% of total billed charges,55.6,40,,,percent of total billed charges,40% of total billed charges,110.09,79.2,,,percent of total billed charges,79.2% of total billed charges,118.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,132.05,95,,,percent of total billed charges,95% of total billed charges,111.2,80,,,percent of total billed charges,80% of total billed charges,118.15,85,,,percent of total billed charges,85% of total billed charges,125.1,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,55.6,40,,,percent of total billed charges,40% of total billed charges,55.6,40,,,percent of total billed charges,40% of total billed charges,125.1,90,,,percent of total billed charges,90% of total billed charges,105.64,76,,,percent of total billed charges,76% of total billed charges,55.6,40,,,percent of total billed charges,40% of total billed charges,118.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,111.2,80,,,percent of total billed charges,80% of total billed charges,53.93,38.8,,,percent of total billed charges,38.8% of total billed charges,118.15,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,132.05,
"84702 Gonadotropin, chorionic (hCG); quantitative",40084702,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,187.9,150.32,,140.93,75,,,percent of total billed charges,75% of total billed charges,75.16,40,,,percent of total billed charges,40% of total billed charges,148.82,79.2,,,percent of total billed charges,79.2% of total billed charges,159.72,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,178.51,95,,,percent of total billed charges,95% of total billed charges,150.32,80,,,percent of total billed charges,80% of total billed charges,159.72,85,,,percent of total billed charges,85% of total billed charges,169.11,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,75.16,40,,,percent of total billed charges,40% of total billed charges,75.16,40,,,percent of total billed charges,40% of total billed charges,169.11,90,,,percent of total billed charges,90% of total billed charges,142.8,76,,,percent of total billed charges,76% of total billed charges,75.16,40,,,percent of total billed charges,40% of total billed charges,159.72,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,150.32,80,,,percent of total billed charges,80% of total billed charges,72.91,38.8,,,percent of total billed charges,38.8% of total billed charges,159.72,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,178.51,
86336 Inhibin A,40086336,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,109.2,87.36,,81.9,75,,,percent of total billed charges,75% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,86.49,79.2,,,percent of total billed charges,79.2% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,103.74,95,,,percent of total billed charges,95% of total billed charges,87.36,80,,,percent of total billed charges,80% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,43.68,40,,,percent of total billed charges,40% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,82.99,76,,,percent of total billed charges,76% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,87.36,80,,,percent of total billed charges,80% of total billed charges,42.37,38.8,,,percent of total billed charges,38.8% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,103.74,
"Immunoglobulins A/E/G/M,  LC",40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,44.1,35.28,,33.08,75,,,percent of total billed charges,75% of total billed charges,17.64,40,,,percent of total billed charges,40% of total billed charges,34.93,79.2,,,percent of total billed charges,79.2% of total billed charges,37.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,41.9,95,,,percent of total billed charges,95% of total billed charges,35.28,80,,,percent of total billed charges,80% of total billed charges,37.49,85,,,percent of total billed charges,85% of total billed charges,39.69,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,17.64,40,,,percent of total billed charges,40% of total billed charges,17.64,40,,,percent of total billed charges,40% of total billed charges,39.69,90,,,percent of total billed charges,90% of total billed charges,33.52,76,,,percent of total billed charges,76% of total billed charges,17.64,40,,,percent of total billed charges,40% of total billed charges,37.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,35.28,80,,,percent of total billed charges,80% of total billed charges,17.11,38.8,,,percent of total billed charges,38.8% of total billed charges,37.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,41.9,
85014 Blood count; hematocrit (Hct),40085014,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,39.3,31.44,,29.48,75,,,percent of total billed charges,75% of total billed charges,15.72,40,,,percent of total billed charges,40% of total billed charges,31.13,79.2,,,percent of total billed charges,79.2% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,37.34,95,,,percent of total billed charges,95% of total billed charges,31.44,80,,,percent of total billed charges,80% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,35.37,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,15.72,40,,,percent of total billed charges,40% of total billed charges,15.72,40,,,percent of total billed charges,40% of total billed charges,35.37,90,,,percent of total billed charges,90% of total billed charges,29.87,76,,,percent of total billed charges,76% of total billed charges,15.72,40,,,percent of total billed charges,40% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,31.44,80,,,percent of total billed charges,80% of total billed charges,15.25,38.8,,,percent of total billed charges,38.8% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,37.34,
82941 Gastrin,40082941,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,126.3,101.04,,94.73,75,,,percent of total billed charges,75% of total billed charges,50.52,40,,,percent of total billed charges,40% of total billed charges,100.03,79.2,,,percent of total billed charges,79.2% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,119.99,95,,,percent of total billed charges,95% of total billed charges,101.04,80,,,percent of total billed charges,80% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,113.67,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,50.52,40,,,percent of total billed charges,40% of total billed charges,50.52,40,,,percent of total billed charges,40% of total billed charges,113.67,90,,,percent of total billed charges,90% of total billed charges,95.99,76,,,percent of total billed charges,76% of total billed charges,50.52,40,,,percent of total billed charges,40% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,101.04,80,,,percent of total billed charges,80% of total billed charges,49,38.8,,,percent of total billed charges,38.8% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,119.99,
85018 Blood count; hemoglobin (Hgb),40085018,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,38.1,30.48,,28.58,75,,,percent of total billed charges,75% of total billed charges,15.24,40,,,percent of total billed charges,40% of total billed charges,30.18,79.2,,,percent of total billed charges,79.2% of total billed charges,32.39,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,36.2,95,,,percent of total billed charges,95% of total billed charges,30.48,80,,,percent of total billed charges,80% of total billed charges,32.39,85,,,percent of total billed charges,85% of total billed charges,34.29,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,15.24,40,,,percent of total billed charges,40% of total billed charges,15.24,40,,,percent of total billed charges,40% of total billed charges,34.29,90,,,percent of total billed charges,90% of total billed charges,28.96,76,,,percent of total billed charges,76% of total billed charges,15.24,40,,,percent of total billed charges,40% of total billed charges,32.39,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,30.48,80,,,percent of total billed charges,80% of total billed charges,14.78,38.8,,,percent of total billed charges,38.8% of total billed charges,32.39,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,36.2,
Immunoassay for analyte other than infectious agent antibody,40083516,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,109.2,87.36,,81.9,75,,,percent of total billed charges,75% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,86.49,79.2,,,percent of total billed charges,79.2% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,103.74,95,,,percent of total billed charges,95% of total billed charges,87.36,80,,,percent of total billed charges,80% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,43.68,40,,,percent of total billed charges,40% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,82.99,76,,,percent of total billed charges,76% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,87.36,80,,,percent of total billed charges,80% of total billed charges,42.37,38.8,,,percent of total billed charges,38.8% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,103.74,
83550 Iron binding capacity,40083550,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,80.66,
"83704 Lipoprotein, blood; quantitation of lipoprotein partic",40083704,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,130.5,104.4,,97.88,75,,,percent of total billed charges,75% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,103.36,79.2,,,percent of total billed charges,79.2% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,123.98,95,,,percent of total billed charges,95% of total billed charges,104.4,80,,,percent of total billed charges,80% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,117.45,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,52.2,40,,,percent of total billed charges,40% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,117.45,90,,,percent of total billed charges,90% of total billed charges,99.18,76,,,percent of total billed charges,76% of total billed charges,52.2,40,,,percent of total billed charges,40% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,104.4,80,,,percent of total billed charges,80% of total billed charges,50.63,38.8,,,percent of total billed charges,38.8% of total billed charges,110.93,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,123.98,
82175 Arsenic,40082175,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,106.2,84.96,,79.65,75,,,percent of total billed charges,75% of total billed charges,42.48,40,,,percent of total billed charges,40% of total billed charges,84.11,79.2,,,percent of total billed charges,79.2% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,100.89,95,,,percent of total billed charges,95% of total billed charges,84.96,80,,,percent of total billed charges,80% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,95.58,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,42.48,40,,,percent of total billed charges,40% of total billed charges,42.48,40,,,percent of total billed charges,40% of total billed charges,95.58,90,,,percent of total billed charges,90% of total billed charges,80.71,76,,,percent of total billed charges,76% of total billed charges,42.48,40,,,percent of total billed charges,40% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,84.96,80,,,percent of total billed charges,80% of total billed charges,41.21,38.8,,,percent of total billed charges,38.8% of total billed charges,90.27,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,100.89,
83655 Lead,40083655,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,78.5,62.8,,58.88,75,,,percent of total billed charges,75% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,62.17,79.2,,,percent of total billed charges,79.2% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,74.58,95,,,percent of total billed charges,95% of total billed charges,62.8,80,,,percent of total billed charges,80% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,70.65,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,31.4,40,,,percent of total billed charges,40% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,70.65,90,,,percent of total billed charges,90% of total billed charges,59.66,76,,,percent of total billed charges,76% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,62.8,80,,,percent of total billed charges,80% of total billed charges,30.46,38.8,,,percent of total billed charges,38.8% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,74.58,
"84075 Phosphatase, alkaline;",40084075,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,59.4,47.52,,44.55,75,,,percent of total billed charges,75% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,47.04,79.2,,,percent of total billed charges,79.2% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,56.43,95,,,percent of total billed charges,95% of total billed charges,47.52,80,,,percent of total billed charges,80% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,23.76,40,,,percent of total billed charges,40% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,53.46,90,,,percent of total billed charges,90% of total billed charges,45.14,76,,,percent of total billed charges,76% of total billed charges,23.76,40,,,percent of total billed charges,40% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,47.52,80,,,percent of total billed charges,80% of total billed charges,23.05,38.8,,,percent of total billed charges,38.8% of total billed charges,50.49,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,56.43,
84153 Prostate specific antigen (PSA); total,40084153,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,118.8,95.04,,89.1,75,,,percent of total billed charges,75% of total billed charges,47.52,40,,,percent of total billed charges,40% of total billed charges,94.09,79.2,,,percent of total billed charges,79.2% of total billed charges,100.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,112.86,95,,,percent of total billed charges,95% of total billed charges,95.04,80,,,percent of total billed charges,80% of total billed charges,100.98,85,,,percent of total billed charges,85% of total billed charges,106.92,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,47.52,40,,,percent of total billed charges,40% of total billed charges,47.52,40,,,percent of total billed charges,40% of total billed charges,106.92,90,,,percent of total billed charges,90% of total billed charges,90.29,76,,,percent of total billed charges,76% of total billed charges,47.52,40,,,percent of total billed charges,40% of total billed charges,100.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,95.04,80,,,percent of total billed charges,80% of total billed charges,46.09,38.8,,,percent of total billed charges,38.8% of total billed charges,100.98,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,112.86,
84166 Protein; electrophoretic fractionation and quantitatio,40084166,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,126.3,101.04,,94.73,75,,,percent of total billed charges,75% of total billed charges,50.52,40,,,percent of total billed charges,40% of total billed charges,100.03,79.2,,,percent of total billed charges,79.2% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,119.99,95,,,percent of total billed charges,95% of total billed charges,101.04,80,,,percent of total billed charges,80% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,113.67,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,50.52,40,,,percent of total billed charges,40% of total billed charges,50.52,40,,,percent of total billed charges,40% of total billed charges,113.67,90,,,percent of total billed charges,90% of total billed charges,95.99,76,,,percent of total billed charges,76% of total billed charges,50.52,40,,,percent of total billed charges,40% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,101.04,80,,,percent of total billed charges,80% of total billed charges,49,38.8,,,percent of total billed charges,38.8% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,119.99,
86335 Immunofixation electrophoresis; other fluids with conc,40086335,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,150.6,120.48,,112.95,75,,,percent of total billed charges,75% of total billed charges,60.24,40,,,percent of total billed charges,40% of total billed charges,119.28,79.2,,,percent of total billed charges,79.2% of total billed charges,128.01,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,143.07,95,,,percent of total billed charges,95% of total billed charges,120.48,80,,,percent of total billed charges,80% of total billed charges,128.01,85,,,percent of total billed charges,85% of total billed charges,135.54,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,60.24,40,,,percent of total billed charges,40% of total billed charges,60.24,40,,,percent of total billed charges,40% of total billed charges,135.54,90,,,percent of total billed charges,90% of total billed charges,114.46,76,,,percent of total billed charges,76% of total billed charges,60.24,40,,,percent of total billed charges,40% of total billed charges,128.01,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,120.48,80,,,percent of total billed charges,80% of total billed charges,58.43,38.8,,,percent of total billed charges,38.8% of total billed charges,128.01,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,143.07,
"84155 Protein, total, except by refractometry; serum, plasma",40084155,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,51.9,41.52,,38.93,75,,,percent of total billed charges,75% of total billed charges,20.76,40,,,percent of total billed charges,40% of total billed charges,41.1,79.2,,,percent of total billed charges,79.2% of total billed charges,44.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,49.31,95,,,percent of total billed charges,95% of total billed charges,41.52,80,,,percent of total billed charges,80% of total billed charges,44.12,85,,,percent of total billed charges,85% of total billed charges,46.71,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,20.76,40,,,percent of total billed charges,40% of total billed charges,20.76,40,,,percent of total billed charges,40% of total billed charges,46.71,90,,,percent of total billed charges,90% of total billed charges,39.44,76,,,percent of total billed charges,76% of total billed charges,20.76,40,,,percent of total billed charges,40% of total billed charges,44.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,41.52,80,,,percent of total billed charges,80% of total billed charges,20.14,38.8,,,percent of total billed charges,38.8% of total billed charges,44.12,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,49.31,
84403 Testosterone; total,40084403,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,177.3,141.84,,132.98,75,,,percent of total billed charges,75% of total billed charges,70.92,40,,,percent of total billed charges,40% of total billed charges,140.42,79.2,,,percent of total billed charges,79.2% of total billed charges,150.71,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,168.44,95,,,percent of total billed charges,95% of total billed charges,141.84,80,,,percent of total billed charges,80% of total billed charges,150.71,85,,,percent of total billed charges,85% of total billed charges,159.57,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,70.92,40,,,percent of total billed charges,40% of total billed charges,70.92,40,,,percent of total billed charges,40% of total billed charges,159.57,90,,,percent of total billed charges,90% of total billed charges,134.75,76,,,percent of total billed charges,76% of total billed charges,70.92,40,,,percent of total billed charges,40% of total billed charges,150.71,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,141.84,80,,,percent of total billed charges,80% of total billed charges,68.79,38.8,,,percent of total billed charges,38.8% of total billed charges,150.71,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,168.44,
86800 Thyroglobulin antibody,40086800,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,109.2,87.36,,81.9,75,,,percent of total billed charges,75% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,86.49,79.2,,,percent of total billed charges,79.2% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,103.74,95,,,percent of total billed charges,95% of total billed charges,87.36,80,,,percent of total billed charges,80% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,43.68,40,,,percent of total billed charges,40% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,82.99,76,,,percent of total billed charges,76% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,87.36,80,,,percent of total billed charges,80% of total billed charges,42.37,38.8,,,percent of total billed charges,38.8% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,103.74,
84436 Thyroxine; total,40084436,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,80.66,
82384 Catecholamines; fractionated,40082384,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,170.8,136.64,,128.1,75,,,percent of total billed charges,75% of total billed charges,68.32,40,,,percent of total billed charges,40% of total billed charges,135.27,79.2,,,percent of total billed charges,79.2% of total billed charges,145.18,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,162.26,95,,,percent of total billed charges,95% of total billed charges,136.64,80,,,percent of total billed charges,80% of total billed charges,145.18,85,,,percent of total billed charges,85% of total billed charges,153.72,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,68.32,40,,,percent of total billed charges,40% of total billed charges,68.32,40,,,percent of total billed charges,40% of total billed charges,153.72,90,,,percent of total billed charges,90% of total billed charges,129.81,76,,,percent of total billed charges,76% of total billed charges,68.32,40,,,percent of total billed charges,40% of total billed charges,145.18,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,136.64,80,,,percent of total billed charges,80% of total billed charges,66.27,38.8,,,percent of total billed charges,38.8% of total billed charges,145.18,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,162.26,
"85240 Clotting; factor VIII (AHG), 1-stage",40085240,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,187.9,150.32,,140.93,75,,,percent of total billed charges,75% of total billed charges,75.16,40,,,percent of total billed charges,40% of total billed charges,148.82,79.2,,,percent of total billed charges,79.2% of total billed charges,159.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,178.51,95,,,percent of total billed charges,95% of total billed charges,150.32,80,,,percent of total billed charges,80% of total billed charges,159.72,85,,,percent of total billed charges,85% of total billed charges,169.11,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,75.16,40,,,percent of total billed charges,40% of total billed charges,75.16,40,,,percent of total billed charges,40% of total billed charges,169.11,90,,,percent of total billed charges,90% of total billed charges,142.8,76,,,percent of total billed charges,76% of total billed charges,75.16,40,,,percent of total billed charges,40% of total billed charges,159.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,150.32,80,,,percent of total billed charges,80% of total billed charges,72.91,38.8,,,percent of total billed charges,38.8% of total billed charges,159.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,178.51,
"85245 Clotting; factor VIII, VW factor, ristocetin cofactor",40085245,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,184.6,147.68,,138.45,75,,,percent of total billed charges,75% of total billed charges,73.84,40,,,percent of total billed charges,40% of total billed charges,146.2,79.2,,,percent of total billed charges,79.2% of total billed charges,156.91,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,175.37,95,,,percent of total billed charges,95% of total billed charges,147.68,80,,,percent of total billed charges,80% of total billed charges,156.91,85,,,percent of total billed charges,85% of total billed charges,166.14,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,73.84,40,,,percent of total billed charges,40% of total billed charges,73.84,40,,,percent of total billed charges,40% of total billed charges,166.14,90,,,percent of total billed charges,90% of total billed charges,140.3,76,,,percent of total billed charges,76% of total billed charges,73.84,40,,,percent of total billed charges,40% of total billed charges,156.91,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,147.68,80,,,percent of total billed charges,80% of total billed charges,71.62,38.8,,,percent of total billed charges,38.8% of total billed charges,156.91,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,175.37,
85301 Clotting inhibitors or anticoagulants; antithrombin II,40085301,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,114.5,91.6,,85.88,75,,,percent of total billed charges,75% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,90.68,79.2,,,percent of total billed charges,79.2% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,108.78,95,,,percent of total billed charges,95% of total billed charges,91.6,80,,,percent of total billed charges,80% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,103.05,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,45.8,40,,,percent of total billed charges,40% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,103.05,90,,,percent of total billed charges,90% of total billed charges,87.02,76,,,percent of total billed charges,76% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,91.6,80,,,percent of total billed charges,80% of total billed charges,44.43,38.8,,,percent of total billed charges,38.8% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,108.78,
"85303 Clotting inhibitors or anticoagulants; protein C, acti",40085303,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,178.3,142.64,,133.73,75,,,percent of total billed charges,75% of total billed charges,71.32,40,,,percent of total billed charges,40% of total billed charges,141.21,79.2,,,percent of total billed charges,79.2% of total billed charges,151.56,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,169.39,95,,,percent of total billed charges,95% of total billed charges,142.64,80,,,percent of total billed charges,80% of total billed charges,151.56,85,,,percent of total billed charges,85% of total billed charges,160.47,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,71.32,40,,,percent of total billed charges,40% of total billed charges,71.32,40,,,percent of total billed charges,40% of total billed charges,160.47,90,,,percent of total billed charges,90% of total billed charges,135.51,76,,,percent of total billed charges,76% of total billed charges,71.32,40,,,percent of total billed charges,40% of total billed charges,151.56,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,142.64,80,,,percent of total billed charges,80% of total billed charges,69.18,38.8,,,percent of total billed charges,38.8% of total billed charges,151.56,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,169.39,
"Clotting inhibitors or anticoagulants; protein S, free",40085306,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,170.8,136.64,,128.1,75,,,percent of total billed charges,75% of total billed charges,68.32,40,,,percent of total billed charges,40% of total billed charges,135.27,79.2,,,percent of total billed charges,79.2% of total billed charges,145.18,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,162.26,95,,,percent of total billed charges,95% of total billed charges,136.64,80,,,percent of total billed charges,80% of total billed charges,145.18,85,,,percent of total billed charges,85% of total billed charges,153.72,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,68.32,40,,,percent of total billed charges,40% of total billed charges,68.32,40,,,percent of total billed charges,40% of total billed charges,153.72,90,,,percent of total billed charges,90% of total billed charges,129.81,76,,,percent of total billed charges,76% of total billed charges,68.32,40,,,percent of total billed charges,40% of total billed charges,145.18,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,136.64,80,,,percent of total billed charges,80% of total billed charges,66.27,38.8,,,percent of total billed charges,38.8% of total billed charges,145.18,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,162.26,
"85611 Prothrombin time; substitution, plasma fractions, each",40085611,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,67.9,54.32,,50.93,75,,,percent of total billed charges,75% of total billed charges,27.16,40,,,percent of total billed charges,40% of total billed charges,53.78,79.2,,,percent of total billed charges,79.2% of total billed charges,57.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,64.51,95,,,percent of total billed charges,95% of total billed charges,54.32,80,,,percent of total billed charges,80% of total billed charges,57.72,85,,,percent of total billed charges,85% of total billed charges,61.11,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,27.16,40,,,percent of total billed charges,40% of total billed charges,27.16,40,,,percent of total billed charges,40% of total billed charges,61.11,90,,,percent of total billed charges,90% of total billed charges,51.6,76,,,percent of total billed charges,76% of total billed charges,27.16,40,,,percent of total billed charges,40% of total billed charges,57.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,54.32,80,,,percent of total billed charges,80% of total billed charges,26.35,38.8,,,percent of total billed charges,38.8% of total billed charges,57.72,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,64.51,
"85732 Thromboplastin time, partial (PTT); substitution, plas",40085732,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,82.7,66.16,,62.03,75,,,percent of total billed charges,75% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,65.5,79.2,,,percent of total billed charges,79.2% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,78.57,95,,,percent of total billed charges,95% of total billed charges,66.16,80,,,percent of total billed charges,80% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,74.43,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,33.08,40,,,percent of total billed charges,40% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,74.43,90,,,percent of total billed charges,90% of total billed charges,62.85,76,,,percent of total billed charges,76% of total billed charges,33.08,40,,,percent of total billed charges,40% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,66.16,80,,,percent of total billed charges,80% of total billed charges,32.09,38.8,,,percent of total billed charges,38.8% of total billed charges,70.3,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,78.57,
86003 Allergen specific IgE; quantitative or semiquantitativ,40086003,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,36.1,28.88,,27.08,75,,,percent of total billed charges,75% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,28.59,79.2,,,percent of total billed charges,79.2% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,34.3,95,,,percent of total billed charges,95% of total billed charges,28.88,80,,,percent of total billed charges,80% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,32.49,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,14.44,40,,,percent of total billed charges,40% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,32.49,90,,,percent of total billed charges,90% of total billed charges,27.44,76,,,percent of total billed charges,76% of total billed charges,14.44,40,,,percent of total billed charges,40% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,28.88,80,,,percent of total billed charges,80% of total billed charges,14.01,38.8,,,percent of total billed charges,38.8% of total billed charges,30.69,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,34.3,
"Beta 2 Glycoprotein I antibody, each",40086146,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,108.2,86.56,,81.15,75,,,percent of total billed charges,75% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,85.69,79.2,,,percent of total billed charges,79.2% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,102.79,95,,,percent of total billed charges,95% of total billed charges,86.56,80,,,percent of total billed charges,80% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,97.38,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,43.28,40,,,percent of total billed charges,40% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,97.38,90,,,percent of total billed charges,90% of total billed charges,82.23,76,,,percent of total billed charges,76% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,86.56,80,,,percent of total billed charges,80% of total billed charges,41.98,38.8,,,percent of total billed charges,38.8% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,102.79,
"Cardiolipin (phospholipid) antibody, each Ig class",40086147,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,126.3,101.04,,94.73,75,,,percent of total billed charges,75% of total billed charges,50.52,40,,,percent of total billed charges,40% of total billed charges,100.03,79.2,,,percent of total billed charges,79.2% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,119.99,95,,,percent of total billed charges,95% of total billed charges,101.04,80,,,percent of total billed charges,80% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,113.67,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.52,40,,,percent of total billed charges,40% of total billed charges,50.52,40,,,percent of total billed charges,40% of total billed charges,113.67,90,,,percent of total billed charges,90% of total billed charges,95.99,76,,,percent of total billed charges,76% of total billed charges,50.52,40,,,percent of total billed charges,40% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,101.04,80,,,percent of total billed charges,80% of total billed charges,49,38.8,,,percent of total billed charges,38.8% of total billed charges,107.36,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,119.99,
"86160 Complement; antigen, each component",40086160,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,116.8,93.44,,87.6,75,,,percent of total billed charges,75% of total billed charges,46.72,40,,,percent of total billed charges,40% of total billed charges,92.51,79.2,,,percent of total billed charges,79.2% of total billed charges,99.28,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,110.96,95,,,percent of total billed charges,95% of total billed charges,93.44,80,,,percent of total billed charges,80% of total billed charges,99.28,85,,,percent of total billed charges,85% of total billed charges,105.12,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,46.72,40,,,percent of total billed charges,40% of total billed charges,46.72,40,,,percent of total billed charges,40% of total billed charges,105.12,90,,,percent of total billed charges,90% of total billed charges,88.77,76,,,percent of total billed charges,76% of total billed charges,46.72,40,,,percent of total billed charges,40% of total billed charges,99.28,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,93.44,80,,,percent of total billed charges,80% of total billed charges,45.32,38.8,,,percent of total billed charges,38.8% of total billed charges,99.28,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,110.96,
"86235 Extractable nuclear antigen, antibody to, any method (",40086235,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,112.4,89.92,,84.3,75,,,percent of total billed charges,75% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,89.02,79.2,,,percent of total billed charges,79.2% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,106.78,95,,,percent of total billed charges,95% of total billed charges,89.92,80,,,percent of total billed charges,80% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,101.16,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,44.96,40,,,percent of total billed charges,40% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,101.16,90,,,percent of total billed charges,90% of total billed charges,85.42,76,,,percent of total billed charges,76% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,89.92,80,,,percent of total billed charges,80% of total billed charges,43.61,38.8,,,percent of total billed charges,38.8% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,106.78,
83519 Immunoassay for analyte other than infectious agent an,40083519,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,192,153.6,,144,75,,,percent of total billed charges,75% of total billed charges,76.8,40,,,percent of total billed charges,40% of total billed charges,152.06,79.2,,,percent of total billed charges,79.2% of total billed charges,163.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,182.4,95,,,percent of total billed charges,95% of total billed charges,153.6,80,,,percent of total billed charges,80% of total billed charges,163.2,85,,,percent of total billed charges,85% of total billed charges,172.8,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,76.8,40,,,percent of total billed charges,40% of total billed charges,76.8,40,,,percent of total billed charges,40% of total billed charges,172.8,90,,,percent of total billed charges,90% of total billed charges,145.92,76,,,percent of total billed charges,76% of total billed charges,76.8,40,,,percent of total billed charges,40% of total billed charges,163.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,153.6,80,,,percent of total billed charges,80% of total billed charges,74.5,38.8,,,percent of total billed charges,38.8% of total billed charges,163.2,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,182.4,
86431 Rheumatoid factor; quantitative,40086431,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,72.1,57.68,,54.08,75,,,percent of total billed charges,75% of total billed charges,28.84,40,,,percent of total billed charges,40% of total billed charges,57.1,79.2,,,percent of total billed charges,79.2% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,68.5,95,,,percent of total billed charges,95% of total billed charges,57.68,80,,,percent of total billed charges,80% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,64.89,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,28.84,40,,,percent of total billed charges,40% of total billed charges,28.84,40,,,percent of total billed charges,40% of total billed charges,64.89,90,,,percent of total billed charges,90% of total billed charges,54.8,76,,,percent of total billed charges,76% of total billed charges,28.84,40,,,percent of total billed charges,40% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,57.68,80,,,percent of total billed charges,80% of total billed charges,27.97,38.8,,,percent of total billed charges,38.8% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,68.5,
"86256 Fluorescent noninfectious agent antibody; titer, each",40086256,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,105,84,,78.75,75,,,percent of total billed charges,75% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,83.16,79.2,,,percent of total billed charges,79.2% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,99.75,95,,,percent of total billed charges,95% of total billed charges,84,80,,,percent of total billed charges,80% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,42,40,,,percent of total billed charges,40% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,79.8,76,,,percent of total billed charges,76% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,84,80,,,percent of total billed charges,80% of total billed charges,40.74,38.8,,,percent of total billed charges,38.8% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,99.75,
83520 Immunoassay for analyte other than infectious agent an,40083520,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,75.4,60.32,,56.55,75,,,percent of total billed charges,75% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,59.72,79.2,,,percent of total billed charges,79.2% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,71.63,95,,,percent of total billed charges,95% of total billed charges,60.32,80,,,percent of total billed charges,80% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,30.16,40,,,percent of total billed charges,40% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,57.3,76,,,percent of total billed charges,76% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,60.32,80,,,percent of total billed charges,80% of total billed charges,29.26,38.8,,,percent of total billed charges,38.8% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,71.63,
"86357 Natural killer (NK) cells, total count",40086357,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,147.5,118,,110.63,75,,,percent of total billed charges,75% of total billed charges,59,40,,,percent of total billed charges,40% of total billed charges,116.82,79.2,,,percent of total billed charges,79.2% of total billed charges,125.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,140.13,95,,,percent of total billed charges,95% of total billed charges,118,80,,,percent of total billed charges,80% of total billed charges,125.38,85,,,percent of total billed charges,85% of total billed charges,132.75,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,59,40,,,percent of total billed charges,40% of total billed charges,59,40,,,percent of total billed charges,40% of total billed charges,132.75,90,,,percent of total billed charges,90% of total billed charges,112.1,76,,,percent of total billed charges,76% of total billed charges,59,40,,,percent of total billed charges,40% of total billed charges,125.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,118,80,,,percent of total billed charges,80% of total billed charges,57.23,38.8,,,percent of total billed charges,38.8% of total billed charges,125.38,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,140.13,
86606 Antibody; Aspergillus,40086606,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,79.6,63.68,,59.7,75,,,percent of total billed charges,75% of total billed charges,31.84,40,,,percent of total billed charges,40% of total billed charges,63.04,79.2,,,percent of total billed charges,79.2% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,75.62,95,,,percent of total billed charges,95% of total billed charges,63.68,80,,,percent of total billed charges,80% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,71.64,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,31.84,40,,,percent of total billed charges,40% of total billed charges,31.84,40,,,percent of total billed charges,40% of total billed charges,71.64,90,,,percent of total billed charges,90% of total billed charges,60.5,76,,,percent of total billed charges,76% of total billed charges,31.84,40,,,percent of total billed charges,40% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,63.68,80,,,percent of total billed charges,80% of total billed charges,30.88,38.8,,,percent of total billed charges,38.8% of total billed charges,67.66,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,75.62,
86611 Antibody; Bartonella,40086611,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,65.8,52.64,,49.35,75,,,percent of total billed charges,75% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,52.11,79.2,,,percent of total billed charges,79.2% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,62.51,95,,,percent of total billed charges,95% of total billed charges,52.64,80,,,percent of total billed charges,80% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,26.32,40,,,percent of total billed charges,40% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,50.01,76,,,percent of total billed charges,76% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,52.64,80,,,percent of total billed charges,80% of total billed charges,25.53,38.8,,,percent of total billed charges,38.8% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,62.51,
86615 Antibody; Bordetella,40086615,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,88,70.4,,66,75,,,percent of total billed charges,75% of total billed charges,35.2,40,,,percent of total billed charges,40% of total billed charges,69.7,79.2,,,percent of total billed charges,79.2% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,83.6,95,,,percent of total billed charges,95% of total billed charges,70.4,80,,,percent of total billed charges,80% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,79.2,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,35.2,40,,,percent of total billed charges,40% of total billed charges,35.2,40,,,percent of total billed charges,40% of total billed charges,79.2,90,,,percent of total billed charges,90% of total billed charges,66.88,76,,,percent of total billed charges,76% of total billed charges,35.2,40,,,percent of total billed charges,40% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,70.4,80,,,percent of total billed charges,80% of total billed charges,34.14,38.8,,,percent of total billed charges,38.8% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,83.6,
Antibody; Borrelia burgdorferi (Lyme disease),40086618,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,133.6,106.88,,100.2,75,,,percent of total billed charges,75% of total billed charges,53.44,40,,,percent of total billed charges,40% of total billed charges,105.81,79.2,,,percent of total billed charges,79.2% of total billed charges,113.56,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,126.92,95,,,percent of total billed charges,95% of total billed charges,106.88,80,,,percent of total billed charges,80% of total billed charges,113.56,85,,,percent of total billed charges,85% of total billed charges,120.24,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,53.44,40,,,percent of total billed charges,40% of total billed charges,53.44,40,,,percent of total billed charges,40% of total billed charges,120.24,90,,,percent of total billed charges,90% of total billed charges,101.54,76,,,percent of total billed charges,76% of total billed charges,53.44,40,,,percent of total billed charges,40% of total billed charges,113.56,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,106.88,80,,,percent of total billed charges,80% of total billed charges,51.84,38.8,,,percent of total billed charges,38.8% of total billed charges,113.56,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,126.92,
86635 Antibody; Coccidioides,40086635,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,174,139.2,,130.5,75,,,percent of total billed charges,75% of total billed charges,69.6,40,,,percent of total billed charges,40% of total billed charges,137.81,79.2,,,percent of total billed charges,79.2% of total billed charges,147.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,165.3,95,,,percent of total billed charges,95% of total billed charges,139.2,80,,,percent of total billed charges,80% of total billed charges,147.9,85,,,percent of total billed charges,85% of total billed charges,156.6,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,69.6,40,,,percent of total billed charges,40% of total billed charges,69.6,40,,,percent of total billed charges,40% of total billed charges,156.6,90,,,percent of total billed charges,90% of total billed charges,132.24,76,,,percent of total billed charges,76% of total billed charges,69.6,40,,,percent of total billed charges,40% of total billed charges,147.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,139.2,80,,,percent of total billed charges,80% of total billed charges,67.51,38.8,,,percent of total billed charges,38.8% of total billed charges,147.9,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,165.3,
"86645 Antibody; cytomegalovirus (CMV), IgM",40086645,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,111.4,89.12,,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,105.83,
"86255 Fluorescent noninfectious agent antibody; screen, each",40086255,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,129.4,103.52,,97.05,75,,,percent of total billed charges,75% of total billed charges,51.76,40,,,percent of total billed charges,40% of total billed charges,102.48,79.2,,,percent of total billed charges,79.2% of total billed charges,109.99,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,122.93,95,,,percent of total billed charges,95% of total billed charges,103.52,80,,,percent of total billed charges,80% of total billed charges,109.99,85,,,percent of total billed charges,85% of total billed charges,116.46,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,51.76,40,,,percent of total billed charges,40% of total billed charges,51.76,40,,,percent of total billed charges,40% of total billed charges,116.46,90,,,percent of total billed charges,90% of total billed charges,98.34,76,,,percent of total billed charges,76% of total billed charges,51.76,40,,,percent of total billed charges,40% of total billed charges,109.99,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,103.52,80,,,percent of total billed charges,80% of total billed charges,50.21,38.8,,,percent of total billed charges,38.8% of total billed charges,109.99,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,122.93,
86677 Antibody; Helicobacter pylori,40086677,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,131.6,105.28,,98.7,75,,,percent of total billed charges,75% of total billed charges,52.64,40,,,percent of total billed charges,40% of total billed charges,104.23,79.2,,,percent of total billed charges,79.2% of total billed charges,111.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,125.02,95,,,percent of total billed charges,95% of total billed charges,105.28,80,,,percent of total billed charges,80% of total billed charges,111.86,85,,,percent of total billed charges,85% of total billed charges,118.44,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,52.64,40,,,percent of total billed charges,40% of total billed charges,52.64,40,,,percent of total billed charges,40% of total billed charges,118.44,90,,,percent of total billed charges,90% of total billed charges,100.02,76,,,percent of total billed charges,76% of total billed charges,52.64,40,,,percent of total billed charges,40% of total billed charges,111.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,105.28,80,,,percent of total billed charges,80% of total billed charges,51.06,38.8,,,percent of total billed charges,38.8% of total billed charges,111.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,125.02,
"86696 Antibody; herpes simplex, type 2",40086696,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,99.8,79.84,,74.85,75,,,percent of total billed charges,75% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,79.04,79.2,,,percent of total billed charges,79.2% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,94.81,95,,,percent of total billed charges,95% of total billed charges,79.84,80,,,percent of total billed charges,80% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,89.82,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,39.92,40,,,percent of total billed charges,40% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,89.82,90,,,percent of total billed charges,90% of total billed charges,75.85,76,,,percent of total billed charges,76% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,79.84,80,,,percent of total billed charges,80% of total billed charges,38.72,38.8,,,percent of total billed charges,38.8% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,94.81,
86704 Hepatitis B core antibody (HBcAb); total,40086704,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,107.2,85.76,,80.4,75,,,percent of total billed charges,75% of total billed charges,42.88,40,,,percent of total billed charges,40% of total billed charges,84.9,79.2,,,percent of total billed charges,79.2% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,101.84,95,,,percent of total billed charges,95% of total billed charges,85.76,80,,,percent of total billed charges,80% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,96.48,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,42.88,40,,,percent of total billed charges,40% of total billed charges,42.88,40,,,percent of total billed charges,40% of total billed charges,96.48,90,,,percent of total billed charges,90% of total billed charges,81.47,76,,,percent of total billed charges,76% of total billed charges,42.88,40,,,percent of total billed charges,40% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,85.76,80,,,percent of total billed charges,80% of total billed charges,41.59,38.8,,,percent of total billed charges,38.8% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,101.84,
86705 Hepatitis B core antibody (HBcAb); IgM antibody,40086705,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,110.4,88.32,,82.8,75,,,percent of total billed charges,75% of total billed charges,44.16,40,,,percent of total billed charges,40% of total billed charges,87.44,79.2,,,percent of total billed charges,79.2% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,104.88,95,,,percent of total billed charges,95% of total billed charges,88.32,80,,,percent of total billed charges,80% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,44.16,40,,,percent of total billed charges,40% of total billed charges,44.16,40,,,percent of total billed charges,40% of total billed charges,99.36,90,,,percent of total billed charges,90% of total billed charges,83.9,76,,,percent of total billed charges,76% of total billed charges,44.16,40,,,percent of total billed charges,40% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,88.32,80,,,percent of total billed charges,80% of total billed charges,42.84,38.8,,,percent of total billed charges,38.8% of total billed charges,93.84,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,104.88,
86706 Hepatitis B surface antibody (HBsAb),40086706,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,108.2,86.56,,81.15,75,,,percent of total billed charges,75% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,85.69,79.2,,,percent of total billed charges,79.2% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,102.79,95,,,percent of total billed charges,95% of total billed charges,86.56,80,,,percent of total billed charges,80% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,97.38,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,43.28,40,,,percent of total billed charges,40% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,97.38,90,,,percent of total billed charges,90% of total billed charges,82.23,76,,,percent of total billed charges,76% of total billed charges,43.28,40,,,percent of total billed charges,40% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,86.56,80,,,percent of total billed charges,80% of total billed charges,41.98,38.8,,,percent of total billed charges,38.8% of total billed charges,91.97,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,102.79,
87340 Infectious agent antigen detection by immunoassay tech,40087340,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,103.9,83.12,,77.93,75,,,percent of total billed charges,75% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,82.29,79.2,,,percent of total billed charges,79.2% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,98.71,95,,,percent of total billed charges,95% of total billed charges,83.12,80,,,percent of total billed charges,80% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,41.56,40,,,percent of total billed charges,40% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,93.51,90,,,percent of total billed charges,90% of total billed charges,78.96,76,,,percent of total billed charges,76% of total billed charges,41.56,40,,,percent of total billed charges,40% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,83.12,80,,,percent of total billed charges,80% of total billed charges,40.31,38.8,,,percent of total billed charges,38.8% of total billed charges,88.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,98.71,
87350 Infectious agent antigen detection by immunoassay tech,40087350,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,80.66,
86747 Antibody; parvovirus,40086747,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,99.8,79.84,,74.85,75,,,percent of total billed charges,75% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,79.04,79.2,,,percent of total billed charges,79.2% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,94.81,95,,,percent of total billed charges,95% of total billed charges,79.84,80,,,percent of total billed charges,80% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,89.82,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,39.92,40,,,percent of total billed charges,40% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,89.82,90,,,percent of total billed charges,90% of total billed charges,75.85,76,,,percent of total billed charges,76% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,79.84,80,,,percent of total billed charges,80% of total billed charges,38.72,38.8,,,percent of total billed charges,38.8% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,94.81,
87798 Infectious agent detection by nucleic acid (DNA or RNA,40087798,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,240.9,192.72,,180.68,75,,,percent of total billed charges,75% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,190.79,79.2,,,percent of total billed charges,79.2% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,228.86,95,,,percent of total billed charges,95% of total billed charges,192.72,80,,,percent of total billed charges,80% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,216.81,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,96.36,40,,,percent of total billed charges,40% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,216.81,90,,,percent of total billed charges,90% of total billed charges,183.08,76,,,percent of total billed charges,76% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,192.72,80,,,percent of total billed charges,80% of total billed charges,93.47,38.8,,,percent of total billed charges,38.8% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,228.86,
"86788 Antibody; West Nile virus, IgM",40086788,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,97.6,78.08,,73.2,75,,,percent of total billed charges,75% of total billed charges,39.04,40,,,percent of total billed charges,40% of total billed charges,77.3,79.2,,,percent of total billed charges,79.2% of total billed charges,82.96,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,92.72,95,,,percent of total billed charges,95% of total billed charges,78.08,80,,,percent of total billed charges,80% of total billed charges,82.96,85,,,percent of total billed charges,85% of total billed charges,87.84,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,39.04,40,,,percent of total billed charges,40% of total billed charges,39.04,40,,,percent of total billed charges,40% of total billed charges,87.84,90,,,percent of total billed charges,90% of total billed charges,74.18,76,,,percent of total billed charges,76% of total billed charges,39.04,40,,,percent of total billed charges,40% of total billed charges,82.96,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,78.08,80,,,percent of total billed charges,80% of total billed charges,37.87,38.8,,,percent of total billed charges,38.8% of total billed charges,82.96,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,92.72,
"87206 Smear, primary source with interpretation; fluorescent",40087206,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,77.4,61.92,,58.05,75,,,percent of total billed charges,75% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,61.3,79.2,,,percent of total billed charges,79.2% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,73.53,95,,,percent of total billed charges,95% of total billed charges,61.92,80,,,percent of total billed charges,80% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,69.66,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,30.96,40,,,percent of total billed charges,40% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,69.66,90,,,percent of total billed charges,90% of total billed charges,58.82,76,,,percent of total billed charges,76% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,61.92,80,,,percent of total billed charges,80% of total billed charges,30.03,38.8,,,percent of total billed charges,38.8% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,73.53,
"87075 Culture, bacterial; any source, except blood, anaerobi",40087075,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,158.1,126.48,,118.58,75,,,percent of total billed charges,75% of total billed charges,63.24,40,,,percent of total billed charges,40% of total billed charges,125.22,79.2,,,percent of total billed charges,79.2% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,150.2,95,,,percent of total billed charges,95% of total billed charges,126.48,80,,,percent of total billed charges,80% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,142.29,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,63.24,40,,,percent of total billed charges,40% of total billed charges,63.24,40,,,percent of total billed charges,40% of total billed charges,142.29,90,,,percent of total billed charges,90% of total billed charges,120.16,76,,,percent of total billed charges,76% of total billed charges,63.24,40,,,percent of total billed charges,40% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,126.48,80,,,percent of total billed charges,80% of total billed charges,61.34,38.8,,,percent of total billed charges,38.8% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,150.2,
"86790 Antibody; virus, not elsewhere specified",40086790,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,113.5,90.8,,85.13,75,,,percent of total billed charges,75% of total billed charges,45.4,40,,,percent of total billed charges,40% of total billed charges,89.89,79.2,,,percent of total billed charges,79.2% of total billed charges,96.48,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,107.83,95,,,percent of total billed charges,95% of total billed charges,90.8,80,,,percent of total billed charges,80% of total billed charges,96.48,85,,,percent of total billed charges,85% of total billed charges,102.15,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,45.4,40,,,percent of total billed charges,40% of total billed charges,45.4,40,,,percent of total billed charges,40% of total billed charges,102.15,90,,,percent of total billed charges,90% of total billed charges,86.26,76,,,percent of total billed charges,76% of total billed charges,45.4,40,,,percent of total billed charges,40% of total billed charges,96.48,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,90.8,80,,,percent of total billed charges,80% of total billed charges,44.04,38.8,,,percent of total billed charges,38.8% of total billed charges,96.48,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,107.83,
86901 Blood typing; Rh (D),40586901,CDM,390,RC,86901,HCPCS,OUTPATIENT,,,68.8,55.04,,51.6,75,,,percent of total billed charges,75% of total billed charges,27.52,40,,,percent of total billed charges,40% of total billed charges,54.49,79.2,,,percent of total billed charges,79.2% of total billed charges,58.48,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,65.36,95,,,percent of total billed charges,95% of total billed charges,55.04,80,,,percent of total billed charges,80% of total billed charges,58.48,85,,,percent of total billed charges,85% of total billed charges,61.92,90,,,percent of total billed charges,90% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rates,5.65,100,,,fee schedule,100% of CO APG rates,33.96,100,,,fee schedule,100% of NM APC rate,27.52,40,,,percent of total billed charges,40% of total billed charges,27.52,40,,,percent of total billed charges,40% of total billed charges,61.92,90,,,percent of total billed charges,90% of total billed charges,52.29,76,,,percent of total billed charges,76% of total billed charges,27.52,40,,,percent of total billed charges,40% of total billed charges,58.48,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of CO APG rate,55.04,80,,,percent of total billed charges,80% of total billed charges,26.69,38.8,,,percent of total billed charges,38.8% of total billed charges,58.48,85,,,percent of total billed charges,85% of total billed charges,5.65,100,,,fee schedule,100% of APG fee schedule,5.98,200,,,fee schedule,200% of CMS fee schedule,5.65,65.36,
"87209 Smear, primary source with interpretation; complex spe",40087209,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,88,70.4,,66,75,,,percent of total billed charges,75% of total billed charges,35.2,40,,,percent of total billed charges,40% of total billed charges,69.7,79.2,,,percent of total billed charges,79.2% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,83.6,95,,,percent of total billed charges,95% of total billed charges,70.4,80,,,percent of total billed charges,80% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,79.2,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,35.2,40,,,percent of total billed charges,40% of total billed charges,35.2,40,,,percent of total billed charges,40% of total billed charges,79.2,90,,,percent of total billed charges,90% of total billed charges,66.88,76,,,percent of total billed charges,76% of total billed charges,35.2,40,,,percent of total billed charges,40% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,70.4,80,,,percent of total billed charges,80% of total billed charges,34.14,38.8,,,percent of total billed charges,38.8% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,83.6,
87254 Virus isolation; centrifuge enhanced (shell vial) tech,40087254,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,117.8,94.24,,88.35,75,,,percent of total billed charges,75% of total billed charges,47.12,40,,,percent of total billed charges,40% of total billed charges,93.3,79.2,,,percent of total billed charges,79.2% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,111.91,95,,,percent of total billed charges,95% of total billed charges,94.24,80,,,percent of total billed charges,80% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,106.02,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,47.12,40,,,percent of total billed charges,40% of total billed charges,47.12,40,,,percent of total billed charges,40% of total billed charges,106.02,90,,,percent of total billed charges,90% of total billed charges,89.53,76,,,percent of total billed charges,76% of total billed charges,47.12,40,,,percent of total billed charges,40% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,94.24,80,,,percent of total billed charges,80% of total billed charges,45.71,38.8,,,percent of total billed charges,38.8% of total billed charges,100.13,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,111.91,
87529 Infectious agent detection by nucleic acid (DNA or RNA,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,64.4,51.52,,48.3,75,,,percent of total billed charges,75% of total billed charges,25.76,40,,,percent of total billed charges,40% of total billed charges,51,79.2,,,percent of total billed charges,79.2% of total billed charges,54.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,61.18,95,,,percent of total billed charges,95% of total billed charges,51.52,80,,,percent of total billed charges,80% of total billed charges,54.74,85,,,percent of total billed charges,85% of total billed charges,57.96,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,25.76,40,,,percent of total billed charges,40% of total billed charges,25.76,40,,,percent of total billed charges,40% of total billed charges,57.96,90,,,percent of total billed charges,90% of total billed charges,48.94,76,,,percent of total billed charges,76% of total billed charges,25.76,40,,,percent of total billed charges,40% of total billed charges,54.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,51.52,80,,,percent of total billed charges,80% of total billed charges,24.99,38.8,,,percent of total billed charges,38.8% of total billed charges,54.74,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,61.18,
87591 Infectious agent detection by nucleic acid (DNA or RNA,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,163.4,130.72,,122.55,75,,,percent of total billed charges,75% of total billed charges,65.36,40,,,percent of total billed charges,40% of total billed charges,129.41,79.2,,,percent of total billed charges,79.2% of total billed charges,138.89,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,155.23,95,,,percent of total billed charges,95% of total billed charges,130.72,80,,,percent of total billed charges,80% of total billed charges,138.89,85,,,percent of total billed charges,85% of total billed charges,147.06,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,65.36,40,,,percent of total billed charges,40% of total billed charges,65.36,40,,,percent of total billed charges,40% of total billed charges,147.06,90,,,percent of total billed charges,90% of total billed charges,124.18,76,,,percent of total billed charges,76% of total billed charges,65.36,40,,,percent of total billed charges,40% of total billed charges,138.89,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,130.72,80,,,percent of total billed charges,80% of total billed charges,63.4,38.8,,,percent of total billed charges,38.8% of total billed charges,138.89,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,155.23,
87798 Infectious agent detection by nucleic acid (DNA or RNA,40087798,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,240.9,192.72,,180.68,75,,,percent of total billed charges,75% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,190.79,79.2,,,percent of total billed charges,79.2% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,228.86,95,,,percent of total billed charges,95% of total billed charges,192.72,80,,,percent of total billed charges,80% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,216.81,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,96.36,40,,,percent of total billed charges,40% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,216.81,90,,,percent of total billed charges,90% of total billed charges,183.08,76,,,percent of total billed charges,76% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,192.72,80,,,percent of total billed charges,80% of total billed charges,93.47,38.8,,,percent of total billed charges,38.8% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,228.86,
87486 Infectious agent detection by nucleic acid (DNA or RNA,40087486,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,158.1,126.48,,118.58,75,,,percent of total billed charges,75% of total billed charges,63.24,40,,,percent of total billed charges,40% of total billed charges,125.22,79.2,,,percent of total billed charges,79.2% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,150.2,95,,,percent of total billed charges,95% of total billed charges,126.48,80,,,percent of total billed charges,80% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,142.29,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,63.24,40,,,percent of total billed charges,40% of total billed charges,63.24,40,,,percent of total billed charges,40% of total billed charges,142.29,90,,,percent of total billed charges,90% of total billed charges,120.16,76,,,percent of total billed charges,76% of total billed charges,63.24,40,,,percent of total billed charges,40% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,126.48,80,,,percent of total billed charges,80% of total billed charges,61.34,38.8,,,percent of total billed charges,38.8% of total billed charges,134.39,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,150.2,
87581 Infectious agent detection by nucleic acid (DNA or RNA,40087581,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,166.7,133.36,,125.03,75,,,percent of total billed charges,75% of total billed charges,66.68,40,,,percent of total billed charges,40% of total billed charges,132.03,79.2,,,percent of total billed charges,79.2% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,158.37,95,,,percent of total billed charges,95% of total billed charges,133.36,80,,,percent of total billed charges,80% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,150.03,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,66.68,40,,,percent of total billed charges,40% of total billed charges,66.68,40,,,percent of total billed charges,40% of total billed charges,150.03,90,,,percent of total billed charges,90% of total billed charges,126.69,76,,,percent of total billed charges,76% of total billed charges,66.68,40,,,percent of total billed charges,40% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,133.36,80,,,percent of total billed charges,80% of total billed charges,64.68,38.8,,,percent of total billed charges,38.8% of total billed charges,141.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,158.37,
"85048 Blood count; leukocyte (WBC), automated",40085048,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,42.4,33.92,,31.8,75,,,percent of total billed charges,75% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,33.58,79.2,,,percent of total billed charges,79.2% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,40.28,95,,,percent of total billed charges,95% of total billed charges,33.92,80,,,percent of total billed charges,80% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,38.16,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,16.96,40,,,percent of total billed charges,40% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,38.16,90,,,percent of total billed charges,90% of total billed charges,32.22,76,,,percent of total billed charges,76% of total billed charges,16.96,40,,,percent of total billed charges,40% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,33.92,80,,,percent of total billed charges,80% of total billed charges,16.45,38.8,,,percent of total billed charges,38.8% of total billed charges,36.04,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,40.28,
26641 - Closed Treatment of Carpometacarpal dislocation,60000628,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,775.8,620.64,,581.85,75,,,percent of total billed charges,75% of total billed charges,310.32,40,,,percent of total billed charges,40% of total billed charges,614.43,79.2,,,percent of total billed charges,79.2% of total billed charges,659.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,737.01,95,,,percent of total billed charges,95% of total billed charges,620.64,80,,,percent of total billed charges,80% of total billed charges,659.43,85,,,percent of total billed charges,85% of total billed charges,698.22,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,310.32,40,,,percent of total billed charges,40% of total billed charges,310.32,40,,,percent of total billed charges,40% of total billed charges,698.22,90,,,percent of total billed charges,90% of total billed charges,589.61,76,,,percent of total billed charges,76% of total billed charges,310.32,40,,,percent of total billed charges,40% of total billed charges,659.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,620.64,80,,,percent of total billed charges,80% of total billed charges,301.01,38.8,,,percent of total billed charges,38.8% of total billed charges,659.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,737.01,
62273 - INJECTION EPIDURAL BLOOD/CLOT PATCH,60000129,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,1935.9,1548.72,,1451.93,75,,,percent of total billed charges,75% of total billed charges,774.36,40,,,percent of total billed charges,40% of total billed charges,1533.23,79.2,,,percent of total billed charges,79.2% of total billed charges,1645.52,85,,,percent of total billed charges,85% of total billed charges,1935.9,100,,,fee schedule,100% of CO APG rates,1839.11,95,,,percent of total billed charges,95% of total billed charges,1548.72,80,,,percent of total billed charges,80% of total billed charges,1645.52,85,,,percent of total billed charges,85% of total billed charges,1742.31,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,774.36,40,,,percent of total billed charges,40% of total billed charges,774.36,40,,,percent of total billed charges,40% of total billed charges,1742.31,90,,,percent of total billed charges,90% of total billed charges,1471.28,76,,,percent of total billed charges,76% of total billed charges,774.36,40,,,percent of total billed charges,40% of total billed charges,1645.52,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1548.72,80,,,percent of total billed charges,80% of total billed charges,751.13,38.8,,,percent of total billed charges,38.8% of total billed charges,1645.52,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
"SEMI-TENDINOSUS TENDON GRAFT, ALLOGRAFT",46052704,CDM,278,RC,,,OUTPATIENT,,,4552.4,3641.92,,3414.3,75,,,percent of total billed charges,75% of total billed charges,1820.96,40,,,percent of total billed charges,40% of total billed charges,3605.5,79.2,,,percent of total billed charges,79.2% of total billed charges,3869.54,85,,,percent of total billed charges,85% of total billed charges,4552.4,100,,,fee schedule,100% of CO APG rates,4324.78,95,,,percent of total billed charges,95% of total billed charges,3641.92,80,,,percent of total billed charges,80% of total billed charges,3869.54,85,,,percent of total billed charges,85% of total billed charges,4097.16,90,,,percent of total billed charges,90% of total billed charges,4552.4,100,,,fee schedule,100% of CO APG rates,4552.4,100,,,fee schedule,100% of CO APG rates,4552.4,100,,,fee schedule,100% of NM fee schedule,1820.96,40,,,percent of total billed charges,40% of total billed charges,1820.96,40,,,percent of total billed charges,40% of total billed charges,4097.16,90,,,percent of total billed charges,90% of total billed charges,3459.82,76,,,percent of total billed charges,76% of total billed charges,1820.96,40,,,percent of total billed charges,40% of total billed charges,3869.54,85,,,percent of total billed charges,85% of total billed charges,4552.4,100,,,fee schedule,100% of CO APG rate,3641.92,80,,,percent of total billed charges,80% of total billed charges,1766.33,38.8,,,percent of total billed charges,38.8% of total billed charges,3869.54,85,,,percent of total billed charges,85% of total billed charges,4552.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1766.33,4552.4,
SUTURE 5-0 GUT CHR RB-1 U202H,52705,CDM,270,RC,,,OUTPATIENT,,,4.4,3.52,,3.3,75,,,percent of total billed charges,75% of total billed charges,1.76,40,,,percent of total billed charges,40% of total billed charges,3.48,79.2,,,percent of total billed charges,79.2% of total billed charges,3.74,85,,,percent of total billed charges,85% of total billed charges,4.4,100,,,fee schedule,100% of CO APG rates,4.18,95,,,percent of total billed charges,95% of total billed charges,3.52,80,,,percent of total billed charges,80% of total billed charges,3.74,85,,,percent of total billed charges,85% of total billed charges,3.96,90,,,percent of total billed charges,90% of total billed charges,4.4,100,,,fee schedule,100% of CO APG rates,4.4,100,,,fee schedule,100% of CO APG rates,4.4,100,,,fee schedule,100% of NM fee schedule,1.76,40,,,percent of total billed charges,40% of total billed charges,1.76,40,,,percent of total billed charges,40% of total billed charges,3.96,90,,,percent of total billed charges,90% of total billed charges,3.34,76,,,percent of total billed charges,76% of total billed charges,1.76,40,,,percent of total billed charges,40% of total billed charges,3.74,85,,,percent of total billed charges,85% of total billed charges,4.4,100,,,fee schedule,100% of CO APG rate,3.52,80,,,percent of total billed charges,80% of total billed charges,1.71,38.8,,,percent of total billed charges,38.8% of total billed charges,3.74,85,,,percent of total billed charges,85% of total billed charges,4.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1.71,4.4,
"99156 Moderate sedation, other health care pro performing di",46299156,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,475.75,380.6,,356.81,75,,,percent of total billed charges,75% of total billed charges,190.3,40,,,percent of total billed charges,40% of total billed charges,376.79,79.2,,,percent of total billed charges,79.2% of total billed charges,404.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,451.96,95,,,percent of total billed charges,95% of total billed charges,380.6,80,,,percent of total billed charges,80% of total billed charges,404.39,85,,,percent of total billed charges,85% of total billed charges,428.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,190.3,40,,,percent of total billed charges,40% of total billed charges,190.3,40,,,percent of total billed charges,40% of total billed charges,428.18,90,,,percent of total billed charges,90% of total billed charges,361.57,76,,,percent of total billed charges,76% of total billed charges,190.3,40,,,percent of total billed charges,40% of total billed charges,404.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,380.6,80,,,percent of total billed charges,80% of total billed charges,184.59,38.8,,,percent of total billed charges,38.8% of total billed charges,404.39,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,451.96,
Blood Draw Law Enforcement,60000119,CDM,999,RC,VA0018A,HCPCS,OUTPATIENT,,,32.5,26,,24.38,75,,,percent of total billed charges,75% of total billed charges,13,40,,,percent of total billed charges,40% of total billed charges,25.74,79.2,,,percent of total billed charges,79.2% of total billed charges,27.63,85,,,percent of total billed charges,85% of total billed charges,32.5,100,,,fee schedule,100% of CO APG rates,30.88,95,,,percent of total billed charges,95% of total billed charges,26,80,,,percent of total billed charges,80% of total billed charges,27.63,85,,,percent of total billed charges,85% of total billed charges,29.25,90,,,percent of total billed charges,90% of total billed charges,32.5,100,,,fee schedule,100% of CO APG rates,32.5,100,,,fee schedule,100% of CO APG rates,32.5,100,,,fee schedule,100% of NM fee schedule,13,40,,,percent of total billed charges,40% of total billed charges,13,40,,,percent of total billed charges,40% of total billed charges,29.25,90,,,percent of total billed charges,90% of total billed charges,24.7,76,,,percent of total billed charges,76% of total billed charges,13,40,,,percent of total billed charges,40% of total billed charges,27.63,85,,,percent of total billed charges,85% of total billed charges,32.5,100,,,fee schedule,100% of CO APG rate,26,80,,,percent of total billed charges,80% of total billed charges,12.61,38.8,,,percent of total billed charges,38.8% of total billed charges,27.63,85,,,percent of total billed charges,85% of total billed charges,32.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,12.61,32.5,
"FOLEY CATH TRAY, SILICONE, 16FR",52706,CDM,270,RC,,,OUTPATIENT,,,130.78,104.624,,98.09,75,,,percent of total billed charges,75% of total billed charges,52.31,40,,,percent of total billed charges,40% of total billed charges,103.58,79.2,,,percent of total billed charges,79.2% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,130.78,100,,,fee schedule,100% of CO APG rates,124.24,95,,,percent of total billed charges,95% of total billed charges,104.62,80,,,percent of total billed charges,80% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,117.7,90,,,percent of total billed charges,90% of total billed charges,130.78,100,,,fee schedule,100% of CO APG rates,130.78,100,,,fee schedule,100% of CO APG rates,130.78,100,,,fee schedule,100% of NM fee schedule,52.31,40,,,percent of total billed charges,40% of total billed charges,52.31,40,,,percent of total billed charges,40% of total billed charges,117.7,90,,,percent of total billed charges,90% of total billed charges,99.39,76,,,percent of total billed charges,76% of total billed charges,52.31,40,,,percent of total billed charges,40% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,130.78,100,,,fee schedule,100% of CO APG rate,104.62,80,,,percent of total billed charges,80% of total billed charges,50.74,38.8,,,percent of total billed charges,38.8% of total billed charges,111.16,85,,,percent of total billed charges,85% of total billed charges,130.78,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,50.74,130.78,
"CANCELLOUS BONE CRUSHED, 1-4MM, 15CC",460ECON0198,CDM,278,RC,,,OUTPATIENT,,,938,750.4,,703.5,75,,,percent of total billed charges,75% of total billed charges,375.2,40,,,percent of total billed charges,40% of total billed charges,742.9,79.2,,,percent of total billed charges,79.2% of total billed charges,797.3,85,,,percent of total billed charges,85% of total billed charges,938,100,,,fee schedule,100% of CO APG rates,891.1,95,,,percent of total billed charges,95% of total billed charges,750.4,80,,,percent of total billed charges,80% of total billed charges,797.3,85,,,percent of total billed charges,85% of total billed charges,844.2,90,,,percent of total billed charges,90% of total billed charges,938,100,,,fee schedule,100% of CO APG rates,938,100,,,fee schedule,100% of CO APG rates,938,100,,,fee schedule,100% of NM fee schedule,375.2,40,,,percent of total billed charges,40% of total billed charges,375.2,40,,,percent of total billed charges,40% of total billed charges,844.2,90,,,percent of total billed charges,90% of total billed charges,712.88,76,,,percent of total billed charges,76% of total billed charges,375.2,40,,,percent of total billed charges,40% of total billed charges,797.3,85,,,percent of total billed charges,85% of total billed charges,938,100,,,fee schedule,100% of CO APG rate,750.4,80,,,percent of total billed charges,80% of total billed charges,363.94,38.8,,,percent of total billed charges,38.8% of total billed charges,797.3,85,,,percent of total billed charges,85% of total billed charges,938,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,363.94,938,
"STRYKER DBM GEL BONE MATRIX PUTTY, 1CC",460ECON0199,CDM,278,RC,,,OUTPATIENT,,,1396,1116.8,,1047,75,,,percent of total billed charges,75% of total billed charges,558.4,40,,,percent of total billed charges,40% of total billed charges,1105.63,79.2,,,percent of total billed charges,79.2% of total billed charges,1186.6,85,,,percent of total billed charges,85% of total billed charges,1396,100,,,fee schedule,100% of CO APG rates,1326.2,95,,,percent of total billed charges,95% of total billed charges,1116.8,80,,,percent of total billed charges,80% of total billed charges,1186.6,85,,,percent of total billed charges,85% of total billed charges,1256.4,90,,,percent of total billed charges,90% of total billed charges,1396,100,,,fee schedule,100% of CO APG rates,1396,100,,,fee schedule,100% of CO APG rates,1396,100,,,fee schedule,100% of NM fee schedule,558.4,40,,,percent of total billed charges,40% of total billed charges,558.4,40,,,percent of total billed charges,40% of total billed charges,1256.4,90,,,percent of total billed charges,90% of total billed charges,1060.96,76,,,percent of total billed charges,76% of total billed charges,558.4,40,,,percent of total billed charges,40% of total billed charges,1186.6,85,,,percent of total billed charges,85% of total billed charges,1396,100,,,fee schedule,100% of CO APG rate,1116.8,80,,,percent of total billed charges,80% of total billed charges,541.65,38.8,,,percent of total billed charges,38.8% of total billed charges,1186.6,85,,,percent of total billed charges,85% of total billed charges,1396,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,541.65,1396,
"INS FLUAD, 0.5mL, Single Dose Syringe Vaccine, 65 ye",60000134,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,103,82.4,,77.25,75,,,percent of total billed charges,75% of total billed charges,41.2,40,,,percent of total billed charges,40% of total billed charges,81.58,79.2,,,percent of total billed charges,79.2% of total billed charges,87.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,97.85,95,,,percent of total billed charges,95% of total billed charges,82.4,80,,,percent of total billed charges,80% of total billed charges,87.55,85,,,percent of total billed charges,85% of total billed charges,92.7,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,103,100,,,fee schedule,100% of NM fee schedule,41.2,40,,,percent of total billed charges,40% of total billed charges,41.2,40,,,percent of total billed charges,40% of total billed charges,92.7,90,,,percent of total billed charges,90% of total billed charges,78.28,76,,,percent of total billed charges,76% of total billed charges,41.2,40,,,percent of total billed charges,40% of total billed charges,87.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,82.4,80,,,percent of total billed charges,80% of total billed charges,39.96,38.8,,,percent of total billed charges,38.8% of total billed charges,87.55,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,103,
"90685 - INS Fluzone Quadrivalent, 0.25mL, Pediatric Single D",60000135,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,34.3,27.44,,25.73,75,,,percent of total billed charges,75% of total billed charges,13.72,40,,,percent of total billed charges,40% of total billed charges,27.17,79.2,,,percent of total billed charges,79.2% of total billed charges,29.16,85,,,percent of total billed charges,85% of total billed charges,34.3,100,,,fee schedule,100% of CO APG rates,32.59,95,,,percent of total billed charges,95% of total billed charges,27.44,80,,,percent of total billed charges,80% of total billed charges,29.16,85,,,percent of total billed charges,85% of total billed charges,30.87,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,34.3,100,,,fee schedule,100% of NM fee schedule,13.72,40,,,percent of total billed charges,40% of total billed charges,13.72,40,,,percent of total billed charges,40% of total billed charges,30.87,90,,,percent of total billed charges,90% of total billed charges,26.07,76,,,percent of total billed charges,76% of total billed charges,13.72,40,,,percent of total billed charges,40% of total billed charges,29.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,27.44,80,,,percent of total billed charges,80% of total billed charges,13.31,38.8,,,percent of total billed charges,38.8% of total billed charges,29.16,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,13.31,35.65,
"90686 - INS Fluzone Quadrivalent, 0.5mL, Single Dose Syringe",60000137,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,51.5,41.2,,38.63,75,,,percent of total billed charges,75% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,40.79,79.2,,,percent of total billed charges,79.2% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,48.93,95,,,percent of total billed charges,95% of total billed charges,41.2,80,,,percent of total billed charges,80% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,46.35,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,51.5,100,,,fee schedule,100% of NM fee schedule,20.6,40,,,percent of total billed charges,40% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,46.35,90,,,percent of total billed charges,90% of total billed charges,39.14,76,,,percent of total billed charges,76% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,41.2,80,,,percent of total billed charges,80% of total billed charges,19.98,38.8,,,percent of total billed charges,38.8% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,19.98,51.5,
Propeptide Type 1 Collagen LC (140850),60001005,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,429.3,343.44,,321.98,75,,,percent of total billed charges,75% of total billed charges,171.72,40,,,percent of total billed charges,40% of total billed charges,340.01,79.2,,,percent of total billed charges,79.2% of total billed charges,364.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,407.84,95,,,percent of total billed charges,95% of total billed charges,343.44,80,,,percent of total billed charges,80% of total billed charges,364.91,85,,,percent of total billed charges,85% of total billed charges,386.37,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,171.72,40,,,percent of total billed charges,40% of total billed charges,171.72,40,,,percent of total billed charges,40% of total billed charges,386.37,90,,,percent of total billed charges,90% of total billed charges,326.27,76,,,percent of total billed charges,76% of total billed charges,171.72,40,,,percent of total billed charges,40% of total billed charges,364.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,343.44,80,,,percent of total billed charges,80% of total billed charges,166.57,38.8,,,percent of total billed charges,38.8% of total billed charges,364.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,407.84,
HCV Antibody RFX to Quant PCR LC,40040659,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,146.3,117.04,,109.73,75,,,percent of total billed charges,75% of total billed charges,58.52,40,,,percent of total billed charges,40% of total billed charges,115.87,79.2,,,percent of total billed charges,79.2% of total billed charges,124.36,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,138.99,95,,,percent of total billed charges,95% of total billed charges,117.04,80,,,percent of total billed charges,80% of total billed charges,124.36,85,,,percent of total billed charges,85% of total billed charges,131.67,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,58.52,40,,,percent of total billed charges,40% of total billed charges,58.52,40,,,percent of total billed charges,40% of total billed charges,131.67,90,,,percent of total billed charges,90% of total billed charges,111.19,76,,,percent of total billed charges,76% of total billed charges,58.52,40,,,percent of total billed charges,40% of total billed charges,124.36,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,117.04,80,,,percent of total billed charges,80% of total billed charges,56.76,38.8,,,percent of total billed charges,38.8% of total billed charges,124.36,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,138.99,
"COLLAGEN DRESSING W/ SILVER PROMOGRAN PRISMA, 4-1/3 X 4-1/3",49152720,CDM,270,RC,,,OUTPATIENT,,,22.9,18.32,,17.18,75,,,percent of total billed charges,75% of total billed charges,9.16,40,,,percent of total billed charges,40% of total billed charges,18.14,79.2,,,percent of total billed charges,79.2% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,22.9,100,,,fee schedule,100% of CO APG rates,21.76,95,,,percent of total billed charges,95% of total billed charges,18.32,80,,,percent of total billed charges,80% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,20.61,90,,,percent of total billed charges,90% of total billed charges,22.9,100,,,fee schedule,100% of CO APG rates,22.9,100,,,fee schedule,100% of CO APG rates,22.9,100,,,fee schedule,100% of NM fee schedule,9.16,40,,,percent of total billed charges,40% of total billed charges,9.16,40,,,percent of total billed charges,40% of total billed charges,20.61,90,,,percent of total billed charges,90% of total billed charges,17.4,76,,,percent of total billed charges,76% of total billed charges,9.16,40,,,percent of total billed charges,40% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,22.9,100,,,fee schedule,100% of CO APG rate,18.32,80,,,percent of total billed charges,80% of total billed charges,8.89,38.8,,,percent of total billed charges,38.8% of total billed charges,19.47,85,,,percent of total billed charges,85% of total billed charges,22.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.89,22.9,
"Viscosity, Serum LC",60000622,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,36.8,29.44,,27.6,75,,,percent of total billed charges,75% of total billed charges,14.72,40,,,percent of total billed charges,40% of total billed charges,29.15,79.2,,,percent of total billed charges,79.2% of total billed charges,31.28,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,34.96,95,,,percent of total billed charges,95% of total billed charges,29.44,80,,,percent of total billed charges,80% of total billed charges,31.28,85,,,percent of total billed charges,85% of total billed charges,33.12,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,14.72,40,,,percent of total billed charges,40% of total billed charges,14.72,40,,,percent of total billed charges,40% of total billed charges,33.12,90,,,percent of total billed charges,90% of total billed charges,27.97,76,,,percent of total billed charges,76% of total billed charges,14.72,40,,,percent of total billed charges,40% of total billed charges,31.28,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,29.44,80,,,percent of total billed charges,80% of total billed charges,14.28,38.8,,,percent of total billed charges,38.8% of total billed charges,31.28,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,34.96,
29580 Strapping; Unna Boot,46029580,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,436.7,349.36,,327.53,75,,,percent of total billed charges,75% of total billed charges,174.68,40,,,percent of total billed charges,40% of total billed charges,345.87,79.2,,,percent of total billed charges,79.2% of total billed charges,371.2,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,414.87,95,,,percent of total billed charges,95% of total billed charges,349.36,80,,,percent of total billed charges,80% of total billed charges,371.2,85,,,percent of total billed charges,85% of total billed charges,393.03,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,174.68,40,,,percent of total billed charges,40% of total billed charges,174.68,40,,,percent of total billed charges,40% of total billed charges,393.03,90,,,percent of total billed charges,90% of total billed charges,331.89,76,,,percent of total billed charges,76% of total billed charges,174.68,40,,,percent of total billed charges,40% of total billed charges,371.2,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,349.36,80,,,percent of total billed charges,80% of total billed charges,169.44,38.8,,,percent of total billed charges,38.8% of total billed charges,371.2,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,169.44,414.87,
US Venous Reflux Study Bil,60000995,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,903.8,723.04,TC,677.85,75,,,percent of total billed charges,75% of total billed charges,361.52,40,,,percent of total billed charges,40% of total billed charges,715.81,79.2,,,percent of total billed charges,79.2% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,858.61,95,,,percent of total billed charges,95% of total billed charges,723.04,80,,,percent of total billed charges,80% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,813.42,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,361.52,40,,,percent of total billed charges,40% of total billed charges,361.52,40,,,percent of total billed charges,40% of total billed charges,813.42,90,,,percent of total billed charges,90% of total billed charges,686.89,76,,,percent of total billed charges,76% of total billed charges,361.52,40,,,percent of total billed charges,40% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,723.04,80,,,percent of total billed charges,80% of total billed charges,350.67,38.8,,,percent of total billed charges,38.8% of total billed charges,768.23,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,858.61,
US Venous Reflux Study Lt,60000993,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,573.5,458.8,TC,430.13,75,,,percent of total billed charges,75% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,454.21,79.2,,,percent of total billed charges,79.2% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,544.83,95,,,percent of total billed charges,95% of total billed charges,458.8,80,,,percent of total billed charges,80% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,229.4,40,,,percent of total billed charges,40% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,435.86,76,,,percent of total billed charges,76% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,458.8,80,,,percent of total billed charges,80% of total billed charges,222.52,38.8,,,percent of total billed charges,38.8% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,544.83,
US Venous Reflux Study Rt,60000994,CDM,921,RC,93880,HCPCS,OUTPATIENT,,,573.5,458.8,TC,430.13,75,,,percent of total billed charges,75% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,454.21,79.2,,,percent of total billed charges,79.2% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,544.83,95,,,percent of total billed charges,95% of total billed charges,458.8,80,,,percent of total billed charges,80% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rates,221.27,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,229.4,40,,,percent of total billed charges,40% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,516.15,90,,,percent of total billed charges,90% of total billed charges,435.86,76,,,percent of total billed charges,76% of total billed charges,229.4,40,,,percent of total billed charges,40% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of CO APG rate,458.8,80,,,percent of total billed charges,80% of total billed charges,222.52,38.8,,,percent of total billed charges,38.8% of total billed charges,487.48,85,,,percent of total billed charges,85% of total billed charges,221.27,100,,,fee schedule,100% of APG fee schedule,403.42,200,,,fee schedule,200% of CMS fee schedule,221.27,544.83,
MA Diag Breast w/ Tomo Lt.,60001001,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,358.7,286.96,TC,269.03,75,,,percent of total billed charges,75% of total billed charges,143.48,40,,,percent of total billed charges,40% of total billed charges,284.09,79.2,,,percent of total billed charges,79.2% of total billed charges,304.9,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,340.77,95,,,percent of total billed charges,95% of total billed charges,286.96,80,,,percent of total billed charges,80% of total billed charges,304.9,85,,,percent of total billed charges,85% of total billed charges,322.83,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,143.48,40,,,percent of total billed charges,40% of total billed charges,143.48,40,,,percent of total billed charges,40% of total billed charges,322.83,90,,,percent of total billed charges,90% of total billed charges,272.61,76,,,percent of total billed charges,76% of total billed charges,143.48,40,,,percent of total billed charges,40% of total billed charges,304.9,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,286.96,80,,,percent of total billed charges,80% of total billed charges,139.18,38.8,,,percent of total billed charges,38.8% of total billed charges,304.9,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,139.18,340.77,
MA Routine Screen Breast w/ Tomo Bil.,60000999,CDM,403,RC,77067,HCPCS,OUTPATIENT,,,395.1,316.08,TC,296.33,75,,,percent of total billed charges,75% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,312.92,79.2,,,percent of total billed charges,79.2% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,375.35,95,,,percent of total billed charges,95% of total billed charges,316.08,80,,,percent of total billed charges,80% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,66.74,100,,,fee schedule,100% of CO APG rates,127.61,100,,,fee schedule,100% of NM fee schedule,158.04,40,,,percent of total billed charges,40% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,300.28,76,,,percent of total billed charges,76% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rate,316.08,80,,,percent of total billed charges,80% of total billed charges,153.3,38.8,,,percent of total billed charges,38.8% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of APG fee schedule,270.8,200,,,fee schedule,200% of CMS fee schedule,66.74,375.35,
MA Routine Screen Breast w/ Tomo Lt.,60001028,CDM,403,RC,77067,HCPCS,OUTPATIENT,,,186.5,149.2,TC,139.88,75,,,percent of total billed charges,75% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,147.71,79.2,,,percent of total billed charges,79.2% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,177.18,95,,,percent of total billed charges,95% of total billed charges,149.2,80,,,percent of total billed charges,80% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,167.85,90,,,percent of total billed charges,90% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,66.74,100,,,fee schedule,100% of CO APG rates,127.61,100,,,fee schedule,100% of NM fee schedule,74.6,40,,,percent of total billed charges,40% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,167.85,90,,,percent of total billed charges,90% of total billed charges,141.74,76,,,percent of total billed charges,76% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rate,149.2,80,,,percent of total billed charges,80% of total billed charges,72.36,38.8,,,percent of total billed charges,38.8% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of APG fee schedule,270.8,200,,,fee schedule,200% of CMS fee schedule,66.74,270.8,
MA Routine Screen Breast w/ Tomo Rt.,60000999,CDM,403,RC,77067,HCPCS,OUTPATIENT,,,186.5,149.2,TC,139.88,75,,,percent of total billed charges,75% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,147.71,79.2,,,percent of total billed charges,79.2% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,177.18,95,,,percent of total billed charges,95% of total billed charges,149.2,80,,,percent of total billed charges,80% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,167.85,90,,,percent of total billed charges,90% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,66.74,100,,,fee schedule,100% of CO APG rates,127.61,100,,,fee schedule,100% of NM fee schedule,74.6,40,,,percent of total billed charges,40% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,167.85,90,,,percent of total billed charges,90% of total billed charges,141.74,76,,,percent of total billed charges,76% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rate,149.2,80,,,percent of total billed charges,80% of total billed charges,72.36,38.8,,,percent of total billed charges,38.8% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of APG fee schedule,270.8,200,,,fee schedule,200% of CMS fee schedule,66.74,270.8,
MA Routine Screen Implant w/ Tomo Bil.,60000999,CDM,403,RC,77067,HCPCS,OUTPATIENT,,,395.1,316.08,TC,296.33,75,,,percent of total billed charges,75% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,312.92,79.2,,,percent of total billed charges,79.2% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,375.35,95,,,percent of total billed charges,95% of total billed charges,316.08,80,,,percent of total billed charges,80% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,66.74,100,,,fee schedule,100% of CO APG rates,127.61,100,,,fee schedule,100% of NM fee schedule,158.04,40,,,percent of total billed charges,40% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,355.59,90,,,percent of total billed charges,90% of total billed charges,300.28,76,,,percent of total billed charges,76% of total billed charges,158.04,40,,,percent of total billed charges,40% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rate,316.08,80,,,percent of total billed charges,80% of total billed charges,153.3,38.8,,,percent of total billed charges,38.8% of total billed charges,335.84,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of APG fee schedule,270.8,200,,,fee schedule,200% of CMS fee schedule,66.74,375.35,
XCEL DILATING TIP TROCAR 12MM D12LT,46052707,CDM,270,RC,,,OUTPATIENT,,,100.6,80.48,,75.45,75,,,percent of total billed charges,75% of total billed charges,40.24,40,,,percent of total billed charges,40% of total billed charges,79.68,79.2,,,percent of total billed charges,79.2% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,100.6,100,,,fee schedule,100% of CO APG rates,95.57,95,,,percent of total billed charges,95% of total billed charges,80.48,80,,,percent of total billed charges,80% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,90.54,90,,,percent of total billed charges,90% of total billed charges,100.6,100,,,fee schedule,100% of CO APG rates,100.6,100,,,fee schedule,100% of CO APG rates,100.6,100,,,fee schedule,100% of NM fee schedule,40.24,40,,,percent of total billed charges,40% of total billed charges,40.24,40,,,percent of total billed charges,40% of total billed charges,90.54,90,,,percent of total billed charges,90% of total billed charges,76.46,76,,,percent of total billed charges,76% of total billed charges,40.24,40,,,percent of total billed charges,40% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,100.6,100,,,fee schedule,100% of CO APG rate,80.48,80,,,percent of total billed charges,80% of total billed charges,39.03,38.8,,,percent of total billed charges,38.8% of total billed charges,85.51,85,,,percent of total billed charges,85% of total billed charges,100.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,39.03,100.6,
XCEL DILATING TIP TROCAR 5MM D5LT,46052708,CDM,270,RC,,,OUTPATIENT,,,101.7,81.36,,76.28,75,,,percent of total billed charges,75% of total billed charges,40.68,40,,,percent of total billed charges,40% of total billed charges,80.55,79.2,,,percent of total billed charges,79.2% of total billed charges,86.45,85,,,percent of total billed charges,85% of total billed charges,101.7,100,,,fee schedule,100% of CO APG rates,96.62,95,,,percent of total billed charges,95% of total billed charges,81.36,80,,,percent of total billed charges,80% of total billed charges,86.45,85,,,percent of total billed charges,85% of total billed charges,91.53,90,,,percent of total billed charges,90% of total billed charges,101.7,100,,,fee schedule,100% of CO APG rates,101.7,100,,,fee schedule,100% of CO APG rates,101.7,100,,,fee schedule,100% of NM fee schedule,40.68,40,,,percent of total billed charges,40% of total billed charges,40.68,40,,,percent of total billed charges,40% of total billed charges,91.53,90,,,percent of total billed charges,90% of total billed charges,77.29,76,,,percent of total billed charges,76% of total billed charges,40.68,40,,,percent of total billed charges,40% of total billed charges,86.45,85,,,percent of total billed charges,85% of total billed charges,101.7,100,,,fee schedule,100% of CO APG rate,81.36,80,,,percent of total billed charges,80% of total billed charges,39.46,38.8,,,percent of total billed charges,38.8% of total billed charges,86.45,85,,,percent of total billed charges,85% of total billed charges,101.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,39.46,101.7,
"29355 Application of long leg cast (thigh to toes), walker",60000150,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,898.6,718.88,,673.95,75,,,percent of total billed charges,75% of total billed charges,359.44,40,,,percent of total billed charges,40% of total billed charges,711.69,79.2,,,percent of total billed charges,79.2% of total billed charges,763.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,853.67,95,,,percent of total billed charges,95% of total billed charges,718.88,80,,,percent of total billed charges,80% of total billed charges,763.81,85,,,percent of total billed charges,85% of total billed charges,808.74,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,359.44,40,,,percent of total billed charges,40% of total billed charges,359.44,40,,,percent of total billed charges,40% of total billed charges,808.74,90,,,percent of total billed charges,90% of total billed charges,682.94,76,,,percent of total billed charges,76% of total billed charges,359.44,40,,,percent of total billed charges,40% of total billed charges,763.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,718.88,80,,,percent of total billed charges,80% of total billed charges,348.66,38.8,,,percent of total billed charges,38.8% of total billed charges,763.81,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,853.67,
MA Routine Screen Breast w/ Tomo Rt.,60001029,CDM,403,RC,77067,HCPCS,OUTPATIENT,,,186.5,149.2,TC,139.88,75,,,percent of total billed charges,75% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,147.71,79.2,,,percent of total billed charges,79.2% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,177.18,95,,,percent of total billed charges,95% of total billed charges,149.2,80,,,percent of total billed charges,80% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,167.85,90,,,percent of total billed charges,90% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,66.74,100,,,fee schedule,100% of CO APG rates,127.61,100,,,fee schedule,100% of NM fee schedule,74.6,40,,,percent of total billed charges,40% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,167.85,90,,,percent of total billed charges,90% of total billed charges,141.74,76,,,percent of total billed charges,76% of total billed charges,74.6,40,,,percent of total billed charges,40% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rate,149.2,80,,,percent of total billed charges,80% of total billed charges,72.36,38.8,,,percent of total billed charges,38.8% of total billed charges,158.53,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of APG fee schedule,270.8,200,,,fee schedule,200% of CMS fee schedule,66.74,270.8,
"DURACLIP, HEMOSTASIS CLIP, 235CM, 11MM WIDE",46052709,CDM,270,RC,,,OUTPATIENT,,,442.5,354,,331.88,75,,,percent of total billed charges,75% of total billed charges,177,40,,,percent of total billed charges,40% of total billed charges,350.46,79.2,,,percent of total billed charges,79.2% of total billed charges,376.13,85,,,percent of total billed charges,85% of total billed charges,442.5,100,,,fee schedule,100% of CO APG rates,420.38,95,,,percent of total billed charges,95% of total billed charges,354,80,,,percent of total billed charges,80% of total billed charges,376.13,85,,,percent of total billed charges,85% of total billed charges,398.25,90,,,percent of total billed charges,90% of total billed charges,442.5,100,,,fee schedule,100% of CO APG rates,442.5,100,,,fee schedule,100% of CO APG rates,442.5,100,,,fee schedule,100% of NM fee schedule,177,40,,,percent of total billed charges,40% of total billed charges,177,40,,,percent of total billed charges,40% of total billed charges,398.25,90,,,percent of total billed charges,90% of total billed charges,336.3,76,,,percent of total billed charges,76% of total billed charges,177,40,,,percent of total billed charges,40% of total billed charges,376.13,85,,,percent of total billed charges,85% of total billed charges,442.5,100,,,fee schedule,100% of CO APG rate,354,80,,,percent of total billed charges,80% of total billed charges,171.69,38.8,,,percent of total billed charges,38.8% of total billed charges,376.13,85,,,percent of total billed charges,85% of total billed charges,442.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,171.69,442.5,
LAPROSCSOPIC ELECTRODE with SUCTION/IRRIGATOR,46052710,CDM,270,RC,,,OUTPATIENT,,,243.6,194.88,,182.7,75,,,percent of total billed charges,75% of total billed charges,97.44,40,,,percent of total billed charges,40% of total billed charges,192.93,79.2,,,percent of total billed charges,79.2% of total billed charges,207.06,85,,,percent of total billed charges,85% of total billed charges,243.6,100,,,fee schedule,100% of CO APG rates,231.42,95,,,percent of total billed charges,95% of total billed charges,194.88,80,,,percent of total billed charges,80% of total billed charges,207.06,85,,,percent of total billed charges,85% of total billed charges,219.24,90,,,percent of total billed charges,90% of total billed charges,243.6,100,,,fee schedule,100% of CO APG rates,243.6,100,,,fee schedule,100% of CO APG rates,243.6,100,,,fee schedule,100% of NM fee schedule,97.44,40,,,percent of total billed charges,40% of total billed charges,97.44,40,,,percent of total billed charges,40% of total billed charges,219.24,90,,,percent of total billed charges,90% of total billed charges,185.14,76,,,percent of total billed charges,76% of total billed charges,97.44,40,,,percent of total billed charges,40% of total billed charges,207.06,85,,,percent of total billed charges,85% of total billed charges,243.6,100,,,fee schedule,100% of CO APG rate,194.88,80,,,percent of total billed charges,80% of total billed charges,94.52,38.8,,,percent of total billed charges,38.8% of total billed charges,207.06,85,,,percent of total billed charges,85% of total billed charges,243.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,94.52,243.6,
BARD MARQUEE BIOPSY 14X10,52711,CDM,270,RC,,,OUTPATIENT,,,275.3,220.24,,206.48,75,,,percent of total billed charges,75% of total billed charges,110.12,40,,,percent of total billed charges,40% of total billed charges,218.04,79.2,,,percent of total billed charges,79.2% of total billed charges,234.01,85,,,percent of total billed charges,85% of total billed charges,275.3,100,,,fee schedule,100% of CO APG rates,261.54,95,,,percent of total billed charges,95% of total billed charges,220.24,80,,,percent of total billed charges,80% of total billed charges,234.01,85,,,percent of total billed charges,85% of total billed charges,247.77,90,,,percent of total billed charges,90% of total billed charges,275.3,100,,,fee schedule,100% of CO APG rates,275.3,100,,,fee schedule,100% of CO APG rates,275.3,100,,,fee schedule,100% of NM fee schedule,110.12,40,,,percent of total billed charges,40% of total billed charges,110.12,40,,,percent of total billed charges,40% of total billed charges,247.77,90,,,percent of total billed charges,90% of total billed charges,209.23,76,,,percent of total billed charges,76% of total billed charges,110.12,40,,,percent of total billed charges,40% of total billed charges,234.01,85,,,percent of total billed charges,85% of total billed charges,275.3,100,,,fee schedule,100% of CO APG rate,220.24,80,,,percent of total billed charges,80% of total billed charges,106.82,38.8,,,percent of total billed charges,38.8% of total billed charges,234.01,85,,,percent of total billed charges,85% of total billed charges,275.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.82,275.3,
BARD MARQUEE BIOPSY 18X16,52712,CDM,270,RC,,,OUTPATIENT,,,338.5,270.8,,253.88,75,,,percent of total billed charges,75% of total billed charges,135.4,40,,,percent of total billed charges,40% of total billed charges,268.09,79.2,,,percent of total billed charges,79.2% of total billed charges,287.73,85,,,percent of total billed charges,85% of total billed charges,338.5,100,,,fee schedule,100% of CO APG rates,321.58,95,,,percent of total billed charges,95% of total billed charges,270.8,80,,,percent of total billed charges,80% of total billed charges,287.73,85,,,percent of total billed charges,85% of total billed charges,304.65,90,,,percent of total billed charges,90% of total billed charges,338.5,100,,,fee schedule,100% of CO APG rates,338.5,100,,,fee schedule,100% of CO APG rates,338.5,100,,,fee schedule,100% of NM fee schedule,135.4,40,,,percent of total billed charges,40% of total billed charges,135.4,40,,,percent of total billed charges,40% of total billed charges,304.65,90,,,percent of total billed charges,90% of total billed charges,257.26,76,,,percent of total billed charges,76% of total billed charges,135.4,40,,,percent of total billed charges,40% of total billed charges,287.73,85,,,percent of total billed charges,85% of total billed charges,338.5,100,,,fee schedule,100% of CO APG rate,270.8,80,,,percent of total billed charges,80% of total billed charges,131.34,38.8,,,percent of total billed charges,38.8% of total billed charges,287.73,85,,,percent of total billed charges,85% of total billed charges,338.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,131.34,338.5,
"LAPROSCOPIC J-HOOK, 5MMX32CM, ULTRA COATING (CONMED)",46052881,CDM,270,RC,,,OUTPATIENT,,,113.6,90.88,,85.2,75,,,percent of total billed charges,75% of total billed charges,45.44,40,,,percent of total billed charges,40% of total billed charges,89.97,79.2,,,percent of total billed charges,79.2% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,113.6,100,,,fee schedule,100% of CO APG rates,107.92,95,,,percent of total billed charges,95% of total billed charges,90.88,80,,,percent of total billed charges,80% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,102.24,90,,,percent of total billed charges,90% of total billed charges,113.6,100,,,fee schedule,100% of CO APG rates,113.6,100,,,fee schedule,100% of CO APG rates,113.6,100,,,fee schedule,100% of NM fee schedule,45.44,40,,,percent of total billed charges,40% of total billed charges,45.44,40,,,percent of total billed charges,40% of total billed charges,102.24,90,,,percent of total billed charges,90% of total billed charges,86.34,76,,,percent of total billed charges,76% of total billed charges,45.44,40,,,percent of total billed charges,40% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,113.6,100,,,fee schedule,100% of CO APG rate,90.88,80,,,percent of total billed charges,80% of total billed charges,44.08,38.8,,,percent of total billed charges,38.8% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,113.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44.08,113.6,
"LAPROSCOPIC L-HOOK, 5MMX32CM, ULTRA COATING (CONMED)",46052883,CDM,270,RC,,,OUTPATIENT,,,113.6,90.88,,85.2,75,,,percent of total billed charges,75% of total billed charges,45.44,40,,,percent of total billed charges,40% of total billed charges,89.97,79.2,,,percent of total billed charges,79.2% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,113.6,100,,,fee schedule,100% of CO APG rates,107.92,95,,,percent of total billed charges,95% of total billed charges,90.88,80,,,percent of total billed charges,80% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,102.24,90,,,percent of total billed charges,90% of total billed charges,113.6,100,,,fee schedule,100% of CO APG rates,113.6,100,,,fee schedule,100% of CO APG rates,113.6,100,,,fee schedule,100% of NM fee schedule,45.44,40,,,percent of total billed charges,40% of total billed charges,45.44,40,,,percent of total billed charges,40% of total billed charges,102.24,90,,,percent of total billed charges,90% of total billed charges,86.34,76,,,percent of total billed charges,76% of total billed charges,45.44,40,,,percent of total billed charges,40% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,113.6,100,,,fee schedule,100% of CO APG rate,90.88,80,,,percent of total billed charges,80% of total billed charges,44.08,38.8,,,percent of total billed charges,38.8% of total billed charges,96.56,85,,,percent of total billed charges,85% of total billed charges,113.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,44.08,113.6,
"UNIV WEDGE/ ACL INTERFERENCE SCREW, TITANIUM, 7X20MM",460ECON0273,CDM,278,RC,,,OUTPATIENT,,,578.8,463.04,,434.1,75,,,percent of total billed charges,75% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,458.41,79.2,,,percent of total billed charges,79.2% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,549.86,95,,,percent of total billed charges,95% of total billed charges,463.04,80,,,percent of total billed charges,80% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of NM fee schedule,231.52,40,,,percent of total billed charges,40% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,439.89,76,,,percent of total billed charges,76% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rate,463.04,80,,,percent of total billed charges,80% of total billed charges,224.57,38.8,,,percent of total billed charges,38.8% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.57,578.8,
"UNIV WEDGE/ ACL INTERFERENCE SCREW, TITANIUM, 7X25MM",460ECON0274,CDM,278,RC,,,OUTPATIENT,,,578.8,463.04,,434.1,75,,,percent of total billed charges,75% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,458.41,79.2,,,percent of total billed charges,79.2% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,549.86,95,,,percent of total billed charges,95% of total billed charges,463.04,80,,,percent of total billed charges,80% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of NM fee schedule,231.52,40,,,percent of total billed charges,40% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,439.89,76,,,percent of total billed charges,76% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rate,463.04,80,,,percent of total billed charges,80% of total billed charges,224.57,38.8,,,percent of total billed charges,38.8% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.57,578.8,
"UNIV WEDGE/ ACL INTERFERENCE SCREW, TITANIUM, 8X20MM",460ECON0275,CDM,278,RC,,,OUTPATIENT,,,578.8,463.04,,434.1,75,,,percent of total billed charges,75% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,458.41,79.2,,,percent of total billed charges,79.2% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,549.86,95,,,percent of total billed charges,95% of total billed charges,463.04,80,,,percent of total billed charges,80% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of NM fee schedule,231.52,40,,,percent of total billed charges,40% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,439.89,76,,,percent of total billed charges,76% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rate,463.04,80,,,percent of total billed charges,80% of total billed charges,224.57,38.8,,,percent of total billed charges,38.8% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.57,578.8,
"UNIV WEDGE/ ACL INTERFERENCE SCREW, TITANIUM, 8X25MM",460ECON0276,CDM,278,RC,,,OUTPATIENT,,,578.8,463.04,,434.1,75,,,percent of total billed charges,75% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,458.41,79.2,,,percent of total billed charges,79.2% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,549.86,95,,,percent of total billed charges,95% of total billed charges,463.04,80,,,percent of total billed charges,80% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of NM fee schedule,231.52,40,,,percent of total billed charges,40% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,439.89,76,,,percent of total billed charges,76% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rate,463.04,80,,,percent of total billed charges,80% of total billed charges,224.57,38.8,,,percent of total billed charges,38.8% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.57,578.8,
"UNIV WEDGE/ ACL INTERFERENCE SCREW, TITANIUM, 9X20MM",460ECON0277,CDM,278,RC,,,OUTPATIENT,,,578.8,463.04,,434.1,75,,,percent of total billed charges,75% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,458.41,79.2,,,percent of total billed charges,79.2% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,549.86,95,,,percent of total billed charges,95% of total billed charges,463.04,80,,,percent of total billed charges,80% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of NM fee schedule,231.52,40,,,percent of total billed charges,40% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,439.89,76,,,percent of total billed charges,76% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rate,463.04,80,,,percent of total billed charges,80% of total billed charges,224.57,38.8,,,percent of total billed charges,38.8% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.57,578.8,
"UNIV WEDGE/ ACL INTERFERENCE SCREW, TITANIUM, 7X30MM",460ECON0278,CDM,278,RC,,,OUTPATIENT,,,578.8,463.04,,434.1,75,,,percent of total billed charges,75% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,458.41,79.2,,,percent of total billed charges,79.2% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,549.86,95,,,percent of total billed charges,95% of total billed charges,463.04,80,,,percent of total billed charges,80% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of NM fee schedule,231.52,40,,,percent of total billed charges,40% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,439.89,76,,,percent of total billed charges,76% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rate,463.04,80,,,percent of total billed charges,80% of total billed charges,224.57,38.8,,,percent of total billed charges,38.8% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.57,578.8,
"UNIV WEDGE/ ACL INTERFERENCE SCREW, TITANIUM, 8X30MM",460ECON0279,CDM,278,RC,,,OUTPATIENT,,,578.8,463.04,,434.1,75,,,percent of total billed charges,75% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,458.41,79.2,,,percent of total billed charges,79.2% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,549.86,95,,,percent of total billed charges,95% of total billed charges,463.04,80,,,percent of total billed charges,80% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of NM fee schedule,231.52,40,,,percent of total billed charges,40% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,439.89,76,,,percent of total billed charges,76% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rate,463.04,80,,,percent of total billed charges,80% of total billed charges,224.57,38.8,,,percent of total billed charges,38.8% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.57,578.8,
"UNIV WEDGE/ ACL INTERFERENCE SCREW, TITANIUM, 9X30MM",460ECON0280,CDM,278,RC,,,OUTPATIENT,,,578.8,463.04,,434.1,75,,,percent of total billed charges,75% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,458.41,79.2,,,percent of total billed charges,79.2% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,549.86,95,,,percent of total billed charges,95% of total billed charges,463.04,80,,,percent of total billed charges,80% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of NM fee schedule,231.52,40,,,percent of total billed charges,40% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,439.89,76,,,percent of total billed charges,76% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rate,463.04,80,,,percent of total billed charges,80% of total billed charges,224.57,38.8,,,percent of total billed charges,38.8% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.57,578.8,
"UNIV WEDGE/ ACL INTERFERENCE SCREW, TITANIUM, 10X20MM",460ECON0281,CDM,278,RC,,,OUTPATIENT,,,578.8,463.04,,434.1,75,,,percent of total billed charges,75% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,458.41,79.2,,,percent of total billed charges,79.2% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,549.86,95,,,percent of total billed charges,95% of total billed charges,463.04,80,,,percent of total billed charges,80% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of NM fee schedule,231.52,40,,,percent of total billed charges,40% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,439.89,76,,,percent of total billed charges,76% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rate,463.04,80,,,percent of total billed charges,80% of total billed charges,224.57,38.8,,,percent of total billed charges,38.8% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.57,578.8,
"UNIV WEDGE/ ACL INTERFERENCE SCREW, TITANIUM, 10X25MM",460ECON0282,CDM,278,RC,,,OUTPATIENT,,,578.8,463.04,,434.1,75,,,percent of total billed charges,75% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,458.41,79.2,,,percent of total billed charges,79.2% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,549.86,95,,,percent of total billed charges,95% of total billed charges,463.04,80,,,percent of total billed charges,80% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of NM fee schedule,231.52,40,,,percent of total billed charges,40% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,439.89,76,,,percent of total billed charges,76% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rate,463.04,80,,,percent of total billed charges,80% of total billed charges,224.57,38.8,,,percent of total billed charges,38.8% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.57,578.8,
"UNIV WEDGE/ ACL INTERFERENCE SCREW, TITANIUM, 10X30MM",460ECON0283,CDM,278,RC,,,OUTPATIENT,,,578.8,463.04,,434.1,75,,,percent of total billed charges,75% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,458.41,79.2,,,percent of total billed charges,79.2% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,549.86,95,,,percent of total billed charges,95% of total billed charges,463.04,80,,,percent of total billed charges,80% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of CO APG rates,578.8,100,,,fee schedule,100% of NM fee schedule,231.52,40,,,percent of total billed charges,40% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,520.92,90,,,percent of total billed charges,90% of total billed charges,439.89,76,,,percent of total billed charges,76% of total billed charges,231.52,40,,,percent of total billed charges,40% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of CO APG rate,463.04,80,,,percent of total billed charges,80% of total billed charges,224.57,38.8,,,percent of total billed charges,38.8% of total billed charges,491.98,85,,,percent of total billed charges,85% of total billed charges,578.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.57,578.8,
"BIOCOMOSITE TENODESIS SCREW, 6.25 X 15MM",460ECON0284,CDM,278,RC,,,OUTPATIENT,,,1415.9,1132.72,,1061.93,75,,,percent of total billed charges,75% of total billed charges,566.36,40,,,percent of total billed charges,40% of total billed charges,1121.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1203.52,85,,,percent of total billed charges,85% of total billed charges,1415.9,100,,,fee schedule,100% of CO APG rates,1345.11,95,,,percent of total billed charges,95% of total billed charges,1132.72,80,,,percent of total billed charges,80% of total billed charges,1203.52,85,,,percent of total billed charges,85% of total billed charges,1274.31,90,,,percent of total billed charges,90% of total billed charges,1415.9,100,,,fee schedule,100% of CO APG rates,1415.9,100,,,fee schedule,100% of CO APG rates,1415.9,100,,,fee schedule,100% of NM fee schedule,566.36,40,,,percent of total billed charges,40% of total billed charges,566.36,40,,,percent of total billed charges,40% of total billed charges,1274.31,90,,,percent of total billed charges,90% of total billed charges,1076.08,76,,,percent of total billed charges,76% of total billed charges,566.36,40,,,percent of total billed charges,40% of total billed charges,1203.52,85,,,percent of total billed charges,85% of total billed charges,1415.9,100,,,fee schedule,100% of CO APG rate,1132.72,80,,,percent of total billed charges,80% of total billed charges,549.37,38.8,,,percent of total billed charges,38.8% of total billed charges,1203.52,85,,,percent of total billed charges,85% of total billed charges,1415.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,549.37,1415.9,
"BIOCOMOSITE TENODESIS SCREW, 5.5 X 15MM",460ECON0285,CDM,278,RC,,,OUTPATIENT,,,1415.9,1132.72,,1061.93,75,,,percent of total billed charges,75% of total billed charges,566.36,40,,,percent of total billed charges,40% of total billed charges,1121.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1203.52,85,,,percent of total billed charges,85% of total billed charges,1415.9,100,,,fee schedule,100% of CO APG rates,1345.11,95,,,percent of total billed charges,95% of total billed charges,1132.72,80,,,percent of total billed charges,80% of total billed charges,1203.52,85,,,percent of total billed charges,85% of total billed charges,1274.31,90,,,percent of total billed charges,90% of total billed charges,1415.9,100,,,fee schedule,100% of CO APG rates,1415.9,100,,,fee schedule,100% of CO APG rates,1415.9,100,,,fee schedule,100% of NM fee schedule,566.36,40,,,percent of total billed charges,40% of total billed charges,566.36,40,,,percent of total billed charges,40% of total billed charges,1274.31,90,,,percent of total billed charges,90% of total billed charges,1076.08,76,,,percent of total billed charges,76% of total billed charges,566.36,40,,,percent of total billed charges,40% of total billed charges,1203.52,85,,,percent of total billed charges,85% of total billed charges,1415.9,100,,,fee schedule,100% of CO APG rate,1132.72,80,,,percent of total billed charges,80% of total billed charges,549.37,38.8,,,percent of total billed charges,38.8% of total billed charges,1203.52,85,,,percent of total billed charges,85% of total billed charges,1415.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,549.37,1415.9,
"BIOCOMOSITE TENODESIS SCREW, SWIVELOCK, 7 X 19.1MM",460ECON0286,CDM,278,RC,,,OUTPATIENT,,,1583.9,1267.12,,1187.93,75,,,percent of total billed charges,75% of total billed charges,633.56,40,,,percent of total billed charges,40% of total billed charges,1254.45,79.2,,,percent of total billed charges,79.2% of total billed charges,1346.32,85,,,percent of total billed charges,85% of total billed charges,1583.9,100,,,fee schedule,100% of CO APG rates,1504.71,95,,,percent of total billed charges,95% of total billed charges,1267.12,80,,,percent of total billed charges,80% of total billed charges,1346.32,85,,,percent of total billed charges,85% of total billed charges,1425.51,90,,,percent of total billed charges,90% of total billed charges,1583.9,100,,,fee schedule,100% of CO APG rates,1583.9,100,,,fee schedule,100% of CO APG rates,1583.9,100,,,fee schedule,100% of NM fee schedule,633.56,40,,,percent of total billed charges,40% of total billed charges,633.56,40,,,percent of total billed charges,40% of total billed charges,1425.51,90,,,percent of total billed charges,90% of total billed charges,1203.76,76,,,percent of total billed charges,76% of total billed charges,633.56,40,,,percent of total billed charges,40% of total billed charges,1346.32,85,,,percent of total billed charges,85% of total billed charges,1583.9,100,,,fee schedule,100% of CO APG rate,1267.12,80,,,percent of total billed charges,80% of total billed charges,614.55,38.8,,,percent of total billed charges,38.8% of total billed charges,1346.32,85,,,percent of total billed charges,85% of total billed charges,1583.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,614.55,1583.9,
"KNOTLESS TIGHTROPE, SYNDESMOSIS REPAIR SYSTEM, STAINLESS STE",460ECON0288,CDM,278,RC,,,OUTPATIENT,,,3086.1,2468.88,,2314.58,75,,,percent of total billed charges,75% of total billed charges,1234.44,40,,,percent of total billed charges,40% of total billed charges,2444.19,79.2,,,percent of total billed charges,79.2% of total billed charges,2623.19,85,,,percent of total billed charges,85% of total billed charges,3086.1,100,,,fee schedule,100% of CO APG rates,2931.8,95,,,percent of total billed charges,95% of total billed charges,2468.88,80,,,percent of total billed charges,80% of total billed charges,2623.19,85,,,percent of total billed charges,85% of total billed charges,2777.49,90,,,percent of total billed charges,90% of total billed charges,3086.1,100,,,fee schedule,100% of CO APG rates,3086.1,100,,,fee schedule,100% of CO APG rates,3086.1,100,,,fee schedule,100% of NM fee schedule,1234.44,40,,,percent of total billed charges,40% of total billed charges,1234.44,40,,,percent of total billed charges,40% of total billed charges,2777.49,90,,,percent of total billed charges,90% of total billed charges,2345.44,76,,,percent of total billed charges,76% of total billed charges,1234.44,40,,,percent of total billed charges,40% of total billed charges,2623.19,85,,,percent of total billed charges,85% of total billed charges,3086.1,100,,,fee schedule,100% of CO APG rate,2468.88,80,,,percent of total billed charges,80% of total billed charges,1197.41,38.8,,,percent of total billed charges,38.8% of total billed charges,2623.19,85,,,percent of total billed charges,85% of total billed charges,3086.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1197.41,3086.1,
"SUTURE, SILK BLK BR 0 30 FSL",52715,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.91,7.5,
NON-LOCKING SCREW 3.5X16MM,460ECON0291,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
NON-LOCKING SCREW 3.5X18MM,460ECON0292,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
"IGP, rfx Aptima HPV ASCU",40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
NON-LOCKING SCREW 3.5X8MM,460ECON0293,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,154.89,399.2,
NON-LOCKING SCREW 3.5X10MM,460ECON0294,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
NON-LOCKING SCREW 3.5X12MM,460ECON0295,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
NON-LOCKING SCREW 3.5X14MM,460ECON0296,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
NON-LOCKING SCREW 3.5X20MM,460ECON0297,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
NON-LOCKING SCREW 3.5X22MM,460ECON0298,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
NON-LOCKING SCREW 3.5X24MM,460ECON0299,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
NON-LOCKING SCREW 3.5X26MM,460ECON0300,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
NON-LOCKING SCREW 3.5X28MM,460ECON0301,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
NON-LOCKING SCREW 3.5X30MM,460ECON0302,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,154.89,399.2,
NON-LOCKING SCREW 3.5X32MM,460ECON0303,CDM,278,RC,,,OUTPATIENT,,,400.2,320.16,,300.15,75,,,percent of total billed charges,75% of total billed charges,160.08,40,,,percent of total billed charges,40% of total billed charges,316.96,79.2,,,percent of total billed charges,79.2% of total billed charges,340.17,85,,,percent of total billed charges,85% of total billed charges,400.2,100,,,fee schedule,100% of CO APG rates,380.19,95,,,percent of total billed charges,95% of total billed charges,320.16,80,,,percent of total billed charges,80% of total billed charges,340.17,85,,,percent of total billed charges,85% of total billed charges,360.18,90,,,percent of total billed charges,90% of total billed charges,400.2,100,,,fee schedule,100% of CO APG rates,400.2,100,,,fee schedule,100% of CO APG rates,400.2,100,,,fee schedule,100% of NM fee schedule,160.08,40,,,percent of total billed charges,40% of total billed charges,160.08,40,,,percent of total billed charges,40% of total billed charges,360.18,90,,,percent of total billed charges,90% of total billed charges,304.15,76,,,percent of total billed charges,76% of total billed charges,160.08,40,,,percent of total billed charges,40% of total billed charges,340.17,85,,,percent of total billed charges,85% of total billed charges,400.2,100,,,fee schedule,100% of CO APG rate,320.16,80,,,percent of total billed charges,80% of total billed charges,155.28,38.8,,,percent of total billed charges,38.8% of total billed charges,340.17,85,,,percent of total billed charges,85% of total billed charges,400.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,155.28,400.2,
NON-LOCKING SCREW 3.5X34MM,460ECON0304,CDM,278,RC,,,OUTPATIENT,,,492.6,394.08,,369.45,75,,,percent of total billed charges,75% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,390.14,79.2,,,percent of total billed charges,79.2% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,467.97,95,,,percent of total billed charges,95% of total billed charges,394.08,80,,,percent of total billed charges,80% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of NM fee schedule,197.04,40,,,percent of total billed charges,40% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,374.38,76,,,percent of total billed charges,76% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rate,394.08,80,,,percent of total billed charges,80% of total billed charges,191.13,38.8,,,percent of total billed charges,38.8% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,191.13,492.6,
NON-LOCKING SCREW 3.5X36MM,460ECON0305,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,154.89,399.2,
NON-LOCKING SCREW 3.5X38MM,460ECON0306,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,154.89,399.2,
NON-LOCKING SCREW 3.5X40MM,460ECON0307,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,154.89,399.2,
NON-LOCKING SCREW 3.5X42MM,460ECON0308,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
NON-LOCKING SCREW 3.5X44MM,460ECON0309,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,154.89,399.2,
NON-LOCKING SCREW 3.5X46MM,460ECON0310,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,798.4,200,,,percent of total billed charges,200% of total billed charges,154.89,798.4,
OTO-RHIO FORGEIN BODY REMOVER- KATZ,31052716,CDM,270,RC,,,OUTPATIENT,,,310.2,248.16,,232.65,75,,,percent of total billed charges,75% of total billed charges,124.08,40,,,percent of total billed charges,40% of total billed charges,245.68,79.2,,,percent of total billed charges,79.2% of total billed charges,263.67,85,,,percent of total billed charges,85% of total billed charges,310.2,100,,,fee schedule,100% of CO APG rates,294.69,95,,,percent of total billed charges,95% of total billed charges,248.16,80,,,percent of total billed charges,80% of total billed charges,263.67,85,,,percent of total billed charges,85% of total billed charges,279.18,90,,,percent of total billed charges,90% of total billed charges,310.2,100,,,fee schedule,100% of CO APG rates,310.2,100,,,fee schedule,100% of CO APG rates,310.2,100,,,fee schedule,100% of NM fee schedule,124.08,40,,,percent of total billed charges,40% of total billed charges,124.08,40,,,percent of total billed charges,40% of total billed charges,279.18,90,,,percent of total billed charges,90% of total billed charges,235.75,76,,,percent of total billed charges,76% of total billed charges,124.08,40,,,percent of total billed charges,40% of total billed charges,263.67,85,,,percent of total billed charges,85% of total billed charges,310.2,100,,,fee schedule,100% of CO APG rate,248.16,80,,,percent of total billed charges,80% of total billed charges,120.36,38.8,,,percent of total billed charges,38.8% of total billed charges,263.67,85,,,percent of total billed charges,85% of total billed charges,310.2,100,,,fee schedule,100% of APG fee schedule,620.4,200,,,percent of total billed charges,200% of total billed charges,120.36,620.4,
NON-LOCKING SCREW 3.5X48MM,460ECON0311,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,798.4,200,,,percent of total billed charges,200% of total billed charges,154.89,798.4,
NON-LOCKING SCREW 3.5X50MM,460ECON0312,CDM,278,RC,,,OUTPATIENT,,,492.6,394.08,,369.45,75,,,percent of total billed charges,75% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,390.14,79.2,,,percent of total billed charges,79.2% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,467.97,95,,,percent of total billed charges,95% of total billed charges,394.08,80,,,percent of total billed charges,80% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of CO APG rates,492.6,100,,,fee schedule,100% of NM fee schedule,197.04,40,,,percent of total billed charges,40% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,443.34,90,,,percent of total billed charges,90% of total billed charges,374.38,76,,,percent of total billed charges,76% of total billed charges,197.04,40,,,percent of total billed charges,40% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of CO APG rate,394.08,80,,,percent of total billed charges,80% of total billed charges,191.13,38.8,,,percent of total billed charges,38.8% of total billed charges,418.71,85,,,percent of total billed charges,85% of total billed charges,492.6,100,,,fee schedule,100% of APG fee schedule,985.2,200,,,percent of total billed charges,200% of total billed charges,191.13,985.2,
NON-LOCKING SCREW 3.5X55MM,460ECON0313,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,798.4,200,,,percent of total billed charges,200% of total billed charges,154.89,798.4,
NON-LOCKING SCREW 3.5X60MM,460ECON0314,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,798.4,200,,,percent of total billed charges,200% of total billed charges,154.89,798.4,
NON-LOCKING SCREW 3.5X65MM,460ECON0315,CDM,278,RC,,,OUTPATIENT,,,399.2,319.36,,299.4,75,,,percent of total billed charges,75% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,316.17,79.2,,,percent of total billed charges,79.2% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,379.24,95,,,percent of total billed charges,95% of total billed charges,319.36,80,,,percent of total billed charges,80% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of CO APG rates,399.2,100,,,fee schedule,100% of NM fee schedule,159.68,40,,,percent of total billed charges,40% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,359.28,90,,,percent of total billed charges,90% of total billed charges,303.39,76,,,percent of total billed charges,76% of total billed charges,159.68,40,,,percent of total billed charges,40% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of CO APG rate,319.36,80,,,percent of total billed charges,80% of total billed charges,154.89,38.8,,,percent of total billed charges,38.8% of total billed charges,339.32,85,,,percent of total billed charges,85% of total billed charges,399.2,100,,,fee schedule,100% of APG fee schedule,798.4,200,,,percent of total billed charges,200% of total billed charges,154.89,798.4,
NON-LOCKING SCREW 3.5X70MM,460ECON0316,CDM,278,RC,,,OUTPATIENT,,,423.3,338.64,,317.48,75,,,percent of total billed charges,75% of total billed charges,169.32,40,,,percent of total billed charges,40% of total billed charges,335.25,79.2,,,percent of total billed charges,79.2% of total billed charges,359.81,85,,,percent of total billed charges,85% of total billed charges,423.3,100,,,fee schedule,100% of CO APG rates,402.14,95,,,percent of total billed charges,95% of total billed charges,338.64,80,,,percent of total billed charges,80% of total billed charges,359.81,85,,,percent of total billed charges,85% of total billed charges,380.97,90,,,percent of total billed charges,90% of total billed charges,423.3,100,,,fee schedule,100% of CO APG rates,423.3,100,,,fee schedule,100% of CO APG rates,423.3,100,,,fee schedule,100% of NM fee schedule,169.32,40,,,percent of total billed charges,40% of total billed charges,169.32,40,,,percent of total billed charges,40% of total billed charges,380.97,90,,,percent of total billed charges,90% of total billed charges,321.71,76,,,percent of total billed charges,76% of total billed charges,169.32,40,,,percent of total billed charges,40% of total billed charges,359.81,85,,,percent of total billed charges,85% of total billed charges,423.3,100,,,fee schedule,100% of CO APG rate,338.64,80,,,percent of total billed charges,80% of total billed charges,164.24,38.8,,,percent of total billed charges,38.8% of total billed charges,359.81,85,,,percent of total billed charges,85% of total billed charges,423.3,100,,,fee schedule,100% of APG fee schedule,846.6,200,,,percent of total billed charges,200% of total billed charges,164.24,846.6,
BONE MARROW TRAY,52717,CDM,272,RC,,,OUTPATIENT,,,126.1,100.88,,94.58,75,,,percent of total billed charges,75% of total billed charges,50.44,40,,,percent of total billed charges,40% of total billed charges,99.87,79.2,,,percent of total billed charges,79.2% of total billed charges,107.19,85,,,percent of total billed charges,85% of total billed charges,126.1,100,,,fee schedule,100% of CO APG rates,119.8,95,,,percent of total billed charges,95% of total billed charges,100.88,80,,,percent of total billed charges,80% of total billed charges,107.19,85,,,percent of total billed charges,85% of total billed charges,113.49,90,,,percent of total billed charges,90% of total billed charges,126.1,100,,,fee schedule,100% of CO APG rates,126.1,100,,,fee schedule,100% of CO APG rates,126.1,100,,,fee schedule,100% of NM fee schedule,50.44,40,,,percent of total billed charges,40% of total billed charges,50.44,40,,,percent of total billed charges,40% of total billed charges,113.49,90,,,percent of total billed charges,90% of total billed charges,95.84,76,,,percent of total billed charges,76% of total billed charges,50.44,40,,,percent of total billed charges,40% of total billed charges,107.19,85,,,percent of total billed charges,85% of total billed charges,126.1,100,,,fee schedule,100% of CO APG rate,100.88,80,,,percent of total billed charges,80% of total billed charges,48.93,38.8,,,percent of total billed charges,38.8% of total billed charges,107.19,85,,,percent of total billed charges,85% of total billed charges,126.1,100,,,fee schedule,100% of APG fee schedule,252.2,200,,,percent of total billed charges,200% of total billed charges,48.93,252.2,
"MALYGUIN RINGS, 6.25",46052718,CDM,272,RC,,,OUTPATIENT,,,420.2,336.16,,315.15,75,,,percent of total billed charges,75% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,332.8,79.2,,,percent of total billed charges,79.2% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,420.2,100,,,fee schedule,100% of CO APG rates,399.19,95,,,percent of total billed charges,95% of total billed charges,336.16,80,,,percent of total billed charges,80% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,378.18,90,,,percent of total billed charges,90% of total billed charges,420.2,100,,,fee schedule,100% of CO APG rates,420.2,100,,,fee schedule,100% of CO APG rates,420.2,100,,,fee schedule,100% of NM fee schedule,168.08,40,,,percent of total billed charges,40% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,378.18,90,,,percent of total billed charges,90% of total billed charges,319.35,76,,,percent of total billed charges,76% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,420.2,100,,,fee schedule,100% of CO APG rate,336.16,80,,,percent of total billed charges,80% of total billed charges,163.04,38.8,,,percent of total billed charges,38.8% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,420.2,100,,,fee schedule,100% of APG fee schedule,840.4,200,,,percent of total billed charges,200% of total billed charges,163.04,840.4,
"MALYGUIN RINGS, 7.0",46052719,CDM,272,RC,,,OUTPATIENT,,,420.2,336.16,,315.15,75,,,percent of total billed charges,75% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,332.8,79.2,,,percent of total billed charges,79.2% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,420.2,100,,,fee schedule,100% of CO APG rates,399.19,95,,,percent of total billed charges,95% of total billed charges,336.16,80,,,percent of total billed charges,80% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,378.18,90,,,percent of total billed charges,90% of total billed charges,420.2,100,,,fee schedule,100% of CO APG rates,420.2,100,,,fee schedule,100% of CO APG rates,420.2,100,,,fee schedule,100% of NM fee schedule,168.08,40,,,percent of total billed charges,40% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,378.18,90,,,percent of total billed charges,90% of total billed charges,319.35,76,,,percent of total billed charges,76% of total billed charges,168.08,40,,,percent of total billed charges,40% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,420.2,100,,,fee schedule,100% of CO APG rate,336.16,80,,,percent of total billed charges,80% of total billed charges,163.04,38.8,,,percent of total billed charges,38.8% of total billed charges,357.17,85,,,percent of total billed charges,85% of total billed charges,420.2,100,,,fee schedule,100% of APG fee schedule,840.4,200,,,percent of total billed charges,200% of total billed charges,163.04,840.4,
Antiphosphatidylserine IgM LC,40086148,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,126.6,101.28,,94.95,75,,,percent of total billed charges,75% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,100.27,79.2,,,percent of total billed charges,79.2% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,120.27,95,,,percent of total billed charges,95% of total billed charges,101.28,80,,,percent of total billed charges,80% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.64,40,,,percent of total billed charges,40% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,96.22,76,,,percent of total billed charges,76% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,101.28,80,,,percent of total billed charges,80% of total billed charges,49.12,38.8,,,percent of total billed charges,38.8% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,120.27,
Antiphosphatidylserine IgA LC,40086148,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,126.6,101.28,,94.95,75,,,percent of total billed charges,75% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,100.27,79.2,,,percent of total billed charges,79.2% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,120.27,95,,,percent of total billed charges,95% of total billed charges,101.28,80,,,percent of total billed charges,80% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.64,40,,,percent of total billed charges,40% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,96.22,76,,,percent of total billed charges,76% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,101.28,80,,,percent of total billed charges,80% of total billed charges,49.12,38.8,,,percent of total billed charges,38.8% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,120.27,
Antiphosphatidylserine IgG LC,40086148,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,126.6,101.28,,94.95,75,,,percent of total billed charges,75% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,100.27,79.2,,,percent of total billed charges,79.2% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,120.27,95,,,percent of total billed charges,95% of total billed charges,101.28,80,,,percent of total billed charges,80% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,50.64,40,,,percent of total billed charges,40% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,113.94,90,,,percent of total billed charges,90% of total billed charges,96.22,76,,,percent of total billed charges,76% of total billed charges,50.64,40,,,percent of total billed charges,40% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,101.28,80,,,percent of total billed charges,80% of total billed charges,49.12,38.8,,,percent of total billed charges,38.8% of total billed charges,107.61,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,120.27,
38220 Marrow Aspiration Only,60000191,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,5508.9,4407.12,,4131.68,75,,,percent of total billed charges,75% of total billed charges,2203.56,40,,,percent of total billed charges,40% of total billed charges,4363.05,79.2,,,percent of total billed charges,79.2% of total billed charges,4682.57,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,5233.46,95,,,percent of total billed charges,95% of total billed charges,4407.12,80,,,percent of total billed charges,80% of total billed charges,4682.57,85,,,percent of total billed charges,85% of total billed charges,4958.01,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,2203.56,40,,,percent of total billed charges,40% of total billed charges,2203.56,40,,,percent of total billed charges,40% of total billed charges,4958.01,90,,,percent of total billed charges,90% of total billed charges,4186.76,76,,,percent of total billed charges,76% of total billed charges,2203.56,40,,,percent of total billed charges,40% of total billed charges,4682.57,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,4407.12,80,,,percent of total billed charges,80% of total billed charges,2137.45,38.8,,,percent of total billed charges,38.8% of total billed charges,4682.57,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,5233.46,
MN60AC+ 8.0,460ECON0317,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
96401 - CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,60000183,CDM,331,RC,96402,HCPCS,OUTPATIENT,,,222.1,177.68,,166.58,75,,,percent of total billed charges,75% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,175.9,79.2,,,percent of total billed charges,79.2% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,211,95,,,percent of total billed charges,95% of total billed charges,177.68,80,,,percent of total billed charges,80% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,199.89,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,88.84,40,,,percent of total billed charges,40% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,199.89,90,,,percent of total billed charges,90% of total billed charges,168.8,76,,,percent of total billed charges,76% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,177.68,80,,,percent of total billed charges,80% of total billed charges,86.17,38.8,,,percent of total billed charges,38.8% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,70.94,200,,,fee schedule,200% of CMS fee schedule,58.22,211,
96402 - CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,60000184,CDM,331,RC,96402,HCPCS,OUTPATIENT,,,222.1,177.68,,166.58,75,,,percent of total billed charges,75% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,175.9,79.2,,,percent of total billed charges,79.2% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,211,95,,,percent of total billed charges,95% of total billed charges,177.68,80,,,percent of total billed charges,80% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,199.89,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,88.84,40,,,percent of total billed charges,40% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,199.89,90,,,percent of total billed charges,90% of total billed charges,168.8,76,,,percent of total billed charges,76% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,177.68,80,,,percent of total billed charges,80% of total billed charges,86.17,38.8,,,percent of total billed charges,38.8% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,70.94,200,,,fee schedule,200% of CMS fee schedule,58.22,211,
96409 - CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,60000185,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,750.5,600.4,,562.88,75,,,percent of total billed charges,75% of total billed charges,300.2,40,,,percent of total billed charges,40% of total billed charges,594.4,79.2,,,percent of total billed charges,79.2% of total billed charges,637.93,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,712.98,95,,,percent of total billed charges,95% of total billed charges,600.4,80,,,percent of total billed charges,80% of total billed charges,637.93,85,,,percent of total billed charges,85% of total billed charges,675.45,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,300.2,40,,,percent of total billed charges,40% of total billed charges,300.2,40,,,percent of total billed charges,40% of total billed charges,675.45,90,,,percent of total billed charges,90% of total billed charges,570.38,76,,,percent of total billed charges,76% of total billed charges,300.2,40,,,percent of total billed charges,40% of total billed charges,637.93,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,600.4,80,,,percent of total billed charges,80% of total billed charges,291.19,38.8,,,percent of total billed charges,38.8% of total billed charges,637.93,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,712.98,
96411- CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,60000186,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,222.1,177.68,,166.58,75,,,percent of total billed charges,75% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,175.9,79.2,,,percent of total billed charges,79.2% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,211,95,,,percent of total billed charges,95% of total billed charges,177.68,80,,,percent of total billed charges,80% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,199.89,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,88.84,40,,,percent of total billed charges,40% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,199.89,90,,,percent of total billed charges,90% of total billed charges,168.8,76,,,percent of total billed charges,76% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,177.68,80,,,percent of total billed charges,80% of total billed charges,86.17,38.8,,,percent of total billed charges,38.8% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,266.44,
96413 - CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,60000187,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,1166.7,933.36,,875.03,75,,,percent of total billed charges,75% of total billed charges,466.68,40,,,percent of total billed charges,40% of total billed charges,924.03,79.2,,,percent of total billed charges,79.2% of total billed charges,991.7,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,1108.37,95,,,percent of total billed charges,95% of total billed charges,933.36,80,,,percent of total billed charges,80% of total billed charges,991.7,85,,,percent of total billed charges,85% of total billed charges,1050.03,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,466.68,40,,,percent of total billed charges,40% of total billed charges,466.68,40,,,percent of total billed charges,40% of total billed charges,1050.03,90,,,percent of total billed charges,90% of total billed charges,886.69,76,,,percent of total billed charges,76% of total billed charges,466.68,40,,,percent of total billed charges,40% of total billed charges,991.7,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,933.36,80,,,percent of total billed charges,80% of total billed charges,452.68,38.8,,,percent of total billed charges,38.8% of total billed charges,991.7,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,1108.37,
96415 - CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,60000188,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,222.1,177.68,,166.58,75,,,percent of total billed charges,75% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,175.9,79.2,,,percent of total billed charges,79.2% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,211,95,,,percent of total billed charges,95% of total billed charges,177.68,80,,,percent of total billed charges,80% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,199.89,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,88.84,40,,,percent of total billed charges,40% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,199.89,90,,,percent of total billed charges,90% of total billed charges,168.8,76,,,percent of total billed charges,76% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,177.68,80,,,percent of total billed charges,80% of total billed charges,86.17,38.8,,,percent of total billed charges,38.8% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,266.44,
96416 - CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,60000189,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,1194.8,955.84,,896.1,75,,,percent of total billed charges,75% of total billed charges,477.92,40,,,percent of total billed charges,40% of total billed charges,946.28,79.2,,,percent of total billed charges,79.2% of total billed charges,1015.58,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,1135.06,95,,,percent of total billed charges,95% of total billed charges,955.84,80,,,percent of total billed charges,80% of total billed charges,1015.58,85,,,percent of total billed charges,85% of total billed charges,1075.32,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,477.92,40,,,percent of total billed charges,40% of total billed charges,477.92,40,,,percent of total billed charges,40% of total billed charges,1075.32,90,,,percent of total billed charges,90% of total billed charges,908.05,76,,,percent of total billed charges,76% of total billed charges,477.92,40,,,percent of total billed charges,40% of total billed charges,1015.58,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,955.84,80,,,percent of total billed charges,80% of total billed charges,463.58,38.8,,,percent of total billed charges,38.8% of total billed charges,1015.58,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,1135.06,
96417 - CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,60000190,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,222.1,177.68,,166.58,75,,,percent of total billed charges,75% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,175.9,79.2,,,percent of total billed charges,79.2% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,211,95,,,percent of total billed charges,95% of total billed charges,177.68,80,,,percent of total billed charges,80% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,199.89,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,88.84,40,,,percent of total billed charges,40% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,199.89,90,,,percent of total billed charges,90% of total billed charges,168.8,76,,,percent of total billed charges,76% of total billed charges,88.84,40,,,percent of total billed charges,40% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,177.68,80,,,percent of total billed charges,80% of total billed charges,86.17,38.8,,,percent of total billed charges,38.8% of total billed charges,188.79,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,266.44,
36416 Puncture of skin for collection of blood sample,60000133,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,30.2,24.16,,22.65,75,,,percent of total billed charges,75% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,23.92,79.2,,,percent of total billed charges,79.2% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,30.2,100,,,fee schedule,100% of CO APG rates,28.69,95,,,percent of total billed charges,95% of total billed charges,24.16,80,,,percent of total billed charges,80% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,27.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,30.2,100,,,fee schedule,100% of NM APC rate,12.08,40,,,percent of total billed charges,40% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,27.18,90,,,percent of total billed charges,90% of total billed charges,22.95,76,,,percent of total billed charges,76% of total billed charges,12.08,40,,,percent of total billed charges,40% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,24.16,80,,,percent of total billed charges,80% of total billed charges,11.72,38.8,,,percent of total billed charges,38.8% of total billed charges,25.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,60.4,200,,,fee schedule,200% of CMS fee schedule,11.72,215.49,
"Prothrombin Ab, IGG, LC",40086849,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,120.6,96.48,,90.45,75,,,percent of total billed charges,75% of total billed charges,48.24,40,,,percent of total billed charges,40% of total billed charges,95.52,79.2,,,percent of total billed charges,79.2% of total billed charges,102.51,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,114.57,95,,,percent of total billed charges,95% of total billed charges,96.48,80,,,percent of total billed charges,80% of total billed charges,102.51,85,,,percent of total billed charges,85% of total billed charges,108.54,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,48.24,40,,,percent of total billed charges,40% of total billed charges,48.24,40,,,percent of total billed charges,40% of total billed charges,108.54,90,,,percent of total billed charges,90% of total billed charges,91.66,76,,,percent of total billed charges,76% of total billed charges,48.24,40,,,percent of total billed charges,40% of total billed charges,102.51,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,96.48,80,,,percent of total billed charges,80% of total billed charges,46.79,38.8,,,percent of total billed charges,38.8% of total billed charges,102.51,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,114.57,
AU00T0 6.0 ULTRASERT PRE-LOADED,460ECON0123,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 6.5 ULTRASERT PRE-LOADED,460ECON0124,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 7.0 ULTRASERT PRE-LOADED,460ECON0125,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 7.5 ULTRASERT PRE-LOADED,460ECON0126,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 8.0 ULTRASERT PRE-LOADED,460ECON0127,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 8.5 ULTRASERT PRE-LOADED,460ECON0128,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 9.0 ULTRASERT PRE-LOADED,460ECON0129,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 9.5 ULTRASERT PRE-LOADED,460ECON0130,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 10.0 ULTRASERT PRE-LOADED,460ECON0131,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 10.5 ULTRASERT PRE-LOADED,460ECON0132,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 11.0 ULTRASERT PRE-LOADED,460ECON0133,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 11.5 ULTRASERT PRE-LOADED,460ECON0134,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 12.0 ULTRASERT PRE-LOADED,460ECON0135,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 12.5 ULTRASERT PRE-LOADED,460ECON0136,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 13.0 ULTRASERT PRE-LOADED,460ECON0137,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 13.5 ULTRASERT PRE-LOADED,460ECON0138,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 14.0 ULTRASERT PRE-LOADED,460-econ0139,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 14.5  ULTRASERT PRE-LOADED,460ECON0140,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 15.0 ULTRASERT PRE-LOADED,460ECON0141,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 15.5 ULTRASERT PRE-LOADED,460ECON0142,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 16.0 ULTRASERT PRE-LOADED,460ECON0143,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 16.5 ULTRASERT PRE-LOADED,460ECON0144,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AU00T0 17.0 ULTRASERT PRE-LOADED,460ECON0145,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 17.5 ULTRASERT PRE-LOADED,460ECON0146,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 18.0 ULTRASERT PRE-LOADED,460ECON0147,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 18.5 ULTRASERT PRE-LOADED,460ECON0148,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 19.0 ULTRASERT PRE-LOADED,460ECON0149,CDM,276,RC,,,OUTPATIENT,,,480,384,,360,75,,,percent of total billed charges,75% of total billed charges,192,40,,,percent of total billed charges,40% of total billed charges,380.16,79.2,,,percent of total billed charges,79.2% of total billed charges,408,85,,,percent of total billed charges,85% of total billed charges,480,100,,,fee schedule,100% of CO APG rates,456,95,,,percent of total billed charges,95% of total billed charges,384,80,,,percent of total billed charges,80% of total billed charges,408,85,,,percent of total billed charges,85% of total billed charges,432,90,,,percent of total billed charges,90% of total billed charges,480,100,,,fee schedule,100% of CO APG rates,480,100,,,fee schedule,100% of CO APG rates,480,100,,,fee schedule,100% of NM fee schedule,192,40,,,percent of total billed charges,40% of total billed charges,192,40,,,percent of total billed charges,40% of total billed charges,432,90,,,percent of total billed charges,90% of total billed charges,364.8,76,,,percent of total billed charges,76% of total billed charges,192,40,,,percent of total billed charges,40% of total billed charges,408,85,,,percent of total billed charges,85% of total billed charges,480,100,,,fee schedule,100% of CO APG rate,384,80,,,percent of total billed charges,80% of total billed charges,186.24,38.8,,,percent of total billed charges,38.8% of total billed charges,408,85,,,percent of total billed charges,85% of total billed charges,480,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,186.24,480,
AUOOTO 19.5 ULTRASERT PRE-LOADED,460ECON0150,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 20.0 ULTRASERT PRE-LOADED,460ECON0151,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 20.5 ULTRASERT PRE-LOADED,460ECON0152,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 21.0 ULTRASERT PRE-LOADED,460ECON0153,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 21.5 ULTRASERT PRE-LOADED,460ECON0154,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 22.0 ULTRASERT PRE-LOADED,460ECON0155,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 22.5 ULTRASERT PRE-LOADED,460ECON0156,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 23.0 ULTRASERT PRE-LOADED,460ECON0157,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 23.5 ULTRASERT PRE-LOADED,460ECON0158,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 24.0 ULTRASERT PRE-LOADED,460ECON0159,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 24.5 ULTRASERT PRE-LOADED,460ECON0160,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 25.0 ULTRASERT PRE-LOADED,460ECON0161,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 25.5 ULTRASERT PRE-LOADED,460ECON0162,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 26.0 ULTRASERT PRE-LOADED,460ECON0163,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 26.5 ULTRASERT PRE-LOADED,460ECON0164,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 27.0 ULTRASERT PRE-LOADED,460ECON0165,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 27.5 ULTRASERT PRE-LOADED,460ECON0166,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 28.0 ULTRASERT PRE-LOADED,460ECON0167,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 28.5 ULTRASERT PRE-LOADED,460ECON0168,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 29.0 ULTRASERT PRE-LOADED,460ECON0169,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 29.5 ULTRASERT PRE-LOADED,460ECON0170,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
AUOOTO 30.0 ULTRASERT PRE-LOADED,460ECON0171,CDM,276,RC,,,OUTPATIENT,,,472.7,378.16,,354.53,75,,,percent of total billed charges,75% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,374.38,79.2,,,percent of total billed charges,79.2% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,449.07,95,,,percent of total billed charges,95% of total billed charges,378.16,80,,,percent of total billed charges,80% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of CO APG rates,472.7,100,,,fee schedule,100% of NM fee schedule,189.08,40,,,percent of total billed charges,40% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,425.43,90,,,percent of total billed charges,90% of total billed charges,359.25,76,,,percent of total billed charges,76% of total billed charges,189.08,40,,,percent of total billed charges,40% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of CO APG rate,378.16,80,,,percent of total billed charges,80% of total billed charges,183.41,38.8,,,percent of total billed charges,38.8% of total billed charges,401.8,85,,,percent of total billed charges,85% of total billed charges,472.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.41,472.7,
96450 - CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,60000201,CDM,331,RC,96402,HCPCS,OUTPATIENT,,,1100.6,880.48,,825.45,75,,,percent of total billed charges,75% of total billed charges,440.24,40,,,percent of total billed charges,40% of total billed charges,871.68,79.2,,,percent of total billed charges,79.2% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,1045.57,95,,,percent of total billed charges,95% of total billed charges,880.48,80,,,percent of total billed charges,80% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,990.54,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,440.24,40,,,percent of total billed charges,40% of total billed charges,440.24,40,,,percent of total billed charges,40% of total billed charges,990.54,90,,,percent of total billed charges,90% of total billed charges,836.46,76,,,percent of total billed charges,76% of total billed charges,440.24,40,,,percent of total billed charges,40% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,880.48,80,,,percent of total billed charges,80% of total billed charges,427.03,38.8,,,percent of total billed charges,38.8% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,70.94,200,,,fee schedule,200% of CMS fee schedule,58.22,1045.57,
96440 - CHEMOTX ADMN PLEURAL CAVITY REQW/THORACNTS,60000199,CDM,331,RC,96402,HCPCS,OUTPATIENT,,,1100.6,880.48,,825.45,75,,,percent of total billed charges,75% of total billed charges,440.24,40,,,percent of total billed charges,40% of total billed charges,871.68,79.2,,,percent of total billed charges,79.2% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,1045.57,95,,,percent of total billed charges,95% of total billed charges,880.48,80,,,percent of total billed charges,80% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,990.54,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,440.24,40,,,percent of total billed charges,40% of total billed charges,440.24,40,,,percent of total billed charges,40% of total billed charges,990.54,90,,,percent of total billed charges,90% of total billed charges,836.46,76,,,percent of total billed charges,76% of total billed charges,440.24,40,,,percent of total billed charges,40% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,880.48,80,,,percent of total billed charges,80% of total billed charges,427.03,38.8,,,percent of total billed charges,38.8% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,70.94,200,,,fee schedule,200% of CMS fee schedule,58.22,1045.57,
96446 - CHEMOTX ADMN PRTL CAVITY PORT/CATH,60000200,CDM,331,RC,96402,HCPCS,OUTPATIENT,,,1100.6,880.48,,825.45,75,,,percent of total billed charges,75% of total billed charges,440.24,40,,,percent of total billed charges,40% of total billed charges,871.68,79.2,,,percent of total billed charges,79.2% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,1045.57,95,,,percent of total billed charges,95% of total billed charges,880.48,80,,,percent of total billed charges,80% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,990.54,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,440.24,40,,,percent of total billed charges,40% of total billed charges,440.24,40,,,percent of total billed charges,40% of total billed charges,990.54,90,,,percent of total billed charges,90% of total billed charges,836.46,76,,,percent of total billed charges,76% of total billed charges,440.24,40,,,percent of total billed charges,40% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,880.48,80,,,percent of total billed charges,80% of total billed charges,427.03,38.8,,,percent of total billed charges,38.8% of total billed charges,935.51,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,70.94,200,,,fee schedule,200% of CMS fee schedule,58.22,1045.57,
ACUTE AC REPAIR IMPLANT SYSTEM (ARTHREX),460ECON0318,CDM,278,RC,,,OUTPATIENT,,,3378.1,2702.48,,2533.58,75,,,percent of total billed charges,75% of total billed charges,1351.24,40,,,percent of total billed charges,40% of total billed charges,2675.46,79.2,,,percent of total billed charges,79.2% of total billed charges,2871.39,85,,,percent of total billed charges,85% of total billed charges,3378.1,100,,,fee schedule,100% of CO APG rates,3209.2,95,,,percent of total billed charges,95% of total billed charges,2702.48,80,,,percent of total billed charges,80% of total billed charges,2871.39,85,,,percent of total billed charges,85% of total billed charges,3040.29,90,,,percent of total billed charges,90% of total billed charges,3378.1,100,,,fee schedule,100% of CO APG rates,3378.1,100,,,fee schedule,100% of CO APG rates,3378.1,100,,,fee schedule,100% of NM fee schedule,1351.24,40,,,percent of total billed charges,40% of total billed charges,1351.24,40,,,percent of total billed charges,40% of total billed charges,3040.29,90,,,percent of total billed charges,90% of total billed charges,2567.36,76,,,percent of total billed charges,76% of total billed charges,1351.24,40,,,percent of total billed charges,40% of total billed charges,2871.39,85,,,percent of total billed charges,85% of total billed charges,3378.1,100,,,fee schedule,100% of CO APG rate,2702.48,80,,,percent of total billed charges,80% of total billed charges,1310.7,38.8,,,percent of total billed charges,38.8% of total billed charges,2871.39,85,,,percent of total billed charges,85% of total billed charges,3378.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1310.7,3378.1,
"TIGER STICK, #2 TIGER WIRE (white/black), 12in",460ECON0319,CDM,278,RC,,,OUTPATIENT,,,236.3,189.04,,177.23,75,,,percent of total billed charges,75% of total billed charges,94.52,40,,,percent of total billed charges,40% of total billed charges,187.15,79.2,,,percent of total billed charges,79.2% of total billed charges,200.86,85,,,percent of total billed charges,85% of total billed charges,236.3,100,,,fee schedule,100% of CO APG rates,224.49,95,,,percent of total billed charges,95% of total billed charges,189.04,80,,,percent of total billed charges,80% of total billed charges,200.86,85,,,percent of total billed charges,85% of total billed charges,212.67,90,,,percent of total billed charges,90% of total billed charges,236.3,100,,,fee schedule,100% of CO APG rates,236.3,100,,,fee schedule,100% of CO APG rates,236.3,100,,,fee schedule,100% of NM fee schedule,94.52,40,,,percent of total billed charges,40% of total billed charges,94.52,40,,,percent of total billed charges,40% of total billed charges,212.67,90,,,percent of total billed charges,90% of total billed charges,179.59,76,,,percent of total billed charges,76% of total billed charges,94.52,40,,,percent of total billed charges,40% of total billed charges,200.86,85,,,percent of total billed charges,85% of total billed charges,236.3,100,,,fee schedule,100% of CO APG rate,189.04,80,,,percent of total billed charges,80% of total billed charges,91.68,38.8,,,percent of total billed charges,38.8% of total billed charges,200.86,85,,,percent of total billed charges,85% of total billed charges,236.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,91.68,236.3,
"FIBER LINK, #2 FIBER WIRE (blue) w/ CLOSED LOOP",460ECON0320,CDM,278,RC,,,OUTPATIENT,,,260.5,208.4,,195.38,75,,,percent of total billed charges,75% of total billed charges,104.2,40,,,percent of total billed charges,40% of total billed charges,206.32,79.2,,,percent of total billed charges,79.2% of total billed charges,221.43,85,,,percent of total billed charges,85% of total billed charges,260.5,100,,,fee schedule,100% of CO APG rates,247.48,95,,,percent of total billed charges,95% of total billed charges,208.4,80,,,percent of total billed charges,80% of total billed charges,221.43,85,,,percent of total billed charges,85% of total billed charges,234.45,90,,,percent of total billed charges,90% of total billed charges,260.5,100,,,fee schedule,100% of CO APG rates,260.5,100,,,fee schedule,100% of CO APG rates,260.5,100,,,fee schedule,100% of NM fee schedule,104.2,40,,,percent of total billed charges,40% of total billed charges,104.2,40,,,percent of total billed charges,40% of total billed charges,234.45,90,,,percent of total billed charges,90% of total billed charges,197.98,76,,,percent of total billed charges,76% of total billed charges,104.2,40,,,percent of total billed charges,40% of total billed charges,221.43,85,,,percent of total billed charges,85% of total billed charges,260.5,100,,,fee schedule,100% of CO APG rate,208.4,80,,,percent of total billed charges,80% of total billed charges,101.07,38.8,,,percent of total billed charges,38.8% of total billed charges,221.43,85,,,percent of total billed charges,85% of total billed charges,260.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,101.07,260.5,
"REAMER SHAFT, MOD. TRINKLE 08 X 510mm",46052721,CDM,270,RC,,,OUTPATIENT,,,1394.9,1115.92,,1046.18,75,,,percent of total billed charges,75% of total billed charges,557.96,40,,,percent of total billed charges,40% of total billed charges,1104.76,79.2,,,percent of total billed charges,79.2% of total billed charges,1185.67,85,,,percent of total billed charges,85% of total billed charges,1394.9,100,,,fee schedule,100% of CO APG rates,1325.16,95,,,percent of total billed charges,95% of total billed charges,1115.92,80,,,percent of total billed charges,80% of total billed charges,1185.67,85,,,percent of total billed charges,85% of total billed charges,1255.41,90,,,percent of total billed charges,90% of total billed charges,1394.9,100,,,fee schedule,100% of CO APG rates,1394.9,100,,,fee schedule,100% of CO APG rates,1394.9,100,,,fee schedule,100% of NM fee schedule,557.96,40,,,percent of total billed charges,40% of total billed charges,557.96,40,,,percent of total billed charges,40% of total billed charges,1255.41,90,,,percent of total billed charges,90% of total billed charges,1060.12,76,,,percent of total billed charges,76% of total billed charges,557.96,40,,,percent of total billed charges,40% of total billed charges,1185.67,85,,,percent of total billed charges,85% of total billed charges,1394.9,100,,,fee schedule,100% of CO APG rate,1115.92,80,,,percent of total billed charges,80% of total billed charges,541.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1185.67,85,,,percent of total billed charges,85% of total billed charges,1394.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,541.22,1394.9,
LOCKING SCREW T10 FULL THREAD 3.5mm / L8mm,460ECON0321,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L10mm,460ECON0322,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 3.5mm / L12mm,460ECON0323,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 3.5mm / L14mm,460ECON0324,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 3.5mm / L16mm,460ECON0325,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 3.5mm / L18mm,460ECON0326,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 3.5mm / L20mm,460ECON0327,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 3.5mm / L22mm,460ECON0328,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 3.5mm / L24mm,460ECON0329,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 3.5mm / L26mm,460ECON0330,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 3.5mm / L28mm,460ECON0331,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L30mm,460ECON0332,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L32mm,460ECON0333,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
42700 DRAINAGE OF TONSIL ABSCES,31042700,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,655.2,524.16,,491.4,75,,,percent of total billed charges,75% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,518.92,79.2,,,percent of total billed charges,79.2% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,622.44,95,,,percent of total billed charges,95% of total billed charges,524.16,80,,,percent of total billed charges,80% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,589.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,262.08,40,,,percent of total billed charges,40% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,589.68,90,,,percent of total billed charges,90% of total billed charges,497.95,76,,,percent of total billed charges,76% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,524.16,80,,,percent of total billed charges,80% of total billed charges,254.22,38.8,,,percent of total billed charges,38.8% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,622.44,
27238 CLOSED TRMT FEMORAL FX,31027238,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4510.5,3608.4,,3382.88,75,,,percent of total billed charges,75% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3572.32,79.2,,,percent of total billed charges,79.2% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4284.98,95,,,percent of total billed charges,95% of total billed charges,3608.4,80,,,percent of total billed charges,80% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1804.2,40,,,percent of total billed charges,40% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,4059.45,90,,,percent of total billed charges,90% of total billed charges,3427.98,76,,,percent of total billed charges,76% of total billed charges,1804.2,40,,,percent of total billed charges,40% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3608.4,80,,,percent of total billed charges,80% of total billed charges,1750.07,38.8,,,percent of total billed charges,38.8% of total billed charges,3833.93,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4284.98,
27265 TREAT HIP DISLOC W/O ANES,60000290,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,793.5,634.8,,595.13,75,,,percent of total billed charges,75% of total billed charges,317.4,40,,,percent of total billed charges,40% of total billed charges,628.45,79.2,,,percent of total billed charges,79.2% of total billed charges,674.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,753.83,95,,,percent of total billed charges,95% of total billed charges,634.8,80,,,percent of total billed charges,80% of total billed charges,674.48,85,,,percent of total billed charges,85% of total billed charges,714.15,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,317.4,40,,,percent of total billed charges,40% of total billed charges,317.4,40,,,percent of total billed charges,40% of total billed charges,714.15,90,,,percent of total billed charges,90% of total billed charges,603.06,76,,,percent of total billed charges,76% of total billed charges,317.4,40,,,percent of total billed charges,40% of total billed charges,674.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,634.8,80,,,percent of total billed charges,80% of total billed charges,307.88,38.8,,,percent of total billed charges,38.8% of total billed charges,674.48,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,753.83,
27266 Closed treatment of post hip arthroplasty dislocation;,31027266,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4564.6,3651.68,,3423.45,75,,,percent of total billed charges,75% of total billed charges,1825.84,40,,,percent of total billed charges,40% of total billed charges,3615.16,79.2,,,percent of total billed charges,79.2% of total billed charges,3879.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4336.37,95,,,percent of total billed charges,95% of total billed charges,3651.68,80,,,percent of total billed charges,80% of total billed charges,3879.91,85,,,percent of total billed charges,85% of total billed charges,4108.14,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1825.84,40,,,percent of total billed charges,40% of total billed charges,1825.84,40,,,percent of total billed charges,40% of total billed charges,4108.14,90,,,percent of total billed charges,90% of total billed charges,3469.1,76,,,percent of total billed charges,76% of total billed charges,1825.84,40,,,percent of total billed charges,40% of total billed charges,3879.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3651.68,80,,,percent of total billed charges,80% of total billed charges,1771.06,38.8,,,percent of total billed charges,38.8% of total billed charges,3879.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4336.37,
"27508 Closed treatment of femoral fracture, distal end, medi",60000398,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,796.6,637.28,,597.45,75,,,percent of total billed charges,75% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,630.91,79.2,,,percent of total billed charges,79.2% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,756.77,95,,,percent of total billed charges,95% of total billed charges,637.28,80,,,percent of total billed charges,80% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,716.94,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,318.64,40,,,percent of total billed charges,40% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,716.94,90,,,percent of total billed charges,90% of total billed charges,605.42,76,,,percent of total billed charges,76% of total billed charges,318.64,40,,,percent of total billed charges,40% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,637.28,80,,,percent of total billed charges,80% of total billed charges,309.08,38.8,,,percent of total billed charges,38.8% of total billed charges,677.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,756.77,
CLOSED TREATMENT OF PATELLAR FRACTURE W/O MANIPULATION,46027520,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,739.4,591.52,,554.55,75,,,percent of total billed charges,75% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,585.6,79.2,,,percent of total billed charges,79.2% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,702.43,95,,,percent of total billed charges,95% of total billed charges,591.52,80,,,percent of total billed charges,80% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,295.76,40,,,percent of total billed charges,40% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,665.46,90,,,percent of total billed charges,90% of total billed charges,561.94,76,,,percent of total billed charges,76% of total billed charges,295.76,40,,,percent of total billed charges,40% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,591.52,80,,,percent of total billed charges,80% of total billed charges,286.89,38.8,,,percent of total billed charges,38.8% of total billed charges,628.49,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,702.43,
27762 - Closed Treatment Of Medial Malleolus Fracture; With,60000661,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4564.6,3651.68,,3423.45,75,,,percent of total billed charges,75% of total billed charges,1825.84,40,,,percent of total billed charges,40% of total billed charges,3615.16,79.2,,,percent of total billed charges,79.2% of total billed charges,3879.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4336.37,95,,,percent of total billed charges,95% of total billed charges,3651.68,80,,,percent of total billed charges,80% of total billed charges,3879.91,85,,,percent of total billed charges,85% of total billed charges,4108.14,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1825.84,40,,,percent of total billed charges,40% of total billed charges,1825.84,40,,,percent of total billed charges,40% of total billed charges,4108.14,90,,,percent of total billed charges,90% of total billed charges,3469.1,76,,,percent of total billed charges,76% of total billed charges,1825.84,40,,,percent of total billed charges,40% of total billed charges,3879.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3651.68,80,,,percent of total billed charges,80% of total billed charges,1771.06,38.8,,,percent of total billed charges,38.8% of total billed charges,3879.91,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4336.37,
28635 Closed treatment of metatarsophalangeal joint dislocat,31028635,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4424.2,3539.36,,3318.15,75,,,percent of total billed charges,75% of total billed charges,1769.68,40,,,percent of total billed charges,40% of total billed charges,3503.97,79.2,,,percent of total billed charges,79.2% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4202.99,95,,,percent of total billed charges,95% of total billed charges,3539.36,80,,,percent of total billed charges,80% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,3981.78,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1769.68,40,,,percent of total billed charges,40% of total billed charges,1769.68,40,,,percent of total billed charges,40% of total billed charges,3981.78,90,,,percent of total billed charges,90% of total billed charges,3362.39,76,,,percent of total billed charges,76% of total billed charges,1769.68,40,,,percent of total billed charges,40% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3539.36,80,,,percent of total billed charges,80% of total billed charges,1716.59,38.8,,,percent of total billed charges,38.8% of total billed charges,3760.57,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4202.99,
"99151 Moderate sedation, same health care pro performing dia",46299151,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,324.5,259.6,,243.38,75,,,percent of total billed charges,75% of total billed charges,129.8,40,,,percent of total billed charges,40% of total billed charges,257,79.2,,,percent of total billed charges,79.2% of total billed charges,275.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,308.28,95,,,percent of total billed charges,95% of total billed charges,259.6,80,,,percent of total billed charges,80% of total billed charges,275.83,85,,,percent of total billed charges,85% of total billed charges,292.05,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,129.8,40,,,percent of total billed charges,40% of total billed charges,129.8,40,,,percent of total billed charges,40% of total billed charges,292.05,90,,,percent of total billed charges,90% of total billed charges,246.62,76,,,percent of total billed charges,76% of total billed charges,129.8,40,,,percent of total billed charges,40% of total billed charges,275.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,259.6,80,,,percent of total billed charges,80% of total billed charges,125.91,38.8,,,percent of total billed charges,38.8% of total billed charges,275.83,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,125.91,308.28,
"99152 Moderate sedation, same health care pro performing dia",46299152,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,491.5,393.2,,368.63,75,,,percent of total billed charges,75% of total billed charges,196.6,40,,,percent of total billed charges,40% of total billed charges,389.27,79.2,,,percent of total billed charges,79.2% of total billed charges,417.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,466.93,95,,,percent of total billed charges,95% of total billed charges,393.2,80,,,percent of total billed charges,80% of total billed charges,417.78,85,,,percent of total billed charges,85% of total billed charges,442.35,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,196.6,40,,,percent of total billed charges,40% of total billed charges,196.6,40,,,percent of total billed charges,40% of total billed charges,442.35,90,,,percent of total billed charges,90% of total billed charges,373.54,76,,,percent of total billed charges,76% of total billed charges,196.6,40,,,percent of total billed charges,40% of total billed charges,417.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,393.2,80,,,percent of total billed charges,80% of total billed charges,190.7,38.8,,,percent of total billed charges,38.8% of total billed charges,417.78,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,466.93,
"30903 Control nasal hemorrhage, anterior, complex (extensive",31030903,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,370.2,296.16,,277.65,75,,,percent of total billed charges,75% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,293.2,79.2,,,percent of total billed charges,79.2% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,351.69,95,,,percent of total billed charges,95% of total billed charges,296.16,80,,,percent of total billed charges,80% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,148.08,40,,,percent of total billed charges,40% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,281.35,76,,,percent of total billed charges,76% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,296.16,80,,,percent of total billed charges,80% of total billed charges,143.64,38.8,,,percent of total billed charges,38.8% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,143.64,351.69,
30905 CNTRL NSAL HMRR-POSTER,31030905,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,370.2,296.16,,277.65,75,,,percent of total billed charges,75% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,293.2,79.2,,,percent of total billed charges,79.2% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,351.69,95,,,percent of total billed charges,95% of total billed charges,296.16,80,,,percent of total billed charges,80% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,148.08,40,,,percent of total billed charges,40% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,281.35,76,,,percent of total billed charges,76% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,296.16,80,,,percent of total billed charges,80% of total billed charges,143.64,38.8,,,percent of total billed charges,38.8% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,143.64,351.69,
30906 CNTRL NSAL HMRR-PSTR SUBS,31030906,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,655.2,524.16,,491.4,75,,,percent of total billed charges,75% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,518.92,79.2,,,percent of total billed charges,79.2% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,622.44,95,,,percent of total billed charges,95% of total billed charges,524.16,80,,,percent of total billed charges,80% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,589.68,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,262.08,40,,,percent of total billed charges,40% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,589.68,90,,,percent of total billed charges,90% of total billed charges,497.95,76,,,percent of total billed charges,76% of total billed charges,262.08,40,,,percent of total billed charges,40% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,524.16,80,,,percent of total billed charges,80% of total billed charges,254.22,38.8,,,percent of total billed charges,38.8% of total billed charges,556.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,622.44,
"20611 Arthrocentesis, aspiration and/or injection, W/US",60000685,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,872.9,698.32,,654.68,75,,,percent of total billed charges,75% of total billed charges,349.16,40,,,percent of total billed charges,40% of total billed charges,691.34,79.2,,,percent of total billed charges,79.2% of total billed charges,741.97,85,,,percent of total billed charges,85% of total billed charges,872.9,100,,,fee schedule,100% of CO APG rates,829.26,95,,,percent of total billed charges,95% of total billed charges,698.32,80,,,percent of total billed charges,80% of total billed charges,741.97,85,,,percent of total billed charges,85% of total billed charges,785.61,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,872.9,100,,,fee schedule,100% of NM APC rate,349.16,40,,,percent of total billed charges,40% of total billed charges,349.16,40,,,percent of total billed charges,40% of total billed charges,785.61,90,,,percent of total billed charges,90% of total billed charges,663.4,76,,,percent of total billed charges,76% of total billed charges,349.16,40,,,percent of total billed charges,40% of total billed charges,741.97,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,698.32,80,,,percent of total billed charges,80% of total billed charges,338.69,38.8,,,percent of total billed charges,38.8% of total billed charges,741.97,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,338.69,2713.28,
"Coccidioides Ab, IgG, EIA LC",40086635,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,58.1,46.48,,43.58,75,,,percent of total billed charges,75% of total billed charges,23.24,40,,,percent of total billed charges,40% of total billed charges,46.02,79.2,,,percent of total billed charges,79.2% of total billed charges,49.39,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,55.2,95,,,percent of total billed charges,95% of total billed charges,46.48,80,,,percent of total billed charges,80% of total billed charges,49.39,85,,,percent of total billed charges,85% of total billed charges,52.29,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,23.24,40,,,percent of total billed charges,40% of total billed charges,23.24,40,,,percent of total billed charges,40% of total billed charges,52.29,90,,,percent of total billed charges,90% of total billed charges,44.16,76,,,percent of total billed charges,76% of total billed charges,23.24,40,,,percent of total billed charges,40% of total billed charges,49.39,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,46.48,80,,,percent of total billed charges,80% of total billed charges,22.54,38.8,,,percent of total billed charges,38.8% of total billed charges,49.39,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,55.2,
"Coccidioides Ab, IgM, EIA LC",40086635,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,58.1,46.48,,43.58,75,,,percent of total billed charges,75% of total billed charges,23.24,40,,,percent of total billed charges,40% of total billed charges,46.02,79.2,,,percent of total billed charges,79.2% of total billed charges,49.39,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,55.2,95,,,percent of total billed charges,95% of total billed charges,46.48,80,,,percent of total billed charges,80% of total billed charges,49.39,85,,,percent of total billed charges,85% of total billed charges,52.29,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,23.24,40,,,percent of total billed charges,40% of total billed charges,23.24,40,,,percent of total billed charges,40% of total billed charges,52.29,90,,,percent of total billed charges,90% of total billed charges,44.16,76,,,percent of total billed charges,76% of total billed charges,23.24,40,,,percent of total billed charges,40% of total billed charges,49.39,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,46.48,80,,,percent of total billed charges,80% of total billed charges,22.54,38.8,,,percent of total billed charges,38.8% of total billed charges,49.39,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,55.2,
"Coccidioides Abs, Qn, DID LC",40086635,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,57.5,46,,43.13,75,,,percent of total billed charges,75% of total billed charges,23,40,,,percent of total billed charges,40% of total billed charges,45.54,79.2,,,percent of total billed charges,79.2% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,54.63,95,,,percent of total billed charges,95% of total billed charges,46,80,,,percent of total billed charges,80% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,51.75,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,23,40,,,percent of total billed charges,40% of total billed charges,23,40,,,percent of total billed charges,40% of total billed charges,51.75,90,,,percent of total billed charges,90% of total billed charges,43.7,76,,,percent of total billed charges,76% of total billed charges,23,40,,,percent of total billed charges,40% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,46,80,,,percent of total billed charges,80% of total billed charges,22.31,38.8,,,percent of total billed charges,38.8% of total billed charges,48.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,54.63,
TALON GRASPING DEVICE,46052725,CDM,270,RC,,,OUTPATIENT,,,445.6,356.48,,334.2,75,,,percent of total billed charges,75% of total billed charges,178.24,40,,,percent of total billed charges,40% of total billed charges,352.92,79.2,,,percent of total billed charges,79.2% of total billed charges,378.76,85,,,percent of total billed charges,85% of total billed charges,445.6,100,,,fee schedule,100% of CO APG rates,423.32,95,,,percent of total billed charges,95% of total billed charges,356.48,80,,,percent of total billed charges,80% of total billed charges,378.76,85,,,percent of total billed charges,85% of total billed charges,401.04,90,,,percent of total billed charges,90% of total billed charges,445.6,100,,,fee schedule,100% of CO APG rates,445.6,100,,,fee schedule,100% of CO APG rates,445.6,100,,,fee schedule,100% of NM fee schedule,178.24,40,,,percent of total billed charges,40% of total billed charges,178.24,40,,,percent of total billed charges,40% of total billed charges,401.04,90,,,percent of total billed charges,90% of total billed charges,338.66,76,,,percent of total billed charges,76% of total billed charges,178.24,40,,,percent of total billed charges,40% of total billed charges,378.76,85,,,percent of total billed charges,85% of total billed charges,445.6,100,,,fee schedule,100% of CO APG rate,356.48,80,,,percent of total billed charges,80% of total billed charges,172.89,38.8,,,percent of total billed charges,38.8% of total billed charges,378.76,85,,,percent of total billed charges,85% of total billed charges,445.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,172.89,445.6,
"REVEAL DISTAL ATTACHMENT CAP, 11.35 MM",46052726,CDM,270,RC,,,OUTPATIENT,,,87.4,69.92,,65.55,75,,,percent of total billed charges,75% of total billed charges,34.96,40,,,percent of total billed charges,40% of total billed charges,69.22,79.2,,,percent of total billed charges,79.2% of total billed charges,74.29,85,,,percent of total billed charges,85% of total billed charges,87.4,100,,,fee schedule,100% of CO APG rates,83.03,95,,,percent of total billed charges,95% of total billed charges,69.92,80,,,percent of total billed charges,80% of total billed charges,74.29,85,,,percent of total billed charges,85% of total billed charges,78.66,90,,,percent of total billed charges,90% of total billed charges,87.4,100,,,fee schedule,100% of CO APG rates,87.4,100,,,fee schedule,100% of CO APG rates,87.4,100,,,fee schedule,100% of NM fee schedule,34.96,40,,,percent of total billed charges,40% of total billed charges,34.96,40,,,percent of total billed charges,40% of total billed charges,78.66,90,,,percent of total billed charges,90% of total billed charges,66.42,76,,,percent of total billed charges,76% of total billed charges,34.96,40,,,percent of total billed charges,40% of total billed charges,74.29,85,,,percent of total billed charges,85% of total billed charges,87.4,100,,,fee schedule,100% of CO APG rate,69.92,80,,,percent of total billed charges,80% of total billed charges,33.91,38.8,,,percent of total billed charges,38.8% of total billed charges,74.29,85,,,percent of total billed charges,85% of total billed charges,87.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,33.91,87.4,
CANN 3.5mm DIA. TWIST DRILL,46052727,CDM,270,RC,,,OUTPATIENT,,,1052,841.6,,789,75,,,percent of total billed charges,75% of total billed charges,420.8,40,,,percent of total billed charges,40% of total billed charges,833.18,79.2,,,percent of total billed charges,79.2% of total billed charges,894.2,85,,,percent of total billed charges,85% of total billed charges,1052,100,,,fee schedule,100% of CO APG rates,999.4,95,,,percent of total billed charges,95% of total billed charges,841.6,80,,,percent of total billed charges,80% of total billed charges,894.2,85,,,percent of total billed charges,85% of total billed charges,946.8,90,,,percent of total billed charges,90% of total billed charges,1052,100,,,fee schedule,100% of CO APG rates,1052,100,,,fee schedule,100% of CO APG rates,1052,100,,,fee schedule,100% of NM fee schedule,420.8,40,,,percent of total billed charges,40% of total billed charges,420.8,40,,,percent of total billed charges,40% of total billed charges,946.8,90,,,percent of total billed charges,90% of total billed charges,799.52,76,,,percent of total billed charges,76% of total billed charges,420.8,40,,,percent of total billed charges,40% of total billed charges,894.2,85,,,percent of total billed charges,85% of total billed charges,1052,100,,,fee schedule,100% of CO APG rate,841.6,80,,,percent of total billed charges,80% of total billed charges,408.18,38.8,,,percent of total billed charges,38.8% of total billed charges,894.2,85,,,percent of total billed charges,85% of total billed charges,1052,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,408.18,1052,
CANN COUNTERSINK 5.0 W/ AO FIT,46052728,CDM,270,RC,,,OUTPATIENT,,,716.6,573.28,,537.45,75,,,percent of total billed charges,75% of total billed charges,286.64,40,,,percent of total billed charges,40% of total billed charges,567.55,79.2,,,percent of total billed charges,79.2% of total billed charges,609.11,85,,,percent of total billed charges,85% of total billed charges,716.6,100,,,fee schedule,100% of CO APG rates,680.77,95,,,percent of total billed charges,95% of total billed charges,573.28,80,,,percent of total billed charges,80% of total billed charges,609.11,85,,,percent of total billed charges,85% of total billed charges,644.94,90,,,percent of total billed charges,90% of total billed charges,716.6,100,,,fee schedule,100% of CO APG rates,716.6,100,,,fee schedule,100% of CO APG rates,716.6,100,,,fee schedule,100% of NM fee schedule,286.64,40,,,percent of total billed charges,40% of total billed charges,286.64,40,,,percent of total billed charges,40% of total billed charges,644.94,90,,,percent of total billed charges,90% of total billed charges,544.62,76,,,percent of total billed charges,76% of total billed charges,286.64,40,,,percent of total billed charges,40% of total billed charges,609.11,85,,,percent of total billed charges,85% of total billed charges,716.6,100,,,fee schedule,100% of CO APG rate,573.28,80,,,percent of total billed charges,80% of total billed charges,278.04,38.8,,,percent of total billed charges,38.8% of total billed charges,609.11,85,,,percent of total billed charges,85% of total billed charges,716.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,278.04,716.6,
CANN 5.0mm TWIST DRILL W/ AO,46052729,CDM,270,RC,,,OUTPATIENT,,,972.1,777.68,,729.08,75,,,percent of total billed charges,75% of total billed charges,388.84,40,,,percent of total billed charges,40% of total billed charges,769.9,79.2,,,percent of total billed charges,79.2% of total billed charges,826.29,85,,,percent of total billed charges,85% of total billed charges,972.1,100,,,fee schedule,100% of CO APG rates,923.5,95,,,percent of total billed charges,95% of total billed charges,777.68,80,,,percent of total billed charges,80% of total billed charges,826.29,85,,,percent of total billed charges,85% of total billed charges,874.89,90,,,percent of total billed charges,90% of total billed charges,972.1,100,,,fee schedule,100% of CO APG rates,972.1,100,,,fee schedule,100% of CO APG rates,972.1,100,,,fee schedule,100% of NM fee schedule,388.84,40,,,percent of total billed charges,40% of total billed charges,388.84,40,,,percent of total billed charges,40% of total billed charges,874.89,90,,,percent of total billed charges,90% of total billed charges,738.8,76,,,percent of total billed charges,76% of total billed charges,388.84,40,,,percent of total billed charges,40% of total billed charges,826.29,85,,,percent of total billed charges,85% of total billed charges,972.1,100,,,fee schedule,100% of CO APG rate,777.68,80,,,percent of total billed charges,80% of total billed charges,377.17,38.8,,,percent of total billed charges,38.8% of total billed charges,826.29,85,,,percent of total billed charges,85% of total billed charges,972.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,377.17,972.1,
SLP Cognitive Function,60000291,CDM,430,RC,97537,HCPCS,OUTPATIENT,,,99,79.2,GN,74.25,75,,,percent of total billed charges,75% of total billed charges,39.6,40,,,percent of total billed charges,40% of total billed charges,78.41,79.2,,,percent of total billed charges,79.2% of total billed charges,84.15,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,94.05,95,,,percent of total billed charges,95% of total billed charges,79.2,80,,,percent of total billed charges,80% of total billed charges,84.15,85,,,percent of total billed charges,85% of total billed charges,89.1,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,26.62,100,,,fee schedule,100% of NM fee schedule,39.6,40,,,percent of total billed charges,40% of total billed charges,39.6,40,,,percent of total billed charges,40% of total billed charges,89.1,90,,,percent of total billed charges,90% of total billed charges,75.24,76,,,percent of total billed charges,76% of total billed charges,39.6,40,,,percent of total billed charges,40% of total billed charges,84.15,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,79.2,80,,,percent of total billed charges,80% of total billed charges,38.41,38.8,,,percent of total billed charges,38.8% of total billed charges,84.15,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,65.96,200,,,fee schedule,200% of CMS fee schedule,26.62,94.05,
"SUTURE 1-0 VICRYL COATED, VIOLET, 1/2 CIRCLE TAPER POINT, 18",46052730,CDM,270,RC,,,OUTPATIENT,,,34.8,27.84,,26.1,75,,,percent of total billed charges,75% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,27.56,79.2,,,percent of total billed charges,79.2% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rates,33.06,95,,,percent of total billed charges,95% of total billed charges,27.84,80,,,percent of total billed charges,80% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,31.32,90,,,percent of total billed charges,90% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rates,34.8,100,,,fee schedule,100% of CO APG rates,34.8,100,,,fee schedule,100% of NM fee schedule,13.92,40,,,percent of total billed charges,40% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,31.32,90,,,percent of total billed charges,90% of total billed charges,26.45,76,,,percent of total billed charges,76% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rate,27.84,80,,,percent of total billed charges,80% of total billed charges,13.5,38.8,,,percent of total billed charges,38.8% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,13.5,34.8,
"SUTURE # 1 SILK, SUTUPAK BLACK BRAID 30 INCH, NONABSORBALBE,",46052857,CDM,270,RC,,,OUTPATIENT,,,5.5,4.4,,4.13,75,,,percent of total billed charges,75% of total billed charges,2.2,40,,,percent of total billed charges,40% of total billed charges,4.36,79.2,,,percent of total billed charges,79.2% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,5.5,100,,,fee schedule,100% of CO APG rates,5.23,95,,,percent of total billed charges,95% of total billed charges,4.4,80,,,percent of total billed charges,80% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,4.95,90,,,percent of total billed charges,90% of total billed charges,5.5,100,,,fee schedule,100% of CO APG rates,5.5,100,,,fee schedule,100% of CO APG rates,5.5,100,,,fee schedule,100% of NM fee schedule,2.2,40,,,percent of total billed charges,40% of total billed charges,2.2,40,,,percent of total billed charges,40% of total billed charges,4.95,90,,,percent of total billed charges,90% of total billed charges,4.18,76,,,percent of total billed charges,76% of total billed charges,2.2,40,,,percent of total billed charges,40% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,5.5,100,,,fee schedule,100% of CO APG rate,4.4,80,,,percent of total billed charges,80% of total billed charges,2.13,38.8,,,percent of total billed charges,38.8% of total billed charges,4.68,85,,,percent of total billed charges,85% of total billed charges,5.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.13,5.5,
62270 - SPINAL PUNCTURE LUMBAR DIAGNOSTIC,60000205,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1880.3,1504.24,,1410.23,75,,,percent of total billed charges,75% of total billed charges,752.12,40,,,percent of total billed charges,40% of total billed charges,1489.2,79.2,,,percent of total billed charges,79.2% of total billed charges,1598.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1786.29,95,,,percent of total billed charges,95% of total billed charges,1504.24,80,,,percent of total billed charges,80% of total billed charges,1598.26,85,,,percent of total billed charges,85% of total billed charges,1692.27,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,752.12,40,,,percent of total billed charges,40% of total billed charges,752.12,40,,,percent of total billed charges,40% of total billed charges,1692.27,90,,,percent of total billed charges,90% of total billed charges,1429.03,76,,,percent of total billed charges,76% of total billed charges,752.12,40,,,percent of total billed charges,40% of total billed charges,1598.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1504.24,80,,,percent of total billed charges,80% of total billed charges,729.56,38.8,,,percent of total billed charges,38.8% of total billed charges,1598.26,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1786.29,
62272 - SPINAL PUNCTURE THER DRAIN CEREBROSPINAL FLUID,60000206,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2540,2032,,1905,75,,,percent of total billed charges,75% of total billed charges,1016,40,,,percent of total billed charges,40% of total billed charges,2011.68,79.2,,,percent of total billed charges,79.2% of total billed charges,2159,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2413,95,,,percent of total billed charges,95% of total billed charges,2032,80,,,percent of total billed charges,80% of total billed charges,2159,85,,,percent of total billed charges,85% of total billed charges,2286,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1016,40,,,percent of total billed charges,40% of total billed charges,1016,40,,,percent of total billed charges,40% of total billed charges,2286,90,,,percent of total billed charges,90% of total billed charges,1930.4,76,,,percent of total billed charges,76% of total billed charges,1016,40,,,percent of total billed charges,40% of total billed charges,2159,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,2032,80,,,percent of total billed charges,80% of total billed charges,985.52,38.8,,,percent of total billed charges,38.8% of total billed charges,2159,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,2413,
T2 ADV COMPRESSION SCREW FEMUR,46052731,CDM,278,RC,,,OUTPATIENT,,,512.6,410.08,,384.45,75,,,percent of total billed charges,75% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,405.98,79.2,,,percent of total billed charges,79.2% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,486.97,95,,,percent of total billed charges,95% of total billed charges,410.08,80,,,percent of total billed charges,80% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of CO APG rates,512.6,100,,,fee schedule,100% of NM fee schedule,205.04,40,,,percent of total billed charges,40% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,461.34,90,,,percent of total billed charges,90% of total billed charges,389.58,76,,,percent of total billed charges,76% of total billed charges,205.04,40,,,percent of total billed charges,40% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of CO APG rate,410.08,80,,,percent of total billed charges,80% of total billed charges,198.89,38.8,,,percent of total billed charges,38.8% of total billed charges,435.71,85,,,percent of total billed charges,85% of total billed charges,512.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.89,512.6,
ONE THIRD TUB PLATE 7 HOLE SS,46052732,CDM,278,RC,,,OUTPATIENT,,,179.6,143.68,,134.7,75,,,percent of total billed charges,75% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,142.24,79.2,,,percent of total billed charges,79.2% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rates,170.62,95,,,percent of total billed charges,95% of total billed charges,143.68,80,,,percent of total billed charges,80% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,161.64,90,,,percent of total billed charges,90% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rates,179.6,100,,,fee schedule,100% of CO APG rates,179.6,100,,,fee schedule,100% of NM fee schedule,71.84,40,,,percent of total billed charges,40% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,161.64,90,,,percent of total billed charges,90% of total billed charges,136.5,76,,,percent of total billed charges,76% of total billed charges,71.84,40,,,percent of total billed charges,40% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of CO APG rate,143.68,80,,,percent of total billed charges,80% of total billed charges,69.68,38.8,,,percent of total billed charges,38.8% of total billed charges,152.66,85,,,percent of total billed charges,85% of total billed charges,179.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,69.68,179.6,
T2 FEMORAL NAIL R1500 9MM X 280MM,46052733,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 9MM X 300MM,46052734,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 9MM X 320MM,46052735,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 9MM X 340MM,46052736,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 9MM X 360MM,46052737,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 9MM X 380MM,46052738,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 9MM X 400MM,46052739,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 9MM X 420MM,46052740,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
56405 I  D OF VULVA/PERINEUM.,31056405,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1021.3,817.04,,765.98,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,808.87,79.2,,,percent of total billed charges,79.2% of total billed charges,868.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,970.24,95,,,percent of total billed charges,95% of total billed charges,817.04,80,,,percent of total billed charges,80% of total billed charges,868.11,85,,,percent of total billed charges,85% of total billed charges,919.17,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1021.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,919.17,90,,,percent of total billed charges,90% of total billed charges,776.19,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,868.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,817.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,868.11,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
T2 FEMORAL NAIL R1500 10MM X 280MM,46052741,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 10MM X 300MM,46052742,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 10MM X 320MM,46052743,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 10MM X 340MM,46052744,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 10MM X 360MM,46052745,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 10MM X 380MM,46052746,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 10MM X 400MM,46052747,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 10MM X 420MM,46052748,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 11MM X 280MM,46052749,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 11MM X 300MM,46052750,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 11MM X 320MM,46052751,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 11MM X 340MM,46052752,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 11MM X 360MM,46052753,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 11MM X 380MM,46052754,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 11MM X 400MM,46052755,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 11MM X 420MM,46052756,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 12MM X 280MM,46052757,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 12MM X 300MM,46052758,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 12MM X 320MM,46052759,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 12MM X 340MM,46052760,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 12MM X 360MM,46052761,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 12MM X 380MM,46052762,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 12MM X 4000MM,46052763,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 12MM X 4200MM,46052764,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 13MM X 300MM,46052765,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 13MM X 320MM,46052766,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 13MM X 340MM,46052767,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 13MM X 360MM,46052768,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 13MM X 380MM,46052769,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 13MM X 400MM,46052770,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 13MM X 420MM,46052771,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
T2 FEMORAL NAIL R1500 13MM X 440MM,46052772,CDM,278,RC,,,OUTPATIENT,,,3232.1,2585.68,,2424.08,75,,,percent of total billed charges,75% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2559.82,79.2,,,percent of total billed charges,79.2% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3070.5,95,,,percent of total billed charges,95% of total billed charges,2585.68,80,,,percent of total billed charges,80% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of CO APG rates,3232.1,100,,,fee schedule,100% of NM fee schedule,1292.84,40,,,percent of total billed charges,40% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2908.89,90,,,percent of total billed charges,90% of total billed charges,2456.4,76,,,percent of total billed charges,76% of total billed charges,1292.84,40,,,percent of total billed charges,40% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of CO APG rate,2585.68,80,,,percent of total billed charges,80% of total billed charges,1254.05,38.8,,,percent of total billed charges,38.8% of total billed charges,2747.29,85,,,percent of total billed charges,85% of total billed charges,3232.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1254.05,3232.1,
General Health Panel 9,40080050,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,347,277.6,,260.25,75,,,percent of total billed charges,75% of total billed charges,138.8,40,,,percent of total billed charges,40% of total billed charges,274.82,79.2,,,percent of total billed charges,79.2% of total billed charges,294.95,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,329.65,95,,,percent of total billed charges,95% of total billed charges,277.6,80,,,percent of total billed charges,80% of total billed charges,294.95,85,,,percent of total billed charges,85% of total billed charges,312.3,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,138.8,40,,,percent of total billed charges,40% of total billed charges,138.8,40,,,percent of total billed charges,40% of total billed charges,312.3,90,,,percent of total billed charges,90% of total billed charges,263.72,76,,,percent of total billed charges,76% of total billed charges,138.8,40,,,percent of total billed charges,40% of total billed charges,294.95,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,277.6,80,,,percent of total billed charges,80% of total billed charges,134.64,38.8,,,percent of total billed charges,38.8% of total billed charges,294.95,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,329.65,
CATHETER SAFE-T-CENTESIS 8FR (THORACENTESIS/PARACENTESIS),52773,CDM,270,RC,,,OUTPATIENT,,,283.9,227.12,,212.93,75,,,percent of total billed charges,75% of total billed charges,113.56,40,,,percent of total billed charges,40% of total billed charges,224.85,79.2,,,percent of total billed charges,79.2% of total billed charges,241.32,85,,,percent of total billed charges,85% of total billed charges,283.9,100,,,fee schedule,100% of CO APG rates,269.71,95,,,percent of total billed charges,95% of total billed charges,227.12,80,,,percent of total billed charges,80% of total billed charges,241.32,85,,,percent of total billed charges,85% of total billed charges,255.51,90,,,percent of total billed charges,90% of total billed charges,283.9,100,,,fee schedule,100% of CO APG rates,283.9,100,,,fee schedule,100% of CO APG rates,283.9,100,,,fee schedule,100% of NM fee schedule,113.56,40,,,percent of total billed charges,40% of total billed charges,113.56,40,,,percent of total billed charges,40% of total billed charges,255.51,90,,,percent of total billed charges,90% of total billed charges,215.76,76,,,percent of total billed charges,76% of total billed charges,113.56,40,,,percent of total billed charges,40% of total billed charges,241.32,85,,,percent of total billed charges,85% of total billed charges,283.9,100,,,fee schedule,100% of CO APG rate,227.12,80,,,percent of total billed charges,80% of total billed charges,110.15,38.8,,,percent of total billed charges,38.8% of total billed charges,241.32,85,,,percent of total billed charges,85% of total billed charges,283.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,110.15,283.9,
"OMEGA3 STANDARD BARREL HIP PLATE, KEYED 140?, 2 HOLES",46052774,CDM,278,RC,,,OUTPATIENT,,,1120.8,896.64,,840.6,75,,,percent of total billed charges,75% of total billed charges,448.32,40,,,percent of total billed charges,40% of total billed charges,887.67,79.2,,,percent of total billed charges,79.2% of total billed charges,952.68,85,,,percent of total billed charges,85% of total billed charges,1120.8,100,,,fee schedule,100% of CO APG rates,1064.76,95,,,percent of total billed charges,95% of total billed charges,896.64,80,,,percent of total billed charges,80% of total billed charges,952.68,85,,,percent of total billed charges,85% of total billed charges,1008.72,90,,,percent of total billed charges,90% of total billed charges,1120.8,100,,,fee schedule,100% of CO APG rates,1120.8,100,,,fee schedule,100% of CO APG rates,1120.8,100,,,fee schedule,100% of NM fee schedule,448.32,40,,,percent of total billed charges,40% of total billed charges,448.32,40,,,percent of total billed charges,40% of total billed charges,1008.72,90,,,percent of total billed charges,90% of total billed charges,851.81,76,,,percent of total billed charges,76% of total billed charges,448.32,40,,,percent of total billed charges,40% of total billed charges,952.68,85,,,percent of total billed charges,85% of total billed charges,1120.8,100,,,fee schedule,100% of CO APG rate,896.64,80,,,percent of total billed charges,80% of total billed charges,434.87,38.8,,,percent of total billed charges,38.8% of total billed charges,952.68,85,,,percent of total billed charges,85% of total billed charges,1120.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,434.87,1120.8,
STANDARD LAG SCREW 13MM LENGTH 50MM,46052775,CDM,270,RC,,,OUTPATIENT,,,867.4,693.92,,650.55,75,,,percent of total billed charges,75% of total billed charges,346.96,40,,,percent of total billed charges,40% of total billed charges,686.98,79.2,,,percent of total billed charges,79.2% of total billed charges,737.29,85,,,percent of total billed charges,85% of total billed charges,867.4,100,,,fee schedule,100% of CO APG rates,824.03,95,,,percent of total billed charges,95% of total billed charges,693.92,80,,,percent of total billed charges,80% of total billed charges,737.29,85,,,percent of total billed charges,85% of total billed charges,780.66,90,,,percent of total billed charges,90% of total billed charges,867.4,100,,,fee schedule,100% of CO APG rates,867.4,100,,,fee schedule,100% of CO APG rates,867.4,100,,,fee schedule,100% of NM fee schedule,346.96,40,,,percent of total billed charges,40% of total billed charges,346.96,40,,,percent of total billed charges,40% of total billed charges,780.66,90,,,percent of total billed charges,90% of total billed charges,659.22,76,,,percent of total billed charges,76% of total billed charges,346.96,40,,,percent of total billed charges,40% of total billed charges,737.29,85,,,percent of total billed charges,85% of total billed charges,867.4,100,,,fee schedule,100% of CO APG rate,693.92,80,,,percent of total billed charges,80% of total billed charges,336.55,38.8,,,percent of total billed charges,38.8% of total billed charges,737.29,85,,,percent of total billed charges,85% of total billed charges,867.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,336.55,867.4,
STANDARD LAG SCREW 13MM LENGTH 55MM,46052776,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,323.59,834,
STANDARD LAG SCREW 13MM LENGTH 60MM,46052777,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,323.59,834,
STANDARD LAG SCREW 13MM LENGTH 65MM,46052778,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,323.59,834,
STANDARD LAG SCREW 13MM LENGTH 70MM,46052779,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,323.59,834,
STANDARD LAG SCREW 13MM LENGTH 75MM,46052780,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,323.59,834,
STANDARD LAG SCREW 13MM LENGTH 80MM,46052781,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,323.59,834,
STANDARD LAG SCREW 13MM LENGTH 85MM,46052782,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,323.59,834,
STANDARD LAG SCREW 13MM LENGTH 90MM,46052783,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,323.59,834,
STANDARD LAG SCREW 13MM LENGTH 95MM,46052784,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,323.59,834,
STANDARD LAG SCREW 13MM LENGTH 100MM,46052785,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,323.59,834,
STANDARD LAG SCREW 13MM LENGTH 105MM,46052786,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,323.59,834,
STANDARD LAG SCREW 13MM LENGTH 110MM,46052787,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,1668,200,,,percent of total billed charges,200% of total billed charges,323.59,1668,
STANDARD LAG SCREW 13MM LENGTH 115MM,46052788,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,1668,200,,,percent of total billed charges,200% of total billed charges,323.59,1668,
STANDARD LAG SCREW 13MM LENGTH 120MM,46052789,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,1668,200,,,percent of total billed charges,200% of total billed charges,323.59,1668,
STANDARD LAG SCREW 13MM LENGTH 125MM,46052790,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,1668,200,,,percent of total billed charges,200% of total billed charges,323.59,1668,
STANDARD LAG SCREW 13MM LENGTH 130MM,46052791,CDM,278,RC,,,OUTPATIENT,,,834,667.2,,625.5,75,,,percent of total billed charges,75% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,660.53,79.2,,,percent of total billed charges,79.2% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,792.3,95,,,percent of total billed charges,95% of total billed charges,667.2,80,,,percent of total billed charges,80% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of CO APG rates,834,100,,,fee schedule,100% of NM fee schedule,333.6,40,,,percent of total billed charges,40% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,750.6,90,,,percent of total billed charges,90% of total billed charges,633.84,76,,,percent of total billed charges,76% of total billed charges,333.6,40,,,percent of total billed charges,40% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of CO APG rate,667.2,80,,,percent of total billed charges,80% of total billed charges,323.59,38.8,,,percent of total billed charges,38.8% of total billed charges,708.9,85,,,percent of total billed charges,85% of total billed charges,834,100,,,fee schedule,100% of APG fee schedule,1668,200,,,percent of total billed charges,200% of total billed charges,323.59,1668,
"OMEGA PLUS 2.8mm THREADED TIP GUIDE PIN, 230mm LENGTH",46052792,CDM,270,RC,,,OUTPATIENT,,,155.2,124.16,,116.4,75,,,percent of total billed charges,75% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,122.92,79.2,,,percent of total billed charges,79.2% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rates,147.44,95,,,percent of total billed charges,95% of total billed charges,124.16,80,,,percent of total billed charges,80% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rates,155.2,100,,,fee schedule,100% of CO APG rates,155.2,100,,,fee schedule,100% of NM fee schedule,62.08,40,,,percent of total billed charges,40% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,117.95,76,,,percent of total billed charges,76% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rate,124.16,80,,,percent of total billed charges,80% of total billed charges,60.22,38.8,,,percent of total billed charges,38.8% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of APG fee schedule,310.4,200,,,percent of total billed charges,200% of total billed charges,60.22,310.4,
Bone Marrow Biopsy and Aspiration,60000451,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,5839.6,4671.68,,4379.7,75,,,percent of total billed charges,75% of total billed charges,2335.84,40,,,percent of total billed charges,40% of total billed charges,4624.96,79.2,,,percent of total billed charges,79.2% of total billed charges,4963.66,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,5547.62,95,,,percent of total billed charges,95% of total billed charges,4671.68,80,,,percent of total billed charges,80% of total billed charges,4963.66,85,,,percent of total billed charges,85% of total billed charges,5255.64,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,2335.84,40,,,percent of total billed charges,40% of total billed charges,2335.84,40,,,percent of total billed charges,40% of total billed charges,5255.64,90,,,percent of total billed charges,90% of total billed charges,4438.1,76,,,percent of total billed charges,76% of total billed charges,2335.84,40,,,percent of total billed charges,40% of total billed charges,4963.66,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,4671.68,80,,,percent of total billed charges,80% of total billed charges,2265.76,38.8,,,percent of total billed charges,38.8% of total billed charges,4963.66,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,5547.62,
"EGG BUR, 4.0MM",46052793,CDM,270,RC,,,OUTPATIENT,,,307.1,245.68,,230.33,75,,,percent of total billed charges,75% of total billed charges,122.84,40,,,percent of total billed charges,40% of total billed charges,243.22,79.2,,,percent of total billed charges,79.2% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,307.1,100,,,fee schedule,100% of CO APG rates,291.75,95,,,percent of total billed charges,95% of total billed charges,245.68,80,,,percent of total billed charges,80% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,276.39,90,,,percent of total billed charges,90% of total billed charges,307.1,100,,,fee schedule,100% of CO APG rates,307.1,100,,,fee schedule,100% of CO APG rates,307.1,100,,,fee schedule,100% of NM fee schedule,122.84,40,,,percent of total billed charges,40% of total billed charges,122.84,40,,,percent of total billed charges,40% of total billed charges,276.39,90,,,percent of total billed charges,90% of total billed charges,233.4,76,,,percent of total billed charges,76% of total billed charges,122.84,40,,,percent of total billed charges,40% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,307.1,100,,,fee schedule,100% of CO APG rate,245.68,80,,,percent of total billed charges,80% of total billed charges,119.15,38.8,,,percent of total billed charges,38.8% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,307.1,100,,,fee schedule,100% of APG fee schedule,614.2,200,,,percent of total billed charges,200% of total billed charges,119.15,614.2,
BONE SCREW T10 FULL THREAD 2.7mm / L14mm,460ECON0334,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,817.2,200,,,percent of total billed charges,200% of total billed charges,158.54,817.2,
"MULTIHANCE CONTRAST MEDIA, GADOBENATE DIMEGLUMINE/ML",41352794,CDM,255,RC,,,OUTPATIENT,,,204.8,163.84,,153.6,75,,,percent of total billed charges,75% of total billed charges,81.92,40,,,percent of total billed charges,40% of total billed charges,162.2,79.2,,,percent of total billed charges,79.2% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,204.8,100,,,fee schedule,100% of CO APG rates,194.56,95,,,percent of total billed charges,95% of total billed charges,163.84,80,,,percent of total billed charges,80% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,184.32,90,,,percent of total billed charges,90% of total billed charges,204.8,100,,,fee schedule,100% of CO APG rates,204.8,100,,,fee schedule,100% of CO APG rates,204.8,100,,,fee schedule,100% of NM fee schedule,81.92,40,,,percent of total billed charges,40% of total billed charges,81.92,40,,,percent of total billed charges,40% of total billed charges,184.32,90,,,percent of total billed charges,90% of total billed charges,155.65,76,,,percent of total billed charges,76% of total billed charges,81.92,40,,,percent of total billed charges,40% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,204.8,100,,,fee schedule,100% of CO APG rate,163.84,80,,,percent of total billed charges,80% of total billed charges,79.46,38.8,,,percent of total billed charges,38.8% of total billed charges,174.08,85,,,percent of total billed charges,85% of total billed charges,204.8,100,,,fee schedule,100% of APG fee schedule,409.6,200,,,percent of total billed charges,200% of total billed charges,79.46,409.6,
Vitamin E (Alpha and Gamma Tocopherol) LC,40084446,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,126.5,101.2,,94.88,75,,,percent of total billed charges,75% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,100.19,79.2,,,percent of total billed charges,79.2% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,120.18,95,,,percent of total billed charges,95% of total billed charges,101.2,80,,,percent of total billed charges,80% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,113.85,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,50.6,40,,,percent of total billed charges,40% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,113.85,90,,,percent of total billed charges,90% of total billed charges,96.14,76,,,percent of total billed charges,76% of total billed charges,50.6,40,,,percent of total billed charges,40% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,101.2,80,,,percent of total billed charges,80% of total billed charges,49.08,38.8,,,percent of total billed charges,38.8% of total billed charges,107.53,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,120.18,
LARIAT SNARE 2.4MM X 230MM,46052795,CDM,270,RC,,,OUTPATIENT,,,65.5,52.4,,49.13,75,,,percent of total billed charges,75% of total billed charges,26.2,40,,,percent of total billed charges,40% of total billed charges,51.88,79.2,,,percent of total billed charges,79.2% of total billed charges,55.68,85,,,percent of total billed charges,85% of total billed charges,65.5,100,,,fee schedule,100% of CO APG rates,62.23,95,,,percent of total billed charges,95% of total billed charges,52.4,80,,,percent of total billed charges,80% of total billed charges,55.68,85,,,percent of total billed charges,85% of total billed charges,58.95,90,,,percent of total billed charges,90% of total billed charges,65.5,100,,,fee schedule,100% of CO APG rates,65.5,100,,,fee schedule,100% of CO APG rates,65.5,100,,,fee schedule,100% of NM fee schedule,26.2,40,,,percent of total billed charges,40% of total billed charges,26.2,40,,,percent of total billed charges,40% of total billed charges,58.95,90,,,percent of total billed charges,90% of total billed charges,49.78,76,,,percent of total billed charges,76% of total billed charges,26.2,40,,,percent of total billed charges,40% of total billed charges,55.68,85,,,percent of total billed charges,85% of total billed charges,65.5,100,,,fee schedule,100% of CO APG rate,52.4,80,,,percent of total billed charges,80% of total billed charges,25.41,38.8,,,percent of total billed charges,38.8% of total billed charges,55.68,85,,,percent of total billed charges,85% of total billed charges,65.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,25.41,65.5,
"Analgesics, non-opioid; 6 or more",26251563,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,846.8,677.44,,635.1,75,,,percent of total billed charges,75% of total billed charges,338.72,40,,,percent of total billed charges,40% of total billed charges,670.67,79.2,,,percent of total billed charges,79.2% of total billed charges,719.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,804.46,95,,,percent of total billed charges,95% of total billed charges,677.44,80,,,percent of total billed charges,80% of total billed charges,719.78,85,,,percent of total billed charges,85% of total billed charges,762.12,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,338.72,40,,,percent of total billed charges,40% of total billed charges,338.72,40,,,percent of total billed charges,40% of total billed charges,762.12,90,,,percent of total billed charges,90% of total billed charges,643.57,76,,,percent of total billed charges,76% of total billed charges,338.72,40,,,percent of total billed charges,40% of total billed charges,719.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,677.44,80,,,percent of total billed charges,80% of total billed charges,328.56,38.8,,,percent of total billed charges,38.8% of total billed charges,719.78,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,804.46,
"Analgesics, non-opioid; 3-5",26251564,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,423.4,338.72,,317.55,75,,,percent of total billed charges,75% of total billed charges,169.36,40,,,percent of total billed charges,40% of total billed charges,335.33,79.2,,,percent of total billed charges,79.2% of total billed charges,359.89,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,402.23,95,,,percent of total billed charges,95% of total billed charges,338.72,80,,,percent of total billed charges,80% of total billed charges,359.89,85,,,percent of total billed charges,85% of total billed charges,381.06,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,169.36,40,,,percent of total billed charges,40% of total billed charges,169.36,40,,,percent of total billed charges,40% of total billed charges,381.06,90,,,percent of total billed charges,90% of total billed charges,321.78,76,,,percent of total billed charges,76% of total billed charges,169.36,40,,,percent of total billed charges,40% of total billed charges,359.89,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,338.72,80,,,percent of total billed charges,80% of total billed charges,164.28,38.8,,,percent of total billed charges,38.8% of total billed charges,359.89,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,402.23,
LOCKING SCREW T10 FULL THREAD 3.5mm / L34mm,ECON0335,CDM,278,RC,,,OUTPATIENT,,,671.2,536.96,,503.4,75,,,percent of total billed charges,75% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,531.59,79.2,,,percent of total billed charges,79.2% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rates,637.64,95,,,percent of total billed charges,95% of total billed charges,536.96,80,,,percent of total billed charges,80% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,604.08,90,,,percent of total billed charges,90% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rates,671.2,100,,,fee schedule,100% of CO APG rates,671.2,100,,,fee schedule,100% of NM fee schedule,268.48,40,,,percent of total billed charges,40% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,604.08,90,,,percent of total billed charges,90% of total billed charges,510.11,76,,,percent of total billed charges,76% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rate,536.96,80,,,percent of total billed charges,80% of total billed charges,260.43,38.8,,,percent of total billed charges,38.8% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,260.43,671.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L36mm,460ECON0336,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L38mm,460ECON0337,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L40mm,460ECON0338,CDM,278,RC,,,OUTPATIENT,,,671.2,536.96,,503.4,75,,,percent of total billed charges,75% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,531.59,79.2,,,percent of total billed charges,79.2% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rates,637.64,95,,,percent of total billed charges,95% of total billed charges,536.96,80,,,percent of total billed charges,80% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,604.08,90,,,percent of total billed charges,90% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rates,671.2,100,,,fee schedule,100% of CO APG rates,671.2,100,,,fee schedule,100% of NM fee schedule,268.48,40,,,percent of total billed charges,40% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,604.08,90,,,percent of total billed charges,90% of total billed charges,510.11,76,,,percent of total billed charges,76% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rate,536.96,80,,,percent of total billed charges,80% of total billed charges,260.43,38.8,,,percent of total billed charges,38.8% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,260.43,671.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L42mm,460ECON0339,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L44mm,460ECON00340,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L46mm,460ECON0341,CDM,278,RC,,,OUTPATIENT,,,671.2,536.96,,503.4,75,,,percent of total billed charges,75% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,531.59,79.2,,,percent of total billed charges,79.2% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rates,637.64,95,,,percent of total billed charges,95% of total billed charges,536.96,80,,,percent of total billed charges,80% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,604.08,90,,,percent of total billed charges,90% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rates,671.2,100,,,fee schedule,100% of CO APG rates,671.2,100,,,fee schedule,100% of NM fee schedule,268.48,40,,,percent of total billed charges,40% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,604.08,90,,,percent of total billed charges,90% of total billed charges,510.11,76,,,percent of total billed charges,76% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rate,536.96,80,,,percent of total billed charges,80% of total billed charges,260.43,38.8,,,percent of total billed charges,38.8% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,260.43,671.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L48mm,460ECON0342,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L50mm,460ECON0343,CDM,278,RC,,,OUTPATIENT,,,671.2,536.96,,503.4,75,,,percent of total billed charges,75% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,531.59,79.2,,,percent of total billed charges,79.2% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rates,637.64,95,,,percent of total billed charges,95% of total billed charges,536.96,80,,,percent of total billed charges,80% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,604.08,90,,,percent of total billed charges,90% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rates,671.2,100,,,fee schedule,100% of CO APG rates,671.2,100,,,fee schedule,100% of NM fee schedule,268.48,40,,,percent of total billed charges,40% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,604.08,90,,,percent of total billed charges,90% of total billed charges,510.11,76,,,percent of total billed charges,76% of total billed charges,268.48,40,,,percent of total billed charges,40% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of CO APG rate,536.96,80,,,percent of total billed charges,80% of total billed charges,260.43,38.8,,,percent of total billed charges,38.8% of total billed charges,570.52,85,,,percent of total billed charges,85% of total billed charges,671.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,260.43,671.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L55mm,460ECON0344,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L60mm,460ECON0345,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L65mm,460ECON0346,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
LOCKING SCREW T10 FULL THREAD 3.5mm / L70mm,460ECON0347,CDM,278,RC,,,OUTPATIENT,,,837.2,669.76,,627.9,75,,,percent of total billed charges,75% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,663.06,79.2,,,percent of total billed charges,79.2% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,795.34,95,,,percent of total billed charges,95% of total billed charges,669.76,80,,,percent of total billed charges,80% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of CO APG rates,837.2,100,,,fee schedule,100% of NM fee schedule,334.88,40,,,percent of total billed charges,40% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,753.48,90,,,percent of total billed charges,90% of total billed charges,636.27,76,,,percent of total billed charges,76% of total billed charges,334.88,40,,,percent of total billed charges,40% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of CO APG rate,669.76,80,,,percent of total billed charges,80% of total billed charges,324.83,38.8,,,percent of total billed charges,38.8% of total billed charges,711.62,85,,,percent of total billed charges,85% of total billed charges,837.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,324.83,837.2,
BONE SCREW T10 FULL THREAD 2.7mm / L8mm,460ECON0348,CDM,278,RC,,,OUTPATIENT,,,440.1,352.08,,330.08,75,,,percent of total billed charges,75% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,348.56,79.2,,,percent of total billed charges,79.2% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,418.1,95,,,percent of total billed charges,95% of total billed charges,352.08,80,,,percent of total billed charges,80% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of NM fee schedule,176.04,40,,,percent of total billed charges,40% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,334.48,76,,,percent of total billed charges,76% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rate,352.08,80,,,percent of total billed charges,80% of total billed charges,170.76,38.8,,,percent of total billed charges,38.8% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,170.76,440.1,
BONE SCREW T10 FULL THREAD 2.7mm / L10mm,460ECON0349,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
BONE SCREW T10 FULL THREAD 2.7mm / L12mm,460ECON0350,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
BONE SCREW T10 FULL THREAD 2.7mm / L16mm,460ECON0351,CDM,278,RC,,,OUTPATIENT,,,408.6,326.88,,306.45,75,,,percent of total billed charges,75% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,323.61,79.2,,,percent of total billed charges,79.2% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,388.17,95,,,percent of total billed charges,95% of total billed charges,326.88,80,,,percent of total billed charges,80% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of CO APG rates,408.6,100,,,fee schedule,100% of NM fee schedule,163.44,40,,,percent of total billed charges,40% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,367.74,90,,,percent of total billed charges,90% of total billed charges,310.54,76,,,percent of total billed charges,76% of total billed charges,163.44,40,,,percent of total billed charges,40% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of CO APG rate,326.88,80,,,percent of total billed charges,80% of total billed charges,158.54,38.8,,,percent of total billed charges,38.8% of total billed charges,347.31,85,,,percent of total billed charges,85% of total billed charges,408.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,158.54,408.6,
BONE SCREW T10 FULL THREAD 2.7mm / L18mm,460ECON0352,CDM,278,RC,,,OUTPATIENT,,,440.1,352.08,,330.08,75,,,percent of total billed charges,75% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,348.56,79.2,,,percent of total billed charges,79.2% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,418.1,95,,,percent of total billed charges,95% of total billed charges,352.08,80,,,percent of total billed charges,80% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of NM fee schedule,176.04,40,,,percent of total billed charges,40% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,334.48,76,,,percent of total billed charges,76% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rate,352.08,80,,,percent of total billed charges,80% of total billed charges,170.76,38.8,,,percent of total billed charges,38.8% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,170.76,440.1,
BONE SCREW T10 FULL THREAD 2.7mm / L20mm,460ECON0353,CDM,278,RC,,,OUTPATIENT,,,440.1,352.08,,330.08,75,,,percent of total billed charges,75% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,348.56,79.2,,,percent of total billed charges,79.2% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,418.1,95,,,percent of total billed charges,95% of total billed charges,352.08,80,,,percent of total billed charges,80% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of NM fee schedule,176.04,40,,,percent of total billed charges,40% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,334.48,76,,,percent of total billed charges,76% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rate,352.08,80,,,percent of total billed charges,80% of total billed charges,170.76,38.8,,,percent of total billed charges,38.8% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,170.76,440.1,
BONE SCREW T10 FULL THREAD 2.7mm / L22mm,460ECON0354,CDM,278,RC,,,OUTPATIENT,,,440.1,352.08,,330.08,75,,,percent of total billed charges,75% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,348.56,79.2,,,percent of total billed charges,79.2% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,418.1,95,,,percent of total billed charges,95% of total billed charges,352.08,80,,,percent of total billed charges,80% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of NM fee schedule,176.04,40,,,percent of total billed charges,40% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,334.48,76,,,percent of total billed charges,76% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rate,352.08,80,,,percent of total billed charges,80% of total billed charges,170.76,38.8,,,percent of total billed charges,38.8% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,170.76,440.1,
BONE SCREW T10 FULL THREAD 2.7mm / L24mm,460ECON0355,CDM,278,RC,,,OUTPATIENT,,,440.1,352.08,,330.08,75,,,percent of total billed charges,75% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,348.56,79.2,,,percent of total billed charges,79.2% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,418.1,95,,,percent of total billed charges,95% of total billed charges,352.08,80,,,percent of total billed charges,80% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of NM fee schedule,176.04,40,,,percent of total billed charges,40% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,334.48,76,,,percent of total billed charges,76% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rate,352.08,80,,,percent of total billed charges,80% of total billed charges,170.76,38.8,,,percent of total billed charges,38.8% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,170.76,440.1,
BONE SCREW T10 FULL THREAD 2.7mm / L26mm,460ECON0356,CDM,278,RC,,,OUTPATIENT,,,440.1,352.08,,330.08,75,,,percent of total billed charges,75% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,348.56,79.2,,,percent of total billed charges,79.2% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,418.1,95,,,percent of total billed charges,95% of total billed charges,352.08,80,,,percent of total billed charges,80% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of NM fee schedule,176.04,40,,,percent of total billed charges,40% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,334.48,76,,,percent of total billed charges,76% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rate,352.08,80,,,percent of total billed charges,80% of total billed charges,170.76,38.8,,,percent of total billed charges,38.8% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,170.76,440.1,
BONE SCREW T10 FULL THREAD 2.7mm / L28mm,460ECON0357,CDM,278,RC,,,OUTPATIENT,,,440.1,352.08,,330.08,75,,,percent of total billed charges,75% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,348.56,79.2,,,percent of total billed charges,79.2% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,418.1,95,,,percent of total billed charges,95% of total billed charges,352.08,80,,,percent of total billed charges,80% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of NM fee schedule,176.04,40,,,percent of total billed charges,40% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,334.48,76,,,percent of total billed charges,76% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rate,352.08,80,,,percent of total billed charges,80% of total billed charges,170.76,38.8,,,percent of total billed charges,38.8% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,170.76,440.1,
BONE SCREW T10 FULL THREAD 2.7mm / L30mm,460ECON0358,CDM,278,RC,,,OUTPATIENT,,,440.1,352.08,,330.08,75,,,percent of total billed charges,75% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,348.56,79.2,,,percent of total billed charges,79.2% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,418.1,95,,,percent of total billed charges,95% of total billed charges,352.08,80,,,percent of total billed charges,80% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of NM fee schedule,176.04,40,,,percent of total billed charges,40% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,334.48,76,,,percent of total billed charges,76% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rate,352.08,80,,,percent of total billed charges,80% of total billed charges,170.76,38.8,,,percent of total billed charges,38.8% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,170.76,440.1,
BONE SCREW T10 FULL THREAD 2.7mm / L32mm,460ECON0359,CDM,278,RC,,,OUTPATIENT,,,440.1,352.08,,330.08,75,,,percent of total billed charges,75% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,348.56,79.2,,,percent of total billed charges,79.2% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,418.1,95,,,percent of total billed charges,95% of total billed charges,352.08,80,,,percent of total billed charges,80% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of CO APG rates,440.1,100,,,fee schedule,100% of NM fee schedule,176.04,40,,,percent of total billed charges,40% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,396.09,90,,,percent of total billed charges,90% of total billed charges,334.48,76,,,percent of total billed charges,76% of total billed charges,176.04,40,,,percent of total billed charges,40% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of CO APG rate,352.08,80,,,percent of total billed charges,80% of total billed charges,170.76,38.8,,,percent of total billed charges,38.8% of total billed charges,374.09,85,,,percent of total billed charges,85% of total billed charges,440.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,170.76,440.1,
BONE SCREW T10 FULL THREAD 2.7mm / L34mm,460ECON0360,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L36mm,460ECON0361,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L38mm,460ECON0362,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L40mm,460ECON0363,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L42mm,460ECON0364,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L44mm,460ECON0365,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L46mm,460ECON0366,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L48mm,460ECON0367,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L50mm,460ECON0368,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L55mm,460ECON0369,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L60mm,460ECON0370,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L65mm,460ECON0371,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
BONE SCREW T10 FULL THREAD 2.7mm / L70mm,460ECON0372,CDM,278,RC,,,OUTPATIENT,,,511.5,409.2,,383.63,75,,,percent of total billed charges,75% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,405.11,79.2,,,percent of total billed charges,79.2% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,485.93,95,,,percent of total billed charges,95% of total billed charges,409.2,80,,,percent of total billed charges,80% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of CO APG rates,511.5,100,,,fee schedule,100% of NM fee schedule,204.6,40,,,percent of total billed charges,40% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,460.35,90,,,percent of total billed charges,90% of total billed charges,388.74,76,,,percent of total billed charges,76% of total billed charges,204.6,40,,,percent of total billed charges,40% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of CO APG rate,409.2,80,,,percent of total billed charges,80% of total billed charges,198.46,38.8,,,percent of total billed charges,38.8% of total billed charges,434.78,85,,,percent of total billed charges,85% of total billed charges,511.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,198.46,511.5,
DRI-LOK THREADED CANNULA 8.0MM X 75MM,46052796,CDM,270,RC,,,OUTPATIENT,,,109.2,87.36,,81.9,75,,,percent of total billed charges,75% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,86.49,79.2,,,percent of total billed charges,79.2% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rates,103.74,95,,,percent of total billed charges,95% of total billed charges,87.36,80,,,percent of total billed charges,80% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rates,109.2,100,,,fee schedule,100% of CO APG rates,109.2,100,,,fee schedule,100% of NM fee schedule,43.68,40,,,percent of total billed charges,40% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,82.99,76,,,percent of total billed charges,76% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rate,87.36,80,,,percent of total billed charges,80% of total billed charges,42.37,38.8,,,percent of total billed charges,38.8% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,42.37,109.2,
96377 - APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,60000231,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,140.4,112.32,,105.3,75,,,percent of total billed charges,75% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,111.2,79.2,,,percent of total billed charges,79.2% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,140.4,100,,,fee schedule,100% of CO APG rates,133.38,95,,,percent of total billed charges,95% of total billed charges,112.32,80,,,percent of total billed charges,80% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,126.36,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,140.4,100,,,fee schedule,100% of NM APC rate,56.16,40,,,percent of total billed charges,40% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,126.36,90,,,percent of total billed charges,90% of total billed charges,106.7,76,,,percent of total billed charges,76% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,112.32,80,,,percent of total billed charges,80% of total billed charges,54.48,38.8,,,percent of total billed charges,38.8% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,280.8,200,,,fee schedule,200% of CMS fee schedule,54.48,2713.28,
GASTROGRAFIN CONSTRAST MEDIA 30ml,41152800,CDM,255,RC,,,OUTPATIENT,,,64.1,51.28,,48.08,75,,,percent of total billed charges,75% of total billed charges,25.64,40,,,percent of total billed charges,40% of total billed charges,50.77,79.2,,,percent of total billed charges,79.2% of total billed charges,54.49,85,,,percent of total billed charges,85% of total billed charges,64.1,100,,,fee schedule,100% of CO APG rates,60.9,95,,,percent of total billed charges,95% of total billed charges,51.28,80,,,percent of total billed charges,80% of total billed charges,54.49,85,,,percent of total billed charges,85% of total billed charges,57.69,90,,,percent of total billed charges,90% of total billed charges,64.1,100,,,fee schedule,100% of CO APG rates,64.1,100,,,fee schedule,100% of CO APG rates,64.1,100,,,fee schedule,100% of NM fee schedule,25.64,40,,,percent of total billed charges,40% of total billed charges,25.64,40,,,percent of total billed charges,40% of total billed charges,57.69,90,,,percent of total billed charges,90% of total billed charges,48.72,76,,,percent of total billed charges,76% of total billed charges,25.64,40,,,percent of total billed charges,40% of total billed charges,54.49,85,,,percent of total billed charges,85% of total billed charges,64.1,100,,,fee schedule,100% of CO APG rate,51.28,80,,,percent of total billed charges,80% of total billed charges,24.87,38.8,,,percent of total billed charges,38.8% of total billed charges,54.49,85,,,percent of total billed charges,85% of total billed charges,64.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,24.87,64.1,
"Pap IG, HSV, rfx HPV ASCU LC",40098355,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,40.1,32.08,,30.08,75,,,percent of total billed charges,75% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,31.76,79.2,,,percent of total billed charges,79.2% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,38.1,95,,,percent of total billed charges,95% of total billed charges,32.08,80,,,percent of total billed charges,80% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,16.04,40,,,percent of total billed charges,40% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,30.48,76,,,percent of total billed charges,76% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,32.08,80,,,percent of total billed charges,80% of total billed charges,15.56,38.8,,,percent of total billed charges,38.8% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,38.1,
PAP,40098355,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,80.66,
LC HSV 1 NAA:,40098355,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
LC HSV 2 NAA:,40098355,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
"Pap IG, rfx HPV all 16/18 LC",40097116,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,168.8,135.04,,126.6,75,,,percent of total billed charges,75% of total billed charges,67.52,40,,,percent of total billed charges,40% of total billed charges,133.69,79.2,,,percent of total billed charges,79.2% of total billed charges,143.48,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,160.36,95,,,percent of total billed charges,95% of total billed charges,135.04,80,,,percent of total billed charges,80% of total billed charges,143.48,85,,,percent of total billed charges,85% of total billed charges,151.92,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,67.52,40,,,percent of total billed charges,40% of total billed charges,67.52,40,,,percent of total billed charges,40% of total billed charges,151.92,90,,,percent of total billed charges,90% of total billed charges,128.29,76,,,percent of total billed charges,76% of total billed charges,67.52,40,,,percent of total billed charges,40% of total billed charges,143.48,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,135.04,80,,,percent of total billed charges,80% of total billed charges,65.49,38.8,,,percent of total billed charges,38.8% of total billed charges,143.48,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,160.36,
"Pap IG, rfx HPV ASCU 16/18 LC",40097132,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,40.1,32.08,,30.08,75,,,percent of total billed charges,75% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,31.76,79.2,,,percent of total billed charges,79.2% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,38.1,95,,,percent of total billed charges,95% of total billed charges,32.08,80,,,percent of total billed charges,80% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,16.04,40,,,percent of total billed charges,40% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,30.48,76,,,percent of total billed charges,76% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,32.08,80,,,percent of total billed charges,80% of total billed charges,15.56,38.8,,,percent of total billed charges,38.8% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,15.56,53.22,
PSMC Multihance Contrast Media,26242546,CDM,255,RC,,,OUTPATIENT,,,12.6,10.08,,9.45,75,,,percent of total billed charges,75% of total billed charges,5.04,40,,,percent of total billed charges,40% of total billed charges,9.98,79.2,,,percent of total billed charges,79.2% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,12.6,100,,,fee schedule,100% of CO APG rates,11.97,95,,,percent of total billed charges,95% of total billed charges,10.08,80,,,percent of total billed charges,80% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,11.34,90,,,percent of total billed charges,90% of total billed charges,12.6,100,,,fee schedule,100% of CO APG rates,12.6,100,,,fee schedule,100% of CO APG rates,12.6,100,,,fee schedule,100% of NM fee schedule,5.04,40,,,percent of total billed charges,40% of total billed charges,5.04,40,,,percent of total billed charges,40% of total billed charges,11.34,90,,,percent of total billed charges,90% of total billed charges,9.58,76,,,percent of total billed charges,76% of total billed charges,5.04,40,,,percent of total billed charges,40% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,12.6,100,,,fee schedule,100% of CO APG rate,10.08,80,,,percent of total billed charges,80% of total billed charges,4.89,38.8,,,percent of total billed charges,38.8% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,12.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,4.89,12.6,
CT Thorax with contrast,60000250,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1642.3,1313.84,TC,1231.73,75,,,percent of total billed charges,75% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1560.19,95,,,percent of total billed charges,95% of total billed charges,1313.84,80,,,percent of total billed charges,80% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,656.92,40,,,percent of total billed charges,40% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,1248.15,76,,,percent of total billed charges,76% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1313.84,80,,,percent of total billed charges,80% of total billed charges,637.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1560.19,
"86008, Allergen specific IgE; quantitative or semiquantitati",40086008,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,70,56,,52.5,75,,,percent of total billed charges,75% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,55.44,79.2,,,percent of total billed charges,79.2% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,66.5,95,,,percent of total billed charges,95% of total billed charges,56,80,,,percent of total billed charges,80% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,63,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,28,40,,,percent of total billed charges,40% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,63,90,,,percent of total billed charges,90% of total billed charges,53.2,76,,,percent of total billed charges,76% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,56,80,,,percent of total billed charges,80% of total billed charges,27.16,38.8,,,percent of total billed charges,38.8% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,66.5,
"85660 Sickling of RBC, reduction",40085660,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,80.66,
"85041 Blood count; red blood cell (RBC), automated",40085041,CDM,305,RC,85018,HCPCS,OUTPATIENT,,,37.1,29.68,,27.83,75,,,percent of total billed charges,75% of total billed charges,14.84,40,,,percent of total billed charges,40% of total billed charges,29.38,79.2,,,percent of total billed charges,79.2% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,35.25,95,,,percent of total billed charges,95% of total billed charges,29.68,80,,,percent of total billed charges,80% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,33.39,90,,,percent of total billed charges,90% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rates,7.45,100,,,fee schedule,100% of CO APG rates,2.23,100,,,fee schedule,100% of NM fee schedule,14.84,40,,,percent of total billed charges,40% of total billed charges,14.84,40,,,percent of total billed charges,40% of total billed charges,33.39,90,,,percent of total billed charges,90% of total billed charges,28.2,76,,,percent of total billed charges,76% of total billed charges,14.84,40,,,percent of total billed charges,40% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of CO APG rate,29.68,80,,,percent of total billed charges,80% of total billed charges,14.39,38.8,,,percent of total billed charges,38.8% of total billed charges,31.54,85,,,percent of total billed charges,85% of total billed charges,7.45,100,,,fee schedule,100% of APG fee schedule,4.74,200,,,fee schedule,200% of CMS fee schedule,2.23,35.25,
83735 Magnesium Level 24 Hour Urine,40003400,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,86,68.8,,64.5,75,,,percent of total billed charges,75% of total billed charges,34.4,40,,,percent of total billed charges,40% of total billed charges,68.11,79.2,,,percent of total billed charges,79.2% of total billed charges,73.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,81.7,95,,,percent of total billed charges,95% of total billed charges,68.8,80,,,percent of total billed charges,80% of total billed charges,73.1,85,,,percent of total billed charges,85% of total billed charges,77.4,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,34.4,40,,,percent of total billed charges,40% of total billed charges,34.4,40,,,percent of total billed charges,40% of total billed charges,77.4,90,,,percent of total billed charges,90% of total billed charges,65.36,76,,,percent of total billed charges,76% of total billed charges,34.4,40,,,percent of total billed charges,40% of total billed charges,73.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,68.8,80,,,percent of total billed charges,80% of total billed charges,33.37,38.8,,,percent of total billed charges,38.8% of total billed charges,73.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,81.7,
"Volume measurement for timed collection, each",40081050,CDM,307,RC,81002,HCPCS,OUTPATIENT,,,21.2,16.96,,15.9,75,,,percent of total billed charges,75% of total billed charges,8.48,40,,,percent of total billed charges,40% of total billed charges,16.79,79.2,,,percent of total billed charges,79.2% of total billed charges,18.02,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,20.14,95,,,percent of total billed charges,95% of total billed charges,16.96,80,,,percent of total billed charges,80% of total billed charges,18.02,85,,,percent of total billed charges,85% of total billed charges,19.08,90,,,percent of total billed charges,90% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rates,3.61,100,,,fee schedule,100% of CO APG rates,3.27,100,,,fee schedule,100% of NM fee schedule,8.48,40,,,percent of total billed charges,40% of total billed charges,8.48,40,,,percent of total billed charges,40% of total billed charges,19.08,90,,,percent of total billed charges,90% of total billed charges,16.11,76,,,percent of total billed charges,76% of total billed charges,8.48,40,,,percent of total billed charges,40% of total billed charges,18.02,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of CO APG rate,16.96,80,,,percent of total billed charges,80% of total billed charges,8.23,38.8,,,percent of total billed charges,38.8% of total billed charges,18.02,85,,,percent of total billed charges,85% of total billed charges,3.61,100,,,fee schedule,100% of APG fee schedule,6.96,200,,,fee schedule,200% of CMS fee schedule,3.27,20.14,
"Pap IG, HSV 1/2 NAA LC",40098300,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,168.8,135.04,,126.6,75,,,percent of total billed charges,75% of total billed charges,67.52,40,,,percent of total billed charges,40% of total billed charges,133.69,79.2,,,percent of total billed charges,79.2% of total billed charges,143.48,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,160.36,95,,,percent of total billed charges,95% of total billed charges,135.04,80,,,percent of total billed charges,80% of total billed charges,143.48,85,,,percent of total billed charges,85% of total billed charges,151.92,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,67.52,40,,,percent of total billed charges,40% of total billed charges,67.52,40,,,percent of total billed charges,40% of total billed charges,151.92,90,,,percent of total billed charges,90% of total billed charges,128.29,76,,,percent of total billed charges,76% of total billed charges,67.52,40,,,percent of total billed charges,40% of total billed charges,143.48,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,135.04,80,,,percent of total billed charges,80% of total billed charges,65.49,38.8,,,percent of total billed charges,38.8% of total billed charges,143.48,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,160.36,
"Pap IG, Ct-Ng TV HSV 1/2 NAA LC",40098315,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,126.7,101.36,,95.03,75,,,percent of total billed charges,75% of total billed charges,50.68,40,,,percent of total billed charges,40% of total billed charges,100.35,79.2,,,percent of total billed charges,79.2% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,120.37,95,,,percent of total billed charges,95% of total billed charges,101.36,80,,,percent of total billed charges,80% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,114.03,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,50.68,40,,,percent of total billed charges,40% of total billed charges,50.68,40,,,percent of total billed charges,40% of total billed charges,114.03,90,,,percent of total billed charges,90% of total billed charges,96.29,76,,,percent of total billed charges,76% of total billed charges,50.68,40,,,percent of total billed charges,40% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,101.36,80,,,percent of total billed charges,80% of total billed charges,49.16,38.8,,,percent of total billed charges,38.8% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,120.37,
86148 Anti-phosphatidylserine (phospholipid) antibody,60000516,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,57.3,45.84,,42.98,75,,,percent of total billed charges,75% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,45.38,79.2,,,percent of total billed charges,79.2% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,54.44,95,,,percent of total billed charges,95% of total billed charges,45.84,80,,,percent of total billed charges,80% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,51.57,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,22.92,40,,,percent of total billed charges,40% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,51.57,90,,,percent of total billed charges,90% of total billed charges,43.55,76,,,percent of total billed charges,76% of total billed charges,22.92,40,,,percent of total billed charges,40% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,45.84,80,,,percent of total billed charges,80% of total billed charges,22.23,38.8,,,percent of total billed charges,38.8% of total billed charges,48.71,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,54.44,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
Trich,40087661,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
Trich,40087661,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
CT Thorax W/O Contrast,60000255,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,901.5,721.2,TC,676.13,75,,,percent of total billed charges,75% of total billed charges,360.6,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,766.28,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,856.43,95,,,percent of total billed charges,95% of total billed charges,721.2,80,,,percent of total billed charges,80% of total billed charges,766.28,85,,,percent of total billed charges,85% of total billed charges,811.35,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,360.6,40,,,percent of total billed charges,40% of total billed charges,360.6,40,,,percent of total billed charges,40% of total billed charges,811.35,90,,,percent of total billed charges,90% of total billed charges,685.14,76,,,percent of total billed charges,76% of total billed charges,360.6,40,,,percent of total billed charges,40% of total billed charges,766.28,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,721.2,80,,,percent of total billed charges,80% of total billed charges,349.78,38.8,,,percent of total billed charges,38.8% of total billed charges,766.28,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,856.43,
87491 CT LC,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,38.6,30.88,,28.95,75,,,percent of total billed charges,75% of total billed charges,15.44,40,,,percent of total billed charges,40% of total billed charges,30.57,79.2,,,percent of total billed charges,79.2% of total billed charges,32.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,36.67,95,,,percent of total billed charges,95% of total billed charges,30.88,80,,,percent of total billed charges,80% of total billed charges,32.81,85,,,percent of total billed charges,85% of total billed charges,34.74,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,15.44,40,,,percent of total billed charges,40% of total billed charges,15.44,40,,,percent of total billed charges,40% of total billed charges,34.74,90,,,percent of total billed charges,90% of total billed charges,29.34,76,,,percent of total billed charges,76% of total billed charges,15.44,40,,,percent of total billed charges,40% of total billed charges,32.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,30.88,80,,,percent of total billed charges,80% of total billed charges,14.98,38.8,,,percent of total billed charges,38.8% of total billed charges,32.81,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,36.67,
87591 NG LC,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,43.9,35.12,,32.93,75,,,percent of total billed charges,75% of total billed charges,17.56,40,,,percent of total billed charges,40% of total billed charges,34.77,79.2,,,percent of total billed charges,79.2% of total billed charges,37.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,41.71,95,,,percent of total billed charges,95% of total billed charges,35.12,80,,,percent of total billed charges,80% of total billed charges,37.32,85,,,percent of total billed charges,85% of total billed charges,39.51,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,17.56,40,,,percent of total billed charges,40% of total billed charges,17.56,40,,,percent of total billed charges,40% of total billed charges,39.51,90,,,percent of total billed charges,90% of total billed charges,33.36,76,,,percent of total billed charges,76% of total billed charges,17.56,40,,,percent of total billed charges,40% of total billed charges,37.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,35.12,80,,,percent of total billed charges,80% of total billed charges,17.03,38.8,,,percent of total billed charges,38.8% of total billed charges,37.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,41.71,
87624 HPV LC,40087624,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,124.6,99.68,,93.45,75,,,percent of total billed charges,75% of total billed charges,49.84,40,,,percent of total billed charges,40% of total billed charges,98.68,79.2,,,percent of total billed charges,79.2% of total billed charges,105.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,118.37,95,,,percent of total billed charges,95% of total billed charges,99.68,80,,,percent of total billed charges,80% of total billed charges,105.91,85,,,percent of total billed charges,85% of total billed charges,112.14,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,49.84,40,,,percent of total billed charges,40% of total billed charges,49.84,40,,,percent of total billed charges,40% of total billed charges,112.14,90,,,percent of total billed charges,90% of total billed charges,94.7,76,,,percent of total billed charges,76% of total billed charges,49.84,40,,,percent of total billed charges,40% of total billed charges,105.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,99.68,80,,,percent of total billed charges,80% of total billed charges,48.34,38.8,,,percent of total billed charges,38.8% of total billed charges,105.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,118.37,
87661 TV LC,40087661,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,68.2,54.56,,51.15,75,,,percent of total billed charges,75% of total billed charges,27.28,40,,,percent of total billed charges,40% of total billed charges,54.01,79.2,,,percent of total billed charges,79.2% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,64.79,95,,,percent of total billed charges,95% of total billed charges,54.56,80,,,percent of total billed charges,80% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,61.38,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,27.28,40,,,percent of total billed charges,40% of total billed charges,27.28,40,,,percent of total billed charges,40% of total billed charges,61.38,90,,,percent of total billed charges,90% of total billed charges,51.83,76,,,percent of total billed charges,76% of total billed charges,27.28,40,,,percent of total billed charges,40% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,54.56,80,,,percent of total billed charges,80% of total billed charges,26.46,38.8,,,percent of total billed charges,38.8% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,64.79,
87529 HSV LC,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,128.8,103.04,,96.6,75,,,percent of total billed charges,75% of total billed charges,51.52,40,,,percent of total billed charges,40% of total billed charges,102.01,79.2,,,percent of total billed charges,79.2% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,122.36,95,,,percent of total billed charges,95% of total billed charges,103.04,80,,,percent of total billed charges,80% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,115.92,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,51.52,40,,,percent of total billed charges,40% of total billed charges,51.52,40,,,percent of total billed charges,40% of total billed charges,115.92,90,,,percent of total billed charges,90% of total billed charges,97.89,76,,,percent of total billed charges,76% of total billed charges,51.52,40,,,percent of total billed charges,40% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,103.04,80,,,percent of total billed charges,80% of total billed charges,49.97,38.8,,,percent of total billed charges,38.8% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,122.36,
CT Thorax W + WO Contrast,60000256,CDM,352,RC,74170,HCPCS,OUTPATIENT,,,1642.3,1313.84,,1231.73,75,,,percent of total billed charges,75% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,1560.19,95,,,percent of total billed charges,95% of total billed charges,1313.84,80,,,percent of total billed charges,80% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,656.92,40,,,percent of total billed charges,40% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1478.07,90,,,percent of total billed charges,90% of total billed charges,1248.15,76,,,percent of total billed charges,76% of total billed charges,656.92,40,,,percent of total billed charges,40% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,1313.84,80,,,percent of total billed charges,80% of total billed charges,637.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1395.96,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,256.84,200,,,fee schedule,200% of CMS fee schedule,180.34,1560.19,
LOCKING SCREW T10 FULL THREAD 2.7mm / L10mm,460ECON0373,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 2.7mm / L12mm,460ECON0374,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 2.7mm / L14mm,460ECON0375,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 2.7mm / L16mm,460ECON0376,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 2.7mm / L18mm,460ECON0377,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 2.7mm / L20mm,460ECON0378,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 2.7mm / L22mm,460ECON0379,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 2.7mm / L24mm,460ECON0380,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
Z0750 - WC INITIAL REPORT,60000245,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,54.1,43.28,,40.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,42.85,79.2,,,percent of total billed charges,79.2% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,54.1,100,,,fee schedule,100% of CO APG rates,51.4,95,,,percent of total billed charges,95% of total billed charges,43.28,80,,,percent of total billed charges,80% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,54.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,48.69,90,,,percent of total billed charges,90% of total billed charges,41.12,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,45.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,43.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,45.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,490.4,100,,,case rate,pays based on per visit rate,40.58,490.4,
Z0751 - WC PROGRESS REPORT,60000246,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,54.1,43.28,,40.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,42.85,79.2,,,percent of total billed charges,79.2% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,54.1,100,,,fee schedule,100% of CO APG rates,51.4,95,,,percent of total billed charges,95% of total billed charges,43.28,80,,,percent of total billed charges,80% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,54.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,48.69,90,,,percent of total billed charges,90% of total billed charges,41.12,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,45.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,43.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,45.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,490.4,100,,,case rate,pays based on per visit rate,40.58,490.4,
Z0752 - WC CLOSING REPORT,60000247,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,54.1,43.28,,40.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,42.85,79.2,,,percent of total billed charges,79.2% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,54.1,100,,,fee schedule,100% of CO APG rates,51.4,95,,,percent of total billed charges,95% of total billed charges,43.28,80,,,percent of total billed charges,80% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,54.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,48.69,90,,,percent of total billed charges,90% of total billed charges,41.12,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,45.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,43.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,45.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,490.4,100,,,case rate,pays based on per visit rate,40.58,490.4,
Z0753 - WC INITIAL AND CLOSING REPORT,60000248,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,54.1,43.28,,40.58,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,42.85,79.2,,,percent of total billed charges,79.2% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,54.1,100,,,fee schedule,100% of CO APG rates,51.4,95,,,percent of total billed charges,95% of total billed charges,43.28,80,,,percent of total billed charges,80% of total billed charges,45.99,85,,,percent of total billed charges,85% of total billed charges,48.69,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,54.1,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,48.69,90,,,percent of total billed charges,90% of total billed charges,41.12,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,45.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,43.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,45.99,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,490.4,100,,,case rate,pays based on per visit rate,40.58,490.4,
"Hemorrhoidectomy, internal by rubber band ligation(s)",60000383,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,629.2,503.36,,471.9,75,,,percent of total billed charges,75% of total billed charges,251.68,40,,,percent of total billed charges,40% of total billed charges,498.33,79.2,,,percent of total billed charges,79.2% of total billed charges,534.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,597.74,95,,,percent of total billed charges,95% of total billed charges,503.36,80,,,percent of total billed charges,80% of total billed charges,534.82,85,,,percent of total billed charges,85% of total billed charges,566.28,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,251.68,40,,,percent of total billed charges,40% of total billed charges,251.68,40,,,percent of total billed charges,40% of total billed charges,566.28,90,,,percent of total billed charges,90% of total billed charges,478.19,76,,,percent of total billed charges,76% of total billed charges,251.68,40,,,percent of total billed charges,40% of total billed charges,534.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,503.36,80,,,percent of total billed charges,80% of total billed charges,244.13,38.8,,,percent of total billed charges,38.8% of total billed charges,534.82,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,597.74,
LOCKING SCREW T10 FULL THREAD 2.7mm / L26mm,460ECON0381,CDM,278,RC,,,OUTPATIENT,,,693.3,554.64,,519.98,75,,,percent of total billed charges,75% of total billed charges,277.32,40,,,percent of total billed charges,40% of total billed charges,549.09,79.2,,,percent of total billed charges,79.2% of total billed charges,589.31,85,,,percent of total billed charges,85% of total billed charges,693.3,100,,,fee schedule,100% of CO APG rates,658.64,95,,,percent of total billed charges,95% of total billed charges,554.64,80,,,percent of total billed charges,80% of total billed charges,589.31,85,,,percent of total billed charges,85% of total billed charges,623.97,90,,,percent of total billed charges,90% of total billed charges,693.3,100,,,fee schedule,100% of CO APG rates,693.3,100,,,fee schedule,100% of CO APG rates,693.3,100,,,fee schedule,100% of NM fee schedule,277.32,40,,,percent of total billed charges,40% of total billed charges,277.32,40,,,percent of total billed charges,40% of total billed charges,623.97,90,,,percent of total billed charges,90% of total billed charges,526.91,76,,,percent of total billed charges,76% of total billed charges,277.32,40,,,percent of total billed charges,40% of total billed charges,589.31,85,,,percent of total billed charges,85% of total billed charges,693.3,100,,,fee schedule,100% of CO APG rate,554.64,80,,,percent of total billed charges,80% of total billed charges,269,38.8,,,percent of total billed charges,38.8% of total billed charges,589.31,85,,,percent of total billed charges,85% of total billed charges,693.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,269,693.3,
LOCKING SCREW T10 FULL THREAD 2.7mm / L28mm,460ECON0382,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 2.7mm / L30mm,460ECON0383,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 2.7mm / L32mm,460ECON0384,CDM,278,RC,,,OUTPATIENT,,,690.1,552.08,,517.58,75,,,percent of total billed charges,75% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,546.56,79.2,,,percent of total billed charges,79.2% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,655.6,95,,,percent of total billed charges,95% of total billed charges,552.08,80,,,percent of total billed charges,80% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of CO APG rates,690.1,100,,,fee schedule,100% of NM fee schedule,276.04,40,,,percent of total billed charges,40% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,621.09,90,,,percent of total billed charges,90% of total billed charges,524.48,76,,,percent of total billed charges,76% of total billed charges,276.04,40,,,percent of total billed charges,40% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of CO APG rate,552.08,80,,,percent of total billed charges,80% of total billed charges,267.76,38.8,,,percent of total billed charges,38.8% of total billed charges,586.59,85,,,percent of total billed charges,85% of total billed charges,690.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,267.76,690.1,
LOCKING SCREW T10 FULL THREAD 2.7mm / L34mm,460ECON0385,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
LOCKING SCREW T10 FULL THREAD 2.7mm / L36mm,460ECON0386,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
LOCKING SCREW T10 FULL THREAD 2.7mm / L38mm,460ECON0387,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
SUTURE 4-0 VICRYL UD BR CT SH J415H,52801,CDM,270,RC,,,OUTPATIENT,,,6.5,5.2,,4.88,75,,,percent of total billed charges,75% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.15,79.2,,,percent of total billed charges,79.2% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.18,95,,,percent of total billed charges,95% of total billed charges,5.2,80,,,percent of total billed charges,80% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of CO APG rates,6.5,100,,,fee schedule,100% of NM fee schedule,2.6,40,,,percent of total billed charges,40% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.85,90,,,percent of total billed charges,90% of total billed charges,4.94,76,,,percent of total billed charges,76% of total billed charges,2.6,40,,,percent of total billed charges,40% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of CO APG rate,5.2,80,,,percent of total billed charges,80% of total billed charges,2.52,38.8,,,percent of total billed charges,38.8% of total billed charges,5.53,85,,,percent of total billed charges,85% of total billed charges,6.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.52,6.5,
UNIVERSAL PLUS 5mm x 32cm LAPROSCOPIC NEEDLE ELECTRODE W/ SU,46052802,CDM,270,RC,,,OUTPATIENT,,,104.8,83.84,,78.6,75,,,percent of total billed charges,75% of total billed charges,41.92,40,,,percent of total billed charges,40% of total billed charges,83,79.2,,,percent of total billed charges,79.2% of total billed charges,89.08,85,,,percent of total billed charges,85% of total billed charges,104.8,100,,,fee schedule,100% of CO APG rates,99.56,95,,,percent of total billed charges,95% of total billed charges,83.84,80,,,percent of total billed charges,80% of total billed charges,89.08,85,,,percent of total billed charges,85% of total billed charges,94.32,90,,,percent of total billed charges,90% of total billed charges,104.8,100,,,fee schedule,100% of CO APG rates,104.8,100,,,fee schedule,100% of CO APG rates,104.8,100,,,fee schedule,100% of NM fee schedule,41.92,40,,,percent of total billed charges,40% of total billed charges,41.92,40,,,percent of total billed charges,40% of total billed charges,94.32,90,,,percent of total billed charges,90% of total billed charges,79.65,76,,,percent of total billed charges,76% of total billed charges,41.92,40,,,percent of total billed charges,40% of total billed charges,89.08,85,,,percent of total billed charges,85% of total billed charges,104.8,100,,,fee schedule,100% of CO APG rate,83.84,80,,,percent of total billed charges,80% of total billed charges,40.66,38.8,,,percent of total billed charges,38.8% of total billed charges,89.08,85,,,percent of total billed charges,85% of total billed charges,104.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,40.66,104.8,
HIV 1/2 Ab Screen,60000258,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,97.9,78.32,,73.43,75,,,percent of total billed charges,75% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,77.54,79.2,,,percent of total billed charges,79.2% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,93.01,95,,,percent of total billed charges,95% of total billed charges,78.32,80,,,percent of total billed charges,80% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,39.16,40,,,percent of total billed charges,40% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,74.4,76,,,percent of total billed charges,76% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,78.32,80,,,percent of total billed charges,80% of total billed charges,37.99,38.8,,,percent of total billed charges,38.8% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,93.01,
SUTURE 2-0 SILK BLK BR 18 in FSL,52806,CDM,270,RC,,,OUTPATIENT,,,7.5,6,,5.63,75,,,percent of total billed charges,75% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,5.94,79.2,,,percent of total billed charges,79.2% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.13,95,,,percent of total billed charges,95% of total billed charges,6,80,,,percent of total billed charges,80% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of CO APG rates,7.5,100,,,fee schedule,100% of NM fee schedule,3,40,,,percent of total billed charges,40% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.75,90,,,percent of total billed charges,90% of total billed charges,5.7,76,,,percent of total billed charges,76% of total billed charges,3,40,,,percent of total billed charges,40% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of CO APG rate,6,80,,,percent of total billed charges,80% of total billed charges,2.91,38.8,,,percent of total billed charges,38.8% of total billed charges,6.38,85,,,percent of total billed charges,85% of total billed charges,7.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2.91,7.5,
SUTURE 3-0 NYLON BLK MONO 18in PS-2 1669H,52807,CDM,270,RC,,,OUTPATIENT,,,14.3,11.44,,10.73,75,,,percent of total billed charges,75% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,11.33,79.2,,,percent of total billed charges,79.2% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,13.59,95,,,percent of total billed charges,95% of total billed charges,11.44,80,,,percent of total billed charges,80% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of CO APG rates,14.3,100,,,fee schedule,100% of NM fee schedule,5.72,40,,,percent of total billed charges,40% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.87,90,,,percent of total billed charges,90% of total billed charges,10.87,76,,,percent of total billed charges,76% of total billed charges,5.72,40,,,percent of total billed charges,40% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of CO APG rate,11.44,80,,,percent of total billed charges,80% of total billed charges,5.55,38.8,,,percent of total billed charges,38.8% of total billed charges,12.16,85,,,percent of total billed charges,85% of total billed charges,14.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.55,14.3,
SUTURE 4-0 NYLON BLK MONO 18in PC-3  1864G,52808,CDM,270,RC,,,OUTPATIENT,,,16.4,13.12,,12.3,75,,,percent of total billed charges,75% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,12.99,79.2,,,percent of total billed charges,79.2% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,15.58,95,,,percent of total billed charges,95% of total billed charges,13.12,80,,,percent of total billed charges,80% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of NM fee schedule,6.56,40,,,percent of total billed charges,40% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,12.46,76,,,percent of total billed charges,76% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rate,13.12,80,,,percent of total billed charges,80% of total billed charges,6.36,38.8,,,percent of total billed charges,38.8% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.36,16.4,
SUTURE 5-0 NYLON BLK MONO 18in PC-3  1865G,52809,CDM,270,RC,,,OUTPATIENT,,,16.4,13.12,,12.3,75,,,percent of total billed charges,75% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,12.99,79.2,,,percent of total billed charges,79.2% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,15.58,95,,,percent of total billed charges,95% of total billed charges,13.12,80,,,percent of total billed charges,80% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of CO APG rates,16.4,100,,,fee schedule,100% of NM fee schedule,6.56,40,,,percent of total billed charges,40% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,14.76,90,,,percent of total billed charges,90% of total billed charges,12.46,76,,,percent of total billed charges,76% of total billed charges,6.56,40,,,percent of total billed charges,40% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of CO APG rate,13.12,80,,,percent of total billed charges,80% of total billed charges,6.36,38.8,,,percent of total billed charges,38.8% of total billed charges,13.94,85,,,percent of total billed charges,85% of total billed charges,16.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,6.36,16.4,
SUTURE 5-0 NYLON BLK MONO 18in PS-2 1666H,52810,CDM,270,RC,,,OUTPATIENT,,,13,10.4,,9.75,75,,,percent of total billed charges,75% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,10.3,79.2,,,percent of total billed charges,79.2% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,12.35,95,,,percent of total billed charges,95% of total billed charges,10.4,80,,,percent of total billed charges,80% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of CO APG rates,13,100,,,fee schedule,100% of NM fee schedule,5.2,40,,,percent of total billed charges,40% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.7,90,,,percent of total billed charges,90% of total billed charges,9.88,76,,,percent of total billed charges,76% of total billed charges,5.2,40,,,percent of total billed charges,40% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of CO APG rate,10.4,80,,,percent of total billed charges,80% of total billed charges,5.04,38.8,,,percent of total billed charges,38.8% of total billed charges,11.05,85,,,percent of total billed charges,85% of total billed charges,13,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.04,13,
SUTURE 3-0 VICRYL UD BR 18in SH J864D,52811,CDM,270,RC,,,OUTPATIENT,,,34.8,27.84,,26.1,75,,,percent of total billed charges,75% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,27.56,79.2,,,percent of total billed charges,79.2% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rates,33.06,95,,,percent of total billed charges,95% of total billed charges,27.84,80,,,percent of total billed charges,80% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,31.32,90,,,percent of total billed charges,90% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rates,34.8,100,,,fee schedule,100% of CO APG rates,34.8,100,,,fee schedule,100% of NM fee schedule,13.92,40,,,percent of total billed charges,40% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,31.32,90,,,percent of total billed charges,90% of total billed charges,26.45,76,,,percent of total billed charges,76% of total billed charges,13.92,40,,,percent of total billed charges,40% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of CO APG rate,27.84,80,,,percent of total billed charges,80% of total billed charges,13.5,38.8,,,percent of total billed charges,38.8% of total billed charges,29.58,85,,,percent of total billed charges,85% of total billed charges,34.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,13.5,34.8,
SUTURE 4-0 CHROMIC GUT PS-2  1637G,52812,CDM,270,RC,,,OUTPATIENT,,,20.8,16.64,,15.6,75,,,percent of total billed charges,75% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,16.47,79.2,,,percent of total billed charges,79.2% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rates,19.76,95,,,percent of total billed charges,95% of total billed charges,16.64,80,,,percent of total billed charges,80% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rates,20.8,100,,,fee schedule,100% of CO APG rates,20.8,100,,,fee schedule,100% of NM fee schedule,8.32,40,,,percent of total billed charges,40% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,18.72,90,,,percent of total billed charges,90% of total billed charges,15.81,76,,,percent of total billed charges,76% of total billed charges,8.32,40,,,percent of total billed charges,40% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of CO APG rate,16.64,80,,,percent of total billed charges,80% of total billed charges,8.07,38.8,,,percent of total billed charges,38.8% of total billed charges,17.68,85,,,percent of total billed charges,85% of total billed charges,20.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.07,20.8,
Hepatitis C Antibody Screen,60000257,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,140.4,112.32,,105.3,75,,,percent of total billed charges,75% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,111.2,79.2,,,percent of total billed charges,79.2% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,133.38,95,,,percent of total billed charges,95% of total billed charges,112.32,80,,,percent of total billed charges,80% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,126.36,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,56.16,40,,,percent of total billed charges,40% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,126.36,90,,,percent of total billed charges,90% of total billed charges,106.7,76,,,percent of total billed charges,76% of total billed charges,56.16,40,,,percent of total billed charges,40% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,112.32,80,,,percent of total billed charges,80% of total billed charges,54.48,38.8,,,percent of total billed charges,38.8% of total billed charges,119.34,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,133.38,
Hepatitis B Surface Antigen Screen,60000259,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,111.6,89.28,,83.7,75,,,percent of total billed charges,75% of total billed charges,44.64,40,,,percent of total billed charges,40% of total billed charges,88.39,79.2,,,percent of total billed charges,79.2% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,106.02,95,,,percent of total billed charges,95% of total billed charges,89.28,80,,,percent of total billed charges,80% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,100.44,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,44.64,40,,,percent of total billed charges,40% of total billed charges,44.64,40,,,percent of total billed charges,40% of total billed charges,100.44,90,,,percent of total billed charges,90% of total billed charges,84.82,76,,,percent of total billed charges,76% of total billed charges,44.64,40,,,percent of total billed charges,40% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,89.28,80,,,percent of total billed charges,80% of total billed charges,43.3,38.8,,,percent of total billed charges,38.8% of total billed charges,94.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,106.02,
"SUCTION COAGULATOR, 10FR, SUCTION VALVE",46052813,CDM,270,RC,,,OUTPATIENT,,,58,46.4,,43.5,75,,,percent of total billed charges,75% of total billed charges,23.2,40,,,percent of total billed charges,40% of total billed charges,45.94,79.2,,,percent of total billed charges,79.2% of total billed charges,49.3,85,,,percent of total billed charges,85% of total billed charges,58,100,,,fee schedule,100% of CO APG rates,55.1,95,,,percent of total billed charges,95% of total billed charges,46.4,80,,,percent of total billed charges,80% of total billed charges,49.3,85,,,percent of total billed charges,85% of total billed charges,52.2,90,,,percent of total billed charges,90% of total billed charges,58,100,,,fee schedule,100% of CO APG rates,58,100,,,fee schedule,100% of CO APG rates,58,100,,,fee schedule,100% of NM fee schedule,23.2,40,,,percent of total billed charges,40% of total billed charges,23.2,40,,,percent of total billed charges,40% of total billed charges,52.2,90,,,percent of total billed charges,90% of total billed charges,44.08,76,,,percent of total billed charges,76% of total billed charges,23.2,40,,,percent of total billed charges,40% of total billed charges,49.3,85,,,percent of total billed charges,85% of total billed charges,58,100,,,fee schedule,100% of CO APG rate,46.4,80,,,percent of total billed charges,80% of total billed charges,22.5,38.8,,,percent of total billed charges,38.8% of total billed charges,49.3,85,,,percent of total billed charges,85% of total billed charges,58,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,22.5,58,
Pap IG (Image Guided) LC,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,40.1,32.08,,30.08,75,,,percent of total billed charges,75% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,31.76,79.2,,,percent of total billed charges,79.2% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,38.1,95,,,percent of total billed charges,95% of total billed charges,32.08,80,,,percent of total billed charges,80% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,16.04,40,,,percent of total billed charges,40% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,36.09,90,,,percent of total billed charges,90% of total billed charges,30.48,76,,,percent of total billed charges,76% of total billed charges,16.04,40,,,percent of total billed charges,40% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,32.08,80,,,percent of total billed charges,80% of total billed charges,15.56,38.8,,,percent of total billed charges,38.8% of total billed charges,34.09,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,15.56,53.22,
LC,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,126.7,101.36,,95.03,75,,,percent of total billed charges,75% of total billed charges,50.68,40,,,percent of total billed charges,40% of total billed charges,100.35,79.2,,,percent of total billed charges,79.2% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,120.37,95,,,percent of total billed charges,95% of total billed charges,101.36,80,,,percent of total billed charges,80% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,114.03,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,50.68,40,,,percent of total billed charges,40% of total billed charges,50.68,40,,,percent of total billed charges,40% of total billed charges,114.03,90,,,percent of total billed charges,90% of total billed charges,96.29,76,,,percent of total billed charges,76% of total billed charges,50.68,40,,,percent of total billed charges,40% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,101.36,80,,,percent of total billed charges,80% of total billed charges,49.16,38.8,,,percent of total billed charges,38.8% of total billed charges,107.7,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,120.37,
"LC Chlamydia, Nuc. Acid Amp",40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
"LC Gonococcus, Nuc. Acid Amp",40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
LOCKING SCREW T10 FULL THREAD 2.7mm / L40mm,460ECON0388,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
LOCKING SCREW T10 FULL THREAD 2.7mm / L42mm,460ECON0389,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
LOCKING SCREW T10 FULL THREAD 2.7mm / L44mm,460ECON0390,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
LOCKING SCREW T10 FULL THREAD 2.7mm / L46mm,460ECON0391,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
LOCKING SCREW T10 FULL THREAD 2.7mm / L48mm,460ECON0392,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
LOCKING SCREW T10 FULL THREAD 2.7mm / L50mm,460ECON0393,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
LOCKING SCREW T10 FULL THREAD 2.7mm / L55mm,460ECON0394,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
LOCKING SCREW T10 FULL THREAD 2.7mm / L60mm,460ECON0395,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
LOCKING SCREW T10 FULL THREAD 2.7mm / L65mm,460ECON0396,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
LOCKING SCREW T10 FULL THREAD 2.7mm / L70mm,460ECON0397,CDM,278,RC,,,OUTPATIENT,,,942.2,753.76,,706.65,75,,,percent of total billed charges,75% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,746.22,79.2,,,percent of total billed charges,79.2% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,895.09,95,,,percent of total billed charges,95% of total billed charges,753.76,80,,,percent of total billed charges,80% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of CO APG rates,942.2,100,,,fee schedule,100% of NM fee schedule,376.88,40,,,percent of total billed charges,40% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,847.98,90,,,percent of total billed charges,90% of total billed charges,716.07,76,,,percent of total billed charges,76% of total billed charges,376.88,40,,,percent of total billed charges,40% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of CO APG rate,753.76,80,,,percent of total billed charges,80% of total billed charges,365.57,38.8,,,percent of total billed charges,38.8% of total billed charges,800.87,85,,,percent of total billed charges,85% of total billed charges,942.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,365.57,942.2,
49082 - ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,60000236,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2913,2330.4,,2184.75,75,,,percent of total billed charges,75% of total billed charges,1165.2,40,,,percent of total billed charges,40% of total billed charges,2307.1,79.2,,,percent of total billed charges,79.2% of total billed charges,2476.05,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2767.35,95,,,percent of total billed charges,95% of total billed charges,2330.4,80,,,percent of total billed charges,80% of total billed charges,2476.05,85,,,percent of total billed charges,85% of total billed charges,2621.7,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,1165.2,40,,,percent of total billed charges,40% of total billed charges,1165.2,40,,,percent of total billed charges,40% of total billed charges,2621.7,90,,,percent of total billed charges,90% of total billed charges,2213.88,76,,,percent of total billed charges,76% of total billed charges,1165.2,40,,,percent of total billed charges,40% of total billed charges,2476.05,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,2330.4,80,,,percent of total billed charges,80% of total billed charges,1130.24,38.8,,,percent of total billed charges,38.8% of total billed charges,2476.05,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2767.35,
29200 STRAPPING THORAX,60000254,CDM,420,RC,97110,HCPCS,OUTPATIENT,,,501.4,401.12,,376.05,75,,,percent of total billed charges,75% of total billed charges,200.56,40,,,percent of total billed charges,40% of total billed charges,397.11,79.2,,,percent of total billed charges,79.2% of total billed charges,426.19,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,476.33,95,,,percent of total billed charges,95% of total billed charges,401.12,80,,,percent of total billed charges,80% of total billed charges,426.19,85,,,percent of total billed charges,85% of total billed charges,451.26,90,,,percent of total billed charges,90% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rates,50.89,100,,,fee schedule,100% of CO APG rates,27.31,100,,,fee schedule,100% of NM fee schedule,200.56,40,,,percent of total billed charges,40% of total billed charges,200.56,40,,,percent of total billed charges,40% of total billed charges,451.26,90,,,percent of total billed charges,90% of total billed charges,381.06,76,,,percent of total billed charges,76% of total billed charges,200.56,40,,,percent of total billed charges,40% of total billed charges,426.19,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of CO APG rate,401.12,80,,,percent of total billed charges,80% of total billed charges,194.54,38.8,,,percent of total billed charges,38.8% of total billed charges,426.19,85,,,percent of total billed charges,85% of total billed charges,50.89,100,,,fee schedule,100% of APG fee schedule,61.06,200,,,fee schedule,200% of CMS fee schedule,27.31,476.33,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
HPV,40087624,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,151.24,
HSV 1,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
HSV 2,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
CT,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
NG,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,93.3,74.64,,69.98,75,,,percent of total billed charges,75% of total billed charges,37.32,40,,,percent of total billed charges,40% of total billed charges,73.89,79.2,,,percent of total billed charges,79.2% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,88.64,95,,,percent of total billed charges,95% of total billed charges,74.64,80,,,percent of total billed charges,80% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,83.97,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,37.32,40,,,percent of total billed charges,40% of total billed charges,37.32,40,,,percent of total billed charges,40% of total billed charges,83.97,90,,,percent of total billed charges,90% of total billed charges,70.91,76,,,percent of total billed charges,76% of total billed charges,37.32,40,,,percent of total billed charges,40% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,74.64,80,,,percent of total billed charges,80% of total billed charges,36.2,38.8,,,percent of total billed charges,38.8% of total billed charges,79.31,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,88.64,
TV,40087661,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
HSV 1,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
HSV 2,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
CT,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
NG,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
TV,40087661,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
HSV 1,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
HSV 2,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
HSV 1,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
HSV 2,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
PAP,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
HPV,40087624,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,151.24,
36592 Collection of blood specimen from central or periphera,60000264,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,387.1,309.68,,290.33,75,,,percent of total billed charges,75% of total billed charges,154.84,40,,,percent of total billed charges,40% of total billed charges,306.58,79.2,,,percent of total billed charges,79.2% of total billed charges,329.04,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,367.75,95,,,percent of total billed charges,95% of total billed charges,309.68,80,,,percent of total billed charges,80% of total billed charges,329.04,85,,,percent of total billed charges,85% of total billed charges,348.39,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,154.84,40,,,percent of total billed charges,40% of total billed charges,154.84,40,,,percent of total billed charges,40% of total billed charges,348.39,90,,,percent of total billed charges,90% of total billed charges,294.2,76,,,percent of total billed charges,76% of total billed charges,154.84,40,,,percent of total billed charges,40% of total billed charges,329.04,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,309.68,80,,,percent of total billed charges,80% of total billed charges,150.19,38.8,,,percent of total billed charges,38.8% of total billed charges,329.04,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,367.75,
CT,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
NG,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
"99153 Moderate sedation, same health care pro performing dia",46299153,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,245.75,196.6,,184.31,75,,,percent of total billed charges,75% of total billed charges,98.3,40,,,percent of total billed charges,40% of total billed charges,194.63,79.2,,,percent of total billed charges,79.2% of total billed charges,208.89,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,233.46,95,,,percent of total billed charges,95% of total billed charges,196.6,80,,,percent of total billed charges,80% of total billed charges,208.89,85,,,percent of total billed charges,85% of total billed charges,221.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,98.3,40,,,percent of total billed charges,40% of total billed charges,98.3,40,,,percent of total billed charges,40% of total billed charges,221.18,90,,,percent of total billed charges,90% of total billed charges,186.77,76,,,percent of total billed charges,76% of total billed charges,98.3,40,,,percent of total billed charges,40% of total billed charges,208.89,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,196.6,80,,,percent of total billed charges,80% of total billed charges,95.35,38.8,,,percent of total billed charges,38.8% of total billed charges,208.89,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,95.35,233.46,
"99155 Moderate sedation, other health care pro performing di",46299155,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,387.5,310,,290.63,75,,,percent of total billed charges,75% of total billed charges,155,40,,,percent of total billed charges,40% of total billed charges,306.9,79.2,,,percent of total billed charges,79.2% of total billed charges,329.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,368.13,95,,,percent of total billed charges,95% of total billed charges,310,80,,,percent of total billed charges,80% of total billed charges,329.38,85,,,percent of total billed charges,85% of total billed charges,348.75,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,155,40,,,percent of total billed charges,40% of total billed charges,155,40,,,percent of total billed charges,40% of total billed charges,348.75,90,,,percent of total billed charges,90% of total billed charges,294.5,76,,,percent of total billed charges,76% of total billed charges,155,40,,,percent of total billed charges,40% of total billed charges,329.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,310,80,,,percent of total billed charges,80% of total billed charges,150.35,38.8,,,percent of total billed charges,38.8% of total billed charges,329.38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,150.35,368.13,
"99157 Moderate sedation, other health care pro performing di",46299157,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,222.5,178,,166.88,75,,,percent of total billed charges,75% of total billed charges,89,40,,,percent of total billed charges,40% of total billed charges,176.22,79.2,,,percent of total billed charges,79.2% of total billed charges,189.13,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,211.38,95,,,percent of total billed charges,95% of total billed charges,178,80,,,percent of total billed charges,80% of total billed charges,189.13,85,,,percent of total billed charges,85% of total billed charges,200.25,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,89,40,,,percent of total billed charges,40% of total billed charges,89,40,,,percent of total billed charges,40% of total billed charges,200.25,90,,,percent of total billed charges,90% of total billed charges,169.1,76,,,percent of total billed charges,76% of total billed charges,89,40,,,percent of total billed charges,40% of total billed charges,189.13,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,178,80,,,percent of total billed charges,80% of total billed charges,86.33,38.8,,,percent of total billed charges,38.8% of total billed charges,189.13,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,86.33,217.66,
US Echo 2D Comp w/ Contrast,428C8929,CDM,483,RC,,,OUTPATIENT,,,2217.3,1773.84,TC,1662.98,75,,,percent of total billed charges,75% of total billed charges,886.92,40,,,percent of total billed charges,40% of total billed charges,1756.1,79.2,,,percent of total billed charges,79.2% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,2217.3,100,,,fee schedule,100% of CO APG rates,2106.44,95,,,percent of total billed charges,95% of total billed charges,1773.84,80,,,percent of total billed charges,80% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,1995.57,90,,,percent of total billed charges,90% of total billed charges,2217.3,100,,,fee schedule,100% of CO APG rates,2217.3,100,,,fee schedule,100% of CO APG rates,2217.3,100,,,fee schedule,100% of NM fee schedule,886.92,40,,,percent of total billed charges,40% of total billed charges,886.92,40,,,percent of total billed charges,40% of total billed charges,1995.57,90,,,percent of total billed charges,90% of total billed charges,1685.15,76,,,percent of total billed charges,76% of total billed charges,886.92,40,,,percent of total billed charges,40% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,2217.3,100,,,fee schedule,100% of CO APG rate,1773.84,80,,,percent of total billed charges,80% of total billed charges,860.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1884.71,85,,,percent of total billed charges,85% of total billed charges,2217.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,860.31,2217.3,
US Echo 2D Ltd w/ Contrast,428C8924,CDM,483,RC,,,OUTPATIENT,,,1439.6,1151.68,TC,1079.7,75,,,percent of total billed charges,75% of total billed charges,575.84,40,,,percent of total billed charges,40% of total billed charges,1140.16,79.2,,,percent of total billed charges,79.2% of total billed charges,1223.66,85,,,percent of total billed charges,85% of total billed charges,1439.6,100,,,fee schedule,100% of CO APG rates,1367.62,95,,,percent of total billed charges,95% of total billed charges,1151.68,80,,,percent of total billed charges,80% of total billed charges,1223.66,85,,,percent of total billed charges,85% of total billed charges,1295.64,90,,,percent of total billed charges,90% of total billed charges,1439.6,100,,,fee schedule,100% of CO APG rates,1439.6,100,,,fee schedule,100% of CO APG rates,1439.6,100,,,fee schedule,100% of NM fee schedule,575.84,40,,,percent of total billed charges,40% of total billed charges,575.84,40,,,percent of total billed charges,40% of total billed charges,1295.64,90,,,percent of total billed charges,90% of total billed charges,1094.1,76,,,percent of total billed charges,76% of total billed charges,575.84,40,,,percent of total billed charges,40% of total billed charges,1223.66,85,,,percent of total billed charges,85% of total billed charges,1439.6,100,,,fee schedule,100% of CO APG rate,1151.68,80,,,percent of total billed charges,80% of total billed charges,558.56,38.8,,,percent of total billed charges,38.8% of total billed charges,1223.66,85,,,percent of total billed charges,85% of total billed charges,1439.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,558.56,1439.6,
96521 Refilling and maintenance of portable pump,60000192,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,708,566.4,,531,75,,,percent of total billed charges,75% of total billed charges,283.2,40,,,percent of total billed charges,40% of total billed charges,560.74,79.2,,,percent of total billed charges,79.2% of total billed charges,601.8,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,672.6,95,,,percent of total billed charges,95% of total billed charges,566.4,80,,,percent of total billed charges,80% of total billed charges,601.8,85,,,percent of total billed charges,85% of total billed charges,637.2,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,283.2,40,,,percent of total billed charges,40% of total billed charges,283.2,40,,,percent of total billed charges,40% of total billed charges,637.2,90,,,percent of total billed charges,90% of total billed charges,538.08,76,,,percent of total billed charges,76% of total billed charges,283.2,40,,,percent of total billed charges,40% of total billed charges,601.8,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,566.4,80,,,percent of total billed charges,80% of total billed charges,274.7,38.8,,,percent of total billed charges,38.8% of total billed charges,601.8,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,672.6,
"OPTISON CONTRAST MEDIA, 3ml vial",41252713,CDM,255,RC,,,OUTPATIENT,,,631.3,505.04,,473.48,75,,,percent of total billed charges,75% of total billed charges,252.52,40,,,percent of total billed charges,40% of total billed charges,499.99,79.2,,,percent of total billed charges,79.2% of total billed charges,536.61,85,,,percent of total billed charges,85% of total billed charges,631.3,100,,,fee schedule,100% of CO APG rates,599.74,95,,,percent of total billed charges,95% of total billed charges,505.04,80,,,percent of total billed charges,80% of total billed charges,536.61,85,,,percent of total billed charges,85% of total billed charges,568.17,90,,,percent of total billed charges,90% of total billed charges,631.3,100,,,fee schedule,100% of CO APG rates,631.3,100,,,fee schedule,100% of CO APG rates,631.3,100,,,fee schedule,100% of NM fee schedule,252.52,40,,,percent of total billed charges,40% of total billed charges,252.52,40,,,percent of total billed charges,40% of total billed charges,568.17,90,,,percent of total billed charges,90% of total billed charges,479.79,76,,,percent of total billed charges,76% of total billed charges,252.52,40,,,percent of total billed charges,40% of total billed charges,536.61,85,,,percent of total billed charges,85% of total billed charges,631.3,100,,,fee schedule,100% of CO APG rate,505.04,80,,,percent of total billed charges,80% of total billed charges,244.94,38.8,,,percent of total billed charges,38.8% of total billed charges,536.61,85,,,percent of total billed charges,85% of total billed charges,631.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,244.94,631.3,
Pap IG,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,84.9,67.92,,63.68,75,,,percent of total billed charges,75% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,67.24,79.2,,,percent of total billed charges,79.2% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,80.66,95,,,percent of total billed charges,95% of total billed charges,67.92,80,,,percent of total billed charges,80% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,33.96,40,,,percent of total billed charges,40% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,76.41,90,,,percent of total billed charges,90% of total billed charges,64.52,76,,,percent of total billed charges,76% of total billed charges,33.96,40,,,percent of total billed charges,40% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,67.92,80,,,percent of total billed charges,80% of total billed charges,32.94,38.8,,,percent of total billed charges,38.8% of total billed charges,72.17,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,80.66,
Esophagogastroduodenoscopy with,60000356,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,2478,1982.4,,1858.5,75,,,percent of total billed charges,75% of total billed charges,991.2,40,,,percent of total billed charges,40% of total billed charges,1962.58,79.2,,,percent of total billed charges,79.2% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,2354.1,95,,,percent of total billed charges,95% of total billed charges,1982.4,80,,,percent of total billed charges,80% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,2230.2,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,991.2,40,,,percent of total billed charges,40% of total billed charges,991.2,40,,,percent of total billed charges,40% of total billed charges,2230.2,90,,,percent of total billed charges,90% of total billed charges,1883.28,76,,,percent of total billed charges,76% of total billed charges,991.2,40,,,percent of total billed charges,40% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1982.4,80,,,percent of total billed charges,80% of total billed charges,961.46,38.8,,,percent of total billed charges,38.8% of total billed charges,2106.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,2354.1,
"76800 - Ultrasound, Spinal canal and contents",60000658,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,379.7,303.76,TC,284.78,75,,,percent of total billed charges,75% of total billed charges,151.88,40,,,percent of total billed charges,40% of total billed charges,300.72,79.2,,,percent of total billed charges,79.2% of total billed charges,322.75,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,360.72,95,,,percent of total billed charges,95% of total billed charges,303.76,80,,,percent of total billed charges,80% of total billed charges,322.75,85,,,percent of total billed charges,85% of total billed charges,341.73,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,151.88,40,,,percent of total billed charges,40% of total billed charges,151.88,40,,,percent of total billed charges,40% of total billed charges,341.73,90,,,percent of total billed charges,90% of total billed charges,288.57,76,,,percent of total billed charges,76% of total billed charges,151.88,40,,,percent of total billed charges,40% of total billed charges,322.75,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,303.76,80,,,percent of total billed charges,80% of total billed charges,147.32,38.8,,,percent of total billed charges,38.8% of total billed charges,322.75,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,360.72,
Colonoscopy With,60000381,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1906,1524.8,,1429.5,75,,,percent of total billed charges,75% of total billed charges,762.4,40,,,percent of total billed charges,40% of total billed charges,1509.55,79.2,,,percent of total billed charges,79.2% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1810.7,95,,,percent of total billed charges,95% of total billed charges,1524.8,80,,,percent of total billed charges,80% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,1715.4,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,762.4,40,,,percent of total billed charges,40% of total billed charges,762.4,40,,,percent of total billed charges,40% of total billed charges,1715.4,90,,,percent of total billed charges,90% of total billed charges,1448.56,76,,,percent of total billed charges,76% of total billed charges,762.4,40,,,percent of total billed charges,40% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1524.8,80,,,percent of total billed charges,80% of total billed charges,739.53,38.8,,,percent of total billed charges,38.8% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1810.7,
Sigmoidoscopy with,60000382,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,1906,1524.8,,1429.5,75,,,percent of total billed charges,75% of total billed charges,762.4,40,,,percent of total billed charges,40% of total billed charges,1509.55,79.2,,,percent of total billed charges,79.2% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1810.7,95,,,percent of total billed charges,95% of total billed charges,1524.8,80,,,percent of total billed charges,80% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,1715.4,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,762.4,40,,,percent of total billed charges,40% of total billed charges,762.4,40,,,percent of total billed charges,40% of total billed charges,1715.4,90,,,percent of total billed charges,90% of total billed charges,1448.56,76,,,percent of total billed charges,76% of total billed charges,762.4,40,,,percent of total billed charges,40% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1524.8,80,,,percent of total billed charges,80% of total billed charges,739.53,38.8,,,percent of total billed charges,38.8% of total billed charges,1620.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,1810.7,
THORACIC VENT PROCEDURE TRAY,31052814,CDM,270,RC,,,OUTPATIENT,,,1080.3,864.24,,810.23,75,,,percent of total billed charges,75% of total billed charges,432.12,40,,,percent of total billed charges,40% of total billed charges,855.6,79.2,,,percent of total billed charges,79.2% of total billed charges,918.26,85,,,percent of total billed charges,85% of total billed charges,1080.3,100,,,fee schedule,100% of CO APG rates,1026.29,95,,,percent of total billed charges,95% of total billed charges,864.24,80,,,percent of total billed charges,80% of total billed charges,918.26,85,,,percent of total billed charges,85% of total billed charges,972.27,90,,,percent of total billed charges,90% of total billed charges,1080.3,100,,,fee schedule,100% of CO APG rates,1080.3,100,,,fee schedule,100% of CO APG rates,1080.3,100,,,fee schedule,100% of NM fee schedule,432.12,40,,,percent of total billed charges,40% of total billed charges,432.12,40,,,percent of total billed charges,40% of total billed charges,972.27,90,,,percent of total billed charges,90% of total billed charges,821.03,76,,,percent of total billed charges,76% of total billed charges,432.12,40,,,percent of total billed charges,40% of total billed charges,918.26,85,,,percent of total billed charges,85% of total billed charges,1080.3,100,,,fee schedule,100% of CO APG rate,864.24,80,,,percent of total billed charges,80% of total billed charges,419.16,38.8,,,percent of total billed charges,38.8% of total billed charges,918.26,85,,,percent of total billed charges,85% of total billed charges,1080.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,419.16,1080.3,
DISTAL POSTERIOR LATERAL PLATE  6 HOLE / RIGHT,460ECON0399,CDM,278,RC,,,OUTPATIENT,,,2258.4,1806.72,,1693.8,75,,,percent of total billed charges,75% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1788.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2145.48,95,,,percent of total billed charges,95% of total billed charges,1806.72,80,,,percent of total billed charges,80% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of NM fee schedule,903.36,40,,,percent of total billed charges,40% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,1716.38,76,,,percent of total billed charges,76% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rate,1806.72,80,,,percent of total billed charges,80% of total billed charges,876.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,876.26,2258.4,
DISTAL POSTERIOR LATERAL PLATE  8 HOLE / RIGHT,460ECON0400,CDM,278,RC,,,OUTPATIENT,,,2483.2,1986.56,,1862.4,75,,,percent of total billed charges,75% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,1966.69,79.2,,,percent of total billed charges,79.2% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2359.04,95,,,percent of total billed charges,95% of total billed charges,1986.56,80,,,percent of total billed charges,80% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of NM fee schedule,993.28,40,,,percent of total billed charges,40% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,1887.23,76,,,percent of total billed charges,76% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rate,1986.56,80,,,percent of total billed charges,80% of total billed charges,963.48,38.8,,,percent of total billed charges,38.8% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,963.48,2483.2,
DISTAL POSTERIOR LATERAL HUMERUS PLATE FOR RIGHT HUMERUS  3,460ECON0401,CDM,278,RC,,,OUTPATIENT,,,2240.5,1792.4,,1680.38,75,,,percent of total billed charges,75% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1774.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2128.48,95,,,percent of total billed charges,95% of total billed charges,1792.4,80,,,percent of total billed charges,80% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of NM fee schedule,896.2,40,,,percent of total billed charges,40% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,1702.78,76,,,percent of total billed charges,76% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rate,1792.4,80,,,percent of total billed charges,80% of total billed charges,869.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,869.31,2240.5,
DISTAL POSTERIOR LATERAL PLATE  4 HOLE / RIGHT,460ECON0402,CDM,278,RC,,,OUTPATIENT,,,2032.5,1626,,1524.38,75,,,percent of total billed charges,75% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1609.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,1930.88,95,,,percent of total billed charges,95% of total billed charges,1626,80,,,percent of total billed charges,80% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of NM fee schedule,813,40,,,percent of total billed charges,40% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,1544.7,76,,,percent of total billed charges,76% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rate,1626,80,,,percent of total billed charges,80% of total billed charges,788.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,788.61,2032.5,
DISTAL LATERAL HUMERUS PLATE  6 HOLE / RIGHT,460ECON0403,CDM,278,RC,,,OUTPATIENT,,,2258.4,1806.72,,1693.8,75,,,percent of total billed charges,75% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1788.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2145.48,95,,,percent of total billed charges,95% of total billed charges,1806.72,80,,,percent of total billed charges,80% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of NM fee schedule,903.36,40,,,percent of total billed charges,40% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,1716.38,76,,,percent of total billed charges,76% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rate,1806.72,80,,,percent of total billed charges,80% of total billed charges,876.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,876.26,2258.4,
DISTAL LATERAL HUMERUS PLATE  8 HOLE / RIGHT,460ECON0404,CDM,278,RC,,,OUTPATIENT,,,2483.2,1986.56,,1862.4,75,,,percent of total billed charges,75% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,1966.69,79.2,,,percent of total billed charges,79.2% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2359.04,95,,,percent of total billed charges,95% of total billed charges,1986.56,80,,,percent of total billed charges,80% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of NM fee schedule,993.28,40,,,percent of total billed charges,40% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,1887.23,76,,,percent of total billed charges,76% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rate,1986.56,80,,,percent of total billed charges,80% of total billed charges,963.48,38.8,,,percent of total billed charges,38.8% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,963.48,2483.2,
DISTAL LATERAL HUMERUS PLATE  4 HOLE / RIGHT,460ECON0405,CDM,278,RC,,,OUTPATIENT,,,2240.5,1792.4,,1680.38,75,,,percent of total billed charges,75% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1774.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2128.48,95,,,percent of total billed charges,95% of total billed charges,1792.4,80,,,percent of total billed charges,80% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of NM fee schedule,896.2,40,,,percent of total billed charges,40% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,1702.78,76,,,percent of total billed charges,76% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rate,1792.4,80,,,percent of total billed charges,80% of total billed charges,869.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,869.31,2240.5,
DISTAL LATERAL HUMERUS PLATE FOR RIGHT HUMERUS  3 HOLE  84MM,460ECON0406,CDM,278,RC,,,OUTPATIENT,,,2032.5,1626,,1524.38,75,,,percent of total billed charges,75% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1609.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,1930.88,95,,,percent of total billed charges,95% of total billed charges,1626,80,,,percent of total billed charges,80% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of NM fee schedule,813,40,,,percent of total billed charges,40% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,1544.7,76,,,percent of total billed charges,76% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rate,1626,80,,,percent of total billed charges,80% of total billed charges,788.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,788.61,2032.5,
DISTAL LATERAL HUMERUS PLATE  4 HOLE / LEFT,460ECON0407,CDM,278,RC,,,OUTPATIENT,,,2032.5,1626,,1524.38,75,,,percent of total billed charges,75% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1609.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,1930.88,95,,,percent of total billed charges,95% of total billed charges,1626,80,,,percent of total billed charges,80% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of NM fee schedule,813,40,,,percent of total billed charges,40% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,1544.7,76,,,percent of total billed charges,76% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rate,1626,80,,,percent of total billed charges,80% of total billed charges,788.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,788.61,2032.5,
DISTAL LATERAL HUMERUS PLATE FOR LEFT HUMERUS  3 HOLE  84MM,460ECON0408,CDM,278,RC,,,OUTPATIENT,,,2240.5,1792.4,,1680.38,75,,,percent of total billed charges,75% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1774.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2128.48,95,,,percent of total billed charges,95% of total billed charges,1792.4,80,,,percent of total billed charges,80% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of NM fee schedule,896.2,40,,,percent of total billed charges,40% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,1702.78,76,,,percent of total billed charges,76% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rate,1792.4,80,,,percent of total billed charges,80% of total billed charges,869.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,869.31,2240.5,
DISTAL LATERAL HUMERUS PLATE  6 HOLE / LEFT,460ECON0409,CDM,278,RC,,,OUTPATIENT,,,2258.4,1806.72,,1693.8,75,,,percent of total billed charges,75% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1788.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2145.48,95,,,percent of total billed charges,95% of total billed charges,1806.72,80,,,percent of total billed charges,80% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of NM fee schedule,903.36,40,,,percent of total billed charges,40% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,1716.38,76,,,percent of total billed charges,76% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rate,1806.72,80,,,percent of total billed charges,80% of total billed charges,876.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,876.26,2258.4,
DISTAL POSTERIOR MEDIAL HUMERUS PLATE FOR LEFT HUMERUS  3 HO,460ECON0410,CDM,278,RC,,,OUTPATIENT,,,2240.5,1792.4,,1680.38,75,,,percent of total billed charges,75% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1774.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2128.48,95,,,percent of total billed charges,95% of total billed charges,1792.4,80,,,percent of total billed charges,80% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of NM fee schedule,896.2,40,,,percent of total billed charges,40% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,1702.78,76,,,percent of total billed charges,76% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rate,1792.4,80,,,percent of total billed charges,80% of total billed charges,869.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of APG fee schedule,4481,200,,,percent of total billed charges,200% of total billed charges,869.31,4481,
DISTAL LATERAL HUMERUS PLATE  8 HOLE / LEFT,460ECON0411,CDM,278,RC,,,OUTPATIENT,,,2483.2,1986.56,,1862.4,75,,,percent of total billed charges,75% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,1966.69,79.2,,,percent of total billed charges,79.2% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2359.04,95,,,percent of total billed charges,95% of total billed charges,1986.56,80,,,percent of total billed charges,80% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of NM fee schedule,993.28,40,,,percent of total billed charges,40% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,1887.23,76,,,percent of total billed charges,76% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rate,1986.56,80,,,percent of total billed charges,80% of total billed charges,963.48,38.8,,,percent of total billed charges,38.8% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of APG fee schedule,4966.4,200,,,percent of total billed charges,200% of total billed charges,963.48,4966.4,
DISTAL POSTERIOR MEDIAL PLATE  4 HOLE / LEFT,460ECON0412,CDM,278,RC,,,OUTPATIENT,,,2032.5,1626,,1524.38,75,,,percent of total billed charges,75% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1609.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,1930.88,95,,,percent of total billed charges,95% of total billed charges,1626,80,,,percent of total billed charges,80% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of NM fee schedule,813,40,,,percent of total billed charges,40% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,1544.7,76,,,percent of total billed charges,76% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rate,1626,80,,,percent of total billed charges,80% of total billed charges,788.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of APG fee schedule,4065,200,,,percent of total billed charges,200% of total billed charges,788.61,4065,
DISTAL POSTERIOR MEDIAL PLATE  6 HOLE / LEFT,460ECON0413,CDM,278,RC,,,OUTPATIENT,,,2258.4,1806.72,,1693.8,75,,,percent of total billed charges,75% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1788.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2145.48,95,,,percent of total billed charges,95% of total billed charges,1806.72,80,,,percent of total billed charges,80% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of NM fee schedule,903.36,40,,,percent of total billed charges,40% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,1716.38,76,,,percent of total billed charges,76% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rate,1806.72,80,,,percent of total billed charges,80% of total billed charges,876.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of APG fee schedule,4516.8,200,,,percent of total billed charges,200% of total billed charges,876.26,4516.8,
DISTAL POSTERIOR MEDIAL PLATE  8 HOLE / LEFT,460ECON0414,CDM,278,RC,,,OUTPATIENT,,,2483.2,1986.56,,1862.4,75,,,percent of total billed charges,75% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,1966.69,79.2,,,percent of total billed charges,79.2% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2359.04,95,,,percent of total billed charges,95% of total billed charges,1986.56,80,,,percent of total billed charges,80% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of NM fee schedule,993.28,40,,,percent of total billed charges,40% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,1887.23,76,,,percent of total billed charges,76% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rate,1986.56,80,,,percent of total billed charges,80% of total billed charges,963.48,38.8,,,percent of total billed charges,38.8% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of APG fee schedule,4966.4,200,,,percent of total billed charges,200% of total billed charges,963.48,4966.4,
DISTAL POSTERIOR MEDIAL PLATE  6 HOLE / RIGHT,460ECON0415,CDM,278,RC,,,OUTPATIENT,,,2258.4,1806.72,,1693.8,75,,,percent of total billed charges,75% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1788.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2145.48,95,,,percent of total billed charges,95% of total billed charges,1806.72,80,,,percent of total billed charges,80% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of NM fee schedule,903.36,40,,,percent of total billed charges,40% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,1716.38,76,,,percent of total billed charges,76% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rate,1806.72,80,,,percent of total billed charges,80% of total billed charges,876.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of APG fee schedule,4516.8,200,,,percent of total billed charges,200% of total billed charges,876.26,4516.8,
DISTAL POSTERIOR MEDIAL PLATE  8 HOLE / RIGHT,460ECON0416,CDM,278,RC,,,OUTPATIENT,,,2483.2,1986.56,,1862.4,75,,,percent of total billed charges,75% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,1966.69,79.2,,,percent of total billed charges,79.2% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2359.04,95,,,percent of total billed charges,95% of total billed charges,1986.56,80,,,percent of total billed charges,80% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of NM fee schedule,993.28,40,,,percent of total billed charges,40% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,1887.23,76,,,percent of total billed charges,76% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rate,1986.56,80,,,percent of total billed charges,80% of total billed charges,963.48,38.8,,,percent of total billed charges,38.8% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of APG fee schedule,4966.4,200,,,percent of total billed charges,200% of total billed charges,963.48,4966.4,
DISTAL POSTERIOR MEDIAL PLATE  4 HOLE / RIGHT,460ECON0417,CDM,278,RC,,,OUTPATIENT,,,2032.5,1626,,1524.38,75,,,percent of total billed charges,75% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1609.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,1930.88,95,,,percent of total billed charges,95% of total billed charges,1626,80,,,percent of total billed charges,80% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of NM fee schedule,813,40,,,percent of total billed charges,40% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,1544.7,76,,,percent of total billed charges,76% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rate,1626,80,,,percent of total billed charges,80% of total billed charges,788.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of APG fee schedule,4065,200,,,percent of total billed charges,200% of total billed charges,788.61,4065,
DISTAL POSTERIOR MEDIAL HUMERUS PLATE FOR RIGHT HUMERUS  3 H,460ECON0418,CDM,278,RC,,,OUTPATIENT,,,2240.5,1792.4,,1680.38,75,,,percent of total billed charges,75% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1774.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2128.48,95,,,percent of total billed charges,95% of total billed charges,1792.4,80,,,percent of total billed charges,80% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of NM fee schedule,896.2,40,,,percent of total billed charges,40% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,1702.78,76,,,percent of total billed charges,76% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rate,1792.4,80,,,percent of total billed charges,80% of total billed charges,869.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of APG fee schedule,4481,200,,,percent of total billed charges,200% of total billed charges,869.31,4481,
DISTAL MEDIAL HUMERUS PLATE   8 HOLE EXTENDED,460ECON0419,CDM,278,RC,,,OUTPATIENT,,,2483.2,1986.56,,1862.4,75,,,percent of total billed charges,75% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,1966.69,79.2,,,percent of total billed charges,79.2% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2359.04,95,,,percent of total billed charges,95% of total billed charges,1986.56,80,,,percent of total billed charges,80% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of NM fee schedule,993.28,40,,,percent of total billed charges,40% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,1887.23,76,,,percent of total billed charges,76% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rate,1986.56,80,,,percent of total billed charges,80% of total billed charges,963.48,38.8,,,percent of total billed charges,38.8% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of APG fee schedule,4966.4,200,,,percent of total billed charges,200% of total billed charges,963.48,4966.4,
DISTAL MEDIAL HUMERUS PLATE  6 HOLE EXTENDED,460ECON0420,CDM,278,RC,,,OUTPATIENT,,,2258.4,1806.72,,1693.8,75,,,percent of total billed charges,75% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1788.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2145.48,95,,,percent of total billed charges,95% of total billed charges,1806.72,80,,,percent of total billed charges,80% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of NM fee schedule,903.36,40,,,percent of total billed charges,40% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,1716.38,76,,,percent of total billed charges,76% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rate,1806.72,80,,,percent of total billed charges,80% of total billed charges,876.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of APG fee schedule,4516.8,200,,,percent of total billed charges,200% of total billed charges,876.26,4516.8,
DISTAL MEDIAL HUMERUS PLATE  4 HOLE EXTENDED,460ECON0421,CDM,279,RC,,,OUTPATIENT,,,2032.5,1626,,1524.38,75,,,percent of total billed charges,75% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1609.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,1930.88,95,,,percent of total billed charges,95% of total billed charges,1626,80,,,percent of total billed charges,80% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of NM fee schedule,813,40,,,percent of total billed charges,40% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,1544.7,76,,,percent of total billed charges,76% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rate,1626,80,,,percent of total billed charges,80% of total billed charges,788.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of APG fee schedule,4065,200,,,percent of total billed charges,200% of total billed charges,788.61,4065,
DISTAL MEDIAL HUMERUS PLATE - EXTENDED LEFT / RIGHT HUMERUS,460ECON0422,CDM,278,RC,,,OUTPATIENT,,,2240.5,1792.4,,1680.38,75,,,percent of total billed charges,75% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1774.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2128.48,95,,,percent of total billed charges,95% of total billed charges,1792.4,80,,,percent of total billed charges,80% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of NM fee schedule,896.2,40,,,percent of total billed charges,40% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,1702.78,76,,,percent of total billed charges,76% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rate,1792.4,80,,,percent of total billed charges,80% of total billed charges,869.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of APG fee schedule,4481,200,,,percent of total billed charges,200% of total billed charges,869.31,4481,
DISTAL MEDIAL HUMERUS PLATE LEFT / RIGHT HUMERUS  3 HOLE  72,460ECON0423,CDM,278,RC,,,OUTPATIENT,,,2240.5,1792.4,,1680.38,75,,,percent of total billed charges,75% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1774.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2128.48,95,,,percent of total billed charges,95% of total billed charges,1792.4,80,,,percent of total billed charges,80% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of NM fee schedule,896.2,40,,,percent of total billed charges,40% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,1702.78,76,,,percent of total billed charges,76% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rate,1792.4,80,,,percent of total billed charges,80% of total billed charges,869.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of APG fee schedule,4481,200,,,percent of total billed charges,200% of total billed charges,869.31,4481,
DISTAL MEDIAL HUMERUS PLATE   4 HOLE,460ECON0424,CDM,278,RC,,,OUTPATIENT,,,2032.5,1626,,1524.38,75,,,percent of total billed charges,75% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1609.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,1930.88,95,,,percent of total billed charges,95% of total billed charges,1626,80,,,percent of total billed charges,80% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of NM fee schedule,813,40,,,percent of total billed charges,40% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,1544.7,76,,,percent of total billed charges,76% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rate,1626,80,,,percent of total billed charges,80% of total billed charges,788.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of APG fee schedule,4065,200,,,percent of total billed charges,200% of total billed charges,788.61,4065,
DISTAL MEDIAL HUMERUS PLATE   6 HOLE,460ECON0425,CDM,278,RC,,,OUTPATIENT,,,2258.4,1806.72,,1693.8,75,,,percent of total billed charges,75% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1788.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2145.48,95,,,percent of total billed charges,95% of total billed charges,1806.72,80,,,percent of total billed charges,80% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of NM fee schedule,903.36,40,,,percent of total billed charges,40% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,1716.38,76,,,percent of total billed charges,76% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rate,1806.72,80,,,percent of total billed charges,80% of total billed charges,876.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of APG fee schedule,4516.8,200,,,percent of total billed charges,200% of total billed charges,876.26,4516.8,
DISTAL MEDIAL HUMERUS PLATE   8 HOLE,460ECON0426,CDM,278,RC,,,OUTPATIENT,,,2483.2,1986.56,,1862.4,75,,,percent of total billed charges,75% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,1966.69,79.2,,,percent of total billed charges,79.2% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2359.04,95,,,percent of total billed charges,95% of total billed charges,1986.56,80,,,percent of total billed charges,80% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of NM fee schedule,993.28,40,,,percent of total billed charges,40% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,1887.23,76,,,percent of total billed charges,76% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rate,1986.56,80,,,percent of total billed charges,80% of total billed charges,963.48,38.8,,,percent of total billed charges,38.8% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of APG fee schedule,4966.4,200,,,percent of total billed charges,200% of total billed charges,963.48,4966.4,
DISTAL POSTERIOR LATERAL PLATE  4 HOLE / LEFT,460ECON0427,CDM,278,RC,,,OUTPATIENT,,,2032.5,1626,,1524.38,75,,,percent of total billed charges,75% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1609.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,1930.88,95,,,percent of total billed charges,95% of total billed charges,1626,80,,,percent of total billed charges,80% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of NM fee schedule,813,40,,,percent of total billed charges,40% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,1544.7,76,,,percent of total billed charges,76% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rate,1626,80,,,percent of total billed charges,80% of total billed charges,788.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of APG fee schedule,4065,200,,,percent of total billed charges,200% of total billed charges,788.61,4065,
DISTAL POSTERIOR LATERAL HUMERUS PLATE FOR LEFT HUMERUS  3 H,460ECON0428,CDM,278,RC,,,OUTPATIENT,,,2240.5,1792.4,,1680.38,75,,,percent of total billed charges,75% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1774.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2128.48,95,,,percent of total billed charges,95% of total billed charges,1792.4,80,,,percent of total billed charges,80% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of NM fee schedule,896.2,40,,,percent of total billed charges,40% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,1702.78,76,,,percent of total billed charges,76% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rate,1792.4,80,,,percent of total billed charges,80% of total billed charges,869.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of APG fee schedule,4481,200,,,percent of total billed charges,200% of total billed charges,869.31,4481,
DISTAL POSTERIOR LATERAL PLATE  6 HOLE / LEFT,460ECON0429,CDM,278,RC,,,OUTPATIENT,,,2258.4,1806.72,,1693.8,75,,,percent of total billed charges,75% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1788.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2145.48,95,,,percent of total billed charges,95% of total billed charges,1806.72,80,,,percent of total billed charges,80% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of NM fee schedule,903.36,40,,,percent of total billed charges,40% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,1716.38,76,,,percent of total billed charges,76% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rate,1806.72,80,,,percent of total billed charges,80% of total billed charges,876.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of APG fee schedule,4516.8,200,,,percent of total billed charges,200% of total billed charges,876.26,4516.8,
DISTAL POSTERIOR LATERAL PLATE  8 HOLE / LEFT,460ECON0430,CDM,278,RC,,,OUTPATIENT,,,2483.2,1986.56,,1862.4,75,,,percent of total billed charges,75% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,1966.69,79.2,,,percent of total billed charges,79.2% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2359.04,95,,,percent of total billed charges,95% of total billed charges,1986.56,80,,,percent of total billed charges,80% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of CO APG rates,2483.2,100,,,fee schedule,100% of NM fee schedule,993.28,40,,,percent of total billed charges,40% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2234.88,90,,,percent of total billed charges,90% of total billed charges,1887.23,76,,,percent of total billed charges,76% of total billed charges,993.28,40,,,percent of total billed charges,40% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of CO APG rate,1986.56,80,,,percent of total billed charges,80% of total billed charges,963.48,38.8,,,percent of total billed charges,38.8% of total billed charges,2110.72,85,,,percent of total billed charges,85% of total billed charges,2483.2,100,,,fee schedule,100% of APG fee schedule,4966.4,200,,,percent of total billed charges,200% of total billed charges,963.48,4966.4,
OLECRANON PLATE   8 HOLE / LEFT,460ECON0431,CDM,278,RC,,,OUTPATIENT,,,2258.4,1806.72,,1693.8,75,,,percent of total billed charges,75% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1788.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2145.48,95,,,percent of total billed charges,95% of total billed charges,1806.72,80,,,percent of total billed charges,80% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of NM fee schedule,903.36,40,,,percent of total billed charges,40% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,1716.38,76,,,percent of total billed charges,76% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rate,1806.72,80,,,percent of total billed charges,80% of total billed charges,876.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of APG fee schedule,4516.8,200,,,percent of total billed charges,200% of total billed charges,876.26,4516.8,
OLECRANON PLATE   6 HOLE / LEFT,460ECON0432,CDM,278,RC,,,OUTPATIENT,,,2144.9,1715.92,,1608.68,75,,,percent of total billed charges,75% of total billed charges,857.96,40,,,percent of total billed charges,40% of total billed charges,1698.76,79.2,,,percent of total billed charges,79.2% of total billed charges,1823.17,85,,,percent of total billed charges,85% of total billed charges,2144.9,100,,,fee schedule,100% of CO APG rates,2037.66,95,,,percent of total billed charges,95% of total billed charges,1715.92,80,,,percent of total billed charges,80% of total billed charges,1823.17,85,,,percent of total billed charges,85% of total billed charges,1930.41,90,,,percent of total billed charges,90% of total billed charges,2144.9,100,,,fee schedule,100% of CO APG rates,2144.9,100,,,fee schedule,100% of CO APG rates,2144.9,100,,,fee schedule,100% of NM fee schedule,857.96,40,,,percent of total billed charges,40% of total billed charges,857.96,40,,,percent of total billed charges,40% of total billed charges,1930.41,90,,,percent of total billed charges,90% of total billed charges,1630.12,76,,,percent of total billed charges,76% of total billed charges,857.96,40,,,percent of total billed charges,40% of total billed charges,1823.17,85,,,percent of total billed charges,85% of total billed charges,2144.9,100,,,fee schedule,100% of CO APG rate,1715.92,80,,,percent of total billed charges,80% of total billed charges,832.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1823.17,85,,,percent of total billed charges,85% of total billed charges,2144.9,100,,,fee schedule,100% of APG fee schedule,4289.8,200,,,percent of total billed charges,200% of total billed charges,832.22,4289.8,
54450 Repositioning of foreskin including scar tissue remova,60000380,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,850.7,680.56,,638.03,75,,,percent of total billed charges,75% of total billed charges,340.28,40,,,percent of total billed charges,40% of total billed charges,673.75,79.2,,,percent of total billed charges,79.2% of total billed charges,723.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,808.17,95,,,percent of total billed charges,95% of total billed charges,680.56,80,,,percent of total billed charges,80% of total billed charges,723.1,85,,,percent of total billed charges,85% of total billed charges,765.63,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,340.28,40,,,percent of total billed charges,40% of total billed charges,340.28,40,,,percent of total billed charges,40% of total billed charges,765.63,90,,,percent of total billed charges,90% of total billed charges,646.53,76,,,percent of total billed charges,76% of total billed charges,340.28,40,,,percent of total billed charges,40% of total billed charges,723.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,680.56,80,,,percent of total billed charges,80% of total billed charges,330.07,38.8,,,percent of total billed charges,38.8% of total billed charges,723.1,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,808.17,
OLECRANON PLATE    4 HOLE / LEFT,460ECON0433,CDM,278,RC,,,OUTPATIENT,,,2032.5,1626,,1524.38,75,,,percent of total billed charges,75% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1609.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,1930.88,95,,,percent of total billed charges,95% of total billed charges,1626,80,,,percent of total billed charges,80% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of NM fee schedule,813,40,,,percent of total billed charges,40% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,1544.7,76,,,percent of total billed charges,76% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rate,1626,80,,,percent of total billed charges,80% of total billed charges,788.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of APG fee schedule,4065,200,,,percent of total billed charges,200% of total billed charges,788.61,4065,
OLECRANON PLATE FOR LEFT ULNA  3 HOLE  65MM,460ECON0434,CDM,278,RC,,,OUTPATIENT,,,2240.5,1792.4,,1680.38,75,,,percent of total billed charges,75% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1774.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2128.48,95,,,percent of total billed charges,95% of total billed charges,1792.4,80,,,percent of total billed charges,80% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of NM fee schedule,896.2,40,,,percent of total billed charges,40% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,1702.78,76,,,percent of total billed charges,76% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rate,1792.4,80,,,percent of total billed charges,80% of total billed charges,869.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of APG fee schedule,4481,200,,,percent of total billed charges,200% of total billed charges,869.31,4481,
OLECRANON PLATE FOR RIGHT ULNA  3 HOLE  65MM,460ECON0435,CDM,278,RC,,,OUTPATIENT,,,2240.5,1792.4,,1680.38,75,,,percent of total billed charges,75% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1774.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2128.48,95,,,percent of total billed charges,95% of total billed charges,1792.4,80,,,percent of total billed charges,80% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of CO APG rates,2240.5,100,,,fee schedule,100% of NM fee schedule,896.2,40,,,percent of total billed charges,40% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,2016.45,90,,,percent of total billed charges,90% of total billed charges,1702.78,76,,,percent of total billed charges,76% of total billed charges,896.2,40,,,percent of total billed charges,40% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of CO APG rate,1792.4,80,,,percent of total billed charges,80% of total billed charges,869.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1904.43,85,,,percent of total billed charges,85% of total billed charges,2240.5,100,,,fee schedule,100% of APG fee schedule,4481,200,,,percent of total billed charges,200% of total billed charges,869.31,4481,
OLECRANON PLATE   4 HOLE / RIGHT,460ECON0436,CDM,278,RC,,,OUTPATIENT,,,2032.5,1626,,1524.38,75,,,percent of total billed charges,75% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1609.74,79.2,,,percent of total billed charges,79.2% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,1930.88,95,,,percent of total billed charges,95% of total billed charges,1626,80,,,percent of total billed charges,80% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of CO APG rates,2032.5,100,,,fee schedule,100% of NM fee schedule,813,40,,,percent of total billed charges,40% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1829.25,90,,,percent of total billed charges,90% of total billed charges,1544.7,76,,,percent of total billed charges,76% of total billed charges,813,40,,,percent of total billed charges,40% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of CO APG rate,1626,80,,,percent of total billed charges,80% of total billed charges,788.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1727.63,85,,,percent of total billed charges,85% of total billed charges,2032.5,100,,,fee schedule,100% of APG fee schedule,4065,200,,,percent of total billed charges,200% of total billed charges,788.61,4065,
OLECRANON PLATE   6 HOLE / RIGHT,460ECON0437,CDM,278,RC,,,OUTPATIENT,,,2144.9,1715.92,,1608.68,75,,,percent of total billed charges,75% of total billed charges,857.96,40,,,percent of total billed charges,40% of total billed charges,1698.76,79.2,,,percent of total billed charges,79.2% of total billed charges,1823.17,85,,,percent of total billed charges,85% of total billed charges,2144.9,100,,,fee schedule,100% of CO APG rates,2037.66,95,,,percent of total billed charges,95% of total billed charges,1715.92,80,,,percent of total billed charges,80% of total billed charges,1823.17,85,,,percent of total billed charges,85% of total billed charges,1930.41,90,,,percent of total billed charges,90% of total billed charges,2144.9,100,,,fee schedule,100% of CO APG rates,2144.9,100,,,fee schedule,100% of CO APG rates,2144.9,100,,,fee schedule,100% of NM fee schedule,857.96,40,,,percent of total billed charges,40% of total billed charges,857.96,40,,,percent of total billed charges,40% of total billed charges,1930.41,90,,,percent of total billed charges,90% of total billed charges,1630.12,76,,,percent of total billed charges,76% of total billed charges,857.96,40,,,percent of total billed charges,40% of total billed charges,1823.17,85,,,percent of total billed charges,85% of total billed charges,2144.9,100,,,fee schedule,100% of CO APG rate,1715.92,80,,,percent of total billed charges,80% of total billed charges,832.22,38.8,,,percent of total billed charges,38.8% of total billed charges,1823.17,85,,,percent of total billed charges,85% of total billed charges,2144.9,100,,,fee schedule,100% of APG fee schedule,4289.8,200,,,percent of total billed charges,200% of total billed charges,832.22,4289.8,
OLECRANON PLATE   8 HOLE / RIGHT,460ECON0438,CDM,278,RC,,,OUTPATIENT,,,2258.4,1806.72,,1693.8,75,,,percent of total billed charges,75% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1788.65,79.2,,,percent of total billed charges,79.2% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2145.48,95,,,percent of total billed charges,95% of total billed charges,1806.72,80,,,percent of total billed charges,80% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of CO APG rates,2258.4,100,,,fee schedule,100% of NM fee schedule,903.36,40,,,percent of total billed charges,40% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,2032.56,90,,,percent of total billed charges,90% of total billed charges,1716.38,76,,,percent of total billed charges,76% of total billed charges,903.36,40,,,percent of total billed charges,40% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of CO APG rate,1806.72,80,,,percent of total billed charges,80% of total billed charges,876.26,38.8,,,percent of total billed charges,38.8% of total billed charges,1919.64,85,,,percent of total billed charges,85% of total billed charges,2258.4,100,,,fee schedule,100% of APG fee schedule,4516.8,200,,,percent of total billed charges,200% of total billed charges,876.26,4516.8,
"I-GEL AIRWAY, SMALL PEDIATRIC, SIZE 2 (GREY)",52815,CDM,270,RC,,,OUTPATIENT,,,52.5,42,,39.38,75,,,percent of total billed charges,75% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,41.58,79.2,,,percent of total billed charges,79.2% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rates,49.88,95,,,percent of total billed charges,95% of total billed charges,42,80,,,percent of total billed charges,80% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,47.25,90,,,percent of total billed charges,90% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rates,52.5,100,,,fee schedule,100% of CO APG rates,52.5,100,,,fee schedule,100% of NM fee schedule,21,40,,,percent of total billed charges,40% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,47.25,90,,,percent of total billed charges,90% of total billed charges,39.9,76,,,percent of total billed charges,76% of total billed charges,21,40,,,percent of total billed charges,40% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of CO APG rate,42,80,,,percent of total billed charges,80% of total billed charges,20.37,38.8,,,percent of total billed charges,38.8% of total billed charges,44.63,85,,,percent of total billed charges,85% of total billed charges,52.5,100,,,fee schedule,100% of APG fee schedule,105,200,,,percent of total billed charges,200% of total billed charges,20.37,105,
"I-GEL AIRWAY, LARGE PEDIATRIC, SIZE 2.5 (WHITE)",52816,CDM,270,RC,,,OUTPATIENT,,,44.7,35.76,,33.53,75,,,percent of total billed charges,75% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,35.4,79.2,,,percent of total billed charges,79.2% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rates,42.47,95,,,percent of total billed charges,95% of total billed charges,35.76,80,,,percent of total billed charges,80% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rates,44.7,100,,,fee schedule,100% of CO APG rates,44.7,100,,,fee schedule,100% of NM fee schedule,17.88,40,,,percent of total billed charges,40% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,33.97,76,,,percent of total billed charges,76% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rate,35.76,80,,,percent of total billed charges,80% of total billed charges,17.34,38.8,,,percent of total billed charges,38.8% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of APG fee schedule,89.4,200,,,percent of total billed charges,200% of total billed charges,17.34,89.4,
"I-GEL AIRWAY, SMALL ADULT, SIZE 3 (YELLOW)",52817,CDM,270,RC,,,OUTPATIENT,,,44.7,35.76,,33.53,75,,,percent of total billed charges,75% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,35.4,79.2,,,percent of total billed charges,79.2% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rates,42.47,95,,,percent of total billed charges,95% of total billed charges,35.76,80,,,percent of total billed charges,80% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rates,44.7,100,,,fee schedule,100% of CO APG rates,44.7,100,,,fee schedule,100% of NM fee schedule,17.88,40,,,percent of total billed charges,40% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,33.97,76,,,percent of total billed charges,76% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rate,35.76,80,,,percent of total billed charges,80% of total billed charges,17.34,38.8,,,percent of total billed charges,38.8% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of APG fee schedule,89.4,200,,,percent of total billed charges,200% of total billed charges,17.34,89.4,
"I-GEL AIRWAY, MEDIUM ADULT, SIZE 4 (GREEN)",52818,CDM,270,RC,,,OUTPATIENT,,,44.7,35.76,,33.53,75,,,percent of total billed charges,75% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,35.4,79.2,,,percent of total billed charges,79.2% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rates,42.47,95,,,percent of total billed charges,95% of total billed charges,35.76,80,,,percent of total billed charges,80% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rates,44.7,100,,,fee schedule,100% of CO APG rates,44.7,100,,,fee schedule,100% of NM fee schedule,17.88,40,,,percent of total billed charges,40% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,33.97,76,,,percent of total billed charges,76% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rate,35.76,80,,,percent of total billed charges,80% of total billed charges,17.34,38.8,,,percent of total billed charges,38.8% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of APG fee schedule,89.4,200,,,percent of total billed charges,200% of total billed charges,17.34,89.4,
"I-GEL AIRWAY, MEDIUM ADULT, SIZE 5 (ORANGE)",52819,CDM,270,RC,,,OUTPATIENT,,,44.7,35.76,,33.53,75,,,percent of total billed charges,75% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,35.4,79.2,,,percent of total billed charges,79.2% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rates,42.47,95,,,percent of total billed charges,95% of total billed charges,35.76,80,,,percent of total billed charges,80% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rates,44.7,100,,,fee schedule,100% of CO APG rates,44.7,100,,,fee schedule,100% of NM fee schedule,17.88,40,,,percent of total billed charges,40% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,33.97,76,,,percent of total billed charges,76% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rate,35.76,80,,,percent of total billed charges,80% of total billed charges,17.34,38.8,,,percent of total billed charges,38.8% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of APG fee schedule,89.4,200,,,percent of total billed charges,200% of total billed charges,17.34,89.4,
"90686 INS Fluarix Quadrivalent, 0.5mL, Single Dose Syringe V",60000137,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,51.5,41.2,,38.63,75,,,percent of total billed charges,75% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,40.79,79.2,,,percent of total billed charges,79.2% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,48.93,95,,,percent of total billed charges,95% of total billed charges,41.2,80,,,percent of total billed charges,80% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,46.35,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,51.5,100,,,fee schedule,100% of NM fee schedule,20.6,40,,,percent of total billed charges,40% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,46.35,90,,,percent of total billed charges,90% of total billed charges,39.14,76,,,percent of total billed charges,76% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,41.2,80,,,percent of total billed charges,80% of total billed charges,19.98,38.8,,,percent of total billed charges,38.8% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,19.98,51.5,
"POWER PICC CATHETER TRAY, 4Fr SINGLE LUMEN",52820,CDM,270,RC,,,OUTPATIENT,,,355.2,284.16,,266.4,75,,,percent of total billed charges,75% of total billed charges,142.08,40,,,percent of total billed charges,40% of total billed charges,281.32,79.2,,,percent of total billed charges,79.2% of total billed charges,301.92,85,,,percent of total billed charges,85% of total billed charges,355.2,100,,,fee schedule,100% of CO APG rates,337.44,95,,,percent of total billed charges,95% of total billed charges,284.16,80,,,percent of total billed charges,80% of total billed charges,301.92,85,,,percent of total billed charges,85% of total billed charges,319.68,90,,,percent of total billed charges,90% of total billed charges,355.2,100,,,fee schedule,100% of CO APG rates,355.2,100,,,fee schedule,100% of CO APG rates,355.2,100,,,fee schedule,100% of NM fee schedule,142.08,40,,,percent of total billed charges,40% of total billed charges,142.08,40,,,percent of total billed charges,40% of total billed charges,319.68,90,,,percent of total billed charges,90% of total billed charges,269.95,76,,,percent of total billed charges,76% of total billed charges,142.08,40,,,percent of total billed charges,40% of total billed charges,301.92,85,,,percent of total billed charges,85% of total billed charges,355.2,100,,,fee schedule,100% of CO APG rate,284.16,80,,,percent of total billed charges,80% of total billed charges,137.82,38.8,,,percent of total billed charges,38.8% of total billed charges,301.92,85,,,percent of total billed charges,85% of total billed charges,355.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,137.82,355.2,
"POWER MIDLINE CATHETER TRAY, 4Fr SINGLE LUMEN",52821,CDM,270,RC,,,OUTPATIENT,,,435.8,348.64,,326.85,75,,,percent of total billed charges,75% of total billed charges,174.32,40,,,percent of total billed charges,40% of total billed charges,345.15,79.2,,,percent of total billed charges,79.2% of total billed charges,370.43,85,,,percent of total billed charges,85% of total billed charges,435.8,100,,,fee schedule,100% of CO APG rates,414.01,95,,,percent of total billed charges,95% of total billed charges,348.64,80,,,percent of total billed charges,80% of total billed charges,370.43,85,,,percent of total billed charges,85% of total billed charges,392.22,90,,,percent of total billed charges,90% of total billed charges,435.8,100,,,fee schedule,100% of CO APG rates,435.8,100,,,fee schedule,100% of CO APG rates,435.8,100,,,fee schedule,100% of NM fee schedule,174.32,40,,,percent of total billed charges,40% of total billed charges,174.32,40,,,percent of total billed charges,40% of total billed charges,392.22,90,,,percent of total billed charges,90% of total billed charges,331.21,76,,,percent of total billed charges,76% of total billed charges,174.32,40,,,percent of total billed charges,40% of total billed charges,370.43,85,,,percent of total billed charges,85% of total billed charges,435.8,100,,,fee schedule,100% of CO APG rate,348.64,80,,,percent of total billed charges,80% of total billed charges,169.09,38.8,,,percent of total billed charges,38.8% of total billed charges,370.43,85,,,percent of total billed charges,85% of total billed charges,435.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,169.09,435.8,
90471 INS Immunization administration; 1 vaccine,49190471,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.8,50.67,
90472 INS Each additional vaccine,49190472,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.8,50.67,
90472 INS Each additional vaccine,60000447,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.8,50.67,
90472 INS Each additional vaccine,60000446,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,44.7,35.76,,33.53,75,,,percent of total billed charges,75% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,35.4,79.2,,,percent of total billed charges,79.2% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,44.7,100,,,fee schedule,100% of CO APG rates,42.47,95,,,percent of total billed charges,95% of total billed charges,35.76,80,,,percent of total billed charges,80% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,44.7,100,,,fee schedule,100% of NM APC rate,17.88,40,,,percent of total billed charges,40% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,40.23,90,,,percent of total billed charges,90% of total billed charges,33.97,76,,,percent of total billed charges,76% of total billed charges,17.88,40,,,percent of total billed charges,40% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,35.76,80,,,percent of total billed charges,80% of total billed charges,17.34,38.8,,,percent of total billed charges,38.8% of total billed charges,38,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,89.4,200,,,fee schedule,200% of CMS fee schedule,17.34,215.49,
"HSV 1 IgG, Type Spec LC",40086695,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,151.24,
"BEAVER BLADE, SPEAR TIP, NARROW SHAFT, OFFSET 45 DEG.",46052823,CDM,270,RC,,,OUTPATIENT,,,48.1,38.48,,36.08,75,,,percent of total billed charges,75% of total billed charges,19.24,40,,,percent of total billed charges,40% of total billed charges,38.1,79.2,,,percent of total billed charges,79.2% of total billed charges,40.89,85,,,percent of total billed charges,85% of total billed charges,48.1,100,,,fee schedule,100% of CO APG rates,45.7,95,,,percent of total billed charges,95% of total billed charges,38.48,80,,,percent of total billed charges,80% of total billed charges,40.89,85,,,percent of total billed charges,85% of total billed charges,43.29,90,,,percent of total billed charges,90% of total billed charges,48.1,100,,,fee schedule,100% of CO APG rates,48.1,100,,,fee schedule,100% of CO APG rates,48.1,100,,,fee schedule,100% of NM fee schedule,19.24,40,,,percent of total billed charges,40% of total billed charges,19.24,40,,,percent of total billed charges,40% of total billed charges,43.29,90,,,percent of total billed charges,90% of total billed charges,36.56,76,,,percent of total billed charges,76% of total billed charges,19.24,40,,,percent of total billed charges,40% of total billed charges,40.89,85,,,percent of total billed charges,85% of total billed charges,48.1,100,,,fee schedule,100% of CO APG rate,38.48,80,,,percent of total billed charges,80% of total billed charges,18.66,38.8,,,percent of total billed charges,38.8% of total billed charges,40.89,85,,,percent of total billed charges,85% of total billed charges,48.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.66,48.1,
"NASAL SEPTAL SPLINT, OPEN LUMEN, 2.77 L X 0.93 W, SILICONE",46052824,CDM,270,RC,,,OUTPATIENT,,,164.8,131.84,,123.6,75,,,percent of total billed charges,75% of total billed charges,65.92,40,,,percent of total billed charges,40% of total billed charges,130.52,79.2,,,percent of total billed charges,79.2% of total billed charges,140.08,85,,,percent of total billed charges,85% of total billed charges,164.8,100,,,fee schedule,100% of CO APG rates,156.56,95,,,percent of total billed charges,95% of total billed charges,131.84,80,,,percent of total billed charges,80% of total billed charges,140.08,85,,,percent of total billed charges,85% of total billed charges,148.32,90,,,percent of total billed charges,90% of total billed charges,164.8,100,,,fee schedule,100% of CO APG rates,164.8,100,,,fee schedule,100% of CO APG rates,164.8,100,,,fee schedule,100% of NM fee schedule,65.92,40,,,percent of total billed charges,40% of total billed charges,65.92,40,,,percent of total billed charges,40% of total billed charges,148.32,90,,,percent of total billed charges,90% of total billed charges,125.25,76,,,percent of total billed charges,76% of total billed charges,65.92,40,,,percent of total billed charges,40% of total billed charges,140.08,85,,,percent of total billed charges,85% of total billed charges,164.8,100,,,fee schedule,100% of CO APG rate,131.84,80,,,percent of total billed charges,80% of total billed charges,63.94,38.8,,,percent of total billed charges,38.8% of total billed charges,140.08,85,,,percent of total billed charges,85% of total billed charges,164.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,63.94,164.8,
SURGICEL FIBRILLAR 2 X 4 IN,46052825,CDM,270,RC,,,OUTPATIENT,,,609.4,487.52,,457.05,75,,,percent of total billed charges,75% of total billed charges,243.76,40,,,percent of total billed charges,40% of total billed charges,482.64,79.2,,,percent of total billed charges,79.2% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,609.4,100,,,fee schedule,100% of CO APG rates,578.93,95,,,percent of total billed charges,95% of total billed charges,487.52,80,,,percent of total billed charges,80% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,548.46,90,,,percent of total billed charges,90% of total billed charges,609.4,100,,,fee schedule,100% of CO APG rates,609.4,100,,,fee schedule,100% of CO APG rates,609.4,100,,,fee schedule,100% of NM fee schedule,243.76,40,,,percent of total billed charges,40% of total billed charges,243.76,40,,,percent of total billed charges,40% of total billed charges,548.46,90,,,percent of total billed charges,90% of total billed charges,463.14,76,,,percent of total billed charges,76% of total billed charges,243.76,40,,,percent of total billed charges,40% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,609.4,100,,,fee schedule,100% of CO APG rate,487.52,80,,,percent of total billed charges,80% of total billed charges,236.45,38.8,,,percent of total billed charges,38.8% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,609.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,236.45,609.4,
"EAR VENTILATION TUBE, MODIFIED 1.32mm I.D. x 4.8 mm L",46052827,CDM,270,RC,,,OUTPATIENT,,,111.5,89.2,,83.63,75,,,percent of total billed charges,75% of total billed charges,44.6,40,,,percent of total billed charges,40% of total billed charges,88.31,79.2,,,percent of total billed charges,79.2% of total billed charges,94.78,85,,,percent of total billed charges,85% of total billed charges,111.5,100,,,fee schedule,100% of CO APG rates,105.93,95,,,percent of total billed charges,95% of total billed charges,89.2,80,,,percent of total billed charges,80% of total billed charges,94.78,85,,,percent of total billed charges,85% of total billed charges,100.35,90,,,percent of total billed charges,90% of total billed charges,111.5,100,,,fee schedule,100% of CO APG rates,111.5,100,,,fee schedule,100% of CO APG rates,111.5,100,,,fee schedule,100% of NM fee schedule,44.6,40,,,percent of total billed charges,40% of total billed charges,44.6,40,,,percent of total billed charges,40% of total billed charges,100.35,90,,,percent of total billed charges,90% of total billed charges,84.74,76,,,percent of total billed charges,76% of total billed charges,44.6,40,,,percent of total billed charges,40% of total billed charges,94.78,85,,,percent of total billed charges,85% of total billed charges,111.5,100,,,fee schedule,100% of CO APG rate,89.2,80,,,percent of total billed charges,80% of total billed charges,43.26,38.8,,,percent of total billed charges,38.8% of total billed charges,94.78,85,,,percent of total billed charges,85% of total billed charges,111.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,43.26,111.5,
"EAR VENTILATION TUBE, DURAVENT 1.27mm I.D. x 4.5mm W, 1.37mm",46052828,CDM,270,RC,,,OUTPATIENT,,,109.2,87.36,,81.9,75,,,percent of total billed charges,75% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,86.49,79.2,,,percent of total billed charges,79.2% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rates,103.74,95,,,percent of total billed charges,95% of total billed charges,87.36,80,,,percent of total billed charges,80% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rates,109.2,100,,,fee schedule,100% of CO APG rates,109.2,100,,,fee schedule,100% of NM fee schedule,43.68,40,,,percent of total billed charges,40% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,98.28,90,,,percent of total billed charges,90% of total billed charges,82.99,76,,,percent of total billed charges,76% of total billed charges,43.68,40,,,percent of total billed charges,40% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of CO APG rate,87.36,80,,,percent of total billed charges,80% of total billed charges,42.37,38.8,,,percent of total billed charges,38.8% of total billed charges,92.82,85,,,percent of total billed charges,85% of total billed charges,109.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,42.37,109.2,
"ARISTA HEMOSTATIC POWDER, 1 GRAM",46052829,CDM,270,RC,,,OUTPATIENT,,,626.1,500.88,,469.58,75,,,percent of total billed charges,75% of total billed charges,250.44,40,,,percent of total billed charges,40% of total billed charges,495.87,79.2,,,percent of total billed charges,79.2% of total billed charges,532.19,85,,,percent of total billed charges,85% of total billed charges,626.1,100,,,fee schedule,100% of CO APG rates,594.8,95,,,percent of total billed charges,95% of total billed charges,500.88,80,,,percent of total billed charges,80% of total billed charges,532.19,85,,,percent of total billed charges,85% of total billed charges,563.49,90,,,percent of total billed charges,90% of total billed charges,626.1,100,,,fee schedule,100% of CO APG rates,626.1,100,,,fee schedule,100% of CO APG rates,626.1,100,,,fee schedule,100% of NM fee schedule,250.44,40,,,percent of total billed charges,40% of total billed charges,250.44,40,,,percent of total billed charges,40% of total billed charges,563.49,90,,,percent of total billed charges,90% of total billed charges,475.84,76,,,percent of total billed charges,76% of total billed charges,250.44,40,,,percent of total billed charges,40% of total billed charges,532.19,85,,,percent of total billed charges,85% of total billed charges,626.1,100,,,fee schedule,100% of CO APG rate,500.88,80,,,percent of total billed charges,80% of total billed charges,242.93,38.8,,,percent of total billed charges,38.8% of total billed charges,532.19,85,,,percent of total billed charges,85% of total billed charges,626.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,242.93,626.1,
"NERVE LOCATOR NEURO-PULSE, 3 OUTPUT SETTINGS",46052830,CDM,270,RC,,,OUTPATIENT,,,166.1,132.88,,124.58,75,,,percent of total billed charges,75% of total billed charges,66.44,40,,,percent of total billed charges,40% of total billed charges,131.55,79.2,,,percent of total billed charges,79.2% of total billed charges,141.19,85,,,percent of total billed charges,85% of total billed charges,166.1,100,,,fee schedule,100% of CO APG rates,157.8,95,,,percent of total billed charges,95% of total billed charges,132.88,80,,,percent of total billed charges,80% of total billed charges,141.19,85,,,percent of total billed charges,85% of total billed charges,149.49,90,,,percent of total billed charges,90% of total billed charges,166.1,100,,,fee schedule,100% of CO APG rates,166.1,100,,,fee schedule,100% of CO APG rates,166.1,100,,,fee schedule,100% of NM fee schedule,66.44,40,,,percent of total billed charges,40% of total billed charges,66.44,40,,,percent of total billed charges,40% of total billed charges,149.49,90,,,percent of total billed charges,90% of total billed charges,126.24,76,,,percent of total billed charges,76% of total billed charges,66.44,40,,,percent of total billed charges,40% of total billed charges,141.19,85,,,percent of total billed charges,85% of total billed charges,166.1,100,,,fee schedule,100% of CO APG rate,132.88,80,,,percent of total billed charges,80% of total billed charges,64.45,38.8,,,percent of total billed charges,38.8% of total billed charges,141.19,85,,,percent of total billed charges,85% of total billed charges,166.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,64.45,166.1,
"TRIUNE VENT TUBE, 1.35MM I.D., 5MM L, SILICONE",46052831,CDM,270,RC,,,OUTPATIENT,,,117,93.6,,87.75,75,,,percent of total billed charges,75% of total billed charges,46.8,40,,,percent of total billed charges,40% of total billed charges,92.66,79.2,,,percent of total billed charges,79.2% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,117,100,,,fee schedule,100% of CO APG rates,111.15,95,,,percent of total billed charges,95% of total billed charges,93.6,80,,,percent of total billed charges,80% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,105.3,90,,,percent of total billed charges,90% of total billed charges,117,100,,,fee schedule,100% of CO APG rates,117,100,,,fee schedule,100% of CO APG rates,117,100,,,fee schedule,100% of NM fee schedule,46.8,40,,,percent of total billed charges,40% of total billed charges,46.8,40,,,percent of total billed charges,40% of total billed charges,105.3,90,,,percent of total billed charges,90% of total billed charges,88.92,76,,,percent of total billed charges,76% of total billed charges,46.8,40,,,percent of total billed charges,40% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,117,100,,,fee schedule,100% of CO APG rate,93.6,80,,,percent of total billed charges,80% of total billed charges,45.4,38.8,,,percent of total billed charges,38.8% of total billed charges,99.45,85,,,percent of total billed charges,85% of total billed charges,117,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,45.4,117,
96549 Unlisted chemotherapy procedure,60000395,CDM,331,RC,96402,HCPCS,OUTPATIENT,,,134.7,107.76,,101.03,75,,,percent of total billed charges,75% of total billed charges,53.88,40,,,percent of total billed charges,40% of total billed charges,106.68,79.2,,,percent of total billed charges,79.2% of total billed charges,114.5,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,127.97,95,,,percent of total billed charges,95% of total billed charges,107.76,80,,,percent of total billed charges,80% of total billed charges,114.5,85,,,percent of total billed charges,85% of total billed charges,121.23,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,53.88,40,,,percent of total billed charges,40% of total billed charges,53.88,40,,,percent of total billed charges,40% of total billed charges,121.23,90,,,percent of total billed charges,90% of total billed charges,102.37,76,,,percent of total billed charges,76% of total billed charges,53.88,40,,,percent of total billed charges,40% of total billed charges,114.5,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,107.76,80,,,percent of total billed charges,80% of total billed charges,52.26,38.8,,,percent of total billed charges,38.8% of total billed charges,114.5,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,70.94,200,,,fee schedule,200% of CMS fee schedule,52.26,127.97,
"SEQURA HEMISPHERE RETRIEVAL BASKET, 3.0F x 90cm x 16mm OD",46052832,CDM,270,RC,,,OUTPATIENT,,,1040,832,,780,75,,,percent of total billed charges,75% of total billed charges,416,40,,,percent of total billed charges,40% of total billed charges,823.68,79.2,,,percent of total billed charges,79.2% of total billed charges,884,85,,,percent of total billed charges,85% of total billed charges,1040,100,,,fee schedule,100% of CO APG rates,988,95,,,percent of total billed charges,95% of total billed charges,832,80,,,percent of total billed charges,80% of total billed charges,884,85,,,percent of total billed charges,85% of total billed charges,936,90,,,percent of total billed charges,90% of total billed charges,1040,100,,,fee schedule,100% of CO APG rates,1040,100,,,fee schedule,100% of CO APG rates,1040,100,,,fee schedule,100% of NM fee schedule,416,40,,,percent of total billed charges,40% of total billed charges,416,40,,,percent of total billed charges,40% of total billed charges,936,90,,,percent of total billed charges,90% of total billed charges,790.4,76,,,percent of total billed charges,76% of total billed charges,416,40,,,percent of total billed charges,40% of total billed charges,884,85,,,percent of total billed charges,85% of total billed charges,1040,100,,,fee schedule,100% of CO APG rate,832,80,,,percent of total billed charges,80% of total billed charges,403.52,38.8,,,percent of total billed charges,38.8% of total billed charges,884,85,,,percent of total billed charges,85% of total billed charges,1040,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,403.52,1040,
SINU FOAM,46052833,CDM,270,RC,,,OUTPATIENT,,,318,254.4,,238.5,75,,,percent of total billed charges,75% of total billed charges,127.2,40,,,percent of total billed charges,40% of total billed charges,251.86,79.2,,,percent of total billed charges,79.2% of total billed charges,270.3,85,,,percent of total billed charges,85% of total billed charges,318,100,,,fee schedule,100% of CO APG rates,302.1,95,,,percent of total billed charges,95% of total billed charges,254.4,80,,,percent of total billed charges,80% of total billed charges,270.3,85,,,percent of total billed charges,85% of total billed charges,286.2,90,,,percent of total billed charges,90% of total billed charges,318,100,,,fee schedule,100% of CO APG rates,318,100,,,fee schedule,100% of CO APG rates,318,100,,,fee schedule,100% of NM fee schedule,127.2,40,,,percent of total billed charges,40% of total billed charges,127.2,40,,,percent of total billed charges,40% of total billed charges,286.2,90,,,percent of total billed charges,90% of total billed charges,241.68,76,,,percent of total billed charges,76% of total billed charges,127.2,40,,,percent of total billed charges,40% of total billed charges,270.3,85,,,percent of total billed charges,85% of total billed charges,318,100,,,fee schedule,100% of CO APG rate,254.4,80,,,percent of total billed charges,80% of total billed charges,123.38,38.8,,,percent of total billed charges,38.8% of total billed charges,270.3,85,,,percent of total billed charges,85% of total billed charges,318,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,123.38,318,
QuantiFERON-TB Gold Plus (client Incubated) LC,40086480,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,96.3,77.04,,72.23,75,,,percent of total billed charges,75% of total billed charges,38.52,40,,,percent of total billed charges,40% of total billed charges,76.27,79.2,,,percent of total billed charges,79.2% of total billed charges,81.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,91.49,95,,,percent of total billed charges,95% of total billed charges,77.04,80,,,percent of total billed charges,80% of total billed charges,81.86,85,,,percent of total billed charges,85% of total billed charges,86.67,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,38.52,40,,,percent of total billed charges,40% of total billed charges,38.52,40,,,percent of total billed charges,40% of total billed charges,86.67,90,,,percent of total billed charges,90% of total billed charges,73.19,76,,,percent of total billed charges,76% of total billed charges,38.52,40,,,percent of total billed charges,40% of total billed charges,81.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,77.04,80,,,percent of total billed charges,80% of total billed charges,37.36,38.8,,,percent of total billed charges,38.8% of total billed charges,81.86,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,91.49,
"96365 - IV Infusion, Initial, w/ Patient Supplied Medication",60000721,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,408.7,326.96,,306.53,75,,,percent of total billed charges,75% of total billed charges,163.48,40,,,percent of total billed charges,40% of total billed charges,323.69,79.2,,,percent of total billed charges,79.2% of total billed charges,347.4,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,388.27,95,,,percent of total billed charges,95% of total billed charges,326.96,80,,,percent of total billed charges,80% of total billed charges,347.4,85,,,percent of total billed charges,85% of total billed charges,367.83,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,163.48,40,,,percent of total billed charges,40% of total billed charges,163.48,40,,,percent of total billed charges,40% of total billed charges,367.83,90,,,percent of total billed charges,90% of total billed charges,310.61,76,,,percent of total billed charges,76% of total billed charges,163.48,40,,,percent of total billed charges,40% of total billed charges,347.4,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,326.96,80,,,percent of total billed charges,80% of total billed charges,158.58,38.8,,,percent of total billed charges,38.8% of total billed charges,347.4,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,388.27,
"IV infusion, each add hour. Patient Supplied Medication",60000782,CDM,260,RC,36592,HCPCS,OUTPATIENT,,,175.9,140.72,,131.93,75,,,percent of total billed charges,75% of total billed charges,70.36,40,,,percent of total billed charges,40% of total billed charges,139.31,79.2,,,percent of total billed charges,79.2% of total billed charges,149.52,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,167.11,95,,,percent of total billed charges,95% of total billed charges,140.72,80,,,percent of total billed charges,80% of total billed charges,149.52,85,,,percent of total billed charges,85% of total billed charges,158.31,90,,,percent of total billed charges,90% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rates,77.32,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,70.36,40,,,percent of total billed charges,40% of total billed charges,70.36,40,,,percent of total billed charges,40% of total billed charges,158.31,90,,,percent of total billed charges,90% of total billed charges,133.68,76,,,percent of total billed charges,76% of total billed charges,70.36,40,,,percent of total billed charges,40% of total billed charges,149.52,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of CO APG rate,140.72,80,,,percent of total billed charges,80% of total billed charges,68.25,38.8,,,percent of total billed charges,38.8% of total billed charges,149.52,85,,,percent of total billed charges,85% of total billed charges,77.32,100,,,fee schedule,100% of APG fee schedule,61.74,200,,,fee schedule,200% of CMS fee schedule,61.74,167.11,
"BALLOON SEEKER, EM MAXILLARY, 5 x 7mm",46052835,CDM,270,RC,,,OUTPATIENT,,,1165.6,932.48,,874.2,75,,,percent of total billed charges,75% of total billed charges,466.24,40,,,percent of total billed charges,40% of total billed charges,923.16,79.2,,,percent of total billed charges,79.2% of total billed charges,990.76,85,,,percent of total billed charges,85% of total billed charges,1165.6,100,,,fee schedule,100% of CO APG rates,1107.32,95,,,percent of total billed charges,95% of total billed charges,932.48,80,,,percent of total billed charges,80% of total billed charges,990.76,85,,,percent of total billed charges,85% of total billed charges,1049.04,90,,,percent of total billed charges,90% of total billed charges,1165.6,100,,,fee schedule,100% of CO APG rates,1165.6,100,,,fee schedule,100% of CO APG rates,1165.6,100,,,fee schedule,100% of NM fee schedule,466.24,40,,,percent of total billed charges,40% of total billed charges,466.24,40,,,percent of total billed charges,40% of total billed charges,1049.04,90,,,percent of total billed charges,90% of total billed charges,885.86,76,,,percent of total billed charges,76% of total billed charges,466.24,40,,,percent of total billed charges,40% of total billed charges,990.76,85,,,percent of total billed charges,85% of total billed charges,1165.6,100,,,fee schedule,100% of CO APG rate,932.48,80,,,percent of total billed charges,80% of total billed charges,452.25,38.8,,,percent of total billed charges,38.8% of total billed charges,990.76,85,,,percent of total billed charges,85% of total billed charges,1165.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,452.25,1165.6,
"BALLOON SEEKER, EM MAXILLARY, 6 x 7mm",46052837,CDM,270,RC,,,OUTPATIENT,,,1165.6,932.48,,874.2,75,,,percent of total billed charges,75% of total billed charges,466.24,40,,,percent of total billed charges,40% of total billed charges,923.16,79.2,,,percent of total billed charges,79.2% of total billed charges,990.76,85,,,percent of total billed charges,85% of total billed charges,1165.6,100,,,fee schedule,100% of CO APG rates,1107.32,95,,,percent of total billed charges,95% of total billed charges,932.48,80,,,percent of total billed charges,80% of total billed charges,990.76,85,,,percent of total billed charges,85% of total billed charges,1049.04,90,,,percent of total billed charges,90% of total billed charges,1165.6,100,,,fee schedule,100% of CO APG rates,1165.6,100,,,fee schedule,100% of CO APG rates,1165.6,100,,,fee schedule,100% of NM fee schedule,466.24,40,,,percent of total billed charges,40% of total billed charges,466.24,40,,,percent of total billed charges,40% of total billed charges,1049.04,90,,,percent of total billed charges,90% of total billed charges,885.86,76,,,percent of total billed charges,76% of total billed charges,466.24,40,,,percent of total billed charges,40% of total billed charges,990.76,85,,,percent of total billed charges,85% of total billed charges,1165.6,100,,,fee schedule,100% of CO APG rate,932.48,80,,,percent of total billed charges,80% of total billed charges,452.25,38.8,,,percent of total billed charges,38.8% of total billed charges,990.76,85,,,percent of total billed charges,85% of total billed charges,1165.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,452.25,1165.6,
INFLATOR KIT (BALLOON SEEKER),46052838,CDM,270,RC,,,OUTPATIENT,,,609.4,487.52,,457.05,75,,,percent of total billed charges,75% of total billed charges,243.76,40,,,percent of total billed charges,40% of total billed charges,482.64,79.2,,,percent of total billed charges,79.2% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,609.4,100,,,fee schedule,100% of CO APG rates,578.93,95,,,percent of total billed charges,95% of total billed charges,487.52,80,,,percent of total billed charges,80% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,548.46,90,,,percent of total billed charges,90% of total billed charges,609.4,100,,,fee schedule,100% of CO APG rates,609.4,100,,,fee schedule,100% of CO APG rates,609.4,100,,,fee schedule,100% of NM fee schedule,243.76,40,,,percent of total billed charges,40% of total billed charges,243.76,40,,,percent of total billed charges,40% of total billed charges,548.46,90,,,percent of total billed charges,90% of total billed charges,463.14,76,,,percent of total billed charges,76% of total billed charges,243.76,40,,,percent of total billed charges,40% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,609.4,100,,,fee schedule,100% of CO APG rate,487.52,80,,,percent of total billed charges,80% of total billed charges,236.45,38.8,,,percent of total billed charges,38.8% of total billed charges,517.99,85,,,percent of total billed charges,85% of total billed charges,609.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,236.45,609.4,
"BRIDGEMASTER SPLINT, LARGE",46052839,CDM,270,RC,,,OUTPATIENT,,,216.3,173.04,,162.23,75,,,percent of total billed charges,75% of total billed charges,86.52,40,,,percent of total billed charges,40% of total billed charges,171.31,79.2,,,percent of total billed charges,79.2% of total billed charges,183.86,85,,,percent of total billed charges,85% of total billed charges,216.3,100,,,fee schedule,100% of CO APG rates,205.49,95,,,percent of total billed charges,95% of total billed charges,173.04,80,,,percent of total billed charges,80% of total billed charges,183.86,85,,,percent of total billed charges,85% of total billed charges,194.67,90,,,percent of total billed charges,90% of total billed charges,216.3,100,,,fee schedule,100% of CO APG rates,216.3,100,,,fee schedule,100% of CO APG rates,216.3,100,,,fee schedule,100% of NM fee schedule,86.52,40,,,percent of total billed charges,40% of total billed charges,86.52,40,,,percent of total billed charges,40% of total billed charges,194.67,90,,,percent of total billed charges,90% of total billed charges,164.39,76,,,percent of total billed charges,76% of total billed charges,86.52,40,,,percent of total billed charges,40% of total billed charges,183.86,85,,,percent of total billed charges,85% of total billed charges,216.3,100,,,fee schedule,100% of CO APG rate,173.04,80,,,percent of total billed charges,80% of total billed charges,83.92,38.8,,,percent of total billed charges,38.8% of total billed charges,183.86,85,,,percent of total billed charges,85% of total billed charges,216.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,83.92,216.3,
"BRIDGEMASTER SPLINT, SMALL",46052840,CDM,270,RC,,,OUTPATIENT,,,216.3,173.04,,162.23,75,,,percent of total billed charges,75% of total billed charges,86.52,40,,,percent of total billed charges,40% of total billed charges,171.31,79.2,,,percent of total billed charges,79.2% of total billed charges,183.86,85,,,percent of total billed charges,85% of total billed charges,216.3,100,,,fee schedule,100% of CO APG rates,205.49,95,,,percent of total billed charges,95% of total billed charges,173.04,80,,,percent of total billed charges,80% of total billed charges,183.86,85,,,percent of total billed charges,85% of total billed charges,194.67,90,,,percent of total billed charges,90% of total billed charges,216.3,100,,,fee schedule,100% of CO APG rates,216.3,100,,,fee schedule,100% of CO APG rates,216.3,100,,,fee schedule,100% of NM fee schedule,86.52,40,,,percent of total billed charges,40% of total billed charges,86.52,40,,,percent of total billed charges,40% of total billed charges,194.67,90,,,percent of total billed charges,90% of total billed charges,164.39,76,,,percent of total billed charges,76% of total billed charges,86.52,40,,,percent of total billed charges,40% of total billed charges,183.86,85,,,percent of total billed charges,85% of total billed charges,216.3,100,,,fee schedule,100% of CO APG rate,173.04,80,,,percent of total billed charges,80% of total billed charges,83.92,38.8,,,percent of total billed charges,38.8% of total billed charges,183.86,85,,,percent of total billed charges,85% of total billed charges,216.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,83.92,216.3,
BLADE TRICUT 13cm,46052845,CDM,270,RC,,,OUTPATIENT,,,1091.2,872.96,,818.4,75,,,percent of total billed charges,75% of total billed charges,436.48,40,,,percent of total billed charges,40% of total billed charges,864.23,79.2,,,percent of total billed charges,79.2% of total billed charges,927.52,85,,,percent of total billed charges,85% of total billed charges,1091.2,100,,,fee schedule,100% of CO APG rates,1036.64,95,,,percent of total billed charges,95% of total billed charges,872.96,80,,,percent of total billed charges,80% of total billed charges,927.52,85,,,percent of total billed charges,85% of total billed charges,982.08,90,,,percent of total billed charges,90% of total billed charges,1091.2,100,,,fee schedule,100% of CO APG rates,1091.2,100,,,fee schedule,100% of CO APG rates,1091.2,100,,,fee schedule,100% of NM fee schedule,436.48,40,,,percent of total billed charges,40% of total billed charges,436.48,40,,,percent of total billed charges,40% of total billed charges,982.08,90,,,percent of total billed charges,90% of total billed charges,829.31,76,,,percent of total billed charges,76% of total billed charges,436.48,40,,,percent of total billed charges,40% of total billed charges,927.52,85,,,percent of total billed charges,85% of total billed charges,1091.2,100,,,fee schedule,100% of CO APG rate,872.96,80,,,percent of total billed charges,80% of total billed charges,423.39,38.8,,,percent of total billed charges,38.8% of total billed charges,927.52,85,,,percent of total billed charges,85% of total billed charges,1091.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,423.39,1091.2,
SHEATH 4mm / 30 DEG. STORZ XOMED,46052846,CDM,270,RC,,,OUTPATIENT,,,244.7,195.76,,183.53,75,,,percent of total billed charges,75% of total billed charges,97.88,40,,,percent of total billed charges,40% of total billed charges,193.8,79.2,,,percent of total billed charges,79.2% of total billed charges,208,85,,,percent of total billed charges,85% of total billed charges,244.7,100,,,fee schedule,100% of CO APG rates,232.47,95,,,percent of total billed charges,95% of total billed charges,195.76,80,,,percent of total billed charges,80% of total billed charges,208,85,,,percent of total billed charges,85% of total billed charges,220.23,90,,,percent of total billed charges,90% of total billed charges,244.7,100,,,fee schedule,100% of CO APG rates,244.7,100,,,fee schedule,100% of CO APG rates,244.7,100,,,fee schedule,100% of NM fee schedule,97.88,40,,,percent of total billed charges,40% of total billed charges,97.88,40,,,percent of total billed charges,40% of total billed charges,220.23,90,,,percent of total billed charges,90% of total billed charges,185.97,76,,,percent of total billed charges,76% of total billed charges,97.88,40,,,percent of total billed charges,40% of total billed charges,208,85,,,percent of total billed charges,85% of total billed charges,244.7,100,,,fee schedule,100% of CO APG rate,195.76,80,,,percent of total billed charges,80% of total billed charges,94.94,38.8,,,percent of total billed charges,38.8% of total billed charges,208,85,,,percent of total billed charges,85% of total billed charges,244.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,94.94,244.7,
TUBING ENDO-SCRUB 2,46052847,CDM,270,RC,,,OUTPATIENT,,,155.2,124.16,,116.4,75,,,percent of total billed charges,75% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,122.92,79.2,,,percent of total billed charges,79.2% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rates,147.44,95,,,percent of total billed charges,95% of total billed charges,124.16,80,,,percent of total billed charges,80% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rates,155.2,100,,,fee schedule,100% of CO APG rates,155.2,100,,,fee schedule,100% of NM fee schedule,62.08,40,,,percent of total billed charges,40% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,139.68,90,,,percent of total billed charges,90% of total billed charges,117.95,76,,,percent of total billed charges,76% of total billed charges,62.08,40,,,percent of total billed charges,40% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of CO APG rate,124.16,80,,,percent of total billed charges,80% of total billed charges,60.22,38.8,,,percent of total billed charges,38.8% of total billed charges,131.92,85,,,percent of total billed charges,85% of total billed charges,155.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,60.22,155.2,
INSTRUMENT TRACKER- ENT,46052849,CDM,270,RC,,,OUTPATIENT,,,490.6,392.48,,367.95,75,,,percent of total billed charges,75% of total billed charges,196.24,40,,,percent of total billed charges,40% of total billed charges,388.56,79.2,,,percent of total billed charges,79.2% of total billed charges,417.01,85,,,percent of total billed charges,85% of total billed charges,490.6,100,,,fee schedule,100% of CO APG rates,466.07,95,,,percent of total billed charges,95% of total billed charges,392.48,80,,,percent of total billed charges,80% of total billed charges,417.01,85,,,percent of total billed charges,85% of total billed charges,441.54,90,,,percent of total billed charges,90% of total billed charges,490.6,100,,,fee schedule,100% of CO APG rates,490.6,100,,,fee schedule,100% of CO APG rates,490.6,100,,,fee schedule,100% of NM fee schedule,196.24,40,,,percent of total billed charges,40% of total billed charges,196.24,40,,,percent of total billed charges,40% of total billed charges,441.54,90,,,percent of total billed charges,90% of total billed charges,372.86,76,,,percent of total billed charges,76% of total billed charges,196.24,40,,,percent of total billed charges,40% of total billed charges,417.01,85,,,percent of total billed charges,85% of total billed charges,490.6,100,,,fee schedule,100% of CO APG rate,392.48,80,,,percent of total billed charges,80% of total billed charges,190.35,38.8,,,percent of total billed charges,38.8% of total billed charges,417.01,85,,,percent of total billed charges,85% of total billed charges,490.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,190.35,490.6,
PATIENT TRACKER- ENT,46052850,CDM,270,RC,,,OUTPATIENT,,,622.7,498.16,,467.03,75,,,percent of total billed charges,75% of total billed charges,249.08,40,,,percent of total billed charges,40% of total billed charges,493.18,79.2,,,percent of total billed charges,79.2% of total billed charges,529.3,85,,,percent of total billed charges,85% of total billed charges,622.7,100,,,fee schedule,100% of CO APG rates,591.57,95,,,percent of total billed charges,95% of total billed charges,498.16,80,,,percent of total billed charges,80% of total billed charges,529.3,85,,,percent of total billed charges,85% of total billed charges,560.43,90,,,percent of total billed charges,90% of total billed charges,622.7,100,,,fee schedule,100% of CO APG rates,622.7,100,,,fee schedule,100% of CO APG rates,622.7,100,,,fee schedule,100% of NM fee schedule,249.08,40,,,percent of total billed charges,40% of total billed charges,249.08,40,,,percent of total billed charges,40% of total billed charges,560.43,90,,,percent of total billed charges,90% of total billed charges,473.25,76,,,percent of total billed charges,76% of total billed charges,249.08,40,,,percent of total billed charges,40% of total billed charges,529.3,85,,,percent of total billed charges,85% of total billed charges,622.7,100,,,fee schedule,100% of CO APG rate,498.16,80,,,percent of total billed charges,80% of total billed charges,241.61,38.8,,,percent of total billed charges,38.8% of total billed charges,529.3,85,,,percent of total billed charges,85% of total billed charges,622.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,241.61,622.7,
"BLANKET WARMING UNDERBODY, ADULT",52851,CDM,270,RC,,,OUTPATIENT,,,73.3,58.64,,54.98,75,,,percent of total billed charges,75% of total billed charges,29.32,40,,,percent of total billed charges,40% of total billed charges,58.05,79.2,,,percent of total billed charges,79.2% of total billed charges,62.31,85,,,percent of total billed charges,85% of total billed charges,73.3,100,,,fee schedule,100% of CO APG rates,69.64,95,,,percent of total billed charges,95% of total billed charges,58.64,80,,,percent of total billed charges,80% of total billed charges,62.31,85,,,percent of total billed charges,85% of total billed charges,65.97,90,,,percent of total billed charges,90% of total billed charges,73.3,100,,,fee schedule,100% of CO APG rates,73.3,100,,,fee schedule,100% of CO APG rates,73.3,100,,,fee schedule,100% of NM fee schedule,29.32,40,,,percent of total billed charges,40% of total billed charges,29.32,40,,,percent of total billed charges,40% of total billed charges,65.97,90,,,percent of total billed charges,90% of total billed charges,55.71,76,,,percent of total billed charges,76% of total billed charges,29.32,40,,,percent of total billed charges,40% of total billed charges,62.31,85,,,percent of total billed charges,85% of total billed charges,73.3,100,,,fee schedule,100% of CO APG rate,58.64,80,,,percent of total billed charges,80% of total billed charges,28.44,38.8,,,percent of total billed charges,38.8% of total billed charges,62.31,85,,,percent of total billed charges,85% of total billed charges,73.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,28.44,73.3,
88104 cyto wash brushing,40088104,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,143.2,114.56,,107.4,75,,,percent of total billed charges,75% of total billed charges,57.28,40,,,percent of total billed charges,40% of total billed charges,113.41,79.2,,,percent of total billed charges,79.2% of total billed charges,121.72,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,136.04,95,,,percent of total billed charges,95% of total billed charges,114.56,80,,,percent of total billed charges,80% of total billed charges,121.72,85,,,percent of total billed charges,85% of total billed charges,128.88,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,57.28,40,,,percent of total billed charges,40% of total billed charges,57.28,40,,,percent of total billed charges,40% of total billed charges,128.88,90,,,percent of total billed charges,90% of total billed charges,108.83,76,,,percent of total billed charges,76% of total billed charges,57.28,40,,,percent of total billed charges,40% of total billed charges,121.72,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,114.56,80,,,percent of total billed charges,80% of total billed charges,55.56,38.8,,,percent of total billed charges,38.8% of total billed charges,121.72,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,136.04,
88108 concentration,40088108,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,125.2,100.16,,93.9,75,,,percent of total billed charges,75% of total billed charges,50.08,40,,,percent of total billed charges,40% of total billed charges,99.16,79.2,,,percent of total billed charges,79.2% of total billed charges,106.42,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,118.94,95,,,percent of total billed charges,95% of total billed charges,100.16,80,,,percent of total billed charges,80% of total billed charges,106.42,85,,,percent of total billed charges,85% of total billed charges,112.68,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,50.08,40,,,percent of total billed charges,40% of total billed charges,50.08,40,,,percent of total billed charges,40% of total billed charges,112.68,90,,,percent of total billed charges,90% of total billed charges,95.15,76,,,percent of total billed charges,76% of total billed charges,50.08,40,,,percent of total billed charges,40% of total billed charges,106.42,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,100.16,80,,,percent of total billed charges,80% of total billed charges,48.58,38.8,,,percent of total billed charges,38.8% of total billed charges,106.42,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,118.94,
88160 cyto other source,40088160,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,151.7,121.36,,113.78,75,,,percent of total billed charges,75% of total billed charges,60.68,40,,,percent of total billed charges,40% of total billed charges,120.15,79.2,,,percent of total billed charges,79.2% of total billed charges,128.95,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,144.12,95,,,percent of total billed charges,95% of total billed charges,121.36,80,,,percent of total billed charges,80% of total billed charges,128.95,85,,,percent of total billed charges,85% of total billed charges,136.53,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,60.68,40,,,percent of total billed charges,40% of total billed charges,60.68,40,,,percent of total billed charges,40% of total billed charges,136.53,90,,,percent of total billed charges,90% of total billed charges,115.29,76,,,percent of total billed charges,76% of total billed charges,60.68,40,,,percent of total billed charges,40% of total billed charges,128.95,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,121.36,80,,,percent of total billed charges,80% of total billed charges,58.86,38.8,,,percent of total billed charges,38.8% of total billed charges,128.95,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,144.12,
88161 fna 1-5 slides,40088161,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,132.6,106.08,,99.45,75,,,percent of total billed charges,75% of total billed charges,53.04,40,,,percent of total billed charges,40% of total billed charges,105.02,79.2,,,percent of total billed charges,79.2% of total billed charges,112.71,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,125.97,95,,,percent of total billed charges,95% of total billed charges,106.08,80,,,percent of total billed charges,80% of total billed charges,112.71,85,,,percent of total billed charges,85% of total billed charges,119.34,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,53.04,40,,,percent of total billed charges,40% of total billed charges,53.04,40,,,percent of total billed charges,40% of total billed charges,119.34,90,,,percent of total billed charges,90% of total billed charges,100.78,76,,,percent of total billed charges,76% of total billed charges,53.04,40,,,percent of total billed charges,40% of total billed charges,112.71,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,106.08,80,,,percent of total billed charges,80% of total billed charges,51.45,38.8,,,percent of total billed charges,38.8% of total billed charges,112.71,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,125.97,
88162 fna multi,40088162,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,188.9,151.12,,141.68,75,,,percent of total billed charges,75% of total billed charges,75.56,40,,,percent of total billed charges,40% of total billed charges,149.61,79.2,,,percent of total billed charges,79.2% of total billed charges,160.57,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,179.46,95,,,percent of total billed charges,95% of total billed charges,151.12,80,,,percent of total billed charges,80% of total billed charges,160.57,85,,,percent of total billed charges,85% of total billed charges,170.01,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,75.56,40,,,percent of total billed charges,40% of total billed charges,75.56,40,,,percent of total billed charges,40% of total billed charges,170.01,90,,,percent of total billed charges,90% of total billed charges,143.56,76,,,percent of total billed charges,76% of total billed charges,75.56,40,,,percent of total billed charges,40% of total billed charges,160.57,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,151.12,80,,,percent of total billed charges,80% of total billed charges,73.29,38.8,,,percent of total billed charges,38.8% of total billed charges,160.57,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,179.46,
88173 fine needle interp and report,40088173,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,269.6,215.68,,202.2,75,,,percent of total billed charges,75% of total billed charges,107.84,40,,,percent of total billed charges,40% of total billed charges,213.52,79.2,,,percent of total billed charges,79.2% of total billed charges,229.16,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,256.12,95,,,percent of total billed charges,95% of total billed charges,215.68,80,,,percent of total billed charges,80% of total billed charges,229.16,85,,,percent of total billed charges,85% of total billed charges,242.64,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,107.84,40,,,percent of total billed charges,40% of total billed charges,107.84,40,,,percent of total billed charges,40% of total billed charges,242.64,90,,,percent of total billed charges,90% of total billed charges,204.9,76,,,percent of total billed charges,76% of total billed charges,107.84,40,,,percent of total billed charges,40% of total billed charges,229.16,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,215.68,80,,,percent of total billed charges,80% of total billed charges,104.6,38.8,,,percent of total billed charges,38.8% of total billed charges,229.16,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,256.12,
88300 level 1 gross exam only,40088300,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,39.3,31.44,,29.48,75,,,percent of total billed charges,75% of total billed charges,15.72,40,,,percent of total billed charges,40% of total billed charges,31.13,79.2,,,percent of total billed charges,79.2% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,37.34,95,,,percent of total billed charges,95% of total billed charges,31.44,80,,,percent of total billed charges,80% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,35.37,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,15.72,40,,,percent of total billed charges,40% of total billed charges,15.72,40,,,percent of total billed charges,40% of total billed charges,35.37,90,,,percent of total billed charges,90% of total billed charges,29.87,76,,,percent of total billed charges,76% of total billed charges,15.72,40,,,percent of total billed charges,40% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,31.44,80,,,percent of total billed charges,80% of total billed charges,15.25,38.8,,,percent of total billed charges,38.8% of total billed charges,33.41,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,15.25,53.22,
88302 level II surgical histo,40088302,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,78.5,62.8,,58.88,75,,,percent of total billed charges,75% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,62.17,79.2,,,percent of total billed charges,79.2% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,74.58,95,,,percent of total billed charges,95% of total billed charges,62.8,80,,,percent of total billed charges,80% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,70.65,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,31.4,40,,,percent of total billed charges,40% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,70.65,90,,,percent of total billed charges,90% of total billed charges,59.66,76,,,percent of total billed charges,76% of total billed charges,31.4,40,,,percent of total billed charges,40% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,62.8,80,,,percent of total billed charges,80% of total billed charges,30.46,38.8,,,percent of total billed charges,38.8% of total billed charges,66.73,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,74.58,
88304 level III surg histo,40088304,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,95.6,76.48,,71.7,75,,,percent of total billed charges,75% of total billed charges,38.24,40,,,percent of total billed charges,40% of total billed charges,75.72,79.2,,,percent of total billed charges,79.2% of total billed charges,81.26,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,90.82,95,,,percent of total billed charges,95% of total billed charges,76.48,80,,,percent of total billed charges,80% of total billed charges,81.26,85,,,percent of total billed charges,85% of total billed charges,86.04,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,38.24,40,,,percent of total billed charges,40% of total billed charges,38.24,40,,,percent of total billed charges,40% of total billed charges,86.04,90,,,percent of total billed charges,90% of total billed charges,72.66,76,,,percent of total billed charges,76% of total billed charges,38.24,40,,,percent of total billed charges,40% of total billed charges,81.26,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,76.48,80,,,percent of total billed charges,80% of total billed charges,37.09,38.8,,,percent of total billed charges,38.8% of total billed charges,81.26,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,90.82,
88305 cell block,40088305,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,97.6,78.08,,73.2,75,,,percent of total billed charges,75% of total billed charges,39.04,40,,,percent of total billed charges,40% of total billed charges,77.3,79.2,,,percent of total billed charges,79.2% of total billed charges,82.96,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,92.72,95,,,percent of total billed charges,95% of total billed charges,78.08,80,,,percent of total billed charges,80% of total billed charges,82.96,85,,,percent of total billed charges,85% of total billed charges,87.84,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,39.04,40,,,percent of total billed charges,40% of total billed charges,39.04,40,,,percent of total billed charges,40% of total billed charges,87.84,90,,,percent of total billed charges,90% of total billed charges,74.18,76,,,percent of total billed charges,76% of total billed charges,39.04,40,,,percent of total billed charges,40% of total billed charges,82.96,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,78.08,80,,,percent of total billed charges,80% of total billed charges,37.87,38.8,,,percent of total billed charges,38.8% of total billed charges,82.96,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,92.72,
88307 level V surg histo,40088307,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,589.9,471.92,,442.43,75,,,percent of total billed charges,75% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,467.2,79.2,,,percent of total billed charges,79.2% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,560.41,95,,,percent of total billed charges,95% of total billed charges,471.92,80,,,percent of total billed charges,80% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,530.91,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,235.96,40,,,percent of total billed charges,40% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,530.91,90,,,percent of total billed charges,90% of total billed charges,448.32,76,,,percent of total billed charges,76% of total billed charges,235.96,40,,,percent of total billed charges,40% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,471.92,80,,,percent of total billed charges,80% of total billed charges,228.88,38.8,,,percent of total billed charges,38.8% of total billed charges,501.42,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,560.41,
88309 level VI surg histo,40088309,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,770.3,616.24,,577.73,75,,,percent of total billed charges,75% of total billed charges,308.12,40,,,percent of total billed charges,40% of total billed charges,610.08,79.2,,,percent of total billed charges,79.2% of total billed charges,654.76,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,731.79,95,,,percent of total billed charges,95% of total billed charges,616.24,80,,,percent of total billed charges,80% of total billed charges,654.76,85,,,percent of total billed charges,85% of total billed charges,693.27,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,308.12,40,,,percent of total billed charges,40% of total billed charges,308.12,40,,,percent of total billed charges,40% of total billed charges,693.27,90,,,percent of total billed charges,90% of total billed charges,585.43,76,,,percent of total billed charges,76% of total billed charges,308.12,40,,,percent of total billed charges,40% of total billed charges,654.76,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,616.24,80,,,percent of total billed charges,80% of total billed charges,298.88,38.8,,,percent of total billed charges,38.8% of total billed charges,654.76,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,731.79,
88311 decalcification,40088311,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,30.7,24.56,,23.03,75,,,percent of total billed charges,75% of total billed charges,12.28,40,,,percent of total billed charges,40% of total billed charges,24.31,79.2,,,percent of total billed charges,79.2% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,29.17,95,,,percent of total billed charges,95% of total billed charges,24.56,80,,,percent of total billed charges,80% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,27.63,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,12.28,40,,,percent of total billed charges,40% of total billed charges,12.28,40,,,percent of total billed charges,40% of total billed charges,27.63,90,,,percent of total billed charges,90% of total billed charges,23.33,76,,,percent of total billed charges,76% of total billed charges,12.28,40,,,percent of total billed charges,40% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,24.56,80,,,percent of total billed charges,80% of total billed charges,11.91,38.8,,,percent of total billed charges,38.8% of total billed charges,26.1,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,11.91,53.22,
"88312 special stain, organism",40088312,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,231.3,185.04,,173.48,75,,,percent of total billed charges,75% of total billed charges,92.52,40,,,percent of total billed charges,40% of total billed charges,183.19,79.2,,,percent of total billed charges,79.2% of total billed charges,196.61,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,219.74,95,,,percent of total billed charges,95% of total billed charges,185.04,80,,,percent of total billed charges,80% of total billed charges,196.61,85,,,percent of total billed charges,85% of total billed charges,208.17,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,92.52,40,,,percent of total billed charges,40% of total billed charges,92.52,40,,,percent of total billed charges,40% of total billed charges,208.17,90,,,percent of total billed charges,90% of total billed charges,175.79,76,,,percent of total billed charges,76% of total billed charges,92.52,40,,,percent of total billed charges,40% of total billed charges,196.61,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,185.04,80,,,percent of total billed charges,80% of total billed charges,89.74,38.8,,,percent of total billed charges,38.8% of total billed charges,196.61,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,219.74,
88313 special stain all others,40088313,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,192,153.6,,144,75,,,percent of total billed charges,75% of total billed charges,76.8,40,,,percent of total billed charges,40% of total billed charges,152.06,79.2,,,percent of total billed charges,79.2% of total billed charges,163.2,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,182.4,95,,,percent of total billed charges,95% of total billed charges,153.6,80,,,percent of total billed charges,80% of total billed charges,163.2,85,,,percent of total billed charges,85% of total billed charges,172.8,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,76.8,40,,,percent of total billed charges,40% of total billed charges,76.8,40,,,percent of total billed charges,40% of total billed charges,172.8,90,,,percent of total billed charges,90% of total billed charges,145.92,76,,,percent of total billed charges,76% of total billed charges,76.8,40,,,percent of total billed charges,40% of total billed charges,163.2,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,153.6,80,,,percent of total billed charges,80% of total billed charges,74.5,38.8,,,percent of total billed charges,38.8% of total billed charges,163.2,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,182.4,
88314 histochem spec stain,40088314,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,205.8,164.64,,154.35,75,,,percent of total billed charges,75% of total billed charges,82.32,40,,,percent of total billed charges,40% of total billed charges,162.99,79.2,,,percent of total billed charges,79.2% of total billed charges,174.93,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,195.51,95,,,percent of total billed charges,95% of total billed charges,164.64,80,,,percent of total billed charges,80% of total billed charges,174.93,85,,,percent of total billed charges,85% of total billed charges,185.22,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,82.32,40,,,percent of total billed charges,40% of total billed charges,82.32,40,,,percent of total billed charges,40% of total billed charges,185.22,90,,,percent of total billed charges,90% of total billed charges,156.41,76,,,percent of total billed charges,76% of total billed charges,82.32,40,,,percent of total billed charges,40% of total billed charges,174.93,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,164.64,80,,,percent of total billed charges,80% of total billed charges,79.85,38.8,,,percent of total billed charges,38.8% of total billed charges,174.93,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,195.51,
88319 enzyme spec stain,40088319,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,200.5,160.4,,150.38,75,,,percent of total billed charges,75% of total billed charges,80.2,40,,,percent of total billed charges,40% of total billed charges,158.8,79.2,,,percent of total billed charges,79.2% of total billed charges,170.43,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,190.48,95,,,percent of total billed charges,95% of total billed charges,160.4,80,,,percent of total billed charges,80% of total billed charges,170.43,85,,,percent of total billed charges,85% of total billed charges,180.45,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,80.2,40,,,percent of total billed charges,40% of total billed charges,80.2,40,,,percent of total billed charges,40% of total billed charges,180.45,90,,,percent of total billed charges,90% of total billed charges,152.38,76,,,percent of total billed charges,76% of total billed charges,80.2,40,,,percent of total billed charges,40% of total billed charges,170.43,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,160.4,80,,,percent of total billed charges,80% of total billed charges,77.79,38.8,,,percent of total billed charges,38.8% of total billed charges,170.43,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,190.48,
88329 path consult,40088329,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,101.2,80.96,,75.9,75,,,percent of total billed charges,75% of total billed charges,40.48,40,,,percent of total billed charges,40% of total billed charges,80.15,79.2,,,percent of total billed charges,79.2% of total billed charges,86.02,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,96.14,95,,,percent of total billed charges,95% of total billed charges,80.96,80,,,percent of total billed charges,80% of total billed charges,86.02,85,,,percent of total billed charges,85% of total billed charges,91.08,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,40.48,40,,,percent of total billed charges,40% of total billed charges,40.48,40,,,percent of total billed charges,40% of total billed charges,91.08,90,,,percent of total billed charges,90% of total billed charges,76.91,76,,,percent of total billed charges,76% of total billed charges,40.48,40,,,percent of total billed charges,40% of total billed charges,86.02,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,80.96,80,,,percent of total billed charges,80% of total billed charges,39.27,38.8,,,percent of total billed charges,38.8% of total billed charges,86.02,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,96.14,
88331 frozen section,40088331,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,107.2,85.76,,80.4,75,,,percent of total billed charges,75% of total billed charges,42.88,40,,,percent of total billed charges,40% of total billed charges,84.9,79.2,,,percent of total billed charges,79.2% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,101.84,95,,,percent of total billed charges,95% of total billed charges,85.76,80,,,percent of total billed charges,80% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,96.48,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,42.88,40,,,percent of total billed charges,40% of total billed charges,42.88,40,,,percent of total billed charges,40% of total billed charges,96.48,90,,,percent of total billed charges,90% of total billed charges,81.47,76,,,percent of total billed charges,76% of total billed charges,42.88,40,,,percent of total billed charges,40% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,85.76,80,,,percent of total billed charges,80% of total billed charges,41.59,38.8,,,percent of total billed charges,38.8% of total billed charges,91.12,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,101.84,
88332 additional froz sect same visit,40088332,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,70,56,,52.5,75,,,percent of total billed charges,75% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,55.44,79.2,,,percent of total billed charges,79.2% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,66.5,95,,,percent of total billed charges,95% of total billed charges,56,80,,,percent of total billed charges,80% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,63,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,28,40,,,percent of total billed charges,40% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,63,90,,,percent of total billed charges,90% of total billed charges,53.2,76,,,percent of total billed charges,76% of total billed charges,28,40,,,percent of total billed charges,40% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,56,80,,,percent of total billed charges,80% of total billed charges,27.16,38.8,,,percent of total billed charges,38.8% of total billed charges,59.5,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,66.5,
88333 touch prep,40088333,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,81.7,65.36,,61.28,75,,,percent of total billed charges,75% of total billed charges,32.68,40,,,percent of total billed charges,40% of total billed charges,64.71,79.2,,,percent of total billed charges,79.2% of total billed charges,69.45,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,77.62,95,,,percent of total billed charges,95% of total billed charges,65.36,80,,,percent of total billed charges,80% of total billed charges,69.45,85,,,percent of total billed charges,85% of total billed charges,73.53,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,32.68,40,,,percent of total billed charges,40% of total billed charges,32.68,40,,,percent of total billed charges,40% of total billed charges,73.53,90,,,percent of total billed charges,90% of total billed charges,62.09,76,,,percent of total billed charges,76% of total billed charges,32.68,40,,,percent of total billed charges,40% of total billed charges,69.45,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,65.36,80,,,percent of total billed charges,80% of total billed charges,31.7,38.8,,,percent of total billed charges,38.8% of total billed charges,69.45,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,77.62,
88341 IHC stain each additional,40088341,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,210.1,168.08,,157.58,75,,,percent of total billed charges,75% of total billed charges,84.04,40,,,percent of total billed charges,40% of total billed charges,166.4,79.2,,,percent of total billed charges,79.2% of total billed charges,178.59,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,199.6,95,,,percent of total billed charges,95% of total billed charges,168.08,80,,,percent of total billed charges,80% of total billed charges,178.59,85,,,percent of total billed charges,85% of total billed charges,189.09,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,84.04,40,,,percent of total billed charges,40% of total billed charges,84.04,40,,,percent of total billed charges,40% of total billed charges,189.09,90,,,percent of total billed charges,90% of total billed charges,159.68,76,,,percent of total billed charges,76% of total billed charges,84.04,40,,,percent of total billed charges,40% of total billed charges,178.59,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,168.08,80,,,percent of total billed charges,80% of total billed charges,81.52,38.8,,,percent of total billed charges,38.8% of total billed charges,178.59,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,199.6,
88342 immunohistochemistry,40088342,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,240.9,192.72,,180.68,75,,,percent of total billed charges,75% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,190.79,79.2,,,percent of total billed charges,79.2% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,228.86,95,,,percent of total billed charges,95% of total billed charges,192.72,80,,,percent of total billed charges,80% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,216.81,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,96.36,40,,,percent of total billed charges,40% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,216.81,90,,,percent of total billed charges,90% of total billed charges,183.08,76,,,percent of total billed charges,76% of total billed charges,96.36,40,,,percent of total billed charges,40% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,192.72,80,,,percent of total billed charges,80% of total billed charges,93.47,38.8,,,percent of total billed charges,38.8% of total billed charges,204.77,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,228.86,
88348 electron microscopy,40088348,CDM,319,RC,88348,HCPCS,OUTPATIENT,,,889.3,711.44,,666.98,75,,,percent of total billed charges,75% of total billed charges,355.72,40,,,percent of total billed charges,40% of total billed charges,704.33,79.2,,,percent of total billed charges,79.2% of total billed charges,755.91,85,,,percent of total billed charges,85% of total billed charges,53.26,100,,,fee schedule,100% of CO APG rates,844.84,95,,,percent of total billed charges,95% of total billed charges,711.44,80,,,percent of total billed charges,80% of total billed charges,755.91,85,,,percent of total billed charges,85% of total billed charges,800.37,90,,,percent of total billed charges,90% of total billed charges,53.26,100,,,fee schedule,100% of CO APG rates,53.26,100,,,fee schedule,100% of CO APG rates,776.51,100,,,fee schedule,100% of NM APC rate,355.72,40,,,percent of total billed charges,40% of total billed charges,355.72,40,,,percent of total billed charges,40% of total billed charges,800.37,90,,,percent of total billed charges,90% of total billed charges,675.87,76,,,percent of total billed charges,76% of total billed charges,355.72,40,,,percent of total billed charges,40% of total billed charges,755.91,85,,,percent of total billed charges,85% of total billed charges,53.26,100,,,fee schedule,100% of CO APG rate,711.44,80,,,percent of total billed charges,80% of total billed charges,345.05,38.8,,,percent of total billed charges,38.8% of total billed charges,755.91,85,,,percent of total billed charges,85% of total billed charges,53.26,100,,,fee schedule,100% of APG fee schedule,997.08,200,,,fee schedule,200% of CMS fee schedule,53.26,997.08,
88360 quant IHC,40088360,CDM,312,RC,88341,HCPCS,OUTPATIENT,,,290.8,232.64,,218.1,75,,,percent of total billed charges,75% of total billed charges,116.32,40,,,percent of total billed charges,40% of total billed charges,230.31,79.2,,,percent of total billed charges,79.2% of total billed charges,247.18,85,,,percent of total billed charges,85% of total billed charges,29.14,100,,,fee schedule,100% of CO APG rates,276.26,95,,,percent of total billed charges,95% of total billed charges,232.64,80,,,percent of total billed charges,80% of total billed charges,247.18,85,,,percent of total billed charges,85% of total billed charges,261.72,90,,,percent of total billed charges,90% of total billed charges,29.14,100,,,fee schedule,100% of CO APG rates,29.14,100,,,fee schedule,100% of CO APG rates,290.8,100,,,fee schedule,100% of NM fee schedule,116.32,40,,,percent of total billed charges,40% of total billed charges,116.32,40,,,percent of total billed charges,40% of total billed charges,261.72,90,,,percent of total billed charges,90% of total billed charges,221.01,76,,,percent of total billed charges,76% of total billed charges,116.32,40,,,percent of total billed charges,40% of total billed charges,247.18,85,,,percent of total billed charges,85% of total billed charges,29.14,100,,,fee schedule,100% of CO APG rate,232.64,80,,,percent of total billed charges,80% of total billed charges,112.83,38.8,,,percent of total billed charges,38.8% of total billed charges,247.18,85,,,percent of total billed charges,85% of total billed charges,29.14,100,,,fee schedule,100% of APG fee schedule,181,200,,,fee schedule,200% of CMS fee schedule,29.14,290.8,
88363 path spec archive retrieval,40088363,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,77.4,61.92,,58.05,75,,,percent of total billed charges,75% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,61.3,79.2,,,percent of total billed charges,79.2% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,73.53,95,,,percent of total billed charges,95% of total billed charges,61.92,80,,,percent of total billed charges,80% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,69.66,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,30.96,40,,,percent of total billed charges,40% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,69.66,90,,,percent of total billed charges,90% of total billed charges,58.82,76,,,percent of total billed charges,76% of total billed charges,30.96,40,,,percent of total billed charges,40% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,61.92,80,,,percent of total billed charges,80% of total billed charges,30.03,38.8,,,percent of total billed charges,38.8% of total billed charges,65.79,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,73.53,
88365 in situ hybridization,40088365,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,444.6,355.68,,333.45,75,,,percent of total billed charges,75% of total billed charges,177.84,40,,,percent of total billed charges,40% of total billed charges,352.12,79.2,,,percent of total billed charges,79.2% of total billed charges,377.91,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,422.37,95,,,percent of total billed charges,95% of total billed charges,355.68,80,,,percent of total billed charges,80% of total billed charges,377.91,85,,,percent of total billed charges,85% of total billed charges,400.14,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,177.84,40,,,percent of total billed charges,40% of total billed charges,177.84,40,,,percent of total billed charges,40% of total billed charges,400.14,90,,,percent of total billed charges,90% of total billed charges,337.9,76,,,percent of total billed charges,76% of total billed charges,177.84,40,,,percent of total billed charges,40% of total billed charges,377.91,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,355.68,80,,,percent of total billed charges,80% of total billed charges,172.5,38.8,,,percent of total billed charges,38.8% of total billed charges,377.91,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,422.37,
BALLOON SEEKER EM SPEHNOID 6 x 17mm,46052852,CDM,270,RC,,,OUTPATIENT,,,920.9,736.72,,690.68,75,,,percent of total billed charges,75% of total billed charges,368.36,40,,,percent of total billed charges,40% of total billed charges,729.35,79.2,,,percent of total billed charges,79.2% of total billed charges,782.77,85,,,percent of total billed charges,85% of total billed charges,920.9,100,,,fee schedule,100% of CO APG rates,874.86,95,,,percent of total billed charges,95% of total billed charges,736.72,80,,,percent of total billed charges,80% of total billed charges,782.77,85,,,percent of total billed charges,85% of total billed charges,828.81,90,,,percent of total billed charges,90% of total billed charges,920.9,100,,,fee schedule,100% of CO APG rates,920.9,100,,,fee schedule,100% of CO APG rates,920.9,100,,,fee schedule,100% of NM fee schedule,368.36,40,,,percent of total billed charges,40% of total billed charges,368.36,40,,,percent of total billed charges,40% of total billed charges,828.81,90,,,percent of total billed charges,90% of total billed charges,699.88,76,,,percent of total billed charges,76% of total billed charges,368.36,40,,,percent of total billed charges,40% of total billed charges,782.77,85,,,percent of total billed charges,85% of total billed charges,920.9,100,,,fee schedule,100% of CO APG rate,736.72,80,,,percent of total billed charges,80% of total billed charges,357.31,38.8,,,percent of total billed charges,38.8% of total billed charges,782.77,85,,,percent of total billed charges,85% of total billed charges,920.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,357.31,920.9,
BALLOON SEEKER EM FRONT 6 x 17mm,46052854,CDM,270,RC,,,OUTPATIENT,,,1997.1,1597.68,,1497.83,75,,,percent of total billed charges,75% of total billed charges,798.84,40,,,percent of total billed charges,40% of total billed charges,1581.7,79.2,,,percent of total billed charges,79.2% of total billed charges,1697.54,85,,,percent of total billed charges,85% of total billed charges,1997.1,100,,,fee schedule,100% of CO APG rates,1897.25,95,,,percent of total billed charges,95% of total billed charges,1597.68,80,,,percent of total billed charges,80% of total billed charges,1697.54,85,,,percent of total billed charges,85% of total billed charges,1797.39,90,,,percent of total billed charges,90% of total billed charges,1997.1,100,,,fee schedule,100% of CO APG rates,1997.1,100,,,fee schedule,100% of CO APG rates,1997.1,100,,,fee schedule,100% of NM fee schedule,798.84,40,,,percent of total billed charges,40% of total billed charges,798.84,40,,,percent of total billed charges,40% of total billed charges,1797.39,90,,,percent of total billed charges,90% of total billed charges,1517.8,76,,,percent of total billed charges,76% of total billed charges,798.84,40,,,percent of total billed charges,40% of total billed charges,1697.54,85,,,percent of total billed charges,85% of total billed charges,1997.1,100,,,fee schedule,100% of CO APG rate,1597.68,80,,,percent of total billed charges,80% of total billed charges,774.87,38.8,,,percent of total billed charges,38.8% of total billed charges,1697.54,85,,,percent of total billed charges,85% of total billed charges,1997.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,774.87,1997.1,
B-Type Natriuretic Peptide LC,40083880,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,248.3,198.64,,186.23,75,,,percent of total billed charges,75% of total billed charges,99.32,40,,,percent of total billed charges,40% of total billed charges,196.65,79.2,,,percent of total billed charges,79.2% of total billed charges,211.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,235.89,95,,,percent of total billed charges,95% of total billed charges,198.64,80,,,percent of total billed charges,80% of total billed charges,211.06,85,,,percent of total billed charges,85% of total billed charges,223.47,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,99.32,40,,,percent of total billed charges,40% of total billed charges,99.32,40,,,percent of total billed charges,40% of total billed charges,223.47,90,,,percent of total billed charges,90% of total billed charges,188.71,76,,,percent of total billed charges,76% of total billed charges,99.32,40,,,percent of total billed charges,40% of total billed charges,211.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,198.64,80,,,percent of total billed charges,80% of total billed charges,96.34,38.8,,,percent of total billed charges,38.8% of total billed charges,211.06,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,235.89,
90471/G0008 Influenza Vaccine Admin,77100008,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.8,50.67,
"HSV 2 IgG, Type Spec LC",40086696,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,151.24,
BIO-COMPRESSION SCREW 3.0 X 26MM (ARTHREX),46052864,CDM,278,RC,,,OUTPATIENT,,,1452.7,1162.16,,1089.53,75,,,percent of total billed charges,75% of total billed charges,581.08,40,,,percent of total billed charges,40% of total billed charges,1150.54,79.2,,,percent of total billed charges,79.2% of total billed charges,1234.8,85,,,percent of total billed charges,85% of total billed charges,1452.7,100,,,fee schedule,100% of CO APG rates,1380.07,95,,,percent of total billed charges,95% of total billed charges,1162.16,80,,,percent of total billed charges,80% of total billed charges,1234.8,85,,,percent of total billed charges,85% of total billed charges,1307.43,90,,,percent of total billed charges,90% of total billed charges,1452.7,100,,,fee schedule,100% of CO APG rates,1452.7,100,,,fee schedule,100% of CO APG rates,1452.7,100,,,fee schedule,100% of NM fee schedule,581.08,40,,,percent of total billed charges,40% of total billed charges,581.08,40,,,percent of total billed charges,40% of total billed charges,1307.43,90,,,percent of total billed charges,90% of total billed charges,1104.05,76,,,percent of total billed charges,76% of total billed charges,581.08,40,,,percent of total billed charges,40% of total billed charges,1234.8,85,,,percent of total billed charges,85% of total billed charges,1452.7,100,,,fee schedule,100% of CO APG rate,1162.16,80,,,percent of total billed charges,80% of total billed charges,563.65,38.8,,,percent of total billed charges,38.8% of total billed charges,1234.8,85,,,percent of total billed charges,85% of total billed charges,1452.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,563.65,1452.7,
"T BUTTRESS PLATE L , 113mm   6 HOLE",46052865,CDM,278,RC,,,OUTPATIENT,,,781.5,625.2,,586.13,75,,,percent of total billed charges,75% of total billed charges,312.6,40,,,percent of total billed charges,40% of total billed charges,618.95,79.2,,,percent of total billed charges,79.2% of total billed charges,664.28,85,,,percent of total billed charges,85% of total billed charges,781.5,100,,,fee schedule,100% of CO APG rates,742.43,95,,,percent of total billed charges,95% of total billed charges,625.2,80,,,percent of total billed charges,80% of total billed charges,664.28,85,,,percent of total billed charges,85% of total billed charges,703.35,90,,,percent of total billed charges,90% of total billed charges,781.5,100,,,fee schedule,100% of CO APG rates,781.5,100,,,fee schedule,100% of CO APG rates,781.5,100,,,fee schedule,100% of NM fee schedule,312.6,40,,,percent of total billed charges,40% of total billed charges,312.6,40,,,percent of total billed charges,40% of total billed charges,703.35,90,,,percent of total billed charges,90% of total billed charges,593.94,76,,,percent of total billed charges,76% of total billed charges,312.6,40,,,percent of total billed charges,40% of total billed charges,664.28,85,,,percent of total billed charges,85% of total billed charges,781.5,100,,,fee schedule,100% of CO APG rate,625.2,80,,,percent of total billed charges,80% of total billed charges,303.22,38.8,,,percent of total billed charges,38.8% of total billed charges,664.28,85,,,percent of total billed charges,85% of total billed charges,781.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,303.22,781.5,
"ANTI-EMBOLISM STOCKING, KNEE XL REGULAR",52866,CDM,270,RC,,,OUTPATIENT,,,21.8,17.44,,16.35,75,,,percent of total billed charges,75% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,17.27,79.2,,,percent of total billed charges,79.2% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rates,20.71,95,,,percent of total billed charges,95% of total billed charges,17.44,80,,,percent of total billed charges,80% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,19.62,90,,,percent of total billed charges,90% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rates,21.8,100,,,fee schedule,100% of CO APG rates,21.8,100,,,fee schedule,100% of NM fee schedule,8.72,40,,,percent of total billed charges,40% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,19.62,90,,,percent of total billed charges,90% of total billed charges,16.57,76,,,percent of total billed charges,76% of total billed charges,8.72,40,,,percent of total billed charges,40% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of CO APG rate,17.44,80,,,percent of total billed charges,80% of total billed charges,8.46,38.8,,,percent of total billed charges,38.8% of total billed charges,18.53,85,,,percent of total billed charges,85% of total billed charges,21.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,8.46,21.8,
"ANTI-EMBOLISM STOCKING, KNEE 2XL REGULAR",52867,CDM,270,RC,,,OUTPATIENT,,,48.1,38.48,,36.08,75,,,percent of total billed charges,75% of total billed charges,19.24,40,,,percent of total billed charges,40% of total billed charges,38.1,79.2,,,percent of total billed charges,79.2% of total billed charges,40.89,85,,,percent of total billed charges,85% of total billed charges,48.1,100,,,fee schedule,100% of CO APG rates,45.7,95,,,percent of total billed charges,95% of total billed charges,38.48,80,,,percent of total billed charges,80% of total billed charges,40.89,85,,,percent of total billed charges,85% of total billed charges,43.29,90,,,percent of total billed charges,90% of total billed charges,48.1,100,,,fee schedule,100% of CO APG rates,48.1,100,,,fee schedule,100% of CO APG rates,48.1,100,,,fee schedule,100% of NM fee schedule,19.24,40,,,percent of total billed charges,40% of total billed charges,19.24,40,,,percent of total billed charges,40% of total billed charges,43.29,90,,,percent of total billed charges,90% of total billed charges,36.56,76,,,percent of total billed charges,76% of total billed charges,19.24,40,,,percent of total billed charges,40% of total billed charges,40.89,85,,,percent of total billed charges,85% of total billed charges,48.1,100,,,fee schedule,100% of CO APG rate,38.48,80,,,percent of total billed charges,80% of total billed charges,18.66,38.8,,,percent of total billed charges,38.8% of total billed charges,40.89,85,,,percent of total billed charges,85% of total billed charges,48.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.66,48.1,
SINU KNIT DISSOLVABLE DRESSING (SMITHNEPHEW),46052885,CDM,270,RC,,,OUTPATIENT,,,186.7,149.36,,140.03,75,,,percent of total billed charges,75% of total billed charges,74.68,40,,,percent of total billed charges,40% of total billed charges,147.87,79.2,,,percent of total billed charges,79.2% of total billed charges,158.7,85,,,percent of total billed charges,85% of total billed charges,186.7,100,,,fee schedule,100% of CO APG rates,177.37,95,,,percent of total billed charges,95% of total billed charges,149.36,80,,,percent of total billed charges,80% of total billed charges,158.7,85,,,percent of total billed charges,85% of total billed charges,168.03,90,,,percent of total billed charges,90% of total billed charges,186.7,100,,,fee schedule,100% of CO APG rates,186.7,100,,,fee schedule,100% of CO APG rates,186.7,100,,,fee schedule,100% of NM fee schedule,74.68,40,,,percent of total billed charges,40% of total billed charges,74.68,40,,,percent of total billed charges,40% of total billed charges,168.03,90,,,percent of total billed charges,90% of total billed charges,141.89,76,,,percent of total billed charges,76% of total billed charges,74.68,40,,,percent of total billed charges,40% of total billed charges,158.7,85,,,percent of total billed charges,85% of total billed charges,186.7,100,,,fee schedule,100% of CO APG rate,149.36,80,,,percent of total billed charges,80% of total billed charges,72.44,38.8,,,percent of total billed charges,38.8% of total billed charges,158.7,85,,,percent of total billed charges,85% of total billed charges,186.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,72.44,186.7,
PROCISE MAX COBLATOR II WAND,46052887,CDM,270,RC,,,OUTPATIENT,,,963.6,770.88,,722.7,75,,,percent of total billed charges,75% of total billed charges,385.44,40,,,percent of total billed charges,40% of total billed charges,763.17,79.2,,,percent of total billed charges,79.2% of total billed charges,819.06,85,,,percent of total billed charges,85% of total billed charges,963.6,100,,,fee schedule,100% of CO APG rates,915.42,95,,,percent of total billed charges,95% of total billed charges,770.88,80,,,percent of total billed charges,80% of total billed charges,819.06,85,,,percent of total billed charges,85% of total billed charges,867.24,90,,,percent of total billed charges,90% of total billed charges,963.6,100,,,fee schedule,100% of CO APG rates,963.6,100,,,fee schedule,100% of CO APG rates,963.6,100,,,fee schedule,100% of NM fee schedule,385.44,40,,,percent of total billed charges,40% of total billed charges,385.44,40,,,percent of total billed charges,40% of total billed charges,867.24,90,,,percent of total billed charges,90% of total billed charges,732.34,76,,,percent of total billed charges,76% of total billed charges,385.44,40,,,percent of total billed charges,40% of total billed charges,819.06,85,,,percent of total billed charges,85% of total billed charges,963.6,100,,,fee schedule,100% of CO APG rate,770.88,80,,,percent of total billed charges,80% of total billed charges,373.88,38.8,,,percent of total billed charges,38.8% of total billed charges,819.06,85,,,percent of total billed charges,85% of total billed charges,963.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,373.88,963.6,
67700 - Drainage of Eyelid Abscess,60000648,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,890.2,712.16,,667.65,75,,,percent of total billed charges,75% of total billed charges,356.08,40,,,percent of total billed charges,40% of total billed charges,705.04,79.2,,,percent of total billed charges,79.2% of total billed charges,756.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,845.69,95,,,percent of total billed charges,95% of total billed charges,712.16,80,,,percent of total billed charges,80% of total billed charges,756.67,85,,,percent of total billed charges,85% of total billed charges,801.18,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,356.08,40,,,percent of total billed charges,40% of total billed charges,356.08,40,,,percent of total billed charges,40% of total billed charges,801.18,90,,,percent of total billed charges,90% of total billed charges,676.55,76,,,percent of total billed charges,76% of total billed charges,356.08,40,,,percent of total billed charges,40% of total billed charges,756.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,712.16,80,,,percent of total billed charges,80% of total billed charges,345.4,38.8,,,percent of total billed charges,38.8% of total billed charges,756.67,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,845.69,
62304 - Myelography Lumbar Inj,60000666,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2311.9,1849.52,,1733.93,75,,,percent of total billed charges,75% of total billed charges,924.76,40,,,percent of total billed charges,40% of total billed charges,1831.02,79.2,,,percent of total billed charges,79.2% of total billed charges,1965.12,85,,,percent of total billed charges,85% of total billed charges,2311.9,100,,,fee schedule,100% of CO APG rates,2196.31,95,,,percent of total billed charges,95% of total billed charges,1849.52,80,,,percent of total billed charges,80% of total billed charges,1965.12,85,,,percent of total billed charges,85% of total billed charges,2080.71,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,924.76,40,,,percent of total billed charges,40% of total billed charges,924.76,40,,,percent of total billed charges,40% of total billed charges,2080.71,90,,,percent of total billed charges,90% of total billed charges,1757.04,76,,,percent of total billed charges,76% of total billed charges,924.76,40,,,percent of total billed charges,40% of total billed charges,1965.12,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1849.52,80,,,percent of total billed charges,80% of total billed charges,897.02,38.8,,,percent of total billed charges,38.8% of total billed charges,1965.12,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
"2.4mm FEMORAL EYELOOP GUIDE PIN (12in), DRILL TIP",46052889,CDM,270,RC,,,OUTPATIENT,,,450.1,360.08,,337.58,75,,,percent of total billed charges,75% of total billed charges,180.04,40,,,percent of total billed charges,40% of total billed charges,356.48,79.2,,,percent of total billed charges,79.2% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,450.1,100,,,fee schedule,100% of CO APG rates,427.6,95,,,percent of total billed charges,95% of total billed charges,360.08,80,,,percent of total billed charges,80% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,405.09,90,,,percent of total billed charges,90% of total billed charges,450.1,100,,,fee schedule,100% of CO APG rates,450.1,100,,,fee schedule,100% of CO APG rates,450.1,100,,,fee schedule,100% of NM fee schedule,180.04,40,,,percent of total billed charges,40% of total billed charges,180.04,40,,,percent of total billed charges,40% of total billed charges,405.09,90,,,percent of total billed charges,90% of total billed charges,342.08,76,,,percent of total billed charges,76% of total billed charges,180.04,40,,,percent of total billed charges,40% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,450.1,100,,,fee schedule,100% of CO APG rate,360.08,80,,,percent of total billed charges,80% of total billed charges,174.64,38.8,,,percent of total billed charges,38.8% of total billed charges,382.59,85,,,percent of total billed charges,85% of total billed charges,450.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,174.64,450.1,
"96372 Therapeutic, prophylactic, or diagnostic injection, su",49196372,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,111.2,88.96,,83.4,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,88.07,79.2,,,percent of total billed charges,79.2% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,111.2,100,,,fee schedule,100% of CO APG rates,105.64,95,,,percent of total billed charges,95% of total billed charges,88.96,80,,,percent of total billed charges,80% of total billed charges,94.52,85,,,percent of total billed charges,85% of total billed charges,100.08,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,111.2,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,100.08,90,,,percent of total billed charges,90% of total billed charges,84.51,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,94.52,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,88.96,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,94.52,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,604.6,100,,,case rate,pays based on per visit rate,83.4,604.6,
PROPEL CONTOUR MOMETASONE FUROATE IMPLANT,46052900,CDM,279,RC,,,OUTPATIENT,,,2350.8,1880.64,,1763.1,75,,,percent of total billed charges,75% of total billed charges,940.32,40,,,percent of total billed charges,40% of total billed charges,1861.83,79.2,,,percent of total billed charges,79.2% of total billed charges,1998.18,85,,,percent of total billed charges,85% of total billed charges,2350.8,100,,,fee schedule,100% of CO APG rates,2233.26,95,,,percent of total billed charges,95% of total billed charges,1880.64,80,,,percent of total billed charges,80% of total billed charges,1998.18,85,,,percent of total billed charges,85% of total billed charges,2115.72,90,,,percent of total billed charges,90% of total billed charges,2350.8,100,,,fee schedule,100% of CO APG rates,2350.8,100,,,fee schedule,100% of CO APG rates,2350.8,100,,,fee schedule,100% of NM fee schedule,940.32,40,,,percent of total billed charges,40% of total billed charges,940.32,40,,,percent of total billed charges,40% of total billed charges,2115.72,90,,,percent of total billed charges,90% of total billed charges,1786.61,76,,,percent of total billed charges,76% of total billed charges,940.32,40,,,percent of total billed charges,40% of total billed charges,1998.18,85,,,percent of total billed charges,85% of total billed charges,2350.8,100,,,fee schedule,100% of CO APG rate,1880.64,80,,,percent of total billed charges,80% of total billed charges,912.11,38.8,,,percent of total billed charges,38.8% of total billed charges,1998.18,85,,,percent of total billed charges,85% of total billed charges,2350.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,912.11,2350.8,
PROPEL MINI MOMETASONE FUROATE IMPLANT,46052901,CDM,279,RC,,,OUTPATIENT,,,2350.8,1880.64,,1763.1,75,,,percent of total billed charges,75% of total billed charges,940.32,40,,,percent of total billed charges,40% of total billed charges,1861.83,79.2,,,percent of total billed charges,79.2% of total billed charges,1998.18,85,,,percent of total billed charges,85% of total billed charges,2350.8,100,,,fee schedule,100% of CO APG rates,2233.26,95,,,percent of total billed charges,95% of total billed charges,1880.64,80,,,percent of total billed charges,80% of total billed charges,1998.18,85,,,percent of total billed charges,85% of total billed charges,2115.72,90,,,percent of total billed charges,90% of total billed charges,2350.8,100,,,fee schedule,100% of CO APG rates,2350.8,100,,,fee schedule,100% of CO APG rates,2350.8,100,,,fee schedule,100% of NM fee schedule,940.32,40,,,percent of total billed charges,40% of total billed charges,940.32,40,,,percent of total billed charges,40% of total billed charges,2115.72,90,,,percent of total billed charges,90% of total billed charges,1786.61,76,,,percent of total billed charges,76% of total billed charges,940.32,40,,,percent of total billed charges,40% of total billed charges,1998.18,85,,,percent of total billed charges,85% of total billed charges,2350.8,100,,,fee schedule,100% of CO APG rate,1880.64,80,,,percent of total billed charges,80% of total billed charges,912.11,38.8,,,percent of total billed charges,38.8% of total billed charges,1998.18,85,,,percent of total billed charges,85% of total billed charges,2350.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,912.11,2350.8,
PROPEL REGULAR MOMETASON FUROATE IMPLANT,46052902,CDM,270,RC,,,OUTPATIENT,,,2526.7,2021.36,,1895.03,75,,,percent of total billed charges,75% of total billed charges,1010.68,40,,,percent of total billed charges,40% of total billed charges,2001.15,79.2,,,percent of total billed charges,79.2% of total billed charges,2147.7,85,,,percent of total billed charges,85% of total billed charges,2526.7,100,,,fee schedule,100% of CO APG rates,2400.37,95,,,percent of total billed charges,95% of total billed charges,2021.36,80,,,percent of total billed charges,80% of total billed charges,2147.7,85,,,percent of total billed charges,85% of total billed charges,2274.03,90,,,percent of total billed charges,90% of total billed charges,2526.7,100,,,fee schedule,100% of CO APG rates,2526.7,100,,,fee schedule,100% of CO APG rates,2526.7,100,,,fee schedule,100% of NM fee schedule,1010.68,40,,,percent of total billed charges,40% of total billed charges,1010.68,40,,,percent of total billed charges,40% of total billed charges,2274.03,90,,,percent of total billed charges,90% of total billed charges,1920.29,76,,,percent of total billed charges,76% of total billed charges,1010.68,40,,,percent of total billed charges,40% of total billed charges,2147.7,85,,,percent of total billed charges,85% of total billed charges,2526.7,100,,,fee schedule,100% of CO APG rate,2021.36,80,,,percent of total billed charges,80% of total billed charges,980.36,38.8,,,percent of total billed charges,38.8% of total billed charges,2147.7,85,,,percent of total billed charges,85% of total billed charges,2526.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,980.36,2526.7,
"10011 Fine needle aspiration biopsy, including MR guidance;",6000466,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
11102 Tangential biopsy of skin; single lesion,60000452,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,12.6,10.08,,9.45,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,9.98,79.2,,,percent of total billed charges,79.2% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,12.6,100,,,fee schedule,100% of CO APG rates,11.97,95,,,percent of total billed charges,95% of total billed charges,10.08,80,,,percent of total billed charges,80% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,11.34,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,12.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,11.34,90,,,percent of total billed charges,90% of total billed charges,9.58,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,10.71,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,10.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,10.71,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,407.4,100,,,case rate,pays based on per visit rate,9.45,407.4,
11103 Tangential biopsy of skin; each additional lesion,60000453,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,302.9,242.32,,227.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,239.9,79.2,,,percent of total billed charges,79.2% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,302.9,100,,,fee schedule,100% of CO APG rates,287.76,95,,,percent of total billed charges,95% of total billed charges,242.32,80,,,percent of total billed charges,80% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,272.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,302.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,272.61,90,,,percent of total billed charges,90% of total billed charges,230.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,257.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,242.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,257.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,988,100,,,case rate,pays based on per visit rate,227.18,988,
"11104 Punch biopsy of skin (including simple closure, when p",60000454,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,12.6,10.08,,9.45,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,9.98,79.2,,,percent of total billed charges,79.2% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,12.6,100,,,fee schedule,100% of CO APG rates,11.97,95,,,percent of total billed charges,95% of total billed charges,10.08,80,,,percent of total billed charges,80% of total billed charges,10.71,85,,,percent of total billed charges,85% of total billed charges,11.34,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,12.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,11.34,90,,,percent of total billed charges,90% of total billed charges,9.58,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,10.71,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,10.08,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,10.71,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,407.4,100,,,case rate,pays based on per visit rate,9.45,407.4,
"11105 Punch biopsy of skin (including simple closure, when p",60000455,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,302.9,242.32,,227.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,239.9,79.2,,,percent of total billed charges,79.2% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,302.9,100,,,fee schedule,100% of CO APG rates,287.76,95,,,percent of total billed charges,95% of total billed charges,242.32,80,,,percent of total billed charges,80% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,272.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,302.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,272.61,90,,,percent of total billed charges,90% of total billed charges,230.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,257.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,242.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,257.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,988,100,,,case rate,pays based on per visit rate,227.18,988,
11106 Incisional biopsy of skin; single lesion,60000456,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1836.3,1469.04,,1377.23,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1454.35,79.2,,,percent of total billed charges,79.2% of total billed charges,1560.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1744.49,95,,,percent of total billed charges,95% of total billed charges,1469.04,80,,,percent of total billed charges,80% of total billed charges,1560.86,85,,,percent of total billed charges,85% of total billed charges,1652.67,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1836.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1652.67,90,,,percent of total billed charges,90% of total billed charges,1395.59,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1560.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1469.04,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1560.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1836.3,
11107 Incisional biopsy of skin; each additional lesion,60000457,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,302.9,242.32,,227.18,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,239.9,79.2,,,percent of total billed charges,79.2% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,302.9,100,,,fee schedule,100% of CO APG rates,287.76,95,,,percent of total billed charges,95% of total billed charges,242.32,80,,,percent of total billed charges,80% of total billed charges,257.47,85,,,percent of total billed charges,85% of total billed charges,272.61,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,302.9,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,272.61,90,,,percent of total billed charges,90% of total billed charges,230.2,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,257.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,242.32,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,257.47,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,988,100,,,case rate,pays based on per visit rate,227.18,988,
"10008 Fine needle aspiration biopsy, including fluoroscopic",60000463,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1020.75,816.6,,765.56,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,808.43,79.2,,,percent of total billed charges,79.2% of total billed charges,867.64,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,969.71,95,,,percent of total billed charges,95% of total billed charges,816.6,80,,,percent of total billed charges,80% of total billed charges,867.64,85,,,percent of total billed charges,85% of total billed charges,918.68,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1020.75,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,918.68,90,,,percent of total billed charges,90% of total billed charges,775.77,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,867.64,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,816.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,867.64,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"10009 Fine needle aspiration biopsy, including CT guidance;",6000464,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,816.6,40,,,percent of total billed charges,40% of total billed charges,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,816.6,40,,,percent of total billed charges,40% of total billed charges,816.6,40,,,percent of total billed charges,40% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,816.6,40,,,percent of total billed charges,40% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,792.1,38.8,,,percent of total billed charges,38.8% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,1939.43,
"10010 Fine needle aspiration biopsy, including CT guidance;",6000465,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1020.75,816.6,,765.56,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,808.43,79.2,,,percent of total billed charges,79.2% of total billed charges,867.64,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,969.71,95,,,percent of total billed charges,95% of total billed charges,816.6,80,,,percent of total billed charges,80% of total billed charges,867.64,85,,,percent of total billed charges,85% of total billed charges,918.68,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1020.75,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,918.68,90,,,percent of total billed charges,90% of total billed charges,775.77,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,867.64,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,816.6,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,867.64,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"10006 Fine needle aspiration biopsy, including ultrasound gu",60000461,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,1020.7,816.56,,765.53,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,808.39,79.2,,,percent of total billed charges,79.2% of total billed charges,867.6,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,969.67,95,,,percent of total billed charges,95% of total billed charges,816.56,80,,,percent of total billed charges,80% of total billed charges,867.6,85,,,percent of total billed charges,85% of total billed charges,918.63,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,1020.7,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,918.63,90,,,percent of total billed charges,90% of total billed charges,775.73,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,867.6,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,816.56,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,867.6,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"10005 Fine needle aspiration biopsy, ultrasound guidance fir",60000460,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"10007 Fine needle aspiration biopsy, including fluoroscopic",60000462,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
"43762 Replacement of gastrostomy tube, percutan, includes re",60000458,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,951.6,761.28,,713.7,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,753.67,79.2,,,percent of total billed charges,79.2% of total billed charges,808.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,904.02,95,,,percent of total billed charges,95% of total billed charges,761.28,80,,,percent of total billed charges,80% of total billed charges,808.86,85,,,percent of total billed charges,85% of total billed charges,856.44,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,951.6,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,856.44,90,,,percent of total billed charges,90% of total billed charges,723.22,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,808.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,761.28,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,808.86,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,1246.08,
"10012 Fine needle aspiration biopsy, including MR guidance;",6000467,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,2041.5,1633.2,,1531.13,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1616.87,79.2,,,percent of total billed charges,79.2% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,1939.43,95,,,percent of total billed charges,95% of total billed charges,1633.2,80,,,percent of total billed charges,80% of total billed charges,1735.28,85,,,percent of total billed charges,85% of total billed charges,1837.35,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,2041.5,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,1837.35,90,,,percent of total billed charges,90% of total billed charges,1551.54,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,1633.2,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,1735.28,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,1246.08,100,,,case rate,pays based on per visit rate,324.76,2041.5,
50360 Biopatch,60000483,CDM,270,RC,,,OUTPATIENT,,,62.1,49.68,,46.58,75,,,percent of total billed charges,75% of total billed charges,24.84,40,,,percent of total billed charges,40% of total billed charges,49.18,79.2,,,percent of total billed charges,79.2% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,62.1,100,,,fee schedule,100% of CO APG rates,59,95,,,percent of total billed charges,95% of total billed charges,49.68,80,,,percent of total billed charges,80% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,55.89,90,,,percent of total billed charges,90% of total billed charges,62.1,100,,,fee schedule,100% of CO APG rates,62.1,100,,,fee schedule,100% of CO APG rates,62.1,100,,,fee schedule,100% of NM fee schedule,24.84,40,,,percent of total billed charges,40% of total billed charges,24.84,40,,,percent of total billed charges,40% of total billed charges,55.89,90,,,percent of total billed charges,90% of total billed charges,47.2,76,,,percent of total billed charges,76% of total billed charges,24.84,40,,,percent of total billed charges,40% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,62.1,100,,,fee schedule,100% of CO APG rate,49.68,80,,,percent of total billed charges,80% of total billed charges,24.09,38.8,,,percent of total billed charges,38.8% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,62.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,24.09,62.1,
50166 PICC Line Dressing Change Kit,50166,CDM,270,RC,,,OUTPATIENT,,,62.1,49.68,,46.58,75,,,percent of total billed charges,75% of total billed charges,24.84,40,,,percent of total billed charges,40% of total billed charges,49.18,79.2,,,percent of total billed charges,79.2% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,62.1,100,,,fee schedule,100% of CO APG rates,59,95,,,percent of total billed charges,95% of total billed charges,49.68,80,,,percent of total billed charges,80% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,55.89,90,,,percent of total billed charges,90% of total billed charges,62.1,100,,,fee schedule,100% of CO APG rates,62.1,100,,,fee schedule,100% of CO APG rates,62.1,100,,,fee schedule,100% of NM fee schedule,24.84,40,,,percent of total billed charges,40% of total billed charges,24.84,40,,,percent of total billed charges,40% of total billed charges,55.89,90,,,percent of total billed charges,90% of total billed charges,47.2,76,,,percent of total billed charges,76% of total billed charges,24.84,40,,,percent of total billed charges,40% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,62.1,100,,,fee schedule,100% of CO APG rate,49.68,80,,,percent of total billed charges,80% of total billed charges,24.09,38.8,,,percent of total billed charges,38.8% of total billed charges,52.79,85,,,percent of total billed charges,85% of total billed charges,62.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,24.09,62.1,
Coccidioidal Serology CF LC,40807042,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,103.2,82.56,,77.4,75,,,percent of total billed charges,75% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,81.73,79.2,,,percent of total billed charges,79.2% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,98.04,95,,,percent of total billed charges,95% of total billed charges,82.56,80,,,percent of total billed charges,80% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,41.28,40,,,percent of total billed charges,40% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,92.88,90,,,percent of total billed charges,90% of total billed charges,78.43,76,,,percent of total billed charges,76% of total billed charges,41.28,40,,,percent of total billed charges,40% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,82.56,80,,,percent of total billed charges,80% of total billed charges,40.04,38.8,,,percent of total billed charges,38.8% of total billed charges,87.72,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,98.04,
"Lactic Acid, CSF LC",40122408,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,25,20,,18.75,75,,,percent of total billed charges,75% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,19.8,79.2,,,percent of total billed charges,79.2% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,23.75,95,,,percent of total billed charges,95% of total billed charges,20,80,,,percent of total billed charges,80% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,22.5,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,10,40,,,percent of total billed charges,40% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,22.5,90,,,percent of total billed charges,90% of total billed charges,19,76,,,percent of total billed charges,76% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,20,80,,,percent of total billed charges,80% of total billed charges,9.7,38.8,,,percent of total billed charges,38.8% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,23.75,
"Fluorescent treponema Ab, CSF LC",40828472,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,37.5,30,,28.13,75,,,percent of total billed charges,75% of total billed charges,15,40,,,percent of total billed charges,40% of total billed charges,29.7,79.2,,,percent of total billed charges,79.2% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,35.63,95,,,percent of total billed charges,95% of total billed charges,30,80,,,percent of total billed charges,80% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,15,40,,,percent of total billed charges,40% of total billed charges,15,40,,,percent of total billed charges,40% of total billed charges,33.75,90,,,percent of total billed charges,90% of total billed charges,28.5,76,,,percent of total billed charges,76% of total billed charges,15,40,,,percent of total billed charges,40% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,30,80,,,percent of total billed charges,80% of total billed charges,14.55,38.8,,,percent of total billed charges,38.8% of total billed charges,31.88,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,35.63,
2.0mm INFERIOR TURBINATE BLADE,46052904,CDM,270,RC,,,OUTPATIENT,,,846.6,677.28,,634.95,75,,,percent of total billed charges,75% of total billed charges,338.64,40,,,percent of total billed charges,40% of total billed charges,670.51,79.2,,,percent of total billed charges,79.2% of total billed charges,719.61,85,,,percent of total billed charges,85% of total billed charges,846.6,100,,,fee schedule,100% of CO APG rates,804.27,95,,,percent of total billed charges,95% of total billed charges,677.28,80,,,percent of total billed charges,80% of total billed charges,719.61,85,,,percent of total billed charges,85% of total billed charges,761.94,90,,,percent of total billed charges,90% of total billed charges,846.6,100,,,fee schedule,100% of CO APG rates,846.6,100,,,fee schedule,100% of CO APG rates,846.6,100,,,fee schedule,100% of NM fee schedule,338.64,40,,,percent of total billed charges,40% of total billed charges,338.64,40,,,percent of total billed charges,40% of total billed charges,761.94,90,,,percent of total billed charges,90% of total billed charges,643.42,76,,,percent of total billed charges,76% of total billed charges,338.64,40,,,percent of total billed charges,40% of total billed charges,719.61,85,,,percent of total billed charges,85% of total billed charges,846.6,100,,,fee schedule,100% of CO APG rate,677.28,80,,,percent of total billed charges,80% of total billed charges,328.48,38.8,,,percent of total billed charges,38.8% of total billed charges,719.61,85,,,percent of total billed charges,85% of total billed charges,846.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,328.48,846.6,
CT Low Dose Lung Screening,60000502,CDM,350,RC,73701,HCPCS,OUTPATIENT,,,353.9,283.12,,265.43,75,,,percent of total billed charges,75% of total billed charges,141.56,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,300.82,85,,,percent of total billed charges,85% of total billed charges,353.9,100,,,fee schedule,100% of CO APG rates,336.21,95,,,percent of total billed charges,95% of total billed charges,283.12,80,,,percent of total billed charges,80% of total billed charges,300.82,85,,,percent of total billed charges,85% of total billed charges,318.51,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,141.56,40,,,percent of total billed charges,40% of total billed charges,141.56,40,,,percent of total billed charges,40% of total billed charges,318.51,90,,,percent of total billed charges,90% of total billed charges,268.96,76,,,percent of total billed charges,76% of total billed charges,141.56,40,,,percent of total billed charges,40% of total billed charges,300.82,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,283.12,80,,,percent of total billed charges,80% of total billed charges,137.31,38.8,,,percent of total billed charges,38.8% of total billed charges,300.82,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,363.7,200,,,fee schedule,200% of CMS fee schedule,137.31,514,
"GASTROSTOMY FEEDING TUBE, MIC 18Fr",52459,CDM,270,RC,,,OUTPATIENT,,,189,151.2,,141.75,75,,,percent of total billed charges,75% of total billed charges,75.6,40,,,percent of total billed charges,40% of total billed charges,149.69,79.2,,,percent of total billed charges,79.2% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,189,100,,,fee schedule,100% of CO APG rates,179.55,95,,,percent of total billed charges,95% of total billed charges,151.2,80,,,percent of total billed charges,80% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,170.1,90,,,percent of total billed charges,90% of total billed charges,189,100,,,fee schedule,100% of CO APG rates,189,100,,,fee schedule,100% of CO APG rates,189,100,,,fee schedule,100% of NM fee schedule,75.6,40,,,percent of total billed charges,40% of total billed charges,75.6,40,,,percent of total billed charges,40% of total billed charges,170.1,90,,,percent of total billed charges,90% of total billed charges,143.64,76,,,percent of total billed charges,76% of total billed charges,75.6,40,,,percent of total billed charges,40% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,189,100,,,fee schedule,100% of CO APG rate,151.2,80,,,percent of total billed charges,80% of total billed charges,73.33,38.8,,,percent of total billed charges,38.8% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,189,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,73.33,189,
"GASTROSTOMY FEEDING TUBE, MIC 20Fr",52460,CDM,270,RC,,,OUTPATIENT,,,189,151.2,,141.75,75,,,percent of total billed charges,75% of total billed charges,75.6,40,,,percent of total billed charges,40% of total billed charges,149.69,79.2,,,percent of total billed charges,79.2% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,189,100,,,fee schedule,100% of CO APG rates,179.55,95,,,percent of total billed charges,95% of total billed charges,151.2,80,,,percent of total billed charges,80% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,170.1,90,,,percent of total billed charges,90% of total billed charges,189,100,,,fee schedule,100% of CO APG rates,189,100,,,fee schedule,100% of CO APG rates,189,100,,,fee schedule,100% of NM fee schedule,75.6,40,,,percent of total billed charges,40% of total billed charges,75.6,40,,,percent of total billed charges,40% of total billed charges,170.1,90,,,percent of total billed charges,90% of total billed charges,143.64,76,,,percent of total billed charges,76% of total billed charges,75.6,40,,,percent of total billed charges,40% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,189,100,,,fee schedule,100% of CO APG rate,151.2,80,,,percent of total billed charges,80% of total billed charges,73.33,38.8,,,percent of total billed charges,38.8% of total billed charges,160.65,85,,,percent of total billed charges,85% of total billed charges,189,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,73.33,189,
"GASTROSTOMY FEEDING TUBE, MIC 22Fr",52464,CDM,270,RC,,,OUTPATIENT,,,173.7,138.96,,130.28,75,,,percent of total billed charges,75% of total billed charges,69.48,40,,,percent of total billed charges,40% of total billed charges,137.57,79.2,,,percent of total billed charges,79.2% of total billed charges,147.65,85,,,percent of total billed charges,85% of total billed charges,173.7,100,,,fee schedule,100% of CO APG rates,165.02,95,,,percent of total billed charges,95% of total billed charges,138.96,80,,,percent of total billed charges,80% of total billed charges,147.65,85,,,percent of total billed charges,85% of total billed charges,156.33,90,,,percent of total billed charges,90% of total billed charges,173.7,100,,,fee schedule,100% of CO APG rates,173.7,100,,,fee schedule,100% of CO APG rates,173.7,100,,,fee schedule,100% of NM fee schedule,69.48,40,,,percent of total billed charges,40% of total billed charges,69.48,40,,,percent of total billed charges,40% of total billed charges,156.33,90,,,percent of total billed charges,90% of total billed charges,132.01,76,,,percent of total billed charges,76% of total billed charges,69.48,40,,,percent of total billed charges,40% of total billed charges,147.65,85,,,percent of total billed charges,85% of total billed charges,173.7,100,,,fee schedule,100% of CO APG rate,138.96,80,,,percent of total billed charges,80% of total billed charges,67.4,38.8,,,percent of total billed charges,38.8% of total billed charges,147.65,85,,,percent of total billed charges,85% of total billed charges,173.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,67.4,173.7,
"GASTROSTOMY FEEDING TUBE, MIC 24Fr",52467,CDM,270,RC,,,OUTPATIENT,,,173.7,138.96,,130.28,75,,,percent of total billed charges,75% of total billed charges,69.48,40,,,percent of total billed charges,40% of total billed charges,137.57,79.2,,,percent of total billed charges,79.2% of total billed charges,147.65,85,,,percent of total billed charges,85% of total billed charges,173.7,100,,,fee schedule,100% of CO APG rates,165.02,95,,,percent of total billed charges,95% of total billed charges,138.96,80,,,percent of total billed charges,80% of total billed charges,147.65,85,,,percent of total billed charges,85% of total billed charges,156.33,90,,,percent of total billed charges,90% of total billed charges,173.7,100,,,fee schedule,100% of CO APG rates,173.7,100,,,fee schedule,100% of CO APG rates,173.7,100,,,fee schedule,100% of NM fee schedule,69.48,40,,,percent of total billed charges,40% of total billed charges,69.48,40,,,percent of total billed charges,40% of total billed charges,156.33,90,,,percent of total billed charges,90% of total billed charges,132.01,76,,,percent of total billed charges,76% of total billed charges,69.48,40,,,percent of total billed charges,40% of total billed charges,147.65,85,,,percent of total billed charges,85% of total billed charges,173.7,100,,,fee schedule,100% of CO APG rate,138.96,80,,,percent of total billed charges,80% of total billed charges,67.4,38.8,,,percent of total billed charges,38.8% of total billed charges,147.65,85,,,percent of total billed charges,85% of total billed charges,173.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,67.4,173.7,
SCORPION MULTIFIRE NEEDLE,46052905,CDM,270,RC,,,OUTPATIENT,,,785.27,628.216,,588.95,75,,,percent of total billed charges,75% of total billed charges,314.11,40,,,percent of total billed charges,40% of total billed charges,621.93,79.2,,,percent of total billed charges,79.2% of total billed charges,667.48,85,,,percent of total billed charges,85% of total billed charges,785.27,100,,,fee schedule,100% of CO APG rates,746.01,95,,,percent of total billed charges,95% of total billed charges,628.22,80,,,percent of total billed charges,80% of total billed charges,667.48,85,,,percent of total billed charges,85% of total billed charges,706.74,90,,,percent of total billed charges,90% of total billed charges,785.27,100,,,fee schedule,100% of CO APG rates,785.27,100,,,fee schedule,100% of CO APG rates,785.27,100,,,fee schedule,100% of NM fee schedule,314.11,40,,,percent of total billed charges,40% of total billed charges,314.11,40,,,percent of total billed charges,40% of total billed charges,706.74,90,,,percent of total billed charges,90% of total billed charges,596.81,76,,,percent of total billed charges,76% of total billed charges,314.11,40,,,percent of total billed charges,40% of total billed charges,667.48,85,,,percent of total billed charges,85% of total billed charges,785.27,100,,,fee schedule,100% of CO APG rate,628.22,80,,,percent of total billed charges,80% of total billed charges,304.68,38.8,,,percent of total billed charges,38.8% of total billed charges,667.48,85,,,percent of total billed charges,85% of total billed charges,785.27,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,304.68,785.27,
"SILICONE FOAM DRESSING, MEPILEX BORDER, 6.2x7.9, SACRAL",52906,CDM,270,RC,,,OUTPATIENT,,,50.2,40.16,,37.65,75,,,percent of total billed charges,75% of total billed charges,20.08,40,,,percent of total billed charges,40% of total billed charges,39.76,79.2,,,percent of total billed charges,79.2% of total billed charges,42.67,85,,,percent of total billed charges,85% of total billed charges,50.2,100,,,fee schedule,100% of CO APG rates,47.69,95,,,percent of total billed charges,95% of total billed charges,40.16,80,,,percent of total billed charges,80% of total billed charges,42.67,85,,,percent of total billed charges,85% of total billed charges,45.18,90,,,percent of total billed charges,90% of total billed charges,50.2,100,,,fee schedule,100% of CO APG rates,50.2,100,,,fee schedule,100% of CO APG rates,50.2,100,,,fee schedule,100% of NM fee schedule,20.08,40,,,percent of total billed charges,40% of total billed charges,20.08,40,,,percent of total billed charges,40% of total billed charges,45.18,90,,,percent of total billed charges,90% of total billed charges,38.15,76,,,percent of total billed charges,76% of total billed charges,20.08,40,,,percent of total billed charges,40% of total billed charges,42.67,85,,,percent of total billed charges,85% of total billed charges,50.2,100,,,fee schedule,100% of CO APG rate,40.16,80,,,percent of total billed charges,80% of total billed charges,19.48,38.8,,,percent of total billed charges,38.8% of total billed charges,42.67,85,,,percent of total billed charges,85% of total billed charges,50.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,19.48,50.2,
LACERATION PREP BUNDLE,31052907,CDM,270,RC,,,OUTPATIENT,,,71.5,57.2,,53.63,75,,,percent of total billed charges,75% of total billed charges,28.6,40,,,percent of total billed charges,40% of total billed charges,56.63,79.2,,,percent of total billed charges,79.2% of total billed charges,60.78,85,,,percent of total billed charges,85% of total billed charges,71.5,100,,,fee schedule,100% of CO APG rates,67.93,95,,,percent of total billed charges,95% of total billed charges,57.2,80,,,percent of total billed charges,80% of total billed charges,60.78,85,,,percent of total billed charges,85% of total billed charges,64.35,90,,,percent of total billed charges,90% of total billed charges,71.5,100,,,fee schedule,100% of CO APG rates,71.5,100,,,fee schedule,100% of CO APG rates,71.5,100,,,fee schedule,100% of NM fee schedule,28.6,40,,,percent of total billed charges,40% of total billed charges,28.6,40,,,percent of total billed charges,40% of total billed charges,64.35,90,,,percent of total billed charges,90% of total billed charges,54.34,76,,,percent of total billed charges,76% of total billed charges,28.6,40,,,percent of total billed charges,40% of total billed charges,60.78,85,,,percent of total billed charges,85% of total billed charges,71.5,100,,,fee schedule,100% of CO APG rate,57.2,80,,,percent of total billed charges,80% of total billed charges,27.74,38.8,,,percent of total billed charges,38.8% of total billed charges,60.78,85,,,percent of total billed charges,85% of total billed charges,71.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,27.74,71.5,
"POWER PICC LINE, DOUBLE LUMEN, 5FR",52908,CDM,270,RC,,,OUTPATIENT,,,370.2,296.16,,277.65,75,,,percent of total billed charges,75% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,293.2,79.2,,,percent of total billed charges,79.2% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,370.2,100,,,fee schedule,100% of CO APG rates,351.69,95,,,percent of total billed charges,95% of total billed charges,296.16,80,,,percent of total billed charges,80% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,370.2,100,,,fee schedule,100% of CO APG rates,370.2,100,,,fee schedule,100% of CO APG rates,370.2,100,,,fee schedule,100% of NM fee schedule,148.08,40,,,percent of total billed charges,40% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,333.18,90,,,percent of total billed charges,90% of total billed charges,281.35,76,,,percent of total billed charges,76% of total billed charges,148.08,40,,,percent of total billed charges,40% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,370.2,100,,,fee schedule,100% of CO APG rate,296.16,80,,,percent of total billed charges,80% of total billed charges,143.64,38.8,,,percent of total billed charges,38.8% of total billed charges,314.67,85,,,percent of total billed charges,85% of total billed charges,370.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,143.64,370.2,
"BALLOON SEEKER, 70 DEGREE FRT, 5 x 17mm",46052892,CDM,270,RC,,,OUTPATIENT,,,1997.1,1597.68,,1497.83,75,,,percent of total billed charges,75% of total billed charges,798.84,40,,,percent of total billed charges,40% of total billed charges,1581.7,79.2,,,percent of total billed charges,79.2% of total billed charges,1697.54,85,,,percent of total billed charges,85% of total billed charges,1997.1,100,,,fee schedule,100% of CO APG rates,1897.25,95,,,percent of total billed charges,95% of total billed charges,1597.68,80,,,percent of total billed charges,80% of total billed charges,1697.54,85,,,percent of total billed charges,85% of total billed charges,1797.39,90,,,percent of total billed charges,90% of total billed charges,1997.1,100,,,fee schedule,100% of CO APG rates,1997.1,100,,,fee schedule,100% of CO APG rates,1997.1,100,,,fee schedule,100% of NM fee schedule,798.84,40,,,percent of total billed charges,40% of total billed charges,798.84,40,,,percent of total billed charges,40% of total billed charges,1797.39,90,,,percent of total billed charges,90% of total billed charges,1517.8,76,,,percent of total billed charges,76% of total billed charges,798.84,40,,,percent of total billed charges,40% of total billed charges,1697.54,85,,,percent of total billed charges,85% of total billed charges,1997.1,100,,,fee schedule,100% of CO APG rate,1597.68,80,,,percent of total billed charges,80% of total billed charges,774.87,38.8,,,percent of total billed charges,38.8% of total billed charges,1697.54,85,,,percent of total billed charges,85% of total billed charges,1997.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,774.87,1997.1,
"GRACILIS TENDON GRAFT, DOUBLE STRAND, ALLOGRAFT",46052893,CDM,278,RC,,,OUTPATIENT,,,5772,4617.6,,4329,75,,,percent of total billed charges,75% of total billed charges,2308.8,40,,,percent of total billed charges,40% of total billed charges,4571.42,79.2,,,percent of total billed charges,79.2% of total billed charges,4906.2,85,,,percent of total billed charges,85% of total billed charges,5772,100,,,fee schedule,100% of CO APG rates,5483.4,95,,,percent of total billed charges,95% of total billed charges,4617.6,80,,,percent of total billed charges,80% of total billed charges,4906.2,85,,,percent of total billed charges,85% of total billed charges,5194.8,90,,,percent of total billed charges,90% of total billed charges,5772,100,,,fee schedule,100% of CO APG rates,5772,100,,,fee schedule,100% of CO APG rates,5772,100,,,fee schedule,100% of NM fee schedule,2308.8,40,,,percent of total billed charges,40% of total billed charges,2308.8,40,,,percent of total billed charges,40% of total billed charges,5194.8,90,,,percent of total billed charges,90% of total billed charges,4386.72,76,,,percent of total billed charges,76% of total billed charges,2308.8,40,,,percent of total billed charges,40% of total billed charges,4906.2,85,,,percent of total billed charges,85% of total billed charges,5772,100,,,fee schedule,100% of CO APG rate,4617.6,80,,,percent of total billed charges,80% of total billed charges,2239.54,38.8,,,percent of total billed charges,38.8% of total billed charges,4906.2,85,,,percent of total billed charges,85% of total billed charges,5772,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2239.54,5772,
"EAR VENTILATION TUBE, REUTER BOBBIN, 1.14 mm ID",46052895,CDM,278,RC,,,OUTPATIENT,,,66.2,52.96,,49.65,75,,,percent of total billed charges,75% of total billed charges,26.48,40,,,percent of total billed charges,40% of total billed charges,52.43,79.2,,,percent of total billed charges,79.2% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,66.2,100,,,fee schedule,100% of CO APG rates,62.89,95,,,percent of total billed charges,95% of total billed charges,52.96,80,,,percent of total billed charges,80% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,59.58,90,,,percent of total billed charges,90% of total billed charges,66.2,100,,,fee schedule,100% of CO APG rates,66.2,100,,,fee schedule,100% of CO APG rates,66.2,100,,,fee schedule,100% of NM fee schedule,26.48,40,,,percent of total billed charges,40% of total billed charges,26.48,40,,,percent of total billed charges,40% of total billed charges,59.58,90,,,percent of total billed charges,90% of total billed charges,50.31,76,,,percent of total billed charges,76% of total billed charges,26.48,40,,,percent of total billed charges,40% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,66.2,100,,,fee schedule,100% of CO APG rate,52.96,80,,,percent of total billed charges,80% of total billed charges,25.69,38.8,,,percent of total billed charges,38.8% of total billed charges,56.27,85,,,percent of total billed charges,85% of total billed charges,66.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,25.69,66.2,
"QUICKCLOT COMBAT GAUZE, X-RAY DETECTABLE",52896,CDM,270,RC,,,OUTPATIENT,,,193.4,154.72,,145.05,75,,,percent of total billed charges,75% of total billed charges,77.36,40,,,percent of total billed charges,40% of total billed charges,153.17,79.2,,,percent of total billed charges,79.2% of total billed charges,164.39,85,,,percent of total billed charges,85% of total billed charges,193.4,100,,,fee schedule,100% of CO APG rates,183.73,95,,,percent of total billed charges,95% of total billed charges,154.72,80,,,percent of total billed charges,80% of total billed charges,164.39,85,,,percent of total billed charges,85% of total billed charges,174.06,90,,,percent of total billed charges,90% of total billed charges,193.4,100,,,fee schedule,100% of CO APG rates,193.4,100,,,fee schedule,100% of CO APG rates,193.4,100,,,fee schedule,100% of NM fee schedule,77.36,40,,,percent of total billed charges,40% of total billed charges,77.36,40,,,percent of total billed charges,40% of total billed charges,174.06,90,,,percent of total billed charges,90% of total billed charges,146.98,76,,,percent of total billed charges,76% of total billed charges,77.36,40,,,percent of total billed charges,40% of total billed charges,164.39,85,,,percent of total billed charges,85% of total billed charges,193.4,100,,,fee schedule,100% of CO APG rate,154.72,80,,,percent of total billed charges,80% of total billed charges,75.04,38.8,,,percent of total billed charges,38.8% of total billed charges,164.39,85,,,percent of total billed charges,85% of total billed charges,193.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,75.04,193.4,
HPV,40087624,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,157.6,126.08,,118.2,75,,,percent of total billed charges,75% of total billed charges,63.04,40,,,percent of total billed charges,40% of total billed charges,124.82,79.2,,,percent of total billed charges,79.2% of total billed charges,133.96,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,149.72,95,,,percent of total billed charges,95% of total billed charges,126.08,80,,,percent of total billed charges,80% of total billed charges,133.96,85,,,percent of total billed charges,85% of total billed charges,141.84,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,63.04,40,,,percent of total billed charges,40% of total billed charges,63.04,40,,,percent of total billed charges,40% of total billed charges,141.84,90,,,percent of total billed charges,90% of total billed charges,119.78,76,,,percent of total billed charges,76% of total billed charges,63.04,40,,,percent of total billed charges,40% of total billed charges,133.96,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,126.08,80,,,percent of total billed charges,80% of total billed charges,61.15,38.8,,,percent of total billed charges,38.8% of total billed charges,133.96,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,149.72,
CT,40087491,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
Trich,40087661,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,90.2,72.16,,67.65,75,,,percent of total billed charges,75% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,71.44,79.2,,,percent of total billed charges,79.2% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,85.69,95,,,percent of total billed charges,95% of total billed charges,72.16,80,,,percent of total billed charges,80% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,36.08,40,,,percent of total billed charges,40% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,81.18,90,,,percent of total billed charges,90% of total billed charges,68.55,76,,,percent of total billed charges,76% of total billed charges,36.08,40,,,percent of total billed charges,40% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,72.16,80,,,percent of total billed charges,80% of total billed charges,35,38.8,,,percent of total billed charges,38.8% of total billed charges,76.67,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,85.69,
NG,40087591,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,89.3,71.44,,66.98,75,,,percent of total billed charges,75% of total billed charges,35.72,40,,,percent of total billed charges,40% of total billed charges,70.73,79.2,,,percent of total billed charges,79.2% of total billed charges,75.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,84.84,95,,,percent of total billed charges,95% of total billed charges,71.44,80,,,percent of total billed charges,80% of total billed charges,75.91,85,,,percent of total billed charges,85% of total billed charges,80.37,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,35.72,40,,,percent of total billed charges,40% of total billed charges,35.72,40,,,percent of total billed charges,40% of total billed charges,80.37,90,,,percent of total billed charges,90% of total billed charges,67.87,76,,,percent of total billed charges,76% of total billed charges,35.72,40,,,percent of total billed charges,40% of total billed charges,75.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,71.44,80,,,percent of total billed charges,80% of total billed charges,34.65,38.8,,,percent of total billed charges,38.8% of total billed charges,75.91,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,84.84,
Strep A Screen by PCR,40087651,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,69,55.2,,51.75,75,,,percent of total billed charges,75% of total billed charges,27.6,40,,,percent of total billed charges,40% of total billed charges,54.65,79.2,,,percent of total billed charges,79.2% of total billed charges,58.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,65.55,95,,,percent of total billed charges,95% of total billed charges,55.2,80,,,percent of total billed charges,80% of total billed charges,58.65,85,,,percent of total billed charges,85% of total billed charges,62.1,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,27.6,40,,,percent of total billed charges,40% of total billed charges,27.6,40,,,percent of total billed charges,40% of total billed charges,62.1,90,,,percent of total billed charges,90% of total billed charges,52.44,76,,,percent of total billed charges,76% of total billed charges,27.6,40,,,percent of total billed charges,40% of total billed charges,58.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,55.2,80,,,percent of total billed charges,80% of total billed charges,26.77,38.8,,,percent of total billed charges,38.8% of total billed charges,58.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,65.55,
Influenza A/B by PCR,40087502,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,114.5,91.6,,85.88,75,,,percent of total billed charges,75% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,90.68,79.2,,,percent of total billed charges,79.2% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,108.78,95,,,percent of total billed charges,95% of total billed charges,91.6,80,,,percent of total billed charges,80% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,103.05,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,45.8,40,,,percent of total billed charges,40% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,103.05,90,,,percent of total billed charges,90% of total billed charges,87.02,76,,,percent of total billed charges,76% of total billed charges,45.8,40,,,percent of total billed charges,40% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,91.6,80,,,percent of total billed charges,80% of total billed charges,44.43,38.8,,,percent of total billed charges,38.8% of total billed charges,97.33,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,108.78,
"A0888 Noncovered ambulance mileage, per mile",60000490,CDM,540,RC,,,OUTPATIENT,,,14,11.2,,10.5,75,,,percent of total billed charges,75% of total billed charges,5.6,40,,,percent of total billed charges,40% of total billed charges,11.09,79.2,,,percent of total billed charges,79.2% of total billed charges,11.9,85,,,percent of total billed charges,85% of total billed charges,14,100,,,fee schedule,100% of CO APG rates,13.3,95,,,percent of total billed charges,95% of total billed charges,11.9,80,,,percent of total billed charges,80% of total billed charges,11.9,85,,,percent of total billed charges,85% of total billed charges,12.6,90,,,percent of total billed charges,90% of total billed charges,14,100,,,fee schedule,100% of CO APG rates,14,100,,,fee schedule,100% of CO APG rates,14,100,,,fee schedule,100% of NM fee schedule,5.6,40,,,percent of total billed charges,40% of total billed charges,5.6,40,,,percent of total billed charges,40% of total billed charges,12.6,90,,,percent of total billed charges,90% of total billed charges,10.64,76,,,percent of total billed charges,76% of total billed charges,5.6,40,,,percent of total billed charges,40% of total billed charges,11.9,85,,,percent of total billed charges,85% of total billed charges,14,100,,,fee schedule,100% of CO APG rate,11.2,80,,,percent of total billed charges,80% of total billed charges,5.43,38.8,,,percent of total billed charges,38.8% of total billed charges,11.9,85,,,percent of total billed charges,85% of total billed charges,14,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.43,14,
RSV POC ED,60000769,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,33.9,27.12,,25.43,75,,,percent of total billed charges,75% of total billed charges,13.56,40,,,percent of total billed charges,40% of total billed charges,26.85,79.2,,,percent of total billed charges,79.2% of total billed charges,28.82,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,32.21,95,,,percent of total billed charges,95% of total billed charges,27.12,80,,,percent of total billed charges,80% of total billed charges,28.82,85,,,percent of total billed charges,85% of total billed charges,30.51,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,13.56,40,,,percent of total billed charges,40% of total billed charges,13.56,40,,,percent of total billed charges,40% of total billed charges,30.51,90,,,percent of total billed charges,90% of total billed charges,25.76,76,,,percent of total billed charges,76% of total billed charges,13.56,40,,,percent of total billed charges,40% of total billed charges,28.82,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,27.12,80,,,percent of total billed charges,80% of total billed charges,13.15,38.8,,,percent of total billed charges,38.8% of total billed charges,28.82,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,33.06,
"64400 ANESTH Injection, trigeminal nerve, any division or br",60000500,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,1035.25,828.2,,776.44,75,,,percent of total billed charges,75% of total billed charges,414.1,40,,,percent of total billed charges,40% of total billed charges,819.92,79.2,,,percent of total billed charges,79.2% of total billed charges,879.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,983.49,95,,,percent of total billed charges,95% of total billed charges,828.2,80,,,percent of total billed charges,80% of total billed charges,879.96,85,,,percent of total billed charges,85% of total billed charges,931.73,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,414.1,40,,,percent of total billed charges,40% of total billed charges,414.1,40,,,percent of total billed charges,40% of total billed charges,931.73,90,,,percent of total billed charges,90% of total billed charges,786.79,76,,,percent of total billed charges,76% of total billed charges,414.1,40,,,percent of total billed charges,40% of total billed charges,879.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,828.2,80,,,percent of total billed charges,80% of total billed charges,401.68,38.8,,,percent of total billed charges,38.8% of total billed charges,879.96,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,983.49,
Misc Surgical Tech Charge for Multiple Procedures,60000659,CDM,360,RC,43215,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1260.54,100,,,fee schedule,100% of CO APG rates,1260.54,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1260.54,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1260.54,100,,,fee schedule,100% of APG fee schedule,0.02,,,,other,not separately reimbursable,0.02,1260.54,
VENTRALIGHT ST MESH W/ ECHO PS POSITIONING. 4.5in CIRCLE,46052911,CDM,278,RC,,,OUTPATIENT,,,1488.4,1190.72,,1116.3,75,,,percent of total billed charges,75% of total billed charges,595.36,40,,,percent of total billed charges,40% of total billed charges,1178.81,79.2,,,percent of total billed charges,79.2% of total billed charges,1265.14,85,,,percent of total billed charges,85% of total billed charges,1488.4,100,,,fee schedule,100% of CO APG rates,1413.98,95,,,percent of total billed charges,95% of total billed charges,1190.72,80,,,percent of total billed charges,80% of total billed charges,1265.14,85,,,percent of total billed charges,85% of total billed charges,1339.56,90,,,percent of total billed charges,90% of total billed charges,1488.4,100,,,fee schedule,100% of CO APG rates,1488.4,100,,,fee schedule,100% of CO APG rates,1488.4,100,,,fee schedule,100% of NM fee schedule,595.36,40,,,percent of total billed charges,40% of total billed charges,595.36,40,,,percent of total billed charges,40% of total billed charges,1339.56,90,,,percent of total billed charges,90% of total billed charges,1131.18,76,,,percent of total billed charges,76% of total billed charges,595.36,40,,,percent of total billed charges,40% of total billed charges,1265.14,85,,,percent of total billed charges,85% of total billed charges,1488.4,100,,,fee schedule,100% of CO APG rate,1190.72,80,,,percent of total billed charges,80% of total billed charges,577.5,38.8,,,percent of total billed charges,38.8% of total billed charges,1265.14,85,,,percent of total billed charges,85% of total billed charges,1488.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,577.5,1488.4,
VENTRALIGHT ST MESCH W/ ECHO PS POSITIONING. 4in x 6in ELLIP,46052912,CDM,278,RC,,,OUTPATIENT,,,1366.6,1093.28,,1024.95,75,,,percent of total billed charges,75% of total billed charges,546.64,40,,,percent of total billed charges,40% of total billed charges,1082.35,79.2,,,percent of total billed charges,79.2% of total billed charges,1161.61,85,,,percent of total billed charges,85% of total billed charges,1366.6,100,,,fee schedule,100% of CO APG rates,1298.27,95,,,percent of total billed charges,95% of total billed charges,1093.28,80,,,percent of total billed charges,80% of total billed charges,1161.61,85,,,percent of total billed charges,85% of total billed charges,1229.94,90,,,percent of total billed charges,90% of total billed charges,1366.6,100,,,fee schedule,100% of CO APG rates,1366.6,100,,,fee schedule,100% of CO APG rates,1366.6,100,,,fee schedule,100% of NM fee schedule,546.64,40,,,percent of total billed charges,40% of total billed charges,546.64,40,,,percent of total billed charges,40% of total billed charges,1229.94,90,,,percent of total billed charges,90% of total billed charges,1038.62,76,,,percent of total billed charges,76% of total billed charges,546.64,40,,,percent of total billed charges,40% of total billed charges,1161.61,85,,,percent of total billed charges,85% of total billed charges,1366.6,100,,,fee schedule,100% of CO APG rate,1093.28,80,,,percent of total billed charges,80% of total billed charges,530.24,38.8,,,percent of total billed charges,38.8% of total billed charges,1161.61,85,,,percent of total billed charges,85% of total billed charges,1366.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,530.24,1366.6,
ELECTRODE 8227411 PAIRED 4 CHANNEL SET,52897,CDM,270,RC,,,OUTPATIENT,,,348.4,278.72,,261.3,75,,,percent of total billed charges,75% of total billed charges,139.36,40,,,percent of total billed charges,40% of total billed charges,275.93,79.2,,,percent of total billed charges,79.2% of total billed charges,296.14,85,,,percent of total billed charges,85% of total billed charges,348.4,100,,,fee schedule,100% of CO APG rates,330.98,95,,,percent of total billed charges,95% of total billed charges,278.72,80,,,percent of total billed charges,80% of total billed charges,296.14,85,,,percent of total billed charges,85% of total billed charges,313.56,90,,,percent of total billed charges,90% of total billed charges,348.4,100,,,fee schedule,100% of CO APG rates,348.4,100,,,fee schedule,100% of CO APG rates,348.4,100,,,fee schedule,100% of NM fee schedule,139.36,40,,,percent of total billed charges,40% of total billed charges,139.36,40,,,percent of total billed charges,40% of total billed charges,313.56,90,,,percent of total billed charges,90% of total billed charges,264.78,76,,,percent of total billed charges,76% of total billed charges,139.36,40,,,percent of total billed charges,40% of total billed charges,296.14,85,,,percent of total billed charges,85% of total billed charges,348.4,100,,,fee schedule,100% of CO APG rate,278.72,80,,,percent of total billed charges,80% of total billed charges,135.18,38.8,,,percent of total billed charges,38.8% of total billed charges,296.14,85,,,percent of total billed charges,85% of total billed charges,348.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,135.18,348.4,
ELECTRODE 8227410 PAIRED 2 CHANNEL SET,52898,CDM,270,RC,,,OUTPATIENT,,,237.1,189.68,,177.83,75,,,percent of total billed charges,75% of total billed charges,94.84,40,,,percent of total billed charges,40% of total billed charges,187.78,79.2,,,percent of total billed charges,79.2% of total billed charges,201.54,85,,,percent of total billed charges,85% of total billed charges,237.1,100,,,fee schedule,100% of CO APG rates,225.25,95,,,percent of total billed charges,95% of total billed charges,189.68,80,,,percent of total billed charges,80% of total billed charges,201.54,85,,,percent of total billed charges,85% of total billed charges,213.39,90,,,percent of total billed charges,90% of total billed charges,237.1,100,,,fee schedule,100% of CO APG rates,237.1,100,,,fee schedule,100% of CO APG rates,237.1,100,,,fee schedule,100% of NM fee schedule,94.84,40,,,percent of total billed charges,40% of total billed charges,94.84,40,,,percent of total billed charges,40% of total billed charges,213.39,90,,,percent of total billed charges,90% of total billed charges,180.2,76,,,percent of total billed charges,76% of total billed charges,94.84,40,,,percent of total billed charges,40% of total billed charges,201.54,85,,,percent of total billed charges,85% of total billed charges,237.1,100,,,fee schedule,100% of CO APG rate,189.68,80,,,percent of total billed charges,80% of total billed charges,91.99,38.8,,,percent of total billed charges,38.8% of total billed charges,201.54,85,,,percent of total billed charges,85% of total billed charges,237.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,91.99,237.1,
77002 XR Fluoroscopic guidance for needle placement,60000520,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,694.2,555.36,,520.65,75,,,percent of total billed charges,75% of total billed charges,277.68,40,,,percent of total billed charges,40% of total billed charges,549.81,79.2,,,percent of total billed charges,79.2% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,659.49,95,,,percent of total billed charges,95% of total billed charges,555.36,80,,,percent of total billed charges,80% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,624.78,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,277.68,40,,,percent of total billed charges,40% of total billed charges,277.68,40,,,percent of total billed charges,40% of total billed charges,624.78,90,,,percent of total billed charges,90% of total billed charges,527.59,76,,,percent of total billed charges,76% of total billed charges,277.68,40,,,percent of total billed charges,40% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,555.36,80,,,percent of total billed charges,80% of total billed charges,269.35,38.8,,,percent of total billed charges,38.8% of total billed charges,590.07,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,659.49,
RSV by PCR,40087634,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,99.8,79.84,,74.85,75,,,percent of total billed charges,75% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,79.04,79.2,,,percent of total billed charges,79.2% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,94.81,95,,,percent of total billed charges,95% of total billed charges,79.84,80,,,percent of total billed charges,80% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,89.82,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,39.92,40,,,percent of total billed charges,40% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,89.82,90,,,percent of total billed charges,90% of total billed charges,75.85,76,,,percent of total billed charges,76% of total billed charges,39.92,40,,,percent of total billed charges,40% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,79.84,80,,,percent of total billed charges,80% of total billed charges,38.72,38.8,,,percent of total billed charges,38.8% of total billed charges,84.83,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,94.81,
"11900 Injection, Intralesional; Up To And Including 7 Lesion",60000521,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,691.6,553.28,,518.7,75,,,percent of total billed charges,75% of total billed charges,276.64,40,,,percent of total billed charges,40% of total billed charges,547.75,79.2,,,percent of total billed charges,79.2% of total billed charges,587.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,657.02,95,,,percent of total billed charges,95% of total billed charges,553.28,80,,,percent of total billed charges,80% of total billed charges,587.86,85,,,percent of total billed charges,85% of total billed charges,622.44,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,276.64,40,,,percent of total billed charges,40% of total billed charges,276.64,40,,,percent of total billed charges,40% of total billed charges,622.44,90,,,percent of total billed charges,90% of total billed charges,525.62,76,,,percent of total billed charges,76% of total billed charges,276.64,40,,,percent of total billed charges,40% of total billed charges,587.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,553.28,80,,,percent of total billed charges,80% of total billed charges,268.34,38.8,,,percent of total billed charges,38.8% of total billed charges,587.86,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,657.02,
"WAYNE PNEUMOTHORAX CATHETER SET/ TRAY, 14 Fr, 18GA X 29CM",41052913,CDM,278,RC,,,OUTPATIENT,,,845.06,676.048,,633.8,75,,,percent of total billed charges,75% of total billed charges,338.02,40,,,percent of total billed charges,40% of total billed charges,669.29,79.2,,,percent of total billed charges,79.2% of total billed charges,718.3,85,,,percent of total billed charges,85% of total billed charges,845.06,100,,,fee schedule,100% of CO APG rates,802.81,95,,,percent of total billed charges,95% of total billed charges,676.05,80,,,percent of total billed charges,80% of total billed charges,718.3,85,,,percent of total billed charges,85% of total billed charges,760.55,90,,,percent of total billed charges,90% of total billed charges,845.06,100,,,fee schedule,100% of CO APG rates,845.06,100,,,fee schedule,100% of CO APG rates,845.06,100,,,fee schedule,100% of NM fee schedule,338.02,40,,,percent of total billed charges,40% of total billed charges,338.02,40,,,percent of total billed charges,40% of total billed charges,760.55,90,,,percent of total billed charges,90% of total billed charges,642.25,76,,,percent of total billed charges,76% of total billed charges,338.02,40,,,percent of total billed charges,40% of total billed charges,718.3,85,,,percent of total billed charges,85% of total billed charges,845.06,100,,,fee schedule,100% of CO APG rate,676.05,80,,,percent of total billed charges,80% of total billed charges,327.88,38.8,,,percent of total billed charges,38.8% of total billed charges,718.3,85,,,percent of total billed charges,85% of total billed charges,845.06,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,327.88,845.06,
"MARQUEE DISPOSABLE CORE BIOPSY INSTRUMENT KIT, 20g x 10cm",41052914,CDM,270,RC,,,OUTPATIENT,,,307.1,245.68,,230.33,75,,,percent of total billed charges,75% of total billed charges,122.84,40,,,percent of total billed charges,40% of total billed charges,243.22,79.2,,,percent of total billed charges,79.2% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,307.1,100,,,fee schedule,100% of CO APG rates,291.75,95,,,percent of total billed charges,95% of total billed charges,245.68,80,,,percent of total billed charges,80% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,276.39,90,,,percent of total billed charges,90% of total billed charges,307.1,100,,,fee schedule,100% of CO APG rates,307.1,100,,,fee schedule,100% of CO APG rates,307.1,100,,,fee schedule,100% of NM fee schedule,122.84,40,,,percent of total billed charges,40% of total billed charges,122.84,40,,,percent of total billed charges,40% of total billed charges,276.39,90,,,percent of total billed charges,90% of total billed charges,233.4,76,,,percent of total billed charges,76% of total billed charges,122.84,40,,,percent of total billed charges,40% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,307.1,100,,,fee schedule,100% of CO APG rate,245.68,80,,,percent of total billed charges,80% of total billed charges,119.15,38.8,,,percent of total billed charges,38.8% of total billed charges,261.04,85,,,percent of total billed charges,85% of total billed charges,307.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,119.15,307.1,
BONE MARROW TRAY,42952717,CDM,272,RC,,,OUTPATIENT,,,105,84,,78.75,75,,,percent of total billed charges,75% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,83.16,79.2,,,percent of total billed charges,79.2% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,105,100,,,fee schedule,100% of CO APG rates,99.75,95,,,percent of total billed charges,95% of total billed charges,84,80,,,percent of total billed charges,80% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,105,100,,,fee schedule,100% of CO APG rates,105,100,,,fee schedule,100% of CO APG rates,105,100,,,fee schedule,100% of NM fee schedule,42,40,,,percent of total billed charges,40% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,94.5,90,,,percent of total billed charges,90% of total billed charges,79.8,76,,,percent of total billed charges,76% of total billed charges,42,40,,,percent of total billed charges,40% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,105,100,,,fee schedule,100% of CO APG rate,84,80,,,percent of total billed charges,80% of total billed charges,40.74,38.8,,,percent of total billed charges,38.8% of total billed charges,89.25,85,,,percent of total billed charges,85% of total billed charges,105,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,40.74,105,
Glucose Tolerance 3 hr Gest Diabetes,40082951,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,145.6,116.48,,109.2,75,,,percent of total billed charges,75% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,115.32,79.2,,,percent of total billed charges,79.2% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,138.32,95,,,percent of total billed charges,95% of total billed charges,116.48,80,,,percent of total billed charges,80% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,58.24,40,,,percent of total billed charges,40% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,131.04,90,,,percent of total billed charges,90% of total billed charges,110.66,76,,,percent of total billed charges,76% of total billed charges,58.24,40,,,percent of total billed charges,40% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,116.48,80,,,percent of total billed charges,80% of total billed charges,56.49,38.8,,,percent of total billed charges,38.8% of total billed charges,123.76,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,138.32,
G0498 Chemo extend iv infus w/pump,60000552,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,1060.2,848.16,,795.15,75,,,percent of total billed charges,75% of total billed charges,424.08,40,,,percent of total billed charges,40% of total billed charges,839.68,79.2,,,percent of total billed charges,79.2% of total billed charges,901.17,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,1007.19,95,,,percent of total billed charges,95% of total billed charges,848.16,80,,,percent of total billed charges,80% of total billed charges,901.17,85,,,percent of total billed charges,85% of total billed charges,954.18,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,424.08,40,,,percent of total billed charges,40% of total billed charges,424.08,40,,,percent of total billed charges,40% of total billed charges,954.18,90,,,percent of total billed charges,90% of total billed charges,805.75,76,,,percent of total billed charges,76% of total billed charges,424.08,40,,,percent of total billed charges,40% of total billed charges,901.17,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,848.16,80,,,percent of total billed charges,80% of total billed charges,411.36,38.8,,,percent of total billed charges,38.8% of total billed charges,901.17,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,1007.19,
"36400 Venipuncture, Younger 3 Years, Nec Skill Of A Physicia",60000538,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,407.7,326.16,,305.78,75,,,percent of total billed charges,75% of total billed charges,163.08,40,,,percent of total billed charges,40% of total billed charges,322.9,79.2,,,percent of total billed charges,79.2% of total billed charges,346.55,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,387.32,95,,,percent of total billed charges,95% of total billed charges,326.16,80,,,percent of total billed charges,80% of total billed charges,346.55,85,,,percent of total billed charges,85% of total billed charges,366.93,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,163.08,40,,,percent of total billed charges,40% of total billed charges,163.08,40,,,percent of total billed charges,40% of total billed charges,366.93,90,,,percent of total billed charges,90% of total billed charges,309.85,76,,,percent of total billed charges,76% of total billed charges,163.08,40,,,percent of total billed charges,40% of total billed charges,346.55,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,326.16,80,,,percent of total billed charges,80% of total billed charges,158.19,38.8,,,percent of total billed charges,38.8% of total billed charges,346.55,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,158.19,387.32,
"36410 Venipuncture, 3 Or Older",60000539,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,136.2,108.96,,102.15,75,,,percent of total billed charges,75% of total billed charges,54.48,40,,,percent of total billed charges,40% of total billed charges,107.87,79.2,,,percent of total billed charges,79.2% of total billed charges,115.77,85,,,percent of total billed charges,85% of total billed charges,136.2,100,,,fee schedule,100% of CO APG rates,129.39,95,,,percent of total billed charges,95% of total billed charges,108.96,80,,,percent of total billed charges,80% of total billed charges,115.77,85,,,percent of total billed charges,85% of total billed charges,122.58,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,136.2,100,,,fee schedule,100% of NM APC rate,54.48,40,,,percent of total billed charges,40% of total billed charges,54.48,40,,,percent of total billed charges,40% of total billed charges,122.58,90,,,percent of total billed charges,90% of total billed charges,103.51,76,,,percent of total billed charges,76% of total billed charges,54.48,40,,,percent of total billed charges,40% of total billed charges,115.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,108.96,80,,,percent of total billed charges,80% of total billed charges,52.85,38.8,,,percent of total billed charges,38.8% of total billed charges,115.77,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,52.85,217.66,
"36573 Insertion of PICC, w/o subq port or pump, inc image gu",60000540,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4141.3,3313.04,,3105.98,75,,,percent of total billed charges,75% of total billed charges,1656.52,40,,,percent of total billed charges,40% of total billed charges,3279.91,79.2,,,percent of total billed charges,79.2% of total billed charges,3520.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,3934.24,95,,,percent of total billed charges,95% of total billed charges,3313.04,80,,,percent of total billed charges,80% of total billed charges,3520.11,85,,,percent of total billed charges,85% of total billed charges,3727.17,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1656.52,40,,,percent of total billed charges,40% of total billed charges,1656.52,40,,,percent of total billed charges,40% of total billed charges,3727.17,90,,,percent of total billed charges,90% of total billed charges,3147.39,76,,,percent of total billed charges,76% of total billed charges,1656.52,40,,,percent of total billed charges,40% of total billed charges,3520.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3313.04,80,,,percent of total billed charges,80% of total billed charges,1606.82,38.8,,,percent of total billed charges,38.8% of total billed charges,3520.11,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,3934.24,
"36584 Replacement, Complete, Of A PICC, Without Subcutaneous",60000541,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,4380.5,3504.4,,3285.38,75,,,percent of total billed charges,75% of total billed charges,1752.2,40,,,percent of total billed charges,40% of total billed charges,3050,79.2,,,percent of total billed charges,79.2% of total billed charges,3723.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4161.48,95,,,percent of total billed charges,95% of total billed charges,3504.4,80,,,percent of total billed charges,80% of total billed charges,3723.43,85,,,percent of total billed charges,85% of total billed charges,3942.45,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,373.07,100,,,fee schedule,100% of NM APC rate,1752.2,40,,,percent of total billed charges,40% of total billed charges,1752.2,40,,,percent of total billed charges,40% of total billed charges,3942.45,90,,,percent of total billed charges,90% of total billed charges,3329.18,76,,,percent of total billed charges,76% of total billed charges,1752.2,40,,,percent of total billed charges,40% of total billed charges,3723.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3504.4,80,,,percent of total billed charges,80% of total billed charges,1699.63,38.8,,,percent of total billed charges,38.8% of total billed charges,3723.43,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,4161.48,
"36585 Replacement, Complete, Of A PICC, With Subcu",60000542,CDM,361,RC,10160,HCPCS,OUTPATIENT,,,10579.9,8463.92,,7934.93,75,,,percent of total billed charges,75% of total billed charges,4231.96,40,,,percent of total billed charges,40% of total billed charges,3050,79.2,,,percent of total billed charges,79.2% of total billed charges,8992.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,10050.91,95,,,percent of total billed charges,95% of total billed charges,8463.92,80,,,percent of total billed charges,80% of total billed charges,8992.92,85,,,percent of total billed charges,85% of total billed charges,9521.91,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,5336.59,100,,,fee schedule,100% of NM APC rate,4231.96,40,,,percent of total billed charges,40% of total billed charges,4231.96,40,,,percent of total billed charges,40% of total billed charges,9521.91,90,,,percent of total billed charges,90% of total billed charges,8040.72,76,,,percent of total billed charges,76% of total billed charges,4231.96,40,,,percent of total billed charges,40% of total billed charges,8992.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,8463.92,80,,,percent of total billed charges,80% of total billed charges,4105,38.8,,,percent of total billed charges,38.8% of total billed charges,8992.92,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,198.22,200,,,fee schedule,200% of CMS fee schedule,198.22,10050.91,
46614 Anoscopy; With Control Of Bleeding,60000544,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,3537,2829.6,,2652.75,75,,,percent of total billed charges,75% of total billed charges,1414.8,40,,,percent of total billed charges,40% of total billed charges,2801.3,79.2,,,percent of total billed charges,79.2% of total billed charges,3006.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,3360.15,95,,,percent of total billed charges,95% of total billed charges,2829.6,80,,,percent of total billed charges,80% of total billed charges,3006.45,85,,,percent of total billed charges,85% of total billed charges,3183.3,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1414.8,40,,,percent of total billed charges,40% of total billed charges,1414.8,40,,,percent of total billed charges,40% of total billed charges,3183.3,90,,,percent of total billed charges,90% of total billed charges,2688.12,76,,,percent of total billed charges,76% of total billed charges,1414.8,40,,,percent of total billed charges,40% of total billed charges,3006.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,2829.6,80,,,percent of total billed charges,80% of total billed charges,1372.36,38.8,,,percent of total billed charges,38.8% of total billed charges,3006.45,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,3360.15,
"96372 Therapeutic, prophylactic, or diagnostic injection, su",49196372,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,108,86.4,,81,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,85.54,79.2,,,percent of total billed charges,79.2% of total billed charges,91.8,85,,,percent of total billed charges,85% of total billed charges,108,100,,,fee schedule,100% of CO APG rates,102.6,95,,,percent of total billed charges,95% of total billed charges,86.4,80,,,percent of total billed charges,80% of total billed charges,91.8,85,,,percent of total billed charges,85% of total billed charges,97.2,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,108,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,97.2,90,,,percent of total billed charges,90% of total billed charges,82.08,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,91.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,86.4,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,91.8,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,598.2,100,,,case rate,pays based on per visit rate,81,598.2,
"SUTURE 10-0 ETHILON CS160-6, 9000G",52915,CDM,270,RC,,,OUTPATIENT,,,55.6,44.48,,41.7,75,,,percent of total billed charges,75% of total billed charges,22.24,40,,,percent of total billed charges,40% of total billed charges,44.04,79.2,,,percent of total billed charges,79.2% of total billed charges,47.26,85,,,percent of total billed charges,85% of total billed charges,55.6,100,,,fee schedule,100% of CO APG rates,52.82,95,,,percent of total billed charges,95% of total billed charges,44.48,80,,,percent of total billed charges,80% of total billed charges,47.26,85,,,percent of total billed charges,85% of total billed charges,50.04,90,,,percent of total billed charges,90% of total billed charges,55.6,100,,,fee schedule,100% of CO APG rates,55.6,100,,,fee schedule,100% of CO APG rates,55.6,100,,,fee schedule,100% of NM fee schedule,22.24,40,,,percent of total billed charges,40% of total billed charges,22.24,40,,,percent of total billed charges,40% of total billed charges,50.04,90,,,percent of total billed charges,90% of total billed charges,42.26,76,,,percent of total billed charges,76% of total billed charges,22.24,40,,,percent of total billed charges,40% of total billed charges,47.26,85,,,percent of total billed charges,85% of total billed charges,55.6,100,,,fee schedule,100% of CO APG rate,44.48,80,,,percent of total billed charges,80% of total billed charges,21.57,38.8,,,percent of total billed charges,38.8% of total billed charges,47.26,85,,,percent of total billed charges,85% of total billed charges,55.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,21.57,55.6,
BARD MARQUEE BIOPSY 14X13,52714,CDM,270,RC,,,OUTPATIENT,,,270.9,216.72,,203.18,75,,,percent of total billed charges,75% of total billed charges,108.36,40,,,percent of total billed charges,40% of total billed charges,214.55,79.2,,,percent of total billed charges,79.2% of total billed charges,230.27,85,,,percent of total billed charges,85% of total billed charges,270.9,100,,,fee schedule,100% of CO APG rates,257.36,95,,,percent of total billed charges,95% of total billed charges,216.72,80,,,percent of total billed charges,80% of total billed charges,230.27,85,,,percent of total billed charges,85% of total billed charges,243.81,90,,,percent of total billed charges,90% of total billed charges,270.9,100,,,fee schedule,100% of CO APG rates,270.9,100,,,fee schedule,100% of CO APG rates,270.9,100,,,fee schedule,100% of NM fee schedule,108.36,40,,,percent of total billed charges,40% of total billed charges,108.36,40,,,percent of total billed charges,40% of total billed charges,243.81,90,,,percent of total billed charges,90% of total billed charges,205.88,76,,,percent of total billed charges,76% of total billed charges,108.36,40,,,percent of total billed charges,40% of total billed charges,230.27,85,,,percent of total billed charges,85% of total billed charges,270.9,100,,,fee schedule,100% of CO APG rate,216.72,80,,,percent of total billed charges,80% of total billed charges,105.11,38.8,,,percent of total billed charges,38.8% of total billed charges,230.27,85,,,percent of total billed charges,85% of total billed charges,270.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,105.11,270.9,
Epstein-Barr Virus (EBV) Antibody Profile LC,40087798,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,105.4,84.32,,79.05,75,,,percent of total billed charges,75% of total billed charges,42.16,40,,,percent of total billed charges,40% of total billed charges,83.48,79.2,,,percent of total billed charges,79.2% of total billed charges,89.59,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,100.13,95,,,percent of total billed charges,95% of total billed charges,84.32,80,,,percent of total billed charges,80% of total billed charges,89.59,85,,,percent of total billed charges,85% of total billed charges,94.86,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,42.16,40,,,percent of total billed charges,40% of total billed charges,42.16,40,,,percent of total billed charges,40% of total billed charges,94.86,90,,,percent of total billed charges,90% of total billed charges,80.1,76,,,percent of total billed charges,76% of total billed charges,42.16,40,,,percent of total billed charges,40% of total billed charges,89.59,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,84.32,80,,,percent of total billed charges,80% of total billed charges,40.9,38.8,,,percent of total billed charges,38.8% of total billed charges,89.59,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,100.13,
INDWELLING CATHETER TRAY/ TEMPERATURE SENSING 16Fr 5cc SILIC,52899,CDM,270,RC,,,OUTPATIENT,,,164.8,131.84,,123.6,75,,,percent of total billed charges,75% of total billed charges,65.92,40,,,percent of total billed charges,40% of total billed charges,130.52,79.2,,,percent of total billed charges,79.2% of total billed charges,140.08,85,,,percent of total billed charges,85% of total billed charges,164.8,100,,,fee schedule,100% of CO APG rates,156.56,95,,,percent of total billed charges,95% of total billed charges,131.84,80,,,percent of total billed charges,80% of total billed charges,140.08,85,,,percent of total billed charges,85% of total billed charges,148.32,90,,,percent of total billed charges,90% of total billed charges,164.8,100,,,fee schedule,100% of CO APG rates,164.8,100,,,fee schedule,100% of CO APG rates,164.8,100,,,fee schedule,100% of NM fee schedule,65.92,40,,,percent of total billed charges,40% of total billed charges,65.92,40,,,percent of total billed charges,40% of total billed charges,148.32,90,,,percent of total billed charges,90% of total billed charges,125.25,76,,,percent of total billed charges,76% of total billed charges,65.92,40,,,percent of total billed charges,40% of total billed charges,140.08,85,,,percent of total billed charges,85% of total billed charges,164.8,100,,,fee schedule,100% of CO APG rate,131.84,80,,,percent of total billed charges,80% of total billed charges,63.94,38.8,,,percent of total billed charges,38.8% of total billed charges,140.08,85,,,percent of total billed charges,85% of total billed charges,164.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,63.94,164.8,
"2019 Novel Coronavirus (CoVID-19), NAA LC",60000602,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,65.8,52.64,,49.35,75,,,percent of total billed charges,75% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,52.11,79.2,,,percent of total billed charges,79.2% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,62.51,95,,,percent of total billed charges,95% of total billed charges,52.64,80,,,percent of total billed charges,80% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,26.32,40,,,percent of total billed charges,40% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,50.01,76,,,percent of total billed charges,76% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,52.64,80,,,percent of total billed charges,80% of total billed charges,25.53,38.8,,,percent of total billed charges,38.8% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,62.51,
"87077 Culture, bacterial isolate",60000611,CDM,521,RC,59425,HCPCS,OUTPATIENT,,,58.3,46.64,,43.73,75,,,percent of total billed charges,75% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,46.17,79.2,,,percent of total billed charges,79.2% of total billed charges,49.56,85,,,percent of total billed charges,85% of total billed charges,58.3,100,,,fee schedule,100% of CO APG rates,55.39,95,,,percent of total billed charges,95% of total billed charges,46.64,80,,,percent of total billed charges,80% of total billed charges,49.56,85,,,percent of total billed charges,85% of total billed charges,52.47,90,,,percent of total billed charges,90% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rates,324.76,100,,,fee schedule,100% of CO APG rates,58.3,100,,,fee schedule,100% of NM fee schedule,382.2,100,,,case rate,pays based on per visit rate,382.2,100,,,case rate,pays based on per visit rate,52.47,90,,,percent of total billed charges,90% of total billed charges,44.31,76,,,percent of total billed charges,76% of total billed charges,382.2,100,,,case rate,pays based on per visit rate,49.56,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of CO APG rate,46.64,80,,,percent of total billed charges,80% of total billed charges,370.73,100,,,case rate,pays based on per visit rate,49.56,85,,,percent of total billed charges,85% of total billed charges,324.76,100,,,fee schedule,100% of APG fee schedule,498.8,100,,,case rate,pays based on per visit rate,43.73,498.8,
87186 - Susceptibility studies,60000612,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,220.7,176.56,,165.53,75,,,percent of total billed charges,75% of total billed charges,88.28,40,,,percent of total billed charges,40% of total billed charges,174.79,79.2,,,percent of total billed charges,79.2% of total billed charges,187.6,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,209.67,95,,,percent of total billed charges,95% of total billed charges,176.56,80,,,percent of total billed charges,80% of total billed charges,187.6,85,,,percent of total billed charges,85% of total billed charges,198.63,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,88.28,40,,,percent of total billed charges,40% of total billed charges,88.28,40,,,percent of total billed charges,40% of total billed charges,198.63,90,,,percent of total billed charges,90% of total billed charges,167.73,76,,,percent of total billed charges,76% of total billed charges,88.28,40,,,percent of total billed charges,40% of total billed charges,187.6,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,176.56,80,,,percent of total billed charges,80% of total billed charges,85.63,38.8,,,percent of total billed charges,38.8% of total billed charges,187.6,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,209.67,
64454 NJX AA/STRD GNCLR NRV BRNCH,60000592,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2009.3,1607.44,,1506.98,75,,,percent of total billed charges,75% of total billed charges,803.72,40,,,percent of total billed charges,40% of total billed charges,1591.37,79.2,,,percent of total billed charges,79.2% of total billed charges,1707.91,85,,,percent of total billed charges,85% of total billed charges,2009.3,100,,,fee schedule,100% of CO APG rates,1908.84,95,,,percent of total billed charges,95% of total billed charges,1607.44,80,,,percent of total billed charges,80% of total billed charges,1707.91,85,,,percent of total billed charges,85% of total billed charges,1808.37,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,803.72,40,,,percent of total billed charges,40% of total billed charges,803.72,40,,,percent of total billed charges,40% of total billed charges,1808.37,90,,,percent of total billed charges,90% of total billed charges,1527.07,76,,,percent of total billed charges,76% of total billed charges,803.72,40,,,percent of total billed charges,40% of total billed charges,1707.91,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1607.44,80,,,percent of total billed charges,80% of total billed charges,779.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1707.91,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
"82955 - Glucose 6-Phosphate Dehydrogenase (G6PD), Quantitati",60000616,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,75.4,60.32,,56.55,75,,,percent of total billed charges,75% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,59.72,79.2,,,percent of total billed charges,79.2% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,71.63,95,,,percent of total billed charges,95% of total billed charges,60.32,80,,,percent of total billed charges,80% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,30.16,40,,,percent of total billed charges,40% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,67.86,90,,,percent of total billed charges,90% of total billed charges,57.3,76,,,percent of total billed charges,76% of total billed charges,30.16,40,,,percent of total billed charges,40% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,60.32,80,,,percent of total billed charges,80% of total billed charges,29.26,38.8,,,percent of total billed charges,38.8% of total billed charges,64.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,71.63,
"JAK2 V617F Mutation Analysis, Quant LC",40081270,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,694.8,555.84,,521.1,75,,,percent of total billed charges,75% of total billed charges,277.92,40,,,percent of total billed charges,40% of total billed charges,550.28,79.2,,,percent of total billed charges,79.2% of total billed charges,590.58,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,660.06,95,,,percent of total billed charges,95% of total billed charges,555.84,80,,,percent of total billed charges,80% of total billed charges,590.58,85,,,percent of total billed charges,85% of total billed charges,625.32,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,277.92,40,,,percent of total billed charges,40% of total billed charges,277.92,40,,,percent of total billed charges,40% of total billed charges,625.32,90,,,percent of total billed charges,90% of total billed charges,528.05,76,,,percent of total billed charges,76% of total billed charges,277.92,40,,,percent of total billed charges,40% of total billed charges,590.58,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,555.84,80,,,percent of total billed charges,80% of total billed charges,269.58,38.8,,,percent of total billed charges,38.8% of total billed charges,590.58,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,660.06,
81219 - CALR (calreticulin) gene analysis LC,60000617,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,596.7,477.36,,447.53,75,,,percent of total billed charges,75% of total billed charges,238.68,40,,,percent of total billed charges,40% of total billed charges,472.59,79.2,,,percent of total billed charges,79.2% of total billed charges,507.2,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,566.87,95,,,percent of total billed charges,95% of total billed charges,477.36,80,,,percent of total billed charges,80% of total billed charges,507.2,85,,,percent of total billed charges,85% of total billed charges,537.03,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,238.68,40,,,percent of total billed charges,40% of total billed charges,238.68,40,,,percent of total billed charges,40% of total billed charges,537.03,90,,,percent of total billed charges,90% of total billed charges,453.49,76,,,percent of total billed charges,76% of total billed charges,238.68,40,,,percent of total billed charges,40% of total billed charges,507.2,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,477.36,80,,,percent of total billed charges,80% of total billed charges,231.52,38.8,,,percent of total billed charges,38.8% of total billed charges,507.2,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,566.87,
"81402- MPL - Molecular pathology procedure, LC",60000618,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,649.3,519.44,,486.98,75,,,percent of total billed charges,75% of total billed charges,259.72,40,,,percent of total billed charges,40% of total billed charges,514.25,79.2,,,percent of total billed charges,79.2% of total billed charges,551.91,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,616.84,95,,,percent of total billed charges,95% of total billed charges,519.44,80,,,percent of total billed charges,80% of total billed charges,551.91,85,,,percent of total billed charges,85% of total billed charges,584.37,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,259.72,40,,,percent of total billed charges,40% of total billed charges,259.72,40,,,percent of total billed charges,40% of total billed charges,584.37,90,,,percent of total billed charges,90% of total billed charges,493.47,76,,,percent of total billed charges,76% of total billed charges,259.72,40,,,percent of total billed charges,40% of total billed charges,551.91,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,519.44,80,,,percent of total billed charges,80% of total billed charges,251.93,38.8,,,percent of total billed charges,38.8% of total billed charges,551.91,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,616.84,
"96401 - Chemo Adm, Subq or IM, NonHor - Patient Supplied Med",60000724,CDM,331,RC,96402,HCPCS,OUTPATIENT,,,314,251.2,,235.5,75,,,percent of total billed charges,75% of total billed charges,125.6,40,,,percent of total billed charges,40% of total billed charges,248.69,79.2,,,percent of total billed charges,79.2% of total billed charges,266.9,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,298.3,95,,,percent of total billed charges,95% of total billed charges,251.2,80,,,percent of total billed charges,80% of total billed charges,266.9,85,,,percent of total billed charges,85% of total billed charges,282.6,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,125.6,40,,,percent of total billed charges,40% of total billed charges,125.6,40,,,percent of total billed charges,40% of total billed charges,282.6,90,,,percent of total billed charges,90% of total billed charges,238.64,76,,,percent of total billed charges,76% of total billed charges,125.6,40,,,percent of total billed charges,40% of total billed charges,266.9,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,251.2,80,,,percent of total billed charges,80% of total billed charges,121.83,38.8,,,percent of total billed charges,38.8% of total billed charges,266.9,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,70.94,200,,,fee schedule,200% of CMS fee schedule,58.22,298.3,
"96409 - Chemo Adm; IV, Initial, - Patient Supplied Med",60000727,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,842.5,674,,631.88,75,,,percent of total billed charges,75% of total billed charges,337,40,,,percent of total billed charges,40% of total billed charges,667.26,79.2,,,percent of total billed charges,79.2% of total billed charges,716.13,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,800.38,95,,,percent of total billed charges,95% of total billed charges,674,80,,,percent of total billed charges,80% of total billed charges,716.13,85,,,percent of total billed charges,85% of total billed charges,758.25,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,337,40,,,percent of total billed charges,40% of total billed charges,337,40,,,percent of total billed charges,40% of total billed charges,758.25,90,,,percent of total billed charges,90% of total billed charges,640.3,76,,,percent of total billed charges,76% of total billed charges,337,40,,,percent of total billed charges,40% of total billed charges,716.13,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,674,80,,,percent of total billed charges,80% of total billed charges,326.89,38.8,,,percent of total billed charges,38.8% of total billed charges,716.13,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,800.38,
"96413 - Chemo Adm, IV Inf Initial - Patient Supplied Med",60000725,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,1258.6,1006.88,,943.95,75,,,percent of total billed charges,75% of total billed charges,503.44,40,,,percent of total billed charges,40% of total billed charges,996.81,79.2,,,percent of total billed charges,79.2% of total billed charges,1069.81,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,1195.67,95,,,percent of total billed charges,95% of total billed charges,1006.88,80,,,percent of total billed charges,80% of total billed charges,1069.81,85,,,percent of total billed charges,85% of total billed charges,1132.74,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,503.44,40,,,percent of total billed charges,40% of total billed charges,503.44,40,,,percent of total billed charges,40% of total billed charges,1132.74,90,,,percent of total billed charges,90% of total billed charges,956.54,76,,,percent of total billed charges,76% of total billed charges,503.44,40,,,percent of total billed charges,40% of total billed charges,1069.81,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,1006.88,80,,,percent of total billed charges,80% of total billed charges,488.34,38.8,,,percent of total billed charges,38.8% of total billed charges,1069.81,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,1195.67,
"Chemo Admin, IV, Patient Supplied Medication",60000780,CDM,335,RC,96521,HCPCS,OUTPATIENT,,,317.3,253.84,,237.98,75,,,percent of total billed charges,75% of total billed charges,126.92,40,,,percent of total billed charges,40% of total billed charges,251.3,79.2,,,percent of total billed charges,79.2% of total billed charges,269.71,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,301.44,95,,,percent of total billed charges,95% of total billed charges,253.84,80,,,percent of total billed charges,80% of total billed charges,269.71,85,,,percent of total billed charges,85% of total billed charges,285.57,90,,,percent of total billed charges,90% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rates,58.22,100,,,fee schedule,100% of CO APG rates,206.57,100,,,fee schedule,100% of NM APC rate,126.92,40,,,percent of total billed charges,40% of total billed charges,126.92,40,,,percent of total billed charges,40% of total billed charges,285.57,90,,,percent of total billed charges,90% of total billed charges,241.15,76,,,percent of total billed charges,76% of total billed charges,126.92,40,,,percent of total billed charges,40% of total billed charges,269.71,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of CO APG rate,253.84,80,,,percent of total billed charges,80% of total billed charges,123.11,38.8,,,percent of total billed charges,38.8% of total billed charges,269.71,85,,,percent of total billed charges,85% of total billed charges,58.22,100,,,fee schedule,100% of APG fee schedule,266.44,200,,,fee schedule,200% of CMS fee schedule,58.22,301.44,
Respiratory Panel 2.1 (BioFire),30087633,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,990,792,,742.5,75,,,percent of total billed charges,75% of total billed charges,396,40,,,percent of total billed charges,40% of total billed charges,784.08,79.2,,,percent of total billed charges,79.2% of total billed charges,841.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,940.5,95,,,percent of total billed charges,95% of total billed charges,792,80,,,percent of total billed charges,80% of total billed charges,841.5,85,,,percent of total billed charges,85% of total billed charges,891,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,396,40,,,percent of total billed charges,40% of total billed charges,396,40,,,percent of total billed charges,40% of total billed charges,891,90,,,percent of total billed charges,90% of total billed charges,752.4,76,,,percent of total billed charges,76% of total billed charges,396,40,,,percent of total billed charges,40% of total billed charges,841.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,792,80,,,percent of total billed charges,80% of total billed charges,384.12,38.8,,,percent of total billed charges,38.8% of total billed charges,841.5,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,940.5,
64645 - Chemodenervation 1 Extremity Ea Addl 5/> Muscles,60001077,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,1005.2,804.16,,753.9,75,,,percent of total billed charges,75% of total billed charges,402.08,40,,,percent of total billed charges,40% of total billed charges,796.12,79.2,,,percent of total billed charges,79.2% of total billed charges,854.42,85,,,percent of total billed charges,85% of total billed charges,1005.2,100,,,fee schedule,100% of CO APG rates,954.94,95,,,percent of total billed charges,95% of total billed charges,804.16,80,,,percent of total billed charges,80% of total billed charges,854.42,85,,,percent of total billed charges,85% of total billed charges,904.68,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1005.2,100,,,fee schedule,100% of NM APC rate,402.08,40,,,percent of total billed charges,40% of total billed charges,402.08,40,,,percent of total billed charges,40% of total billed charges,904.68,90,,,percent of total billed charges,90% of total billed charges,763.95,76,,,percent of total billed charges,76% of total billed charges,402.08,40,,,percent of total billed charges,40% of total billed charges,854.42,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,804.16,80,,,percent of total billed charges,80% of total billed charges,390.02,38.8,,,percent of total billed charges,38.8% of total billed charges,854.42,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,390.02,2713.28,
64644 -Chemodenervation 1 Extremity 5 Or More Muscles,60001076,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2010.3,1608.24,,1507.73,75,,,percent of total billed charges,75% of total billed charges,804.12,40,,,percent of total billed charges,40% of total billed charges,1592.16,79.2,,,percent of total billed charges,79.2% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,2010.3,100,,,fee schedule,100% of CO APG rates,1909.79,95,,,percent of total billed charges,95% of total billed charges,1608.24,80,,,percent of total billed charges,80% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,1809.27,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,804.12,40,,,percent of total billed charges,40% of total billed charges,804.12,40,,,percent of total billed charges,40% of total billed charges,1809.27,90,,,percent of total billed charges,90% of total billed charges,1527.83,76,,,percent of total billed charges,76% of total billed charges,804.12,40,,,percent of total billed charges,40% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1608.24,80,,,percent of total billed charges,80% of total billed charges,780,38.8,,,percent of total billed charges,38.8% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
64643 - Chemodenervation 1 Extremity Ea Addl 1-4 Muscle,60001080,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,1005.2,804.16,,753.9,75,,,percent of total billed charges,75% of total billed charges,402.08,40,,,percent of total billed charges,40% of total billed charges,796.12,79.2,,,percent of total billed charges,79.2% of total billed charges,854.42,85,,,percent of total billed charges,85% of total billed charges,1005.2,100,,,fee schedule,100% of CO APG rates,954.94,95,,,percent of total billed charges,95% of total billed charges,804.16,80,,,percent of total billed charges,80% of total billed charges,854.42,85,,,percent of total billed charges,85% of total billed charges,904.68,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1005.2,100,,,fee schedule,100% of NM APC rate,402.08,40,,,percent of total billed charges,40% of total billed charges,402.08,40,,,percent of total billed charges,40% of total billed charges,904.68,90,,,percent of total billed charges,90% of total billed charges,763.95,76,,,percent of total billed charges,76% of total billed charges,402.08,40,,,percent of total billed charges,40% of total billed charges,854.42,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,804.16,80,,,percent of total billed charges,80% of total billed charges,390.02,38.8,,,percent of total billed charges,38.8% of total billed charges,854.42,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,390.02,2713.28,
64642Chemodenervation One Extremity 1-4 Muscle,60001079,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2010.3,1608.24,,1507.73,75,,,percent of total billed charges,75% of total billed charges,804.12,40,,,percent of total billed charges,40% of total billed charges,1592.16,79.2,,,percent of total billed charges,79.2% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,2010.3,100,,,fee schedule,100% of CO APG rates,1909.79,95,,,percent of total billed charges,95% of total billed charges,1608.24,80,,,percent of total billed charges,80% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,1809.27,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,804.12,40,,,percent of total billed charges,40% of total billed charges,804.12,40,,,percent of total billed charges,40% of total billed charges,1809.27,90,,,percent of total billed charges,90% of total billed charges,1527.83,76,,,percent of total billed charges,76% of total billed charges,804.12,40,,,percent of total billed charges,40% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1608.24,80,,,percent of total billed charges,80% of total billed charges,780,38.8,,,percent of total billed charges,38.8% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
"INFUSION HOME PUMP, 270 mL 5mL/HR",42952918,CDM,270,RC,,,OUTPATIENT,,,130,104,,97.5,75,,,percent of total billed charges,75% of total billed charges,52,40,,,percent of total billed charges,40% of total billed charges,102.96,79.2,,,percent of total billed charges,79.2% of total billed charges,110.5,85,,,percent of total billed charges,85% of total billed charges,130,100,,,fee schedule,100% of CO APG rates,123.5,95,,,percent of total billed charges,95% of total billed charges,104,80,,,percent of total billed charges,80% of total billed charges,110.5,85,,,percent of total billed charges,85% of total billed charges,117,90,,,percent of total billed charges,90% of total billed charges,130,100,,,fee schedule,100% of CO APG rates,130,100,,,fee schedule,100% of CO APG rates,130,100,,,fee schedule,100% of NM fee schedule,52,40,,,percent of total billed charges,40% of total billed charges,52,40,,,percent of total billed charges,40% of total billed charges,117,90,,,percent of total billed charges,90% of total billed charges,98.8,76,,,percent of total billed charges,76% of total billed charges,52,40,,,percent of total billed charges,40% of total billed charges,110.5,85,,,percent of total billed charges,85% of total billed charges,130,100,,,fee schedule,100% of CO APG rate,104,80,,,percent of total billed charges,80% of total billed charges,50.44,38.8,,,percent of total billed charges,38.8% of total billed charges,110.5,85,,,percent of total billed charges,85% of total billed charges,130,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,50.44,130,
"INFUSION HOME PUMP, 100 mL 2mL/HR",429552919,CDM,270,RC,,,OUTPATIENT,,,104.8,83.84,,78.6,75,,,percent of total billed charges,75% of total billed charges,41.92,40,,,percent of total billed charges,40% of total billed charges,83,79.2,,,percent of total billed charges,79.2% of total billed charges,89.08,85,,,percent of total billed charges,85% of total billed charges,104.8,100,,,fee schedule,100% of CO APG rates,99.56,95,,,percent of total billed charges,95% of total billed charges,83.84,80,,,percent of total billed charges,80% of total billed charges,89.08,85,,,percent of total billed charges,85% of total billed charges,94.32,90,,,percent of total billed charges,90% of total billed charges,104.8,100,,,fee schedule,100% of CO APG rates,104.8,100,,,fee schedule,100% of CO APG rates,104.8,100,,,fee schedule,100% of NM fee schedule,41.92,40,,,percent of total billed charges,40% of total billed charges,41.92,40,,,percent of total billed charges,40% of total billed charges,94.32,90,,,percent of total billed charges,90% of total billed charges,79.65,76,,,percent of total billed charges,76% of total billed charges,41.92,40,,,percent of total billed charges,40% of total billed charges,89.08,85,,,percent of total billed charges,85% of total billed charges,104.8,100,,,fee schedule,100% of CO APG rate,83.84,80,,,percent of total billed charges,80% of total billed charges,40.66,38.8,,,percent of total billed charges,38.8% of total billed charges,89.08,85,,,percent of total billed charges,85% of total billed charges,104.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,40.66,104.8,
SARS-CoV-2 (COVID-19) Total Abs (No Ratio),60000619,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,60.42,
Immunoglobulins A/G/M,40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,101,80.8,,75.75,75,,,percent of total billed charges,75% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,79.99,79.2,,,percent of total billed charges,79.2% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,95.95,95,,,percent of total billed charges,95% of total billed charges,80.8,80,,,percent of total billed charges,80% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,40.4,40,,,percent of total billed charges,40% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,90.9,90,,,percent of total billed charges,90% of total billed charges,76.76,76,,,percent of total billed charges,76% of total billed charges,40.4,40,,,percent of total billed charges,40% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,80.8,80,,,percent of total billed charges,80% of total billed charges,39.19,38.8,,,percent of total billed charges,38.8% of total billed charges,85.85,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,95.95,
82784 Gammaglobulin,40082784,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,88,70.4,,66,75,,,percent of total billed charges,75% of total billed charges,35.2,40,,,percent of total billed charges,40% of total billed charges,69.7,79.2,,,percent of total billed charges,79.2% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,83.6,95,,,percent of total billed charges,95% of total billed charges,70.4,80,,,percent of total billed charges,80% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,79.2,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,35.2,40,,,percent of total billed charges,40% of total billed charges,35.2,40,,,percent of total billed charges,40% of total billed charges,79.2,90,,,percent of total billed charges,90% of total billed charges,66.88,76,,,percent of total billed charges,76% of total billed charges,35.2,40,,,percent of total billed charges,40% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,70.4,80,,,percent of total billed charges,80% of total billed charges,34.14,38.8,,,percent of total billed charges,38.8% of total billed charges,74.8,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,83.6,
SARS-CoV-2 (COVID-19) RNA (ID Now),60000602,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,65.9,52.72,,49.43,75,,,percent of total billed charges,75% of total billed charges,26.36,40,,,percent of total billed charges,40% of total billed charges,52.19,79.2,,,percent of total billed charges,79.2% of total billed charges,56.02,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,62.61,95,,,percent of total billed charges,95% of total billed charges,52.72,80,,,percent of total billed charges,80% of total billed charges,56.02,85,,,percent of total billed charges,85% of total billed charges,59.31,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,26.36,40,,,percent of total billed charges,40% of total billed charges,26.36,40,,,percent of total billed charges,40% of total billed charges,59.31,90,,,percent of total billed charges,90% of total billed charges,50.08,76,,,percent of total billed charges,76% of total billed charges,26.36,40,,,percent of total billed charges,40% of total billed charges,56.02,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,52.72,80,,,percent of total billed charges,80% of total billed charges,25.57,38.8,,,percent of total billed charges,38.8% of total billed charges,56.02,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,62.61,
SARS-(COVID-19) IgG Abs (No Ratio),60000619,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,60.42,
64646 - Chemodenervation Of Trunk Muscle 1-5 Muscles,60001078,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2010.3,1608.24,,1507.73,75,,,percent of total billed charges,75% of total billed charges,804.12,40,,,percent of total billed charges,40% of total billed charges,1592.16,79.2,,,percent of total billed charges,79.2% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,2010.3,100,,,fee schedule,100% of CO APG rates,1909.79,95,,,percent of total billed charges,95% of total billed charges,1608.24,80,,,percent of total billed charges,80% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,1809.27,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,804.12,40,,,percent of total billed charges,40% of total billed charges,804.12,40,,,percent of total billed charges,40% of total billed charges,1809.27,90,,,percent of total billed charges,90% of total billed charges,1527.83,76,,,percent of total billed charges,76% of total billed charges,804.12,40,,,percent of total billed charges,40% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1608.24,80,,,percent of total billed charges,80% of total billed charges,780,38.8,,,percent of total billed charges,38.8% of total billed charges,1708.76,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
SYSTEM ANCHOR 4.75MM PEEK KNOTLESS DOUBLE-DOUBLE OMEGA,ECON0444,CDM,278,RC,,,OUTPATIENT,,,3533.6,2826.88,,2650.2,75,,,percent of total billed charges,75% of total billed charges,1413.44,40,,,percent of total billed charges,40% of total billed charges,2798.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3003.56,85,,,percent of total billed charges,85% of total billed charges,3533.6,100,,,fee schedule,100% of CO APG rates,3356.92,95,,,percent of total billed charges,95% of total billed charges,2826.88,80,,,percent of total billed charges,80% of total billed charges,3003.56,85,,,percent of total billed charges,85% of total billed charges,3180.24,90,,,percent of total billed charges,90% of total billed charges,3533.6,100,,,fee schedule,100% of CO APG rates,3533.6,100,,,fee schedule,100% of CO APG rates,3533.6,100,,,fee schedule,100% of NM fee schedule,1413.44,40,,,percent of total billed charges,40% of total billed charges,1413.44,40,,,percent of total billed charges,40% of total billed charges,3180.24,90,,,percent of total billed charges,90% of total billed charges,2685.54,76,,,percent of total billed charges,76% of total billed charges,1413.44,40,,,percent of total billed charges,40% of total billed charges,3003.56,85,,,percent of total billed charges,85% of total billed charges,3533.6,100,,,fee schedule,100% of CO APG rate,2826.88,80,,,percent of total billed charges,80% of total billed charges,1371.04,38.8,,,percent of total billed charges,38.8% of total billed charges,3003.56,85,,,percent of total billed charges,85% of total billed charges,3533.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1371.04,3533.6,
SYSTEM ANCHOR 4.75MM PEEK KNOTLESS SINGLE OMEGA,ECON0445,CDM,278,RC,,,OUTPATIENT,,,2157.06,1725.648,,1617.8,75,,,percent of total billed charges,75% of total billed charges,862.82,40,,,percent of total billed charges,40% of total billed charges,1708.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1833.5,85,,,percent of total billed charges,85% of total billed charges,2157.06,100,,,fee schedule,100% of CO APG rates,2049.21,95,,,percent of total billed charges,95% of total billed charges,1725.65,80,,,percent of total billed charges,80% of total billed charges,1833.5,85,,,percent of total billed charges,85% of total billed charges,1941.35,90,,,percent of total billed charges,90% of total billed charges,2157.06,100,,,fee schedule,100% of CO APG rates,2157.06,100,,,fee schedule,100% of CO APG rates,2157.06,100,,,fee schedule,100% of NM fee schedule,862.82,40,,,percent of total billed charges,40% of total billed charges,862.82,40,,,percent of total billed charges,40% of total billed charges,1941.35,90,,,percent of total billed charges,90% of total billed charges,1639.37,76,,,percent of total billed charges,76% of total billed charges,862.82,40,,,percent of total billed charges,40% of total billed charges,1833.5,85,,,percent of total billed charges,85% of total billed charges,2157.06,100,,,fee schedule,100% of CO APG rate,1725.65,80,,,percent of total billed charges,80% of total billed charges,836.94,38.8,,,percent of total billed charges,38.8% of total billed charges,1833.5,85,,,percent of total billed charges,85% of total billed charges,2157.06,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,836.94,2157.06,
SYSTEM ANCHOR 3.9MM PEEK KNOTLESS SINGLE OMEGA,ECON0446,CDM,278,RC,,,OUTPATIENT,,,2115.5,1692.4,,1586.63,75,,,percent of total billed charges,75% of total billed charges,846.2,40,,,percent of total billed charges,40% of total billed charges,1675.48,79.2,,,percent of total billed charges,79.2% of total billed charges,1798.18,85,,,percent of total billed charges,85% of total billed charges,2115.5,100,,,fee schedule,100% of CO APG rates,2009.73,95,,,percent of total billed charges,95% of total billed charges,1692.4,80,,,percent of total billed charges,80% of total billed charges,1798.18,85,,,percent of total billed charges,85% of total billed charges,1903.95,90,,,percent of total billed charges,90% of total billed charges,2115.5,100,,,fee schedule,100% of CO APG rates,2115.5,100,,,fee schedule,100% of CO APG rates,2115.5,100,,,fee schedule,100% of NM fee schedule,846.2,40,,,percent of total billed charges,40% of total billed charges,846.2,40,,,percent of total billed charges,40% of total billed charges,1903.95,90,,,percent of total billed charges,90% of total billed charges,1607.78,76,,,percent of total billed charges,76% of total billed charges,846.2,40,,,percent of total billed charges,40% of total billed charges,1798.18,85,,,percent of total billed charges,85% of total billed charges,2115.5,100,,,fee schedule,100% of CO APG rate,1692.4,80,,,percent of total billed charges,80% of total billed charges,820.81,38.8,,,percent of total billed charges,38.8% of total billed charges,1798.18,85,,,percent of total billed charges,85% of total billed charges,2115.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,820.81,2115.5,
SYSTEM ANCHOR 6.5MM PEEK KNOTLESS W/ EYELET OMEGA,ECON0447,CDM,278,RC,,,OUTPATIENT,,,1820.3,1456.24,,1365.23,75,,,percent of total billed charges,75% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1441.68,79.2,,,percent of total billed charges,79.2% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rates,1729.29,95,,,percent of total billed charges,95% of total billed charges,1456.24,80,,,percent of total billed charges,80% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1638.27,90,,,percent of total billed charges,90% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rates,1820.3,100,,,fee schedule,100% of CO APG rates,1820.3,100,,,fee schedule,100% of NM fee schedule,728.12,40,,,percent of total billed charges,40% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1638.27,90,,,percent of total billed charges,90% of total billed charges,1383.43,76,,,percent of total billed charges,76% of total billed charges,728.12,40,,,percent of total billed charges,40% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of CO APG rate,1456.24,80,,,percent of total billed charges,80% of total billed charges,706.28,38.8,,,percent of total billed charges,38.8% of total billed charges,1547.26,85,,,percent of total billed charges,85% of total billed charges,1820.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,706.28,1820.3,
ANCHOR SUTURE 2.3MM 3 STRAND 1.22MM XRAID TT SUTURE TAPE SPE,ECON0449,CDM,278,RC,,,OUTPATIENT,,,2123.9,1699.12,,1592.93,75,,,percent of total billed charges,75% of total billed charges,849.56,40,,,percent of total billed charges,40% of total billed charges,1682.13,79.2,,,percent of total billed charges,79.2% of total billed charges,1805.32,85,,,percent of total billed charges,85% of total billed charges,2123.9,100,,,fee schedule,100% of CO APG rates,2017.71,95,,,percent of total billed charges,95% of total billed charges,1699.12,80,,,percent of total billed charges,80% of total billed charges,1805.32,85,,,percent of total billed charges,85% of total billed charges,1911.51,90,,,percent of total billed charges,90% of total billed charges,2123.9,100,,,fee schedule,100% of CO APG rates,2123.9,100,,,fee schedule,100% of CO APG rates,2123.9,100,,,fee schedule,100% of NM fee schedule,849.56,40,,,percent of total billed charges,40% of total billed charges,849.56,40,,,percent of total billed charges,40% of total billed charges,1911.51,90,,,percent of total billed charges,90% of total billed charges,1614.16,76,,,percent of total billed charges,76% of total billed charges,849.56,40,,,percent of total billed charges,40% of total billed charges,1805.32,85,,,percent of total billed charges,85% of total billed charges,2123.9,100,,,fee schedule,100% of CO APG rate,1699.12,80,,,percent of total billed charges,80% of total billed charges,824.07,38.8,,,percent of total billed charges,38.8% of total billed charges,1805.32,85,,,percent of total billed charges,85% of total billed charges,2123.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,824.07,2123.9,
SYSTEM ANCHOR 3.9MM PEEK KNOTLESS DOUBLE-DOUBLE OMEGA,ECON0450,CDM,278,RC,,,OUTPATIENT,,,3532.5,2826,,2649.38,75,,,percent of total billed charges,75% of total billed charges,1413,40,,,percent of total billed charges,40% of total billed charges,2797.74,79.2,,,percent of total billed charges,79.2% of total billed charges,3002.63,85,,,percent of total billed charges,85% of total billed charges,3532.5,100,,,fee schedule,100% of CO APG rates,3355.88,95,,,percent of total billed charges,95% of total billed charges,2826,80,,,percent of total billed charges,80% of total billed charges,3002.63,85,,,percent of total billed charges,85% of total billed charges,3179.25,90,,,percent of total billed charges,90% of total billed charges,3532.5,100,,,fee schedule,100% of CO APG rates,3532.5,100,,,fee schedule,100% of CO APG rates,3532.5,100,,,fee schedule,100% of NM fee schedule,1413,40,,,percent of total billed charges,40% of total billed charges,1413,40,,,percent of total billed charges,40% of total billed charges,3179.25,90,,,percent of total billed charges,90% of total billed charges,2684.7,76,,,percent of total billed charges,76% of total billed charges,1413,40,,,percent of total billed charges,40% of total billed charges,3002.63,85,,,percent of total billed charges,85% of total billed charges,3532.5,100,,,fee schedule,100% of CO APG rate,2826,80,,,percent of total billed charges,80% of total billed charges,1370.61,38.8,,,percent of total billed charges,38.8% of total billed charges,3002.63,85,,,percent of total billed charges,85% of total billed charges,3532.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1370.61,3532.5,
GATEWAY 8X40 SILICONE CANNULA,460ECON0451,CDM,270,RC,,,OUTPATIENT,,,255.6,204.48,,191.7,75,,,percent of total billed charges,75% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,202.44,79.2,,,percent of total billed charges,79.2% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,255.6,100,,,fee schedule,100% of CO APG rates,242.82,95,,,percent of total billed charges,95% of total billed charges,204.48,80,,,percent of total billed charges,80% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,230.04,90,,,percent of total billed charges,90% of total billed charges,255.6,100,,,fee schedule,100% of CO APG rates,255.6,100,,,fee schedule,100% of CO APG rates,255.6,100,,,fee schedule,100% of NM fee schedule,102.24,40,,,percent of total billed charges,40% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,230.04,90,,,percent of total billed charges,90% of total billed charges,194.26,76,,,percent of total billed charges,76% of total billed charges,102.24,40,,,percent of total billed charges,40% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,255.6,100,,,fee schedule,100% of CO APG rate,204.48,80,,,percent of total billed charges,80% of total billed charges,99.17,38.8,,,percent of total billed charges,38.8% of total billed charges,217.26,85,,,percent of total billed charges,85% of total billed charges,255.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,99.17,255.6,
"VERSAGRAFT, 245mm",46052301,CDM,278,RC,,,OUTPATIENT,,,3387.5,2710,,2540.63,75,,,percent of total billed charges,75% of total billed charges,1355,40,,,percent of total billed charges,40% of total billed charges,2682.9,79.2,,,percent of total billed charges,79.2% of total billed charges,2879.38,85,,,percent of total billed charges,85% of total billed charges,3387.5,100,,,fee schedule,100% of CO APG rates,3218.13,95,,,percent of total billed charges,95% of total billed charges,2710,80,,,percent of total billed charges,80% of total billed charges,2879.38,85,,,percent of total billed charges,85% of total billed charges,3048.75,90,,,percent of total billed charges,90% of total billed charges,3387.5,100,,,fee schedule,100% of CO APG rates,3387.5,100,,,fee schedule,100% of CO APG rates,3387.5,100,,,fee schedule,100% of NM fee schedule,1355,40,,,percent of total billed charges,40% of total billed charges,1355,40,,,percent of total billed charges,40% of total billed charges,3048.75,90,,,percent of total billed charges,90% of total billed charges,2574.5,76,,,percent of total billed charges,76% of total billed charges,1355,40,,,percent of total billed charges,40% of total billed charges,2879.38,85,,,percent of total billed charges,85% of total billed charges,3387.5,100,,,fee schedule,100% of CO APG rate,2710,80,,,percent of total billed charges,80% of total billed charges,1314.35,38.8,,,percent of total billed charges,38.8% of total billed charges,2879.38,85,,,percent of total billed charges,85% of total billed charges,3387.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1314.35,3387.5,
CLOSED SUCTION CATHETER 14FR,4225920,CDM,270,RC,,,OUTPATIENT,,,131,104.8,,98.25,75,,,percent of total billed charges,75% of total billed charges,52.4,40,,,percent of total billed charges,40% of total billed charges,103.75,79.2,,,percent of total billed charges,79.2% of total billed charges,111.35,85,,,percent of total billed charges,85% of total billed charges,131,100,,,fee schedule,100% of CO APG rates,124.45,95,,,percent of total billed charges,95% of total billed charges,104.8,80,,,percent of total billed charges,80% of total billed charges,111.35,85,,,percent of total billed charges,85% of total billed charges,117.9,90,,,percent of total billed charges,90% of total billed charges,131,100,,,fee schedule,100% of CO APG rates,131,100,,,fee schedule,100% of CO APG rates,131,100,,,fee schedule,100% of NM fee schedule,52.4,40,,,percent of total billed charges,40% of total billed charges,52.4,40,,,percent of total billed charges,40% of total billed charges,117.9,90,,,percent of total billed charges,90% of total billed charges,99.56,76,,,percent of total billed charges,76% of total billed charges,52.4,40,,,percent of total billed charges,40% of total billed charges,111.35,85,,,percent of total billed charges,85% of total billed charges,131,100,,,fee schedule,100% of CO APG rate,104.8,80,,,percent of total billed charges,80% of total billed charges,50.83,38.8,,,percent of total billed charges,38.8% of total billed charges,111.35,85,,,percent of total billed charges,85% of total billed charges,131,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,50.83,131,
C Diff Toxin/GDH w/rflx to PCR,60000632,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,171.9,137.52,,128.93,75,,,percent of total billed charges,75% of total billed charges,68.76,40,,,percent of total billed charges,40% of total billed charges,136.14,79.2,,,percent of total billed charges,79.2% of total billed charges,146.12,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,163.31,95,,,percent of total billed charges,95% of total billed charges,137.52,80,,,percent of total billed charges,80% of total billed charges,146.12,85,,,percent of total billed charges,85% of total billed charges,154.71,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,68.76,40,,,percent of total billed charges,40% of total billed charges,68.76,40,,,percent of total billed charges,40% of total billed charges,154.71,90,,,percent of total billed charges,90% of total billed charges,130.64,76,,,percent of total billed charges,76% of total billed charges,68.76,40,,,percent of total billed charges,40% of total billed charges,146.12,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,137.52,80,,,percent of total billed charges,80% of total billed charges,66.7,38.8,,,percent of total billed charges,38.8% of total billed charges,146.12,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,163.31,
87324-C Diff GDH/Toxin w/rflx to PCR,27616106,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,171.9,137.52,,128.93,75,,,percent of total billed charges,75% of total billed charges,68.76,40,,,percent of total billed charges,40% of total billed charges,136.14,79.2,,,percent of total billed charges,79.2% of total billed charges,146.12,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,163.31,95,,,percent of total billed charges,95% of total billed charges,137.52,80,,,percent of total billed charges,80% of total billed charges,146.12,85,,,percent of total billed charges,85% of total billed charges,154.71,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,68.76,40,,,percent of total billed charges,40% of total billed charges,68.76,40,,,percent of total billed charges,40% of total billed charges,154.71,90,,,percent of total billed charges,90% of total billed charges,130.64,76,,,percent of total billed charges,76% of total billed charges,68.76,40,,,percent of total billed charges,40% of total billed charges,146.12,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,137.52,80,,,percent of total billed charges,80% of total billed charges,66.7,38.8,,,percent of total billed charges,38.8% of total billed charges,146.12,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,163.31,
CANDIDA SPECIES,60000645,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,40.8,32.64,,30.6,75,,,percent of total billed charges,75% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,32.31,79.2,,,percent of total billed charges,79.2% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,38.76,95,,,percent of total billed charges,95% of total billed charges,32.64,80,,,percent of total billed charges,80% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,16.32,40,,,percent of total billed charges,40% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,31.01,76,,,percent of total billed charges,76% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,32.64,80,,,percent of total billed charges,80% of total billed charges,15.83,38.8,,,percent of total billed charges,38.8% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,38.76,
GARDNERELLA VAGINALIS,60000646,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,40.8,32.64,,30.6,75,,,percent of total billed charges,75% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,32.31,79.2,,,percent of total billed charges,79.2% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,38.76,95,,,percent of total billed charges,95% of total billed charges,32.64,80,,,percent of total billed charges,80% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,16.32,40,,,percent of total billed charges,40% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,31.01,76,,,percent of total billed charges,76% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,32.64,80,,,percent of total billed charges,80% of total billed charges,15.83,38.8,,,percent of total billed charges,38.8% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,38.76,
TRICHOMONAS VAGINALIS,60000647,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,40.8,32.64,,30.6,75,,,percent of total billed charges,75% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,32.31,79.2,,,percent of total billed charges,79.2% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,38.76,95,,,percent of total billed charges,95% of total billed charges,32.64,80,,,percent of total billed charges,80% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,16.32,40,,,percent of total billed charges,40% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,36.72,90,,,percent of total billed charges,90% of total billed charges,31.01,76,,,percent of total billed charges,76% of total billed charges,16.32,40,,,percent of total billed charges,40% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,32.64,80,,,percent of total billed charges,80% of total billed charges,15.83,38.8,,,percent of total billed charges,38.8% of total billed charges,34.68,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,38.76,
SARS-CoV-2 (COVID-19)/Flu/RSV (GeneXpert),60000660,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,174.6,139.68,,130.95,75,,,percent of total billed charges,75% of total billed charges,69.84,40,,,percent of total billed charges,40% of total billed charges,138.28,79.2,,,percent of total billed charges,79.2% of total billed charges,148.41,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,165.87,95,,,percent of total billed charges,95% of total billed charges,139.68,80,,,percent of total billed charges,80% of total billed charges,148.41,85,,,percent of total billed charges,85% of total billed charges,157.14,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,69.84,40,,,percent of total billed charges,40% of total billed charges,69.84,40,,,percent of total billed charges,40% of total billed charges,157.14,90,,,percent of total billed charges,90% of total billed charges,132.7,76,,,percent of total billed charges,76% of total billed charges,69.84,40,,,percent of total billed charges,40% of total billed charges,148.41,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,139.68,80,,,percent of total billed charges,80% of total billed charges,67.74,38.8,,,percent of total billed charges,38.8% of total billed charges,148.41,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,165.87,
IGH VARI REGIONAL MUTATION,60000779,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,727.2,581.76,,545.4,75,,,percent of total billed charges,75% of total billed charges,290.88,40,,,percent of total billed charges,40% of total billed charges,575.94,79.2,,,percent of total billed charges,79.2% of total billed charges,618.12,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,690.84,95,,,percent of total billed charges,95% of total billed charges,581.76,80,,,percent of total billed charges,80% of total billed charges,618.12,85,,,percent of total billed charges,85% of total billed charges,654.48,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,290.88,40,,,percent of total billed charges,40% of total billed charges,290.88,40,,,percent of total billed charges,40% of total billed charges,654.48,90,,,percent of total billed charges,90% of total billed charges,552.67,76,,,percent of total billed charges,76% of total billed charges,290.88,40,,,percent of total billed charges,40% of total billed charges,618.12,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,581.76,80,,,percent of total billed charges,80% of total billed charges,282.15,38.8,,,percent of total billed charges,38.8% of total billed charges,618.12,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,690.84,
0001A Pfizer-Biontech Covid-19 Vaccine - 1st Dose,60000668,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,57.2,45.76,,42.9,75,,,percent of total billed charges,75% of total billed charges,22.88,40,,,percent of total billed charges,40% of total billed charges,45.3,79.2,,,percent of total billed charges,79.2% of total billed charges,48.62,85,,,percent of total billed charges,85% of total billed charges,57.2,100,,,fee schedule,100% of CO APG rates,54.34,95,,,percent of total billed charges,95% of total billed charges,45.76,80,,,percent of total billed charges,80% of total billed charges,48.62,85,,,percent of total billed charges,85% of total billed charges,51.48,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,57.2,100,,,fee schedule,100% of NM APC rate,22.88,40,,,percent of total billed charges,40% of total billed charges,22.88,40,,,percent of total billed charges,40% of total billed charges,51.48,90,,,percent of total billed charges,90% of total billed charges,43.47,76,,,percent of total billed charges,76% of total billed charges,22.88,40,,,percent of total billed charges,40% of total billed charges,48.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,45.76,80,,,percent of total billed charges,80% of total billed charges,22.19,38.8,,,percent of total billed charges,38.8% of total billed charges,48.62,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,114.4,200,,,fee schedule,200% of CMS fee schedule,22.19,215.49,
0002A Pfizer-Biontech Covid-19 Vaccine - 2nd Dose,60000669,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,95.7,76.56,,71.78,75,,,percent of total billed charges,75% of total billed charges,38.28,40,,,percent of total billed charges,40% of total billed charges,75.79,79.2,,,percent of total billed charges,79.2% of total billed charges,81.35,85,,,percent of total billed charges,85% of total billed charges,95.7,100,,,fee schedule,100% of CO APG rates,90.92,95,,,percent of total billed charges,95% of total billed charges,76.56,80,,,percent of total billed charges,80% of total billed charges,81.35,85,,,percent of total billed charges,85% of total billed charges,86.13,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,95.7,100,,,fee schedule,100% of NM APC rate,38.28,40,,,percent of total billed charges,40% of total billed charges,38.28,40,,,percent of total billed charges,40% of total billed charges,86.13,90,,,percent of total billed charges,90% of total billed charges,72.73,76,,,percent of total billed charges,76% of total billed charges,38.28,40,,,percent of total billed charges,40% of total billed charges,81.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,76.56,80,,,percent of total billed charges,80% of total billed charges,37.13,38.8,,,percent of total billed charges,38.8% of total billed charges,81.35,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,191.4,200,,,fee schedule,200% of CMS fee schedule,37.13,215.49,
ALTV,40084460,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,73.5,58.8,,55.13,75,,,percent of total billed charges,75% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,58.21,79.2,,,percent of total billed charges,79.2% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,69.83,95,,,percent of total billed charges,95% of total billed charges,58.8,80,,,percent of total billed charges,80% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,29.4,40,,,percent of total billed charges,40% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,66.15,90,,,percent of total billed charges,90% of total billed charges,55.86,76,,,percent of total billed charges,76% of total billed charges,29.4,40,,,percent of total billed charges,40% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,58.8,80,,,percent of total billed charges,80% of total billed charges,28.52,38.8,,,percent of total billed charges,38.8% of total billed charges,62.48,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,69.83,
"32408 - Core needle biopsy, lung or mediastinum, percutaneou",60000707,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,4702.4,3761.92,,3526.8,75,,,percent of total billed charges,75% of total billed charges,1880.96,40,,,percent of total billed charges,40% of total billed charges,3724.3,79.2,,,percent of total billed charges,79.2% of total billed charges,3997.04,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,4467.28,95,,,percent of total billed charges,95% of total billed charges,3761.92,80,,,percent of total billed charges,80% of total billed charges,3997.04,85,,,percent of total billed charges,85% of total billed charges,4232.16,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,1880.96,40,,,percent of total billed charges,40% of total billed charges,1880.96,40,,,percent of total billed charges,40% of total billed charges,4232.16,90,,,percent of total billed charges,90% of total billed charges,3573.82,76,,,percent of total billed charges,76% of total billed charges,1880.96,40,,,percent of total billed charges,40% of total billed charges,3997.04,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,3761.92,80,,,percent of total billed charges,80% of total billed charges,1824.53,38.8,,,percent of total billed charges,38.8% of total billed charges,3997.04,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,4467.28,
MICROPUNCTURE INTRODUCER,46052921,CDM,270,RC,,,OUTPATIENT,,,201,160.8,,150.75,75,,,percent of total billed charges,75% of total billed charges,80.4,40,,,percent of total billed charges,40% of total billed charges,159.19,79.2,,,percent of total billed charges,79.2% of total billed charges,170.85,85,,,percent of total billed charges,85% of total billed charges,201,100,,,fee schedule,100% of CO APG rates,190.95,95,,,percent of total billed charges,95% of total billed charges,160.8,80,,,percent of total billed charges,80% of total billed charges,170.85,85,,,percent of total billed charges,85% of total billed charges,180.9,90,,,percent of total billed charges,90% of total billed charges,201,100,,,fee schedule,100% of CO APG rates,201,100,,,fee schedule,100% of CO APG rates,201,100,,,fee schedule,100% of NM fee schedule,80.4,40,,,percent of total billed charges,40% of total billed charges,80.4,40,,,percent of total billed charges,40% of total billed charges,180.9,90,,,percent of total billed charges,90% of total billed charges,152.76,76,,,percent of total billed charges,76% of total billed charges,80.4,40,,,percent of total billed charges,40% of total billed charges,170.85,85,,,percent of total billed charges,85% of total billed charges,201,100,,,fee schedule,100% of CO APG rate,160.8,80,,,percent of total billed charges,80% of total billed charges,77.99,38.8,,,percent of total billed charges,38.8% of total billed charges,170.85,85,,,percent of total billed charges,85% of total billed charges,201,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,77.99,201,
SHARP SHOOTER HANDLE,460ECON0253,CDM,278,RC,,,OUTPATIENT,,,1501,1200.8,,1125.75,75,,,percent of total billed charges,75% of total billed charges,600.4,40,,,percent of total billed charges,40% of total billed charges,1188.79,79.2,,,percent of total billed charges,79.2% of total billed charges,1275.85,85,,,percent of total billed charges,85% of total billed charges,1501,100,,,fee schedule,100% of CO APG rates,1425.95,95,,,percent of total billed charges,95% of total billed charges,1200.8,80,,,percent of total billed charges,80% of total billed charges,1275.85,85,,,percent of total billed charges,85% of total billed charges,1350.9,90,,,percent of total billed charges,90% of total billed charges,1501,100,,,fee schedule,100% of CO APG rates,1501,100,,,fee schedule,100% of CO APG rates,1501,100,,,fee schedule,100% of NM fee schedule,600.4,40,,,percent of total billed charges,40% of total billed charges,600.4,40,,,percent of total billed charges,40% of total billed charges,1350.9,90,,,percent of total billed charges,90% of total billed charges,1140.76,76,,,percent of total billed charges,76% of total billed charges,600.4,40,,,percent of total billed charges,40% of total billed charges,1275.85,85,,,percent of total billed charges,85% of total billed charges,1501,100,,,fee schedule,100% of CO APG rate,1200.8,80,,,percent of total billed charges,80% of total billed charges,582.39,38.8,,,percent of total billed charges,38.8% of total billed charges,1275.85,85,,,percent of total billed charges,85% of total billed charges,1501,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,582.39,1501,
0031A - Janssen Covid-19 Vaccine Administration,60000712,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,92.1,73.68,,69.08,75,,,percent of total billed charges,75% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,72.94,79.2,,,percent of total billed charges,79.2% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,87.5,95,,,percent of total billed charges,95% of total billed charges,73.68,80,,,percent of total billed charges,80% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,36.84,40,,,percent of total billed charges,40% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,70,76,,,percent of total billed charges,76% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,73.68,80,,,percent of total billed charges,80% of total billed charges,35.73,38.8,,,percent of total billed charges,38.8% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,35.73,87.5,
M0245 - bamlanivimab-xxxx infusion,60000695,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,965.95,772.76,,724.46,75,,,percent of total billed charges,75% of total billed charges,386.38,40,,,percent of total billed charges,40% of total billed charges,765.03,79.2,,,percent of total billed charges,79.2% of total billed charges,821.06,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,917.65,95,,,percent of total billed charges,95% of total billed charges,772.76,80,,,percent of total billed charges,80% of total billed charges,821.06,85,,,percent of total billed charges,85% of total billed charges,869.36,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,386.38,40,,,percent of total billed charges,40% of total billed charges,386.38,40,,,percent of total billed charges,40% of total billed charges,869.36,90,,,percent of total billed charges,90% of total billed charges,734.12,76,,,percent of total billed charges,76% of total billed charges,386.38,40,,,percent of total billed charges,40% of total billed charges,821.06,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,772.76,80,,,percent of total billed charges,80% of total billed charges,374.79,38.8,,,percent of total billed charges,38.8% of total billed charges,821.06,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,42,917.65,
M0243 - casirivi and imdevi infusion,60000696,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,1004.6,803.68,,753.45,75,,,percent of total billed charges,75% of total billed charges,401.84,40,,,percent of total billed charges,40% of total billed charges,795.64,79.2,,,percent of total billed charges,79.2% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,954.37,95,,,percent of total billed charges,95% of total billed charges,803.68,80,,,percent of total billed charges,80% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,904.14,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,401.84,40,,,percent of total billed charges,40% of total billed charges,401.84,40,,,percent of total billed charges,40% of total billed charges,904.14,90,,,percent of total billed charges,90% of total billed charges,763.5,76,,,percent of total billed charges,76% of total billed charges,401.84,40,,,percent of total billed charges,40% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,803.68,80,,,percent of total billed charges,80% of total billed charges,389.78,38.8,,,percent of total billed charges,38.8% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,42,954.37,
"87184- Suscep studies, antimicrobical disk method per plate",60000784,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,68,54.4,,51,75,,,percent of total billed charges,75% of total billed charges,27.2,40,,,percent of total billed charges,40% of total billed charges,53.86,79.2,,,percent of total billed charges,79.2% of total billed charges,57.8,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,64.6,95,,,percent of total billed charges,95% of total billed charges,54.4,80,,,percent of total billed charges,80% of total billed charges,57.8,85,,,percent of total billed charges,85% of total billed charges,61.2,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,27.2,40,,,percent of total billed charges,40% of total billed charges,27.2,40,,,percent of total billed charges,40% of total billed charges,61.2,90,,,percent of total billed charges,90% of total billed charges,51.68,76,,,percent of total billed charges,76% of total billed charges,27.2,40,,,percent of total billed charges,40% of total billed charges,57.8,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,54.4,80,,,percent of total billed charges,80% of total billed charges,26.38,38.8,,,percent of total billed charges,38.8% of total billed charges,57.8,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,64.6,
CT Venogram Head w/ Contrast,60001040,CDM,351,RC,70470,HCPCS,OUTPATIENT,,,779.1,623.28,TC,584.33,75,,,percent of total billed charges,75% of total billed charges,311.64,40,,,percent of total billed charges,40% of total billed charges,514,100,,,case rate,pays based on per visit rate,662.24,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,740.15,95,,,percent of total billed charges,95% of total billed charges,623.28,80,,,percent of total billed charges,80% of total billed charges,662.24,85,,,percent of total billed charges,85% of total billed charges,701.19,90,,,percent of total billed charges,90% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rates,416.44,100,,,fee schedule,100% of CO APG rates,180.34,100,,,fee schedule,100% of NM APC rate,311.64,40,,,percent of total billed charges,40% of total billed charges,311.64,40,,,percent of total billed charges,40% of total billed charges,701.19,90,,,percent of total billed charges,90% of total billed charges,592.12,76,,,percent of total billed charges,76% of total billed charges,311.64,40,,,percent of total billed charges,40% of total billed charges,662.24,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of CO APG rate,623.28,80,,,percent of total billed charges,80% of total billed charges,302.29,38.8,,,percent of total billed charges,38.8% of total billed charges,662.24,85,,,percent of total billed charges,85% of total billed charges,416.44,100,,,fee schedule,100% of APG fee schedule,378.86,200,,,fee schedule,200% of CMS fee schedule,180.34,740.15,
FUHRMAN PLEURAL/PNUEUMOCARDIAL DRAINGE SET,41252923,CDM,270,RC,,,OUTPATIENT,,,542.9,434.32,,407.18,75,,,percent of total billed charges,75% of total billed charges,217.16,40,,,percent of total billed charges,40% of total billed charges,429.98,79.2,,,percent of total billed charges,79.2% of total billed charges,461.47,85,,,percent of total billed charges,85% of total billed charges,542.9,100,,,fee schedule,100% of CO APG rates,515.76,95,,,percent of total billed charges,95% of total billed charges,434.32,80,,,percent of total billed charges,80% of total billed charges,461.47,85,,,percent of total billed charges,85% of total billed charges,488.61,90,,,percent of total billed charges,90% of total billed charges,542.9,100,,,fee schedule,100% of CO APG rates,542.9,100,,,fee schedule,100% of CO APG rates,542.9,100,,,fee schedule,100% of NM fee schedule,217.16,40,,,percent of total billed charges,40% of total billed charges,217.16,40,,,percent of total billed charges,40% of total billed charges,488.61,90,,,percent of total billed charges,90% of total billed charges,412.6,76,,,percent of total billed charges,76% of total billed charges,217.16,40,,,percent of total billed charges,40% of total billed charges,461.47,85,,,percent of total billed charges,85% of total billed charges,542.9,100,,,fee schedule,100% of CO APG rate,434.32,80,,,percent of total billed charges,80% of total billed charges,210.65,38.8,,,percent of total billed charges,38.8% of total billed charges,461.47,85,,,percent of total billed charges,85% of total billed charges,542.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,210.65,542.9,
Bld ID Yeast PCR,4008150,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,60.42,
"NOVAPAK NASAL PACKING, STANDARD",46052925,CDM,270,RC,,,OUTPATIENT,,,724.4,579.52,,543.3,75,,,percent of total billed charges,75% of total billed charges,289.76,40,,,percent of total billed charges,40% of total billed charges,573.72,79.2,,,percent of total billed charges,79.2% of total billed charges,615.74,85,,,percent of total billed charges,85% of total billed charges,724.4,100,,,fee schedule,100% of CO APG rates,688.18,95,,,percent of total billed charges,95% of total billed charges,579.52,80,,,percent of total billed charges,80% of total billed charges,615.74,85,,,percent of total billed charges,85% of total billed charges,651.96,90,,,percent of total billed charges,90% of total billed charges,724.4,100,,,fee schedule,100% of CO APG rates,724.4,100,,,fee schedule,100% of CO APG rates,724.4,100,,,fee schedule,100% of NM fee schedule,289.76,40,,,percent of total billed charges,40% of total billed charges,289.76,40,,,percent of total billed charges,40% of total billed charges,651.96,90,,,percent of total billed charges,90% of total billed charges,550.54,76,,,percent of total billed charges,76% of total billed charges,289.76,40,,,percent of total billed charges,40% of total billed charges,615.74,85,,,percent of total billed charges,85% of total billed charges,724.4,100,,,fee schedule,100% of CO APG rate,579.52,80,,,percent of total billed charges,80% of total billed charges,281.07,38.8,,,percent of total billed charges,38.8% of total billed charges,615.74,85,,,percent of total billed charges,85% of total billed charges,724.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,281.07,724.4,
COOLIEF COOLED RADIOFREQUENCY KIT,46052926,CDM,270,RC,,,OUTPATIENT,,,2048.3,1638.64,,1536.23,75,,,percent of total billed charges,75% of total billed charges,819.32,40,,,percent of total billed charges,40% of total billed charges,1622.25,79.2,,,percent of total billed charges,79.2% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,2048.3,100,,,fee schedule,100% of CO APG rates,1945.89,95,,,percent of total billed charges,95% of total billed charges,1638.64,80,,,percent of total billed charges,80% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,1843.47,90,,,percent of total billed charges,90% of total billed charges,2048.3,100,,,fee schedule,100% of CO APG rates,2048.3,100,,,fee schedule,100% of CO APG rates,2048.3,100,,,fee schedule,100% of NM fee schedule,819.32,40,,,percent of total billed charges,40% of total billed charges,819.32,40,,,percent of total billed charges,40% of total billed charges,1843.47,90,,,percent of total billed charges,90% of total billed charges,1556.71,76,,,percent of total billed charges,76% of total billed charges,819.32,40,,,percent of total billed charges,40% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,2048.3,100,,,fee schedule,100% of CO APG rate,1638.64,80,,,percent of total billed charges,80% of total billed charges,794.74,38.8,,,percent of total billed charges,38.8% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,2048.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,794.74,2048.3,
COOLIEF COOLED RADIOFREQUENCY KIT 17G 75X4MM (2 PROBE),46052927,CDM,270,RC,,,OUTPATIENT,,,3277.3,2621.84,,2457.98,75,,,percent of total billed charges,75% of total billed charges,1310.92,40,,,percent of total billed charges,40% of total billed charges,2595.62,79.2,,,percent of total billed charges,79.2% of total billed charges,2785.71,85,,,percent of total billed charges,85% of total billed charges,3277.3,100,,,fee schedule,100% of CO APG rates,3113.44,95,,,percent of total billed charges,95% of total billed charges,2621.84,80,,,percent of total billed charges,80% of total billed charges,2785.71,85,,,percent of total billed charges,85% of total billed charges,2949.57,90,,,percent of total billed charges,90% of total billed charges,3277.3,100,,,fee schedule,100% of CO APG rates,3277.3,100,,,fee schedule,100% of CO APG rates,3277.3,100,,,fee schedule,100% of NM fee schedule,1310.92,40,,,percent of total billed charges,40% of total billed charges,1310.92,40,,,percent of total billed charges,40% of total billed charges,2949.57,90,,,percent of total billed charges,90% of total billed charges,2490.75,76,,,percent of total billed charges,76% of total billed charges,1310.92,40,,,percent of total billed charges,40% of total billed charges,2785.71,85,,,percent of total billed charges,85% of total billed charges,3277.3,100,,,fee schedule,100% of CO APG rate,2621.84,80,,,percent of total billed charges,80% of total billed charges,1271.59,38.8,,,percent of total billed charges,38.8% of total billed charges,2785.71,85,,,percent of total billed charges,85% of total billed charges,3277.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1271.59,3277.3,
COOLIEF COOLED RADIOFREQUENCY KIT 17G 75X4MM (3 PROBE),46052928,CDM,270,RC,,,OUTPATIENT,,,4719.3,3775.44,,3539.48,75,,,percent of total billed charges,75% of total billed charges,1887.72,40,,,percent of total billed charges,40% of total billed charges,3737.69,79.2,,,percent of total billed charges,79.2% of total billed charges,4011.41,85,,,percent of total billed charges,85% of total billed charges,4719.3,100,,,fee schedule,100% of CO APG rates,4483.34,95,,,percent of total billed charges,95% of total billed charges,3775.44,80,,,percent of total billed charges,80% of total billed charges,4011.41,85,,,percent of total billed charges,85% of total billed charges,4247.37,90,,,percent of total billed charges,90% of total billed charges,4719.3,100,,,fee schedule,100% of CO APG rates,4719.3,100,,,fee schedule,100% of CO APG rates,4719.3,100,,,fee schedule,100% of NM fee schedule,1887.72,40,,,percent of total billed charges,40% of total billed charges,1887.72,40,,,percent of total billed charges,40% of total billed charges,4247.37,90,,,percent of total billed charges,90% of total billed charges,3586.67,76,,,percent of total billed charges,76% of total billed charges,1887.72,40,,,percent of total billed charges,40% of total billed charges,4011.41,85,,,percent of total billed charges,85% of total billed charges,4719.3,100,,,fee schedule,100% of CO APG rate,3775.44,80,,,percent of total billed charges,80% of total billed charges,1831.09,38.8,,,percent of total billed charges,38.8% of total billed charges,4011.41,85,,,percent of total billed charges,85% of total billed charges,4719.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1831.09,4719.3,
LAPROSCOPIC CHOLANGIOGRAPHY SET W/ KARLAN BALLOON CATHETER,52929,CDM,270,RC,,,OUTPATIENT,,,434.5,347.6,,325.88,75,,,percent of total billed charges,75% of total billed charges,173.8,40,,,percent of total billed charges,40% of total billed charges,344.12,79.2,,,percent of total billed charges,79.2% of total billed charges,369.33,85,,,percent of total billed charges,85% of total billed charges,434.5,100,,,fee schedule,100% of CO APG rates,412.78,95,,,percent of total billed charges,95% of total billed charges,347.6,80,,,percent of total billed charges,80% of total billed charges,369.33,85,,,percent of total billed charges,85% of total billed charges,391.05,90,,,percent of total billed charges,90% of total billed charges,434.5,100,,,fee schedule,100% of CO APG rates,434.5,100,,,fee schedule,100% of CO APG rates,434.5,100,,,fee schedule,100% of NM fee schedule,173.8,40,,,percent of total billed charges,40% of total billed charges,173.8,40,,,percent of total billed charges,40% of total billed charges,391.05,90,,,percent of total billed charges,90% of total billed charges,330.22,76,,,percent of total billed charges,76% of total billed charges,173.8,40,,,percent of total billed charges,40% of total billed charges,369.33,85,,,percent of total billed charges,85% of total billed charges,434.5,100,,,fee schedule,100% of CO APG rate,347.6,80,,,percent of total billed charges,80% of total billed charges,168.59,38.8,,,percent of total billed charges,38.8% of total billed charges,369.33,85,,,percent of total billed charges,85% of total billed charges,434.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,168.59,434.5,
TRANSGASTRIC-JEJUNAL FEEDING TUBE  MIC 22FR 45CM TUBE SILICO,52930,CDM,270,RC,,,OUTPATIENT,,,1066.3,853.04,,799.73,75,,,percent of total billed charges,75% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,844.51,79.2,,,percent of total billed charges,79.2% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rates,1012.99,95,,,percent of total billed charges,95% of total billed charges,853.04,80,,,percent of total billed charges,80% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,959.67,90,,,percent of total billed charges,90% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rates,1066.3,100,,,fee schedule,100% of CO APG rates,1066.3,100,,,fee schedule,100% of NM fee schedule,426.52,40,,,percent of total billed charges,40% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,959.67,90,,,percent of total billed charges,90% of total billed charges,810.39,76,,,percent of total billed charges,76% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rate,853.04,80,,,percent of total billed charges,80% of total billed charges,413.72,38.8,,,percent of total billed charges,38.8% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,413.72,1066.3,
TRANSGASTRIC-JEJUNAL FEEDING TUBE  MIC 18FR 30CM TUBE SILICO,52931,CDM,270,RC,,,OUTPATIENT,,,1066.3,853.04,,799.73,75,,,percent of total billed charges,75% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,844.51,79.2,,,percent of total billed charges,79.2% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rates,1012.99,95,,,percent of total billed charges,95% of total billed charges,853.04,80,,,percent of total billed charges,80% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,959.67,90,,,percent of total billed charges,90% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rates,1066.3,100,,,fee schedule,100% of CO APG rates,1066.3,100,,,fee schedule,100% of NM fee schedule,426.52,40,,,percent of total billed charges,40% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,959.67,90,,,percent of total billed charges,90% of total billed charges,810.39,76,,,percent of total billed charges,76% of total billed charges,426.52,40,,,percent of total billed charges,40% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of CO APG rate,853.04,80,,,percent of total billed charges,80% of total billed charges,413.72,38.8,,,percent of total billed charges,38.8% of total billed charges,906.36,85,,,percent of total billed charges,85% of total billed charges,1066.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,413.72,1066.3,
0003A ADMIN COVID-19 VACCINE 3RD DOSE PFIZER,60000749,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,92.1,73.68,,69.08,75,,,percent of total billed charges,75% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,72.94,79.2,,,percent of total billed charges,79.2% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,87.5,95,,,percent of total billed charges,95% of total billed charges,73.68,80,,,percent of total billed charges,80% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,36.84,40,,,percent of total billed charges,40% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,70,76,,,percent of total billed charges,76% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,73.68,80,,,percent of total billed charges,80% of total billed charges,35.73,38.8,,,percent of total billed charges,38.8% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,35.73,87.5,
"87150 Culture, typing identification by nucleic acid(DNA or",4008150,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,65.8,52.64,,49.35,75,,,percent of total billed charges,75% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,52.11,79.2,,,percent of total billed charges,79.2% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,62.51,95,,,percent of total billed charges,95% of total billed charges,52.64,80,,,percent of total billed charges,80% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,26.32,40,,,percent of total billed charges,40% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,50.01,76,,,percent of total billed charges,76% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,52.64,80,,,percent of total billed charges,80% of total billed charges,25.53,38.8,,,percent of total billed charges,38.8% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,62.51,
Bld ID Gr Pos PCR,4008150,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,60.42,
Bld ID Gr Neg PCR,4008150,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,60.42,
COOLIEF COOLED RADIOFREQUENCY KIT 17G 100X4MM (2 PROBE),46052932,CDM,270,RC,,,OUTPATIENT,,,3277.3,2621.84,,2457.98,75,,,percent of total billed charges,75% of total billed charges,1310.92,40,,,percent of total billed charges,40% of total billed charges,2595.62,79.2,,,percent of total billed charges,79.2% of total billed charges,2785.71,85,,,percent of total billed charges,85% of total billed charges,3277.3,100,,,fee schedule,100% of CO APG rates,3113.44,95,,,percent of total billed charges,95% of total billed charges,2621.84,80,,,percent of total billed charges,80% of total billed charges,2785.71,85,,,percent of total billed charges,85% of total billed charges,2949.57,90,,,percent of total billed charges,90% of total billed charges,3277.3,100,,,fee schedule,100% of CO APG rates,3277.3,100,,,fee schedule,100% of CO APG rates,3277.3,100,,,fee schedule,100% of NM fee schedule,1310.92,40,,,percent of total billed charges,40% of total billed charges,1310.92,40,,,percent of total billed charges,40% of total billed charges,2949.57,90,,,percent of total billed charges,90% of total billed charges,2490.75,76,,,percent of total billed charges,76% of total billed charges,1310.92,40,,,percent of total billed charges,40% of total billed charges,2785.71,85,,,percent of total billed charges,85% of total billed charges,3277.3,100,,,fee schedule,100% of CO APG rate,2621.84,80,,,percent of total billed charges,80% of total billed charges,1271.59,38.8,,,percent of total billed charges,38.8% of total billed charges,2785.71,85,,,percent of total billed charges,85% of total billed charges,3277.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1271.59,3277.3,
COOLIEF COOLED RADIOFREQUENCY KIT 17G 100X4MM (3 PROBE),46052933,CDM,270,RC,,,OUTPATIENT,,,4719.3,3775.44,,3539.48,75,,,percent of total billed charges,75% of total billed charges,1887.72,40,,,percent of total billed charges,40% of total billed charges,3737.69,79.2,,,percent of total billed charges,79.2% of total billed charges,4011.41,85,,,percent of total billed charges,85% of total billed charges,4719.3,100,,,fee schedule,100% of CO APG rates,4483.34,95,,,percent of total billed charges,95% of total billed charges,3775.44,80,,,percent of total billed charges,80% of total billed charges,4011.41,85,,,percent of total billed charges,85% of total billed charges,4247.37,90,,,percent of total billed charges,90% of total billed charges,4719.3,100,,,fee schedule,100% of CO APG rates,4719.3,100,,,fee schedule,100% of CO APG rates,4719.3,100,,,fee schedule,100% of NM fee schedule,1887.72,40,,,percent of total billed charges,40% of total billed charges,1887.72,40,,,percent of total billed charges,40% of total billed charges,4247.37,90,,,percent of total billed charges,90% of total billed charges,3586.67,76,,,percent of total billed charges,76% of total billed charges,1887.72,40,,,percent of total billed charges,40% of total billed charges,4011.41,85,,,percent of total billed charges,85% of total billed charges,4719.3,100,,,fee schedule,100% of CO APG rate,3775.44,80,,,percent of total billed charges,80% of total billed charges,1831.09,38.8,,,percent of total billed charges,38.8% of total billed charges,4011.41,85,,,percent of total billed charges,85% of total billed charges,4719.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1831.09,4719.3,
Sotrovimab infusion,60000770,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,1004.6,803.68,,753.45,75,,,percent of total billed charges,75% of total billed charges,401.84,40,,,percent of total billed charges,40% of total billed charges,795.64,79.2,,,percent of total billed charges,79.2% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,954.37,95,,,percent of total billed charges,95% of total billed charges,803.68,80,,,percent of total billed charges,80% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,904.14,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,401.84,40,,,percent of total billed charges,40% of total billed charges,401.84,40,,,percent of total billed charges,40% of total billed charges,904.14,90,,,percent of total billed charges,90% of total billed charges,763.5,76,,,percent of total billed charges,76% of total billed charges,401.84,40,,,percent of total billed charges,40% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,803.68,80,,,percent of total billed charges,80% of total billed charges,389.78,38.8,,,percent of total billed charges,38.8% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,42,954.37,
COOLIEF COOLED RADIOFREQUENCY KIT 17g 100X4mm (1 PROBE),46052935,CDM,270,RC,,,OUTPATIENT,,,2048.3,1638.64,,1536.23,75,,,percent of total billed charges,75% of total billed charges,819.32,40,,,percent of total billed charges,40% of total billed charges,1622.25,79.2,,,percent of total billed charges,79.2% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,2048.3,100,,,fee schedule,100% of CO APG rates,1945.89,95,,,percent of total billed charges,95% of total billed charges,1638.64,80,,,percent of total billed charges,80% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,1843.47,90,,,percent of total billed charges,90% of total billed charges,2048.3,100,,,fee schedule,100% of CO APG rates,2048.3,100,,,fee schedule,100% of CO APG rates,2048.3,100,,,fee schedule,100% of NM fee schedule,819.32,40,,,percent of total billed charges,40% of total billed charges,819.32,40,,,percent of total billed charges,40% of total billed charges,1843.47,90,,,percent of total billed charges,90% of total billed charges,1556.71,76,,,percent of total billed charges,76% of total billed charges,819.32,40,,,percent of total billed charges,40% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,2048.3,100,,,fee schedule,100% of CO APG rate,1638.64,80,,,percent of total billed charges,80% of total billed charges,794.74,38.8,,,percent of total billed charges,38.8% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,2048.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,794.74,2048.3,
Covid-19 Pediatric Vaccine 1st dose,60000765,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,55,44,,41.25,75,,,percent of total billed charges,75% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,43.56,79.2,,,percent of total billed charges,79.2% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,52.25,95,,,percent of total billed charges,95% of total billed charges,44,80,,,percent of total billed charges,80% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,49.5,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,55,100,,,fee schedule,100% of NM APC rate,22,40,,,percent of total billed charges,40% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,49.5,90,,,percent of total billed charges,90% of total billed charges,41.8,76,,,percent of total billed charges,76% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,44,80,,,percent of total billed charges,80% of total billed charges,21.34,38.8,,,percent of total billed charges,38.8% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,21.34,55,
Covid-19 Pediatric Vaccine 2nd dose,60000766,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,92.1,73.68,,69.08,75,,,percent of total billed charges,75% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,72.94,79.2,,,percent of total billed charges,79.2% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,87.5,95,,,percent of total billed charges,95% of total billed charges,73.68,80,,,percent of total billed charges,80% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,36.84,40,,,percent of total billed charges,40% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,70,76,,,percent of total billed charges,76% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,73.68,80,,,percent of total billed charges,80% of total billed charges,35.73,38.8,,,percent of total billed charges,38.8% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,35.73,87.5,
Influenza A  B POC PSMC,30087804,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,112.4,89.92,,84.3,75,,,percent of total billed charges,75% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,89.02,79.2,,,percent of total billed charges,79.2% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,106.78,95,,,percent of total billed charges,95% of total billed charges,89.92,80,,,percent of total billed charges,80% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,101.16,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,44.96,40,,,percent of total billed charges,40% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,101.16,90,,,percent of total billed charges,90% of total billed charges,85.42,76,,,percent of total billed charges,76% of total billed charges,44.96,40,,,percent of total billed charges,40% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,89.92,80,,,percent of total billed charges,80% of total billed charges,43.61,38.8,,,percent of total billed charges,38.8% of total billed charges,95.54,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,106.78,
RSV POC PSMC,60000769,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,33.9,27.12,,25.43,75,,,percent of total billed charges,75% of total billed charges,13.56,40,,,percent of total billed charges,40% of total billed charges,26.85,79.2,,,percent of total billed charges,79.2% of total billed charges,28.82,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,32.21,95,,,percent of total billed charges,95% of total billed charges,27.12,80,,,percent of total billed charges,80% of total billed charges,28.82,85,,,percent of total billed charges,85% of total billed charges,30.51,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,13.56,40,,,percent of total billed charges,40% of total billed charges,13.56,40,,,percent of total billed charges,40% of total billed charges,30.51,90,,,percent of total billed charges,90% of total billed charges,25.76,76,,,percent of total billed charges,76% of total billed charges,13.56,40,,,percent of total billed charges,40% of total billed charges,28.82,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,27.12,80,,,percent of total billed charges,80% of total billed charges,13.15,38.8,,,percent of total billed charges,38.8% of total billed charges,28.82,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,33.06,
0071A Pfizer-Biontech Covid-19 Pediatric Vaccine - 1st Pedia,60000765,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,55,44,,41.25,75,,,percent of total billed charges,75% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,43.56,79.2,,,percent of total billed charges,79.2% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,52.25,95,,,percent of total billed charges,95% of total billed charges,44,80,,,percent of total billed charges,80% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,49.5,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,55,100,,,fee schedule,100% of NM APC rate,22,40,,,percent of total billed charges,40% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,49.5,90,,,percent of total billed charges,90% of total billed charges,41.8,76,,,percent of total billed charges,76% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,44,80,,,percent of total billed charges,80% of total billed charges,21.34,38.8,,,percent of total billed charges,38.8% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,21.34,55,
0072A Pfizer-Biontech Covid-19 Pediatric Vaccine - 2nd Pedia,60000766,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,92.1,73.68,,69.08,75,,,percent of total billed charges,75% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,72.94,79.2,,,percent of total billed charges,79.2% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,87.5,95,,,percent of total billed charges,95% of total billed charges,73.68,80,,,percent of total billed charges,80% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,36.84,40,,,percent of total billed charges,40% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,82.89,90,,,percent of total billed charges,90% of total billed charges,70,76,,,percent of total billed charges,76% of total billed charges,36.84,40,,,percent of total billed charges,40% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,73.68,80,,,percent of total billed charges,80% of total billed charges,35.73,38.8,,,percent of total billed charges,38.8% of total billed charges,78.29,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,35.73,87.5,
COOLIEF COOLED RADIOFREQUENCY KIT 17g 50X4mm (1 PROBE),46052939,CDM,270,RC,,,OUTPATIENT,,,2048.3,1638.64,,1536.23,75,,,percent of total billed charges,75% of total billed charges,819.32,40,,,percent of total billed charges,40% of total billed charges,1622.25,79.2,,,percent of total billed charges,79.2% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,2048.3,100,,,fee schedule,100% of CO APG rates,1945.89,95,,,percent of total billed charges,95% of total billed charges,1638.64,80,,,percent of total billed charges,80% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,1843.47,90,,,percent of total billed charges,90% of total billed charges,2048.3,100,,,fee schedule,100% of CO APG rates,2048.3,100,,,fee schedule,100% of CO APG rates,2048.3,100,,,fee schedule,100% of NM fee schedule,819.32,40,,,percent of total billed charges,40% of total billed charges,819.32,40,,,percent of total billed charges,40% of total billed charges,1843.47,90,,,percent of total billed charges,90% of total billed charges,1556.71,76,,,percent of total billed charges,76% of total billed charges,819.32,40,,,percent of total billed charges,40% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,2048.3,100,,,fee schedule,100% of CO APG rate,1638.64,80,,,percent of total billed charges,80% of total billed charges,794.74,38.8,,,percent of total billed charges,38.8% of total billed charges,1741.06,85,,,percent of total billed charges,85% of total billed charges,2048.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,794.74,2048.3,
MRV Head w/ Cont,60001036,CDM,615,RC,70545,HCPCS,OUTPATIENT,,,2540.1,2032.08,TC,1905.08,75,,,percent of total billed charges,75% of total billed charges,1016.04,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2159.09,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,2413.1,95,,,percent of total billed charges,95% of total billed charges,2032.08,80,,,percent of total billed charges,80% of total billed charges,2159.09,85,,,percent of total billed charges,85% of total billed charges,2286.09,90,,,percent of total billed charges,90% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rates,657.92,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1016.04,40,,,percent of total billed charges,40% of total billed charges,1016.04,40,,,percent of total billed charges,40% of total billed charges,2286.09,90,,,percent of total billed charges,90% of total billed charges,1930.48,76,,,percent of total billed charges,76% of total billed charges,1016.04,40,,,percent of total billed charges,40% of total billed charges,2159.09,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of CO APG rate,2032.08,80,,,percent of total billed charges,80% of total billed charges,985.56,38.8,,,percent of total billed charges,38.8% of total billed charges,2159.09,85,,,percent of total billed charges,85% of total billed charges,657.92,100,,,fee schedule,100% of APG fee schedule,499.88,200,,,fee schedule,200% of CMS fee schedule,368.43,2413.1,
Coolief Cooled RFA KIT 50x2MM,60000791,CDM,270,RC,,,OUTPATIENT,,,2621.8,2097.44,,1966.35,75,,,percent of total billed charges,75% of total billed charges,1048.72,40,,,percent of total billed charges,40% of total billed charges,2076.47,79.2,,,percent of total billed charges,79.2% of total billed charges,2228.53,85,,,percent of total billed charges,85% of total billed charges,2621.8,100,,,fee schedule,100% of CO APG rates,2490.71,95,,,percent of total billed charges,95% of total billed charges,2097.44,80,,,percent of total billed charges,80% of total billed charges,2228.53,85,,,percent of total billed charges,85% of total billed charges,2359.62,90,,,percent of total billed charges,90% of total billed charges,2621.8,100,,,fee schedule,100% of CO APG rates,2621.8,100,,,fee schedule,100% of CO APG rates,2621.8,100,,,fee schedule,100% of NM fee schedule,1048.72,40,,,percent of total billed charges,40% of total billed charges,1048.72,40,,,percent of total billed charges,40% of total billed charges,2359.62,90,,,percent of total billed charges,90% of total billed charges,1992.57,76,,,percent of total billed charges,76% of total billed charges,1048.72,40,,,percent of total billed charges,40% of total billed charges,2228.53,85,,,percent of total billed charges,85% of total billed charges,2621.8,100,,,fee schedule,100% of CO APG rate,2097.44,80,,,percent of total billed charges,80% of total billed charges,1017.26,38.8,,,percent of total billed charges,38.8% of total billed charges,2228.53,85,,,percent of total billed charges,85% of total billed charges,2621.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1017.26,2621.8,
"Acute Viral Hepatitis HAV, HBV, HCV,  LC",40022744,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,56.5,45.2,,42.38,75,,,percent of total billed charges,75% of total billed charges,22.6,40,,,percent of total billed charges,40% of total billed charges,44.75,79.2,,,percent of total billed charges,79.2% of total billed charges,48.03,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,53.68,95,,,percent of total billed charges,95% of total billed charges,45.2,80,,,percent of total billed charges,80% of total billed charges,48.03,85,,,percent of total billed charges,85% of total billed charges,50.85,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,22.6,40,,,percent of total billed charges,40% of total billed charges,22.6,40,,,percent of total billed charges,40% of total billed charges,50.85,90,,,percent of total billed charges,90% of total billed charges,42.94,76,,,percent of total billed charges,76% of total billed charges,22.6,40,,,percent of total billed charges,40% of total billed charges,48.03,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,45.2,80,,,percent of total billed charges,80% of total billed charges,21.92,38.8,,,percent of total billed charges,38.8% of total billed charges,48.03,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,53.68,
"H Pylori Stool Ag, EIA",4008738,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,243.1,194.48,,182.33,75,,,percent of total billed charges,75% of total billed charges,97.24,40,,,percent of total billed charges,40% of total billed charges,192.54,79.2,,,percent of total billed charges,79.2% of total billed charges,206.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,230.95,95,,,percent of total billed charges,95% of total billed charges,194.48,80,,,percent of total billed charges,80% of total billed charges,206.64,85,,,percent of total billed charges,85% of total billed charges,218.79,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,97.24,40,,,percent of total billed charges,40% of total billed charges,97.24,40,,,percent of total billed charges,40% of total billed charges,218.79,90,,,percent of total billed charges,90% of total billed charges,184.76,76,,,percent of total billed charges,76% of total billed charges,97.24,40,,,percent of total billed charges,40% of total billed charges,206.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,194.48,80,,,percent of total billed charges,80% of total billed charges,94.32,38.8,,,percent of total billed charges,38.8% of total billed charges,206.64,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,230.95,
M0222 - Bebtelovimab Admin,60000803,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,1004.6,803.68,,753.45,75,,,percent of total billed charges,75% of total billed charges,401.84,40,,,percent of total billed charges,40% of total billed charges,795.64,79.2,,,percent of total billed charges,79.2% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,954.37,95,,,percent of total billed charges,95% of total billed charges,803.68,80,,,percent of total billed charges,80% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,904.14,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,67.47,100,,,fee schedule,100% of NM APC rate,401.84,40,,,percent of total billed charges,40% of total billed charges,401.84,40,,,percent of total billed charges,40% of total billed charges,904.14,90,,,percent of total billed charges,90% of total billed charges,763.5,76,,,percent of total billed charges,76% of total billed charges,401.84,40,,,percent of total billed charges,40% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,803.68,80,,,percent of total billed charges,80% of total billed charges,389.78,38.8,,,percent of total billed charges,38.8% of total billed charges,853.91,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,42,954.37,
Shoulder Stabilization KIt,60000802,CDM,270,RC,,,OUTPATIENT,,,455,364,,341.25,75,,,percent of total billed charges,75% of total billed charges,182,40,,,percent of total billed charges,40% of total billed charges,360.36,79.2,,,percent of total billed charges,79.2% of total billed charges,386.75,85,,,percent of total billed charges,85% of total billed charges,455,100,,,fee schedule,100% of CO APG rates,432.25,95,,,percent of total billed charges,95% of total billed charges,364,80,,,percent of total billed charges,80% of total billed charges,386.75,85,,,percent of total billed charges,85% of total billed charges,409.5,90,,,percent of total billed charges,90% of total billed charges,455,100,,,fee schedule,100% of CO APG rates,455,100,,,fee schedule,100% of CO APG rates,455,100,,,fee schedule,100% of NM fee schedule,182,40,,,percent of total billed charges,40% of total billed charges,182,40,,,percent of total billed charges,40% of total billed charges,409.5,90,,,percent of total billed charges,90% of total billed charges,345.8,76,,,percent of total billed charges,76% of total billed charges,182,40,,,percent of total billed charges,40% of total billed charges,386.75,85,,,percent of total billed charges,85% of total billed charges,455,100,,,fee schedule,100% of CO APG rate,364,80,,,percent of total billed charges,80% of total billed charges,176.54,38.8,,,percent of total billed charges,38.8% of total billed charges,386.75,85,,,percent of total billed charges,85% of total billed charges,455,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,176.54,455,
"86665 Antibody; Epstein-Barr (EB) virus, viral capsid (VCA)",40087798,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,77.2,61.76,,57.9,75,,,percent of total billed charges,75% of total billed charges,30.88,40,,,percent of total billed charges,40% of total billed charges,61.14,79.2,,,percent of total billed charges,79.2% of total billed charges,65.62,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,73.34,95,,,percent of total billed charges,95% of total billed charges,61.76,80,,,percent of total billed charges,80% of total billed charges,65.62,85,,,percent of total billed charges,85% of total billed charges,69.48,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,30.88,40,,,percent of total billed charges,40% of total billed charges,30.88,40,,,percent of total billed charges,40% of total billed charges,69.48,90,,,percent of total billed charges,90% of total billed charges,58.67,76,,,percent of total billed charges,76% of total billed charges,30.88,40,,,percent of total billed charges,40% of total billed charges,65.62,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,61.76,80,,,percent of total billed charges,80% of total billed charges,29.95,38.8,,,percent of total billed charges,38.8% of total billed charges,65.62,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,73.34,
"Proximal Lateral Humerus Plate, 3 Hole, Left",60000816,CDM,278,RC,,,OUTPATIENT,,,5122,4097.6,,3841.5,75,,,percent of total billed charges,75% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4056.62,79.2,,,percent of total billed charges,79.2% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of CO APG rates,4865.9,95,,,percent of total billed charges,95% of total billed charges,4097.6,80,,,percent of total billed charges,80% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,4609.8,90,,,percent of total billed charges,90% of total billed charges,5122,100,,,fee schedule,100% of CO APG rates,5122,100,,,fee schedule,100% of CO APG rates,5122,100,,,fee schedule,100% of NM fee schedule,2048.8,40,,,percent of total billed charges,40% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4609.8,90,,,percent of total billed charges,90% of total billed charges,3892.72,76,,,percent of total billed charges,76% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of CO APG rate,4097.6,80,,,percent of total billed charges,80% of total billed charges,1987.34,38.8,,,percent of total billed charges,38.8% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1987.34,5122,
"Proximal Lateral Humerus Plate, 4 Hole, Left",60000817,CDM,278,RC,,,OUTPATIENT,,,5122,4097.6,,3841.5,75,,,percent of total billed charges,75% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4056.62,79.2,,,percent of total billed charges,79.2% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of CO APG rates,4865.9,95,,,percent of total billed charges,95% of total billed charges,4097.6,80,,,percent of total billed charges,80% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,4609.8,90,,,percent of total billed charges,90% of total billed charges,5122,100,,,fee schedule,100% of CO APG rates,5122,100,,,fee schedule,100% of CO APG rates,5122,100,,,fee schedule,100% of NM fee schedule,2048.8,40,,,percent of total billed charges,40% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4609.8,90,,,percent of total billed charges,90% of total billed charges,3892.72,76,,,percent of total billed charges,76% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of CO APG rate,4097.6,80,,,percent of total billed charges,80% of total billed charges,1987.34,38.8,,,percent of total billed charges,38.8% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1987.34,5122,
"Proximal Lateral Humerus Plate, 5 Hole, Left",60000818,CDM,278,RC,,,OUTPATIENT,,,5122,4097.6,,3841.5,75,,,percent of total billed charges,75% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4056.62,79.2,,,percent of total billed charges,79.2% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of CO APG rates,4865.9,95,,,percent of total billed charges,95% of total billed charges,4097.6,80,,,percent of total billed charges,80% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,4609.8,90,,,percent of total billed charges,90% of total billed charges,5122,100,,,fee schedule,100% of CO APG rates,5122,100,,,fee schedule,100% of CO APG rates,5122,100,,,fee schedule,100% of NM fee schedule,2048.8,40,,,percent of total billed charges,40% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4609.8,90,,,percent of total billed charges,90% of total billed charges,3892.72,76,,,percent of total billed charges,76% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of CO APG rate,4097.6,80,,,percent of total billed charges,80% of total billed charges,1987.34,38.8,,,percent of total billed charges,38.8% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1987.34,5122,
"Proximal Lateral Humerus Plate, 6 Hole, Left",60000819,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 8 Hole, Left",60000820,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 10 Hole, Left",60000821,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 12 Hole, Left",60000822,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 14 Hole, Left",60000823,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 16 Hole, Left",60000824,CDM,278,RC,,,OUTPATIENT,,,5528.1,4422.48,,4146.08,75,,,percent of total billed charges,75% of total billed charges,2211.24,40,,,percent of total billed charges,40% of total billed charges,4378.26,79.2,,,percent of total billed charges,79.2% of total billed charges,4698.89,85,,,percent of total billed charges,85% of total billed charges,5528.1,100,,,fee schedule,100% of CO APG rates,5251.7,95,,,percent of total billed charges,95% of total billed charges,4422.48,80,,,percent of total billed charges,80% of total billed charges,4698.89,85,,,percent of total billed charges,85% of total billed charges,4975.29,90,,,percent of total billed charges,90% of total billed charges,5528.1,100,,,fee schedule,100% of CO APG rates,5528.1,100,,,fee schedule,100% of CO APG rates,5528.1,100,,,fee schedule,100% of NM fee schedule,2211.24,40,,,percent of total billed charges,40% of total billed charges,2211.24,40,,,percent of total billed charges,40% of total billed charges,4975.29,90,,,percent of total billed charges,90% of total billed charges,4201.36,76,,,percent of total billed charges,76% of total billed charges,2211.24,40,,,percent of total billed charges,40% of total billed charges,4698.89,85,,,percent of total billed charges,85% of total billed charges,5528.1,100,,,fee schedule,100% of CO APG rate,4422.48,80,,,percent of total billed charges,80% of total billed charges,2144.9,38.8,,,percent of total billed charges,38.8% of total billed charges,4698.89,85,,,percent of total billed charges,85% of total billed charges,5528.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2144.9,5528.1,
"Proximal Lateral Humerus Plate, 18 Hole, Left",60000825,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 20 Hole, Left",60000826,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 3 Hole, Right",60000827,CDM,278,RC,,,OUTPATIENT,,,5122,4097.6,,3841.5,75,,,percent of total billed charges,75% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4056.62,79.2,,,percent of total billed charges,79.2% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of CO APG rates,4865.9,95,,,percent of total billed charges,95% of total billed charges,4097.6,80,,,percent of total billed charges,80% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,4609.8,90,,,percent of total billed charges,90% of total billed charges,5122,100,,,fee schedule,100% of CO APG rates,5122,100,,,fee schedule,100% of CO APG rates,5122,100,,,fee schedule,100% of NM fee schedule,2048.8,40,,,percent of total billed charges,40% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4609.8,90,,,percent of total billed charges,90% of total billed charges,3892.72,76,,,percent of total billed charges,76% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of CO APG rate,4097.6,80,,,percent of total billed charges,80% of total billed charges,1987.34,38.8,,,percent of total billed charges,38.8% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1987.34,5122,
"Proximal Lateral Humerus Plate, 4 Hole, Right",60000828,CDM,278,RC,,,OUTPATIENT,,,5122,4097.6,,3841.5,75,,,percent of total billed charges,75% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4056.62,79.2,,,percent of total billed charges,79.2% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of CO APG rates,4865.9,95,,,percent of total billed charges,95% of total billed charges,4097.6,80,,,percent of total billed charges,80% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,4609.8,90,,,percent of total billed charges,90% of total billed charges,5122,100,,,fee schedule,100% of CO APG rates,5122,100,,,fee schedule,100% of CO APG rates,5122,100,,,fee schedule,100% of NM fee schedule,2048.8,40,,,percent of total billed charges,40% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4609.8,90,,,percent of total billed charges,90% of total billed charges,3892.72,76,,,percent of total billed charges,76% of total billed charges,2048.8,40,,,percent of total billed charges,40% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of CO APG rate,4097.6,80,,,percent of total billed charges,80% of total billed charges,1987.34,38.8,,,percent of total billed charges,38.8% of total billed charges,4353.7,85,,,percent of total billed charges,85% of total billed charges,5122,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1987.34,5122,
ANCA Profile LC,40083520,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,85.1,68.08,,63.83,75,,,percent of total billed charges,75% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,67.4,79.2,,,percent of total billed charges,79.2% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,80.85,95,,,percent of total billed charges,95% of total billed charges,68.08,80,,,percent of total billed charges,80% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,34.04,40,,,percent of total billed charges,40% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,76.59,90,,,percent of total billed charges,90% of total billed charges,64.68,76,,,percent of total billed charges,76% of total billed charges,34.04,40,,,percent of total billed charges,40% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,68.08,80,,,percent of total billed charges,80% of total billed charges,33.02,38.8,,,percent of total billed charges,38.8% of total billed charges,72.34,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,80.85,
"Proximal Lateral Humerus Plate, 6 Hole, Right",60000830,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 8 Hole, Right",60000831,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 10 Hole, Right",60000832,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 12 Hole, Right",6000833,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 14 Hole, Right",60000834,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 16 Hole, Right",60000835,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 18 Hole, Right",600000836,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Proximal Lateral Humerus Plate, 20 Hole, Right",60000837,CDM,278,RC,,,OUTPATIENT,,,5910.4,4728.32,,4432.8,75,,,percent of total billed charges,75% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,4681.04,79.2,,,percent of total billed charges,79.2% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5614.88,95,,,percent of total billed charges,95% of total billed charges,4728.32,80,,,percent of total billed charges,80% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of CO APG rates,5910.4,100,,,fee schedule,100% of NM fee schedule,2364.16,40,,,percent of total billed charges,40% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5319.36,90,,,percent of total billed charges,90% of total billed charges,4491.9,76,,,percent of total billed charges,76% of total billed charges,2364.16,40,,,percent of total billed charges,40% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of CO APG rate,4728.32,80,,,percent of total billed charges,80% of total billed charges,2293.24,38.8,,,percent of total billed charges,38.8% of total billed charges,5023.84,85,,,percent of total billed charges,85% of total billed charges,5910.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,2293.24,5910.4,
"Straight Broad Plate, Right/Left, 4 Holes, 55mm",60000838,CDM,278,RC,,,OUTPATIENT,,,1027.3,821.84,,770.48,75,,,percent of total billed charges,75% of total billed charges,410.92,40,,,percent of total billed charges,40% of total billed charges,813.62,79.2,,,percent of total billed charges,79.2% of total billed charges,873.21,85,,,percent of total billed charges,85% of total billed charges,1027.3,100,,,fee schedule,100% of CO APG rates,975.94,95,,,percent of total billed charges,95% of total billed charges,821.84,80,,,percent of total billed charges,80% of total billed charges,873.21,85,,,percent of total billed charges,85% of total billed charges,924.57,90,,,percent of total billed charges,90% of total billed charges,1027.3,100,,,fee schedule,100% of CO APG rates,1027.3,100,,,fee schedule,100% of CO APG rates,1027.3,100,,,fee schedule,100% of NM fee schedule,410.92,40,,,percent of total billed charges,40% of total billed charges,410.92,40,,,percent of total billed charges,40% of total billed charges,924.57,90,,,percent of total billed charges,90% of total billed charges,780.75,76,,,percent of total billed charges,76% of total billed charges,410.92,40,,,percent of total billed charges,40% of total billed charges,873.21,85,,,percent of total billed charges,85% of total billed charges,1027.3,100,,,fee schedule,100% of CO APG rate,821.84,80,,,percent of total billed charges,80% of total billed charges,398.59,38.8,,,percent of total billed charges,38.8% of total billed charges,873.21,85,,,percent of total billed charges,85% of total billed charges,1027.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,398.59,1027.3,
"Straight Broad Plate, Right/Left, 5 Holes, 67mm",60000839,CDM,278,RC,,,OUTPATIENT,,,1362.9,1090.32,,1022.18,75,,,percent of total billed charges,75% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1079.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1294.76,95,,,percent of total billed charges,95% of total billed charges,1090.32,80,,,percent of total billed charges,80% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of NM fee schedule,545.16,40,,,percent of total billed charges,40% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1035.8,76,,,percent of total billed charges,76% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rate,1090.32,80,,,percent of total billed charges,80% of total billed charges,528.81,38.8,,,percent of total billed charges,38.8% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,528.81,1362.9,
"Straight Broad Plate, Right/Left, 6 Holes, 79mm",60000840,CDM,278,RC,,,OUTPATIENT,,,1362.9,1090.32,,1022.18,75,,,percent of total billed charges,75% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1079.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1294.76,95,,,percent of total billed charges,95% of total billed charges,1090.32,80,,,percent of total billed charges,80% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of NM fee schedule,545.16,40,,,percent of total billed charges,40% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1035.8,76,,,percent of total billed charges,76% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rate,1090.32,80,,,percent of total billed charges,80% of total billed charges,528.81,38.8,,,percent of total billed charges,38.8% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,528.81,1362.9,
"Straight Broad Plate, Right/Left, 7,4, Locking Holes, 91mm",60000841,CDM,278,RC,,,OUTPATIENT,,,1362.9,1090.32,,1022.18,75,,,percent of total billed charges,75% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1079.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1294.76,95,,,percent of total billed charges,95% of total billed charges,1090.32,80,,,percent of total billed charges,80% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of NM fee schedule,545.16,40,,,percent of total billed charges,40% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1035.8,76,,,percent of total billed charges,76% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rate,1090.32,80,,,percent of total billed charges,80% of total billed charges,528.81,38.8,,,percent of total billed charges,38.8% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,528.81,1362.9,
"Straight Broad Plate, Right/Left, 7 Holes, 91mm",60000842,CDM,278,RC,,,OUTPATIENT,,,1362.9,1090.32,,1022.18,75,,,percent of total billed charges,75% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1079.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1294.76,95,,,percent of total billed charges,95% of total billed charges,1090.32,80,,,percent of total billed charges,80% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of NM fee schedule,545.16,40,,,percent of total billed charges,40% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1035.8,76,,,percent of total billed charges,76% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rate,1090.32,80,,,percent of total billed charges,80% of total billed charges,528.81,38.8,,,percent of total billed charges,38.8% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,528.81,1362.9,
"Straight Broad Plate, Right/Left, 8 Holes, 91mm",60000843,CDM,278,RC,,,OUTPATIENT,,,1713.5,1370.8,,1285.13,75,,,percent of total billed charges,75% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1357.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1627.83,95,,,percent of total billed charges,95% of total billed charges,1370.8,80,,,percent of total billed charges,80% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of NM fee schedule,685.4,40,,,percent of total billed charges,40% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1302.26,76,,,percent of total billed charges,76% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rate,1370.8,80,,,percent of total billed charges,80% of total billed charges,664.84,38.8,,,percent of total billed charges,38.8% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,664.84,1713.5,
"Curved Broad Plate, Right/Left, 9 Holes, 115mm",60000844,CDM,278,RC,,,OUTPATIENT,,,1713.5,1370.8,,1285.13,75,,,percent of total billed charges,75% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1357.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1627.83,95,,,percent of total billed charges,95% of total billed charges,1370.8,80,,,percent of total billed charges,80% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of NM fee schedule,685.4,40,,,percent of total billed charges,40% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1302.26,76,,,percent of total billed charges,76% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rate,1370.8,80,,,percent of total billed charges,80% of total billed charges,664.84,38.8,,,percent of total billed charges,38.8% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,664.84,1713.5,
"Curved Broad Plate, Right/Left, 10 Holes, 127mm",60000845,CDM,278,RC,,,OUTPATIENT,,,1713.5,1370.8,,1285.13,75,,,percent of total billed charges,75% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1357.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1627.83,95,,,percent of total billed charges,95% of total billed charges,1370.8,80,,,percent of total billed charges,80% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of NM fee schedule,685.4,40,,,percent of total billed charges,40% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1302.26,76,,,percent of total billed charges,76% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rate,1370.8,80,,,percent of total billed charges,80% of total billed charges,664.84,38.8,,,percent of total billed charges,38.8% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,664.84,1713.5,
"Curved Broad Plate, Right/Left, 11 Holes, 139mm",60000846,CDM,278,RC,,,OUTPATIENT,,,2038.2,1630.56,,1528.65,75,,,percent of total billed charges,75% of total billed charges,815.28,40,,,percent of total billed charges,40% of total billed charges,1614.25,79.2,,,percent of total billed charges,79.2% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,2038.2,100,,,fee schedule,100% of CO APG rates,1936.29,95,,,percent of total billed charges,95% of total billed charges,1630.56,80,,,percent of total billed charges,80% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,1834.38,90,,,percent of total billed charges,90% of total billed charges,2038.2,100,,,fee schedule,100% of CO APG rates,2038.2,100,,,fee schedule,100% of CO APG rates,2038.2,100,,,fee schedule,100% of NM fee schedule,815.28,40,,,percent of total billed charges,40% of total billed charges,815.28,40,,,percent of total billed charges,40% of total billed charges,1834.38,90,,,percent of total billed charges,90% of total billed charges,1549.03,76,,,percent of total billed charges,76% of total billed charges,815.28,40,,,percent of total billed charges,40% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,2038.2,100,,,fee schedule,100% of CO APG rate,1630.56,80,,,percent of total billed charges,80% of total billed charges,790.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,2038.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,790.82,2038.2,
"Curved Broad Plate, Right/Left, 12 Holes, 151mm",60000847,CDM,278,RC,,,OUTPATIENT,,,2038.2,1630.56,,1528.65,75,,,percent of total billed charges,75% of total billed charges,815.28,40,,,percent of total billed charges,40% of total billed charges,1614.25,79.2,,,percent of total billed charges,79.2% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,2038.2,100,,,fee schedule,100% of CO APG rates,1936.29,95,,,percent of total billed charges,95% of total billed charges,1630.56,80,,,percent of total billed charges,80% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,1834.38,90,,,percent of total billed charges,90% of total billed charges,2038.2,100,,,fee schedule,100% of CO APG rates,2038.2,100,,,fee schedule,100% of CO APG rates,2038.2,100,,,fee schedule,100% of NM fee schedule,815.28,40,,,percent of total billed charges,40% of total billed charges,815.28,40,,,percent of total billed charges,40% of total billed charges,1834.38,90,,,percent of total billed charges,90% of total billed charges,1549.03,76,,,percent of total billed charges,76% of total billed charges,815.28,40,,,percent of total billed charges,40% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,2038.2,100,,,fee schedule,100% of CO APG rate,1630.56,80,,,percent of total billed charges,80% of total billed charges,790.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,2038.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,790.82,2038.2,
"Curved Broad Plate, Right/Left, 14 Holes, 175mm",60000848,CDM,278,RC,,,OUTPATIENT,,,2038.2,1630.56,,1528.65,75,,,percent of total billed charges,75% of total billed charges,815.28,40,,,percent of total billed charges,40% of total billed charges,1614.25,79.2,,,percent of total billed charges,79.2% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,2038.2,100,,,fee schedule,100% of CO APG rates,1936.29,95,,,percent of total billed charges,95% of total billed charges,1630.56,80,,,percent of total billed charges,80% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,1834.38,90,,,percent of total billed charges,90% of total billed charges,2038.2,100,,,fee schedule,100% of CO APG rates,2038.2,100,,,fee schedule,100% of CO APG rates,2038.2,100,,,fee schedule,100% of NM fee schedule,815.28,40,,,percent of total billed charges,40% of total billed charges,815.28,40,,,percent of total billed charges,40% of total billed charges,1834.38,90,,,percent of total billed charges,90% of total billed charges,1549.03,76,,,percent of total billed charges,76% of total billed charges,815.28,40,,,percent of total billed charges,40% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,2038.2,100,,,fee schedule,100% of CO APG rate,1630.56,80,,,percent of total billed charges,80% of total billed charges,790.82,38.8,,,percent of total billed charges,38.8% of total billed charges,1732.47,85,,,percent of total billed charges,85% of total billed charges,2038.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,790.82,2038.2,
"Straight Narrow Plate, 4 Hole, 54mm",60000849,CDM,278,RC,,,OUTPATIENT,,,1027.3,821.84,,770.48,75,,,percent of total billed charges,75% of total billed charges,410.92,40,,,percent of total billed charges,40% of total billed charges,813.62,79.2,,,percent of total billed charges,79.2% of total billed charges,873.21,85,,,percent of total billed charges,85% of total billed charges,1027.3,100,,,fee schedule,100% of CO APG rates,975.94,95,,,percent of total billed charges,95% of total billed charges,821.84,80,,,percent of total billed charges,80% of total billed charges,873.21,85,,,percent of total billed charges,85% of total billed charges,924.57,90,,,percent of total billed charges,90% of total billed charges,1027.3,100,,,fee schedule,100% of CO APG rates,1027.3,100,,,fee schedule,100% of CO APG rates,1027.3,100,,,fee schedule,100% of NM fee schedule,410.92,40,,,percent of total billed charges,40% of total billed charges,410.92,40,,,percent of total billed charges,40% of total billed charges,924.57,90,,,percent of total billed charges,90% of total billed charges,780.75,76,,,percent of total billed charges,76% of total billed charges,410.92,40,,,percent of total billed charges,40% of total billed charges,873.21,85,,,percent of total billed charges,85% of total billed charges,1027.3,100,,,fee schedule,100% of CO APG rate,821.84,80,,,percent of total billed charges,80% of total billed charges,398.59,38.8,,,percent of total billed charges,38.8% of total billed charges,873.21,85,,,percent of total billed charges,85% of total billed charges,1027.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,398.59,1027.3,
"Straight Narrow Plate, 5 Hole, 66mm",60000850,CDM,278,RC,,,OUTPATIENT,,,1362.9,1090.32,,1022.18,75,,,percent of total billed charges,75% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1079.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1294.76,95,,,percent of total billed charges,95% of total billed charges,1090.32,80,,,percent of total billed charges,80% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of NM fee schedule,545.16,40,,,percent of total billed charges,40% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1035.8,76,,,percent of total billed charges,76% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rate,1090.32,80,,,percent of total billed charges,80% of total billed charges,528.81,38.8,,,percent of total billed charges,38.8% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,528.81,1362.9,
"Straight Narrow Plate, 6 Hole, 78mm",60000851,CDM,278,RC,,,OUTPATIENT,,,1362.9,1090.32,,1022.18,75,,,percent of total billed charges,75% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1079.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1294.76,95,,,percent of total billed charges,95% of total billed charges,1090.32,80,,,percent of total billed charges,80% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of NM fee schedule,545.16,40,,,percent of total billed charges,40% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1035.8,76,,,percent of total billed charges,76% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rate,1090.32,80,,,percent of total billed charges,80% of total billed charges,528.81,38.8,,,percent of total billed charges,38.8% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,528.81,1362.9,
"Straight Narrow Plate, 7 Hole, 90mm",60000852,CDM,278,RC,,,OUTPATIENT,,,1362.9,1090.32,,1022.18,75,,,percent of total billed charges,75% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1079.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1294.76,95,,,percent of total billed charges,95% of total billed charges,1090.32,80,,,percent of total billed charges,80% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of NM fee schedule,545.16,40,,,percent of total billed charges,40% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1035.8,76,,,percent of total billed charges,76% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rate,1090.32,80,,,percent of total billed charges,80% of total billed charges,528.81,38.8,,,percent of total billed charges,38.8% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,528.81,1362.9,
"Straight Narrow Plate 7,4 Locking Holes 90mm",60000853,CDM,278,RC,,,OUTPATIENT,,,1362.9,1090.32,,1022.18,75,,,percent of total billed charges,75% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1079.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1294.76,95,,,percent of total billed charges,95% of total billed charges,1090.32,80,,,percent of total billed charges,80% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of CO APG rates,1362.9,100,,,fee schedule,100% of NM fee schedule,545.16,40,,,percent of total billed charges,40% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1226.61,90,,,percent of total billed charges,90% of total billed charges,1035.8,76,,,percent of total billed charges,76% of total billed charges,545.16,40,,,percent of total billed charges,40% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of CO APG rate,1090.32,80,,,percent of total billed charges,80% of total billed charges,528.81,38.8,,,percent of total billed charges,38.8% of total billed charges,1158.47,85,,,percent of total billed charges,85% of total billed charges,1362.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,528.81,1362.9,
Straight Narrow Plate 8 Holes 102mm,60000854,CDM,278,RC,,,OUTPATIENT,,,1713.5,1370.8,,1285.13,75,,,percent of total billed charges,75% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1357.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1627.83,95,,,percent of total billed charges,95% of total billed charges,1370.8,80,,,percent of total billed charges,80% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of NM fee schedule,685.4,40,,,percent of total billed charges,40% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1302.26,76,,,percent of total billed charges,76% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rate,1370.8,80,,,percent of total billed charges,80% of total billed charges,664.84,38.8,,,percent of total billed charges,38.8% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,664.84,1713.5,
Straight Narrow Plate 9 Holes 114mm,60000855,CDM,278,RC,,,OUTPATIENT,,,1713.5,1370.8,,1285.13,75,,,percent of total billed charges,75% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1357.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1627.83,95,,,percent of total billed charges,95% of total billed charges,1370.8,80,,,percent of total billed charges,80% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of NM fee schedule,685.4,40,,,percent of total billed charges,40% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1302.26,76,,,percent of total billed charges,76% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rate,1370.8,80,,,percent of total billed charges,80% of total billed charges,664.84,38.8,,,percent of total billed charges,38.8% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,664.84,1713.5,
Straight Narrow Plate 10 Holes 126mm,60000856,CDM,278,RC,,,OUTPATIENT,,,1713.5,1370.8,,1285.13,75,,,percent of total billed charges,75% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1357.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1627.83,95,,,percent of total billed charges,95% of total billed charges,1370.8,80,,,percent of total billed charges,80% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of NM fee schedule,685.4,40,,,percent of total billed charges,40% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1302.26,76,,,percent of total billed charges,76% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rate,1370.8,80,,,percent of total billed charges,80% of total billed charges,664.84,38.8,,,percent of total billed charges,38.8% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,664.84,1713.5,
Straight Narrow Plate 12 Holes 150mm,60000857,CDM,278,RC,,,OUTPATIENT,,,1713.5,1370.8,,1285.13,75,,,percent of total billed charges,75% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1357.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1627.83,95,,,percent of total billed charges,95% of total billed charges,1370.8,80,,,percent of total billed charges,80% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of NM fee schedule,685.4,40,,,percent of total billed charges,40% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1302.26,76,,,percent of total billed charges,76% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rate,1370.8,80,,,percent of total billed charges,80% of total billed charges,664.84,38.8,,,percent of total billed charges,38.8% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,664.84,1713.5,
Straight Narrow Plate 14 Holes 174mm,60000858,CDM,278,RC,,,OUTPATIENT,,,1713.5,1370.8,,1285.13,75,,,percent of total billed charges,75% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1357.09,79.2,,,percent of total billed charges,79.2% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1627.83,95,,,percent of total billed charges,95% of total billed charges,1370.8,80,,,percent of total billed charges,80% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of CO APG rates,1713.5,100,,,fee schedule,100% of NM fee schedule,685.4,40,,,percent of total billed charges,40% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1542.15,90,,,percent of total billed charges,90% of total billed charges,1302.26,76,,,percent of total billed charges,76% of total billed charges,685.4,40,,,percent of total billed charges,40% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of CO APG rate,1370.8,80,,,percent of total billed charges,80% of total billed charges,664.84,38.8,,,percent of total billed charges,38.8% of total billed charges,1456.48,85,,,percent of total billed charges,85% of total billed charges,1713.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,664.84,1713.5,
1/3 Tubular Plates 2 Holes 23mm,60000859,CDM,278,RC,,,OUTPATIENT,,,1489,1191.2,,1116.75,75,,,percent of total billed charges,75% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1179.29,79.2,,,percent of total billed charges,79.2% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1414.55,95,,,percent of total billed charges,95% of total billed charges,1191.2,80,,,percent of total billed charges,80% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of NM fee schedule,595.6,40,,,percent of total billed charges,40% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1131.64,76,,,percent of total billed charges,76% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rate,1191.2,80,,,percent of total billed charges,80% of total billed charges,577.73,38.8,,,percent of total billed charges,38.8% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,577.73,1489,
1/3 Tubular Plates 3 Holes 35mm,60000860,CDM,278,RC,,,OUTPATIENT,,,1489,1191.2,,1116.75,75,,,percent of total billed charges,75% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1179.29,79.2,,,percent of total billed charges,79.2% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1414.55,95,,,percent of total billed charges,95% of total billed charges,1191.2,80,,,percent of total billed charges,80% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of NM fee schedule,595.6,40,,,percent of total billed charges,40% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1131.64,76,,,percent of total billed charges,76% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rate,1191.2,80,,,percent of total billed charges,80% of total billed charges,577.73,38.8,,,percent of total billed charges,38.8% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,577.73,1489,
1/3 Tubular Plates 4 Holes 47mm,60000861,CDM,278,RC,,,OUTPATIENT,,,1545.7,1236.56,,1159.28,75,,,percent of total billed charges,75% of total billed charges,618.28,40,,,percent of total billed charges,40% of total billed charges,1224.19,79.2,,,percent of total billed charges,79.2% of total billed charges,1313.85,85,,,percent of total billed charges,85% of total billed charges,1545.7,100,,,fee schedule,100% of CO APG rates,1468.42,95,,,percent of total billed charges,95% of total billed charges,1236.56,80,,,percent of total billed charges,80% of total billed charges,1313.85,85,,,percent of total billed charges,85% of total billed charges,1391.13,90,,,percent of total billed charges,90% of total billed charges,1545.7,100,,,fee schedule,100% of CO APG rates,1545.7,100,,,fee schedule,100% of CO APG rates,1545.7,100,,,fee schedule,100% of NM fee schedule,618.28,40,,,percent of total billed charges,40% of total billed charges,618.28,40,,,percent of total billed charges,40% of total billed charges,1391.13,90,,,percent of total billed charges,90% of total billed charges,1174.73,76,,,percent of total billed charges,76% of total billed charges,618.28,40,,,percent of total billed charges,40% of total billed charges,1313.85,85,,,percent of total billed charges,85% of total billed charges,1545.7,100,,,fee schedule,100% of CO APG rate,1236.56,80,,,percent of total billed charges,80% of total billed charges,599.73,38.8,,,percent of total billed charges,38.8% of total billed charges,1313.85,85,,,percent of total billed charges,85% of total billed charges,1545.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,599.73,1545.7,
1/3 Tubular Plates 5 Holes 59mm,60000862,CDM,278,RC,,,OUTPATIENT,,,1489,1191.2,,1116.75,75,,,percent of total billed charges,75% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1179.29,79.2,,,percent of total billed charges,79.2% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1414.55,95,,,percent of total billed charges,95% of total billed charges,1191.2,80,,,percent of total billed charges,80% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of NM fee schedule,595.6,40,,,percent of total billed charges,40% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1131.64,76,,,percent of total billed charges,76% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rate,1191.2,80,,,percent of total billed charges,80% of total billed charges,577.73,38.8,,,percent of total billed charges,38.8% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,577.73,1489,
1/3 Tubular Plates 6 Holes 71mm,60000863,CDM,278,RC,,,OUTPATIENT,,,1489,1191.2,,1116.75,75,,,percent of total billed charges,75% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1179.29,79.2,,,percent of total billed charges,79.2% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1414.55,95,,,percent of total billed charges,95% of total billed charges,1191.2,80,,,percent of total billed charges,80% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of NM fee schedule,595.6,40,,,percent of total billed charges,40% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1131.64,76,,,percent of total billed charges,76% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rate,1191.2,80,,,percent of total billed charges,80% of total billed charges,577.73,38.8,,,percent of total billed charges,38.8% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,577.73,1489,
1/3 Tubular Plates 7 Holes 83mm,60000864,CDM,278,RC,,,OUTPATIENT,,,1489,1191.2,,1116.75,75,,,percent of total billed charges,75% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1179.29,79.2,,,percent of total billed charges,79.2% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1414.55,95,,,percent of total billed charges,95% of total billed charges,1191.2,80,,,percent of total billed charges,80% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of NM fee schedule,595.6,40,,,percent of total billed charges,40% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1131.64,76,,,percent of total billed charges,76% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rate,1191.2,80,,,percent of total billed charges,80% of total billed charges,577.73,38.8,,,percent of total billed charges,38.8% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,577.73,1489,
1/3 Tubular Plates 8 Holes 95mm,60000865,CDM,278,RC,,,OUTPATIENT,,,1489,1191.2,,1116.75,75,,,percent of total billed charges,75% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1179.29,79.2,,,percent of total billed charges,79.2% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1414.55,95,,,percent of total billed charges,95% of total billed charges,1191.2,80,,,percent of total billed charges,80% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of CO APG rates,1489,100,,,fee schedule,100% of NM fee schedule,595.6,40,,,percent of total billed charges,40% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1340.1,90,,,percent of total billed charges,90% of total billed charges,1131.64,76,,,percent of total billed charges,76% of total billed charges,595.6,40,,,percent of total billed charges,40% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of CO APG rate,1191.2,80,,,percent of total billed charges,80% of total billed charges,577.73,38.8,,,percent of total billed charges,38.8% of total billed charges,1265.65,85,,,percent of total billed charges,85% of total billed charges,1489,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,577.73,1489,
1/3 Tubular Plates 9 Holes 107mm,60000866,CDM,278,RC,,,OUTPATIENT,,,1843.5,1474.8,,1382.63,75,,,percent of total billed charges,75% of total billed charges,737.4,40,,,percent of total billed charges,40% of total billed charges,1460.05,79.2,,,percent of total billed charges,79.2% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1843.5,100,,,fee schedule,100% of CO APG rates,1751.33,95,,,percent of total billed charges,95% of total billed charges,1474.8,80,,,percent of total billed charges,80% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1659.15,90,,,percent of total billed charges,90% of total billed charges,1843.5,100,,,fee schedule,100% of CO APG rates,1843.5,100,,,fee schedule,100% of CO APG rates,1843.5,100,,,fee schedule,100% of NM fee schedule,737.4,40,,,percent of total billed charges,40% of total billed charges,737.4,40,,,percent of total billed charges,40% of total billed charges,1659.15,90,,,percent of total billed charges,90% of total billed charges,1401.06,76,,,percent of total billed charges,76% of total billed charges,737.4,40,,,percent of total billed charges,40% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1843.5,100,,,fee schedule,100% of CO APG rate,1474.8,80,,,percent of total billed charges,80% of total billed charges,715.28,38.8,,,percent of total billed charges,38.8% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1843.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,715.28,1843.5,
1/3 Tubular Plates 10 Holes 119mm,60000867,CDM,278,RC,,,OUTPATIENT,,,1843.5,1474.8,,1382.63,75,,,percent of total billed charges,75% of total billed charges,737.4,40,,,percent of total billed charges,40% of total billed charges,1460.05,79.2,,,percent of total billed charges,79.2% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1843.5,100,,,fee schedule,100% of CO APG rates,1751.33,95,,,percent of total billed charges,95% of total billed charges,1474.8,80,,,percent of total billed charges,80% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1659.15,90,,,percent of total billed charges,90% of total billed charges,1843.5,100,,,fee schedule,100% of CO APG rates,1843.5,100,,,fee schedule,100% of CO APG rates,1843.5,100,,,fee schedule,100% of NM fee schedule,737.4,40,,,percent of total billed charges,40% of total billed charges,737.4,40,,,percent of total billed charges,40% of total billed charges,1659.15,90,,,percent of total billed charges,90% of total billed charges,1401.06,76,,,percent of total billed charges,76% of total billed charges,737.4,40,,,percent of total billed charges,40% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1843.5,100,,,fee schedule,100% of CO APG rate,1474.8,80,,,percent of total billed charges,80% of total billed charges,715.28,38.8,,,percent of total billed charges,38.8% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1843.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,715.28,1843.5,
1/3 Tubular Plates 12 Holes 143mm,60000868,CDM,278,RC,,,OUTPATIENT,,,1843.5,1474.8,,1382.63,75,,,percent of total billed charges,75% of total billed charges,737.4,40,,,percent of total billed charges,40% of total billed charges,1460.05,79.2,,,percent of total billed charges,79.2% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1843.5,100,,,fee schedule,100% of CO APG rates,1751.33,95,,,percent of total billed charges,95% of total billed charges,1474.8,80,,,percent of total billed charges,80% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1659.15,90,,,percent of total billed charges,90% of total billed charges,1843.5,100,,,fee schedule,100% of CO APG rates,1843.5,100,,,fee schedule,100% of CO APG rates,1843.5,100,,,fee schedule,100% of NM fee schedule,737.4,40,,,percent of total billed charges,40% of total billed charges,737.4,40,,,percent of total billed charges,40% of total billed charges,1659.15,90,,,percent of total billed charges,90% of total billed charges,1401.06,76,,,percent of total billed charges,76% of total billed charges,737.4,40,,,percent of total billed charges,40% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1843.5,100,,,fee schedule,100% of CO APG rate,1474.8,80,,,percent of total billed charges,80% of total billed charges,715.28,38.8,,,percent of total billed charges,38.8% of total billed charges,1566.98,85,,,percent of total billed charges,85% of total billed charges,1843.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,715.28,1843.5,
1/3 Tubular Plates 14 Holes 167mm,60000869,CDM,278,RC,,,OUTPATIENT,,,2127.1,1701.68,,1595.33,75,,,percent of total billed charges,75% of total billed charges,850.84,40,,,percent of total billed charges,40% of total billed charges,1684.66,79.2,,,percent of total billed charges,79.2% of total billed charges,1808.04,85,,,percent of total billed charges,85% of total billed charges,2127.1,100,,,fee schedule,100% of CO APG rates,2020.75,95,,,percent of total billed charges,95% of total billed charges,1701.68,80,,,percent of total billed charges,80% of total billed charges,1808.04,85,,,percent of total billed charges,85% of total billed charges,1914.39,90,,,percent of total billed charges,90% of total billed charges,2127.1,100,,,fee schedule,100% of CO APG rates,2127.1,100,,,fee schedule,100% of CO APG rates,2127.1,100,,,fee schedule,100% of NM fee schedule,850.84,40,,,percent of total billed charges,40% of total billed charges,850.84,40,,,percent of total billed charges,40% of total billed charges,1914.39,90,,,percent of total billed charges,90% of total billed charges,1616.6,76,,,percent of total billed charges,76% of total billed charges,850.84,40,,,percent of total billed charges,40% of total billed charges,1808.04,85,,,percent of total billed charges,85% of total billed charges,2127.1,100,,,fee schedule,100% of CO APG rate,1701.68,80,,,percent of total billed charges,80% of total billed charges,825.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1808.04,85,,,percent of total billed charges,85% of total billed charges,2127.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,825.31,2127.1,
1/3 Tubular Plates 16 Holes 191mm,60000870,CDM,278,RC,,,OUTPATIENT,,,2127.1,1701.68,,1595.33,75,,,percent of total billed charges,75% of total billed charges,850.84,40,,,percent of total billed charges,40% of total billed charges,1684.66,79.2,,,percent of total billed charges,79.2% of total billed charges,1808.04,85,,,percent of total billed charges,85% of total billed charges,2127.1,100,,,fee schedule,100% of CO APG rates,2020.75,95,,,percent of total billed charges,95% of total billed charges,1701.68,80,,,percent of total billed charges,80% of total billed charges,1808.04,85,,,percent of total billed charges,85% of total billed charges,1914.39,90,,,percent of total billed charges,90% of total billed charges,2127.1,100,,,fee schedule,100% of CO APG rates,2127.1,100,,,fee schedule,100% of CO APG rates,2127.1,100,,,fee schedule,100% of NM fee schedule,850.84,40,,,percent of total billed charges,40% of total billed charges,850.84,40,,,percent of total billed charges,40% of total billed charges,1914.39,90,,,percent of total billed charges,90% of total billed charges,1616.6,76,,,percent of total billed charges,76% of total billed charges,850.84,40,,,percent of total billed charges,40% of total billed charges,1808.04,85,,,percent of total billed charges,85% of total billed charges,2127.1,100,,,fee schedule,100% of CO APG rate,1701.68,80,,,percent of total billed charges,80% of total billed charges,825.31,38.8,,,percent of total billed charges,38.8% of total billed charges,1808.04,85,,,percent of total billed charges,85% of total billed charges,2127.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,825.31,2127.1,
1/3 Tubular Plate Trials 5 Holes 59mm,60000871,CDM,278,RC,,,OUTPATIENT,,,265.9,212.72,,199.43,75,,,percent of total billed charges,75% of total billed charges,106.36,40,,,percent of total billed charges,40% of total billed charges,210.59,79.2,,,percent of total billed charges,79.2% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,265.9,100,,,fee schedule,100% of CO APG rates,252.61,95,,,percent of total billed charges,95% of total billed charges,212.72,80,,,percent of total billed charges,80% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,239.31,90,,,percent of total billed charges,90% of total billed charges,265.9,100,,,fee schedule,100% of CO APG rates,265.9,100,,,fee schedule,100% of CO APG rates,265.9,100,,,fee schedule,100% of NM fee schedule,106.36,40,,,percent of total billed charges,40% of total billed charges,106.36,40,,,percent of total billed charges,40% of total billed charges,239.31,90,,,percent of total billed charges,90% of total billed charges,202.08,76,,,percent of total billed charges,76% of total billed charges,106.36,40,,,percent of total billed charges,40% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,265.9,100,,,fee schedule,100% of CO APG rate,212.72,80,,,percent of total billed charges,80% of total billed charges,103.17,38.8,,,percent of total billed charges,38.8% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,265.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.17,265.9,
1/3 Tubular Plate Trials 10 Holes 119mm,60000872,CDM,278,RC,,,OUTPATIENT,,,265.9,212.72,,199.43,75,,,percent of total billed charges,75% of total billed charges,106.36,40,,,percent of total billed charges,40% of total billed charges,210.59,79.2,,,percent of total billed charges,79.2% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,265.9,100,,,fee schedule,100% of CO APG rates,252.61,95,,,percent of total billed charges,95% of total billed charges,212.72,80,,,percent of total billed charges,80% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,239.31,90,,,percent of total billed charges,90% of total billed charges,265.9,100,,,fee schedule,100% of CO APG rates,265.9,100,,,fee schedule,100% of CO APG rates,265.9,100,,,fee schedule,100% of NM fee schedule,106.36,40,,,percent of total billed charges,40% of total billed charges,106.36,40,,,percent of total billed charges,40% of total billed charges,239.31,90,,,percent of total billed charges,90% of total billed charges,202.08,76,,,percent of total billed charges,76% of total billed charges,106.36,40,,,percent of total billed charges,40% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,265.9,100,,,fee schedule,100% of CO APG rate,212.72,80,,,percent of total billed charges,80% of total billed charges,103.17,38.8,,,percent of total billed charges,38.8% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,265.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.17,265.9,
1/3 Tubular Plate Trials 16 Holes 191mm,60000873,CDM,278,RC,,,OUTPATIENT,,,265.9,212.72,,199.43,75,,,percent of total billed charges,75% of total billed charges,106.36,40,,,percent of total billed charges,40% of total billed charges,210.59,79.2,,,percent of total billed charges,79.2% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,265.9,100,,,fee schedule,100% of CO APG rates,252.61,95,,,percent of total billed charges,95% of total billed charges,212.72,80,,,percent of total billed charges,80% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,239.31,90,,,percent of total billed charges,90% of total billed charges,265.9,100,,,fee schedule,100% of CO APG rates,265.9,100,,,fee schedule,100% of CO APG rates,265.9,100,,,fee schedule,100% of NM fee schedule,106.36,40,,,percent of total billed charges,40% of total billed charges,106.36,40,,,percent of total billed charges,40% of total billed charges,239.31,90,,,percent of total billed charges,90% of total billed charges,202.08,76,,,percent of total billed charges,76% of total billed charges,106.36,40,,,percent of total billed charges,40% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,265.9,100,,,fee schedule,100% of CO APG rate,212.72,80,,,percent of total billed charges,80% of total billed charges,103.17,38.8,,,percent of total billed charges,38.8% of total billed charges,226.02,85,,,percent of total billed charges,85% of total billed charges,265.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,103.17,265.9,
Partially Threaded Cannulated Screws 24mm,60000874,CDM,278,RC,,,OUTPATIENT,,,486.6,389.28,,364.95,75,,,percent of total billed charges,75% of total billed charges,194.64,40,,,percent of total billed charges,40% of total billed charges,385.39,79.2,,,percent of total billed charges,79.2% of total billed charges,413.61,85,,,percent of total billed charges,85% of total billed charges,486.6,100,,,fee schedule,100% of CO APG rates,462.27,95,,,percent of total billed charges,95% of total billed charges,389.28,80,,,percent of total billed charges,80% of total billed charges,413.61,85,,,percent of total billed charges,85% of total billed charges,437.94,90,,,percent of total billed charges,90% of total billed charges,486.6,100,,,fee schedule,100% of CO APG rates,486.6,100,,,fee schedule,100% of CO APG rates,486.6,100,,,fee schedule,100% of NM fee schedule,194.64,40,,,percent of total billed charges,40% of total billed charges,194.64,40,,,percent of total billed charges,40% of total billed charges,437.94,90,,,percent of total billed charges,90% of total billed charges,369.82,76,,,percent of total billed charges,76% of total billed charges,194.64,40,,,percent of total billed charges,40% of total billed charges,413.61,85,,,percent of total billed charges,85% of total billed charges,486.6,100,,,fee schedule,100% of CO APG rate,389.28,80,,,percent of total billed charges,80% of total billed charges,188.8,38.8,,,percent of total billed charges,38.8% of total billed charges,413.61,85,,,percent of total billed charges,85% of total billed charges,486.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.8,486.6,
Partially Threaded Cannulated Screws 26mm,60000875,CDM,278,RC,,,OUTPATIENT,,,568.9,455.12,,426.68,75,,,percent of total billed charges,75% of total billed charges,227.56,40,,,percent of total billed charges,40% of total billed charges,450.57,79.2,,,percent of total billed charges,79.2% of total billed charges,483.57,85,,,percent of total billed charges,85% of total billed charges,568.9,100,,,fee schedule,100% of CO APG rates,540.46,95,,,percent of total billed charges,95% of total billed charges,455.12,80,,,percent of total billed charges,80% of total billed charges,483.57,85,,,percent of total billed charges,85% of total billed charges,512.01,90,,,percent of total billed charges,90% of total billed charges,568.9,100,,,fee schedule,100% of CO APG rates,568.9,100,,,fee schedule,100% of CO APG rates,568.9,100,,,fee schedule,100% of NM fee schedule,227.56,40,,,percent of total billed charges,40% of total billed charges,227.56,40,,,percent of total billed charges,40% of total billed charges,512.01,90,,,percent of total billed charges,90% of total billed charges,432.36,76,,,percent of total billed charges,76% of total billed charges,227.56,40,,,percent of total billed charges,40% of total billed charges,483.57,85,,,percent of total billed charges,85% of total billed charges,568.9,100,,,fee schedule,100% of CO APG rate,455.12,80,,,percent of total billed charges,80% of total billed charges,220.73,38.8,,,percent of total billed charges,38.8% of total billed charges,483.57,85,,,percent of total billed charges,85% of total billed charges,568.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,220.73,568.9,
Partially Threaded Cannulated Screws 28mm,60000876,CDM,278,RC,,,OUTPATIENT,,,451.5,361.2,,338.63,75,,,percent of total billed charges,75% of total billed charges,180.6,40,,,percent of total billed charges,40% of total billed charges,357.59,79.2,,,percent of total billed charges,79.2% of total billed charges,383.78,85,,,percent of total billed charges,85% of total billed charges,451.5,100,,,fee schedule,100% of CO APG rates,428.93,95,,,percent of total billed charges,95% of total billed charges,361.2,80,,,percent of total billed charges,80% of total billed charges,383.78,85,,,percent of total billed charges,85% of total billed charges,406.35,90,,,percent of total billed charges,90% of total billed charges,451.5,100,,,fee schedule,100% of CO APG rates,451.5,100,,,fee schedule,100% of CO APG rates,451.5,100,,,fee schedule,100% of NM fee schedule,180.6,40,,,percent of total billed charges,40% of total billed charges,180.6,40,,,percent of total billed charges,40% of total billed charges,406.35,90,,,percent of total billed charges,90% of total billed charges,343.14,76,,,percent of total billed charges,76% of total billed charges,180.6,40,,,percent of total billed charges,40% of total billed charges,383.78,85,,,percent of total billed charges,85% of total billed charges,451.5,100,,,fee schedule,100% of CO APG rate,361.2,80,,,percent of total billed charges,80% of total billed charges,175.18,38.8,,,percent of total billed charges,38.8% of total billed charges,383.78,85,,,percent of total billed charges,85% of total billed charges,451.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,175.18,451.5,
Partially Threaded Cannulated Screws 30mm,60000877,CDM,278,RC,,,OUTPATIENT,,,524,419.2,,393,75,,,percent of total billed charges,75% of total billed charges,209.6,40,,,percent of total billed charges,40% of total billed charges,415.01,79.2,,,percent of total billed charges,79.2% of total billed charges,445.4,85,,,percent of total billed charges,85% of total billed charges,524,100,,,fee schedule,100% of CO APG rates,497.8,95,,,percent of total billed charges,95% of total billed charges,419.2,80,,,percent of total billed charges,80% of total billed charges,445.4,85,,,percent of total billed charges,85% of total billed charges,471.6,90,,,percent of total billed charges,90% of total billed charges,524,100,,,fee schedule,100% of CO APG rates,524,100,,,fee schedule,100% of CO APG rates,524,100,,,fee schedule,100% of NM fee schedule,209.6,40,,,percent of total billed charges,40% of total billed charges,209.6,40,,,percent of total billed charges,40% of total billed charges,471.6,90,,,percent of total billed charges,90% of total billed charges,398.24,76,,,percent of total billed charges,76% of total billed charges,209.6,40,,,percent of total billed charges,40% of total billed charges,445.4,85,,,percent of total billed charges,85% of total billed charges,524,100,,,fee schedule,100% of CO APG rate,419.2,80,,,percent of total billed charges,80% of total billed charges,203.31,38.8,,,percent of total billed charges,38.8% of total billed charges,445.4,85,,,percent of total billed charges,85% of total billed charges,524,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.31,524,
Partially Threaded Cannulated Screws 32mm,60000878,CDM,278,RC,,,OUTPATIENT,,,485.2,388.16,,363.9,75,,,percent of total billed charges,75% of total billed charges,194.08,40,,,percent of total billed charges,40% of total billed charges,384.28,79.2,,,percent of total billed charges,79.2% of total billed charges,412.42,85,,,percent of total billed charges,85% of total billed charges,485.2,100,,,fee schedule,100% of CO APG rates,460.94,95,,,percent of total billed charges,95% of total billed charges,388.16,80,,,percent of total billed charges,80% of total billed charges,412.42,85,,,percent of total billed charges,85% of total billed charges,436.68,90,,,percent of total billed charges,90% of total billed charges,485.2,100,,,fee schedule,100% of CO APG rates,485.2,100,,,fee schedule,100% of CO APG rates,485.2,100,,,fee schedule,100% of NM fee schedule,194.08,40,,,percent of total billed charges,40% of total billed charges,194.08,40,,,percent of total billed charges,40% of total billed charges,436.68,90,,,percent of total billed charges,90% of total billed charges,368.75,76,,,percent of total billed charges,76% of total billed charges,194.08,40,,,percent of total billed charges,40% of total billed charges,412.42,85,,,percent of total billed charges,85% of total billed charges,485.2,100,,,fee schedule,100% of CO APG rate,388.16,80,,,percent of total billed charges,80% of total billed charges,188.26,38.8,,,percent of total billed charges,38.8% of total billed charges,412.42,85,,,percent of total billed charges,85% of total billed charges,485.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,188.26,485.2,
Partially Threaded Cannulated Screws 34mm,60000879,CDM,278,RC,,,OUTPATIENT,,,524,419.2,,393,75,,,percent of total billed charges,75% of total billed charges,209.6,40,,,percent of total billed charges,40% of total billed charges,415.01,79.2,,,percent of total billed charges,79.2% of total billed charges,445.4,85,,,percent of total billed charges,85% of total billed charges,524,100,,,fee schedule,100% of CO APG rates,497.8,95,,,percent of total billed charges,95% of total billed charges,419.2,80,,,percent of total billed charges,80% of total billed charges,445.4,85,,,percent of total billed charges,85% of total billed charges,471.6,90,,,percent of total billed charges,90% of total billed charges,524,100,,,fee schedule,100% of CO APG rates,524,100,,,fee schedule,100% of CO APG rates,524,100,,,fee schedule,100% of NM fee schedule,209.6,40,,,percent of total billed charges,40% of total billed charges,209.6,40,,,percent of total billed charges,40% of total billed charges,471.6,90,,,percent of total billed charges,90% of total billed charges,398.24,76,,,percent of total billed charges,76% of total billed charges,209.6,40,,,percent of total billed charges,40% of total billed charges,445.4,85,,,percent of total billed charges,85% of total billed charges,524,100,,,fee schedule,100% of CO APG rate,419.2,80,,,percent of total billed charges,80% of total billed charges,203.31,38.8,,,percent of total billed charges,38.8% of total billed charges,445.4,85,,,percent of total billed charges,85% of total billed charges,524,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,203.31,524,
Partially Threaded Cannulated Screws 36mm,60000880,CDM,278,RC,,,OUTPATIENT,,,471.6,377.28,,353.7,75,,,percent of total billed charges,75% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,373.51,79.2,,,percent of total billed charges,79.2% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,448.02,95,,,percent of total billed charges,95% of total billed charges,377.28,80,,,percent of total billed charges,80% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of CO APG rates,471.6,100,,,fee schedule,100% of NM fee schedule,188.64,40,,,percent of total billed charges,40% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,424.44,90,,,percent of total billed charges,90% of total billed charges,358.42,76,,,percent of total billed charges,76% of total billed charges,188.64,40,,,percent of total billed charges,40% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of CO APG rate,377.28,80,,,percent of total billed charges,80% of total billed charges,182.98,38.8,,,percent of total billed charges,38.8% of total billed charges,400.86,85,,,percent of total billed charges,85% of total billed charges,471.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.98,471.6,
"Volar Distal Radius Plate Left Narrow Short, 49mm",60000881,CDM,278,RC,,,OUTPATIENT,,,2022,1617.6,,1516.5,75,,,percent of total billed charges,75% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1601.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,1920.9,95,,,percent of total billed charges,95% of total billed charges,1617.6,80,,,percent of total billed charges,80% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of NM fee schedule,808.8,40,,,percent of total billed charges,40% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,1536.72,76,,,percent of total billed charges,76% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rate,1617.6,80,,,percent of total billed charges,80% of total billed charges,784.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,784.54,2022,
"Volar Distal Radius Plate Left Narrow Short, 56mm",60000882,CDM,278,RC,,,OUTPATIENT,,,2198.8,1759.04,,1649.1,75,,,percent of total billed charges,75% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1741.45,79.2,,,percent of total billed charges,79.2% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2088.86,95,,,percent of total billed charges,95% of total billed charges,1759.04,80,,,percent of total billed charges,80% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of NM fee schedule,879.52,40,,,percent of total billed charges,40% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,1671.09,76,,,percent of total billed charges,76% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rate,1759.04,80,,,percent of total billed charges,80% of total billed charges,853.13,38.8,,,percent of total billed charges,38.8% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,853.13,2198.8,
"Volar Distal Radius Plate Left Narrow Long, 76mm",60000883,CDM,278,RC,,,OUTPATIENT,,,2198.8,1759.04,,1649.1,75,,,percent of total billed charges,75% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1741.45,79.2,,,percent of total billed charges,79.2% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2088.86,95,,,percent of total billed charges,95% of total billed charges,1759.04,80,,,percent of total billed charges,80% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of NM fee schedule,879.52,40,,,percent of total billed charges,40% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,1671.09,76,,,percent of total billed charges,76% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rate,1759.04,80,,,percent of total billed charges,80% of total billed charges,853.13,38.8,,,percent of total billed charges,38.8% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,853.13,2198.8,
"Volar Distal Radius Plate Left  Intermediate Extra  Short, 4",60000884,CDM,278,RC,,,OUTPATIENT,,,2022,1617.6,,1516.5,75,,,percent of total billed charges,75% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1601.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,1920.9,95,,,percent of total billed charges,95% of total billed charges,1617.6,80,,,percent of total billed charges,80% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of NM fee schedule,808.8,40,,,percent of total billed charges,40% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,1536.72,76,,,percent of total billed charges,76% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rate,1617.6,80,,,percent of total billed charges,80% of total billed charges,784.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,784.54,2022,
"Volar Distal Radius Plate Left Intermediate Short, 56mm",60000885,CDM,278,RC,,,OUTPATIENT,,,2022,1617.6,,1516.5,75,,,percent of total billed charges,75% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1601.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,1920.9,95,,,percent of total billed charges,95% of total billed charges,1617.6,80,,,percent of total billed charges,80% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of NM fee schedule,808.8,40,,,percent of total billed charges,40% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,1536.72,76,,,percent of total billed charges,76% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rate,1617.6,80,,,percent of total billed charges,80% of total billed charges,784.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,784.54,2022,
"Volar Distal Radius Plate Left  Intermediate  Long, 76mm",60000886,CDM,278,RC,,,OUTPATIENT,,,2330.8,1864.64,,1748.1,75,,,percent of total billed charges,75% of total billed charges,932.32,40,,,percent of total billed charges,40% of total billed charges,1845.99,79.2,,,percent of total billed charges,79.2% of total billed charges,1981.18,85,,,percent of total billed charges,85% of total billed charges,2330.8,100,,,fee schedule,100% of CO APG rates,2214.26,95,,,percent of total billed charges,95% of total billed charges,1864.64,80,,,percent of total billed charges,80% of total billed charges,1981.18,85,,,percent of total billed charges,85% of total billed charges,2097.72,90,,,percent of total billed charges,90% of total billed charges,2330.8,100,,,fee schedule,100% of CO APG rates,2330.8,100,,,fee schedule,100% of CO APG rates,2330.8,100,,,fee schedule,100% of NM fee schedule,932.32,40,,,percent of total billed charges,40% of total billed charges,932.32,40,,,percent of total billed charges,40% of total billed charges,2097.72,90,,,percent of total billed charges,90% of total billed charges,1771.41,76,,,percent of total billed charges,76% of total billed charges,932.32,40,,,percent of total billed charges,40% of total billed charges,1981.18,85,,,percent of total billed charges,85% of total billed charges,2330.8,100,,,fee schedule,100% of CO APG rate,1864.64,80,,,percent of total billed charges,80% of total billed charges,904.35,38.8,,,percent of total billed charges,38.8% of total billed charges,1981.18,85,,,percent of total billed charges,85% of total billed charges,2330.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,904.35,2330.8,
"Volar Distal Radius Plate Left  Standard Extra  Short, 49mm",60000887,CDM,278,RC,,,OUTPATIENT,,,2022,1617.6,,1516.5,75,,,percent of total billed charges,75% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1601.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,1920.9,95,,,percent of total billed charges,95% of total billed charges,1617.6,80,,,percent of total billed charges,80% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of NM fee schedule,808.8,40,,,percent of total billed charges,40% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,1536.72,76,,,percent of total billed charges,76% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rate,1617.6,80,,,percent of total billed charges,80% of total billed charges,784.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,784.54,2022,
"Volar Distal Radius Plate Left Standard Short, 56mm",60000888,CDM,278,RC,,,OUTPATIENT,,,2198.8,1759.04,,1649.1,75,,,percent of total billed charges,75% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1741.45,79.2,,,percent of total billed charges,79.2% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2088.86,95,,,percent of total billed charges,95% of total billed charges,1759.04,80,,,percent of total billed charges,80% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of NM fee schedule,879.52,40,,,percent of total billed charges,40% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,1671.09,76,,,percent of total billed charges,76% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rate,1759.04,80,,,percent of total billed charges,80% of total billed charges,853.13,38.8,,,percent of total billed charges,38.8% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,853.13,2198.8,
"Volar Distal Radius Plate Left Standard Long, 76mm",600008889,CDM,278,RC,,,OUTPATIENT,,,2198.8,1759.04,,1649.1,75,,,percent of total billed charges,75% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1741.45,79.2,,,percent of total billed charges,79.2% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2088.86,95,,,percent of total billed charges,95% of total billed charges,1759.04,80,,,percent of total billed charges,80% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of NM fee schedule,879.52,40,,,percent of total billed charges,40% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,1671.09,76,,,percent of total billed charges,76% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rate,1759.04,80,,,percent of total billed charges,80% of total billed charges,853.13,38.8,,,percent of total billed charges,38.8% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,853.13,2198.8,
"Volar Distal Radius Plate Right Narrow Extra Short, 49mm",60000890,CDM,278,RC,,,OUTPATIENT,,,2022,1617.6,,1516.5,75,,,percent of total billed charges,75% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1601.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,1920.9,95,,,percent of total billed charges,95% of total billed charges,1617.6,80,,,percent of total billed charges,80% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of NM fee schedule,808.8,40,,,percent of total billed charges,40% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,1536.72,76,,,percent of total billed charges,76% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rate,1617.6,80,,,percent of total billed charges,80% of total billed charges,784.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,784.54,2022,
"Volar Distal Radius Plate Right Narrow Short, 56mm",60000891,CDM,278,RC,,,OUTPATIENT,,,2198.8,1759.04,,1649.1,75,,,percent of total billed charges,75% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1741.45,79.2,,,percent of total billed charges,79.2% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2088.86,95,,,percent of total billed charges,95% of total billed charges,1759.04,80,,,percent of total billed charges,80% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of NM fee schedule,879.52,40,,,percent of total billed charges,40% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,1671.09,76,,,percent of total billed charges,76% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rate,1759.04,80,,,percent of total billed charges,80% of total billed charges,853.13,38.8,,,percent of total billed charges,38.8% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,853.13,2198.8,
"Volar Distal Radius Plate Right Narrow Long, 76mm",60000892,CDM,278,RC,,,OUTPATIENT,,,2198.8,1759.04,,1649.1,75,,,percent of total billed charges,75% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1741.45,79.2,,,percent of total billed charges,79.2% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2088.86,95,,,percent of total billed charges,95% of total billed charges,1759.04,80,,,percent of total billed charges,80% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of NM fee schedule,879.52,40,,,percent of total billed charges,40% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,1671.09,76,,,percent of total billed charges,76% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rate,1759.04,80,,,percent of total billed charges,80% of total billed charges,853.13,38.8,,,percent of total billed charges,38.8% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,853.13,2198.8,
"Volar Distal Radius Plate Right  Intermediate Extra Short, 4",60000893,CDM,278,RC,,,OUTPATIENT,,,2022,1617.6,,1516.5,75,,,percent of total billed charges,75% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1601.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,1920.9,95,,,percent of total billed charges,95% of total billed charges,1617.6,80,,,percent of total billed charges,80% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of NM fee schedule,808.8,40,,,percent of total billed charges,40% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,1536.72,76,,,percent of total billed charges,76% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rate,1617.6,80,,,percent of total billed charges,80% of total billed charges,784.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,784.54,2022,
"Volar Distal Radius Plate Right Intermediate Short, 56mm",60000894,CDM,278,RC,,,OUTPATIENT,,,2022,1617.6,,1516.5,75,,,percent of total billed charges,75% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1601.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,1920.9,95,,,percent of total billed charges,95% of total billed charges,1617.6,80,,,percent of total billed charges,80% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of NM fee schedule,808.8,40,,,percent of total billed charges,40% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,1536.72,76,,,percent of total billed charges,76% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rate,1617.6,80,,,percent of total billed charges,80% of total billed charges,784.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,784.54,2022,
"Volar Distal Radius Plate Right Intermediate Long, 76mm",60000895,CDM,278,RC,,,OUTPATIENT,,,2330.8,1864.64,,1748.1,75,,,percent of total billed charges,75% of total billed charges,932.32,40,,,percent of total billed charges,40% of total billed charges,1845.99,79.2,,,percent of total billed charges,79.2% of total billed charges,1981.18,85,,,percent of total billed charges,85% of total billed charges,2330.8,100,,,fee schedule,100% of CO APG rates,2214.26,95,,,percent of total billed charges,95% of total billed charges,1864.64,80,,,percent of total billed charges,80% of total billed charges,1981.18,85,,,percent of total billed charges,85% of total billed charges,2097.72,90,,,percent of total billed charges,90% of total billed charges,2330.8,100,,,fee schedule,100% of CO APG rates,2330.8,100,,,fee schedule,100% of CO APG rates,2330.8,100,,,fee schedule,100% of NM fee schedule,932.32,40,,,percent of total billed charges,40% of total billed charges,932.32,40,,,percent of total billed charges,40% of total billed charges,2097.72,90,,,percent of total billed charges,90% of total billed charges,1771.41,76,,,percent of total billed charges,76% of total billed charges,932.32,40,,,percent of total billed charges,40% of total billed charges,1981.18,85,,,percent of total billed charges,85% of total billed charges,2330.8,100,,,fee schedule,100% of CO APG rate,1864.64,80,,,percent of total billed charges,80% of total billed charges,904.35,38.8,,,percent of total billed charges,38.8% of total billed charges,1981.18,85,,,percent of total billed charges,85% of total billed charges,2330.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,904.35,2330.8,
"Volar Distal Radius Plate Right Standard Extra Short, 49mm",60000896,CDM,278,RC,,,OUTPATIENT,,,2022,1617.6,,1516.5,75,,,percent of total billed charges,75% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1601.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,1920.9,95,,,percent of total billed charges,95% of total billed charges,1617.6,80,,,percent of total billed charges,80% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of CO APG rates,2022,100,,,fee schedule,100% of NM fee schedule,808.8,40,,,percent of total billed charges,40% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1819.8,90,,,percent of total billed charges,90% of total billed charges,1536.72,76,,,percent of total billed charges,76% of total billed charges,808.8,40,,,percent of total billed charges,40% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of CO APG rate,1617.6,80,,,percent of total billed charges,80% of total billed charges,784.54,38.8,,,percent of total billed charges,38.8% of total billed charges,1718.7,85,,,percent of total billed charges,85% of total billed charges,2022,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,784.54,2022,
"Volar Distal Radius Plate Right  Standard Short, 56mm",60000897,CDM,278,RC,,,OUTPATIENT,,,2198.8,1759.04,,1649.1,75,,,percent of total billed charges,75% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1741.45,79.2,,,percent of total billed charges,79.2% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2088.86,95,,,percent of total billed charges,95% of total billed charges,1759.04,80,,,percent of total billed charges,80% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of NM fee schedule,879.52,40,,,percent of total billed charges,40% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,1671.09,76,,,percent of total billed charges,76% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rate,1759.04,80,,,percent of total billed charges,80% of total billed charges,853.13,38.8,,,percent of total billed charges,38.8% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,853.13,2198.8,
"Volar Distal Radius Plate Right Standard Long, 76mm",60000898,CDM,278,RC,,,OUTPATIENT,,,2198.8,1759.04,,1649.1,75,,,percent of total billed charges,75% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1741.45,79.2,,,percent of total billed charges,79.2% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2088.86,95,,,percent of total billed charges,95% of total billed charges,1759.04,80,,,percent of total billed charges,80% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of CO APG rates,2198.8,100,,,fee schedule,100% of NM fee schedule,879.52,40,,,percent of total billed charges,40% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1978.92,90,,,percent of total billed charges,90% of total billed charges,1671.09,76,,,percent of total billed charges,76% of total billed charges,879.52,40,,,percent of total billed charges,40% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of CO APG rate,1759.04,80,,,percent of total billed charges,80% of total billed charges,853.13,38.8,,,percent of total billed charges,38.8% of total billed charges,1868.98,85,,,percent of total billed charges,85% of total billed charges,2198.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,853.13,2198.8,
2.4mm Locking Screws 8mm,60000899,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,176.19,454.1,
2.4mm Locking Screws 10mm,60000900,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,176.19,454.1,
2.4mm Locking Screws 12mm,60000901,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,176.19,454.1,
2.4mm Locking Screws 14mm,60000902,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,176.19,454.1,
2.4mm Locking Screws 16mm,60000903,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,176.19,454.1,
2.4mm Locking Screws 18mm,60000904,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,176.19,454.1,
2.4mm Locking Screws 20mm,60000905,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,176.19,454.1,
2.4mm Locking Screws 22mm,60000906,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,176.19,454.1,
2.4mm Locking Screws 24mm,60000907,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,176.19,454.1,
2.4mm Locking Screws 26mm,60000908,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,176.19,454.1,
2.4mm Locking Screws 28mm,60000909,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.4mm Locking Screws 30mm,60000910,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.4mm Locking Screws 32mm,60000911,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.4mm Locking Screws 34mm,60000912,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.4mm Locking Screws 36mm,60000913,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.4mm Locking Screws 38mm,60000914,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.4mm Non-Locking Screws 8mm,60000915,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 10mm,60000916,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 12mm,60000917,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 14mm,60000918,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 16mm,60000919,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 18mm,60000920,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 20mm,60000921,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 22mm,60000922,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 24mm,60000923,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 26mm,60000924,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 28mm,60000925,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 30mm,60000926,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 32mm,60000927,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 34mm,60000928,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 36mm,60000929,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.4mm Non-Locking Screws 38mm,60000930,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
Locking Pegs 16mm,60000931,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
Locking Pegs 18mm,60000932,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
Locking Pegs 20mm,60000933,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
Locking Pegs 22mm,60000934,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
Locking Pegs 24mm,60000935,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
Locking Pegs 26mm,60000936,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 8mm,60000937,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 10mm,60000938,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 12mm,60000939,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 14mm,60000940,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 16mm,60000941,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 18mm,60000942,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 20mm,60000943,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 22mm,60000944,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 24mm,60000945,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 26mm,60000946,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 28mm,60000947,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 30mm,60000948,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 32mm,60000949,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 34mm,60000950,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 36mm,60000951,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 38mm,60000952,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 40mm,60000953,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 45mm,60000954,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Locking Screws 50mm,60000955,CDM,278,RC,,,OUTPATIENT,,,454.1,363.28,,340.58,75,,,percent of total billed charges,75% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,359.65,79.2,,,percent of total billed charges,79.2% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,431.4,95,,,percent of total billed charges,95% of total billed charges,363.28,80,,,percent of total billed charges,80% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of CO APG rates,454.1,100,,,fee schedule,100% of NM fee schedule,181.64,40,,,percent of total billed charges,40% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,408.69,90,,,percent of total billed charges,90% of total billed charges,345.12,76,,,percent of total billed charges,76% of total billed charges,181.64,40,,,percent of total billed charges,40% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of CO APG rate,363.28,80,,,percent of total billed charges,80% of total billed charges,176.19,38.8,,,percent of total billed charges,38.8% of total billed charges,385.99,85,,,percent of total billed charges,85% of total billed charges,454.1,100,,,fee schedule,100% of APG fee schedule,908.2,200,,,percent of total billed charges,200% of total billed charges,176.19,908.2,
2.7mm Non-Locking Screws 8mm,60000956,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 10mm,60000957,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 12mm,60000958,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 14mm,60000959,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 16mm,60000960,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 18mm,60000961,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 20mm,60000962,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 22mm,60000963,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 24mm,60000964,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 26mm,60000965,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 28mm,60000966,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 30mm,60000967,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 32mm,60000968,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 34mm,60000969,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 36mm,60000970,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 38mm,60000971,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 40mm,60000972,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 45mm,60000973,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
2.7mm Non-Locking Screws 50mm,60000974,CDM,278,RC,,,OUTPATIENT,,,397.1,317.68,,297.83,75,,,percent of total billed charges,75% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,314.5,79.2,,,percent of total billed charges,79.2% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,377.25,95,,,percent of total billed charges,95% of total billed charges,317.68,80,,,percent of total billed charges,80% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of CO APG rates,397.1,100,,,fee schedule,100% of NM fee schedule,158.84,40,,,percent of total billed charges,40% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,357.39,90,,,percent of total billed charges,90% of total billed charges,301.8,76,,,percent of total billed charges,76% of total billed charges,158.84,40,,,percent of total billed charges,40% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of CO APG rate,317.68,80,,,percent of total billed charges,80% of total billed charges,154.07,38.8,,,percent of total billed charges,38.8% of total billed charges,337.54,85,,,percent of total billed charges,85% of total billed charges,397.1,100,,,fee schedule,100% of APG fee schedule,794.2,200,,,percent of total billed charges,200% of total billed charges,154.07,794.2,
"64510 - Injection, Anesthetic Agent; Stellate Gang",60000813,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2658.2,2126.56,,1993.65,75,,,percent of total billed charges,75% of total billed charges,1063.28,40,,,percent of total billed charges,40% of total billed charges,2105.29,79.2,,,percent of total billed charges,79.2% of total billed charges,2259.47,85,,,percent of total billed charges,85% of total billed charges,2658.2,100,,,fee schedule,100% of CO APG rates,2525.29,95,,,percent of total billed charges,95% of total billed charges,2126.56,80,,,percent of total billed charges,80% of total billed charges,2259.47,85,,,percent of total billed charges,85% of total billed charges,2392.38,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,1063.28,40,,,percent of total billed charges,40% of total billed charges,1063.28,40,,,percent of total billed charges,40% of total billed charges,2392.38,90,,,percent of total billed charges,90% of total billed charges,2020.23,76,,,percent of total billed charges,76% of total billed charges,1063.28,40,,,percent of total billed charges,40% of total billed charges,2259.47,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,2126.56,80,,,percent of total billed charges,80% of total billed charges,1031.38,38.8,,,percent of total billed charges,38.8% of total billed charges,2259.47,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
Marquee Disposable Core Biopsy Kit 18Gx10cm,60000983,CDM,270,RC,,,OUTPATIENT,,,373.6,298.88,,280.2,75,,,percent of total billed charges,75% of total billed charges,149.44,40,,,percent of total billed charges,40% of total billed charges,295.89,79.2,,,percent of total billed charges,79.2% of total billed charges,317.56,85,,,percent of total billed charges,85% of total billed charges,373.6,100,,,fee schedule,100% of CO APG rates,354.92,95,,,percent of total billed charges,95% of total billed charges,298.88,80,,,percent of total billed charges,80% of total billed charges,317.56,85,,,percent of total billed charges,85% of total billed charges,336.24,90,,,percent of total billed charges,90% of total billed charges,373.6,100,,,fee schedule,100% of CO APG rates,373.6,100,,,fee schedule,100% of CO APG rates,373.6,100,,,fee schedule,100% of NM fee schedule,149.44,40,,,percent of total billed charges,40% of total billed charges,149.44,40,,,percent of total billed charges,40% of total billed charges,336.24,90,,,percent of total billed charges,90% of total billed charges,283.94,76,,,percent of total billed charges,76% of total billed charges,149.44,40,,,percent of total billed charges,40% of total billed charges,317.56,85,,,percent of total billed charges,85% of total billed charges,373.6,100,,,fee schedule,100% of CO APG rate,298.88,80,,,percent of total billed charges,80% of total billed charges,144.96,38.8,,,percent of total billed charges,38.8% of total billed charges,317.56,85,,,percent of total billed charges,85% of total billed charges,373.6,100,,,fee schedule,100% of APG fee schedule,747.2,200,,,percent of total billed charges,200% of total billed charges,144.96,747.2,
Marquee Disposable Core Biopsy Lit 20Gx16cm,60000984,CDM,270,RC,,,OUTPATIENT,,,373.6,298.88,,280.2,75,,,percent of total billed charges,75% of total billed charges,149.44,40,,,percent of total billed charges,40% of total billed charges,295.89,79.2,,,percent of total billed charges,79.2% of total billed charges,317.56,85,,,percent of total billed charges,85% of total billed charges,373.6,100,,,fee schedule,100% of CO APG rates,354.92,95,,,percent of total billed charges,95% of total billed charges,298.88,80,,,percent of total billed charges,80% of total billed charges,317.56,85,,,percent of total billed charges,85% of total billed charges,336.24,90,,,percent of total billed charges,90% of total billed charges,373.6,100,,,fee schedule,100% of CO APG rates,373.6,100,,,fee schedule,100% of CO APG rates,373.6,100,,,fee schedule,100% of NM fee schedule,149.44,40,,,percent of total billed charges,40% of total billed charges,149.44,40,,,percent of total billed charges,40% of total billed charges,336.24,90,,,percent of total billed charges,90% of total billed charges,283.94,76,,,percent of total billed charges,76% of total billed charges,149.44,40,,,percent of total billed charges,40% of total billed charges,317.56,85,,,percent of total billed charges,85% of total billed charges,373.6,100,,,fee schedule,100% of CO APG rate,298.88,80,,,percent of total billed charges,80% of total billed charges,144.96,38.8,,,percent of total billed charges,38.8% of total billed charges,317.56,85,,,percent of total billed charges,85% of total billed charges,373.6,100,,,fee schedule,100% of APG fee schedule,747.2,200,,,percent of total billed charges,200% of total billed charges,144.96,747.2,
O2-Max CPAP System with 5-SET Adult Large,60000985,CDM,270,RC,,,OUTPATIENT,,,202.3,161.84,,151.73,75,,,percent of total billed charges,75% of total billed charges,80.92,40,,,percent of total billed charges,40% of total billed charges,160.22,79.2,,,percent of total billed charges,79.2% of total billed charges,171.96,85,,,percent of total billed charges,85% of total billed charges,202.3,100,,,fee schedule,100% of CO APG rates,192.19,95,,,percent of total billed charges,95% of total billed charges,161.84,80,,,percent of total billed charges,80% of total billed charges,171.96,85,,,percent of total billed charges,85% of total billed charges,182.07,90,,,percent of total billed charges,90% of total billed charges,202.3,100,,,fee schedule,100% of CO APG rates,202.3,100,,,fee schedule,100% of CO APG rates,202.3,100,,,fee schedule,100% of NM fee schedule,80.92,40,,,percent of total billed charges,40% of total billed charges,80.92,40,,,percent of total billed charges,40% of total billed charges,182.07,90,,,percent of total billed charges,90% of total billed charges,153.75,76,,,percent of total billed charges,76% of total billed charges,80.92,40,,,percent of total billed charges,40% of total billed charges,171.96,85,,,percent of total billed charges,85% of total billed charges,202.3,100,,,fee schedule,100% of CO APG rate,161.84,80,,,percent of total billed charges,80% of total billed charges,78.49,38.8,,,percent of total billed charges,38.8% of total billed charges,171.96,85,,,percent of total billed charges,85% of total billed charges,202.3,100,,,fee schedule,100% of APG fee schedule,404.6,200,,,percent of total billed charges,200% of total billed charges,78.49,404.6,
O2-MAX CPAP System with 3-SET Adult Mediun,60000986,CDM,270,RC,,,OUTPATIENT,,,195,156,,146.25,75,,,percent of total billed charges,75% of total billed charges,78,40,,,percent of total billed charges,40% of total billed charges,154.44,79.2,,,percent of total billed charges,79.2% of total billed charges,165.75,85,,,percent of total billed charges,85% of total billed charges,195,100,,,fee schedule,100% of CO APG rates,185.25,95,,,percent of total billed charges,95% of total billed charges,156,80,,,percent of total billed charges,80% of total billed charges,165.75,85,,,percent of total billed charges,85% of total billed charges,175.5,90,,,percent of total billed charges,90% of total billed charges,195,100,,,fee schedule,100% of CO APG rates,195,100,,,fee schedule,100% of CO APG rates,195,100,,,fee schedule,100% of NM fee schedule,78,40,,,percent of total billed charges,40% of total billed charges,78,40,,,percent of total billed charges,40% of total billed charges,175.5,90,,,percent of total billed charges,90% of total billed charges,148.2,76,,,percent of total billed charges,76% of total billed charges,78,40,,,percent of total billed charges,40% of total billed charges,165.75,85,,,percent of total billed charges,85% of total billed charges,195,100,,,fee schedule,100% of CO APG rate,156,80,,,percent of total billed charges,80% of total billed charges,75.66,38.8,,,percent of total billed charges,38.8% of total billed charges,165.75,85,,,percent of total billed charges,85% of total billed charges,195,100,,,fee schedule,100% of APG fee schedule,390,200,,,percent of total billed charges,200% of total billed charges,75.66,390,
0124A ADMIN COVID-19 VACCINE BIVALENT,60000992,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,55,44,,41.25,75,,,percent of total billed charges,75% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,43.56,79.2,,,percent of total billed charges,79.2% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,52.25,95,,,percent of total billed charges,95% of total billed charges,44,80,,,percent of total billed charges,80% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,49.5,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,55,100,,,fee schedule,100% of NM APC rate,22,40,,,percent of total billed charges,40% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,49.5,90,,,percent of total billed charges,90% of total billed charges,41.8,76,,,percent of total billed charges,76% of total billed charges,22,40,,,percent of total billed charges,40% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,44,80,,,percent of total billed charges,80% of total billed charges,21.34,38.8,,,percent of total billed charges,38.8% of total billed charges,46.75,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,21.34,55,
HSV 1/2 CSF PCR LC,40087529,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,128.8,103.04,,96.6,75,,,percent of total billed charges,75% of total billed charges,51.52,40,,,percent of total billed charges,40% of total billed charges,102.01,79.2,,,percent of total billed charges,79.2% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,122.36,95,,,percent of total billed charges,95% of total billed charges,103.04,80,,,percent of total billed charges,80% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,115.92,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,51.52,40,,,percent of total billed charges,40% of total billed charges,51.52,40,,,percent of total billed charges,40% of total billed charges,115.92,90,,,percent of total billed charges,90% of total billed charges,97.89,76,,,percent of total billed charges,76% of total billed charges,51.52,40,,,percent of total billed charges,40% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,103.04,80,,,percent of total billed charges,80% of total billed charges,49.97,38.8,,,percent of total billed charges,38.8% of total billed charges,109.48,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,122.36,
MA Screening Tomo,60000999,CDM,403,RC,77067,HCPCS,OUTPATIENT,,,107.1,85.68,TC,80.33,75,,,percent of total billed charges,75% of total billed charges,42.84,40,,,percent of total billed charges,40% of total billed charges,84.82,79.2,,,percent of total billed charges,79.2% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,101.75,95,,,percent of total billed charges,95% of total billed charges,85.68,80,,,percent of total billed charges,80% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,96.39,90,,,percent of total billed charges,90% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rates,66.74,100,,,fee schedule,100% of CO APG rates,107.1,100,,,fee schedule,100% of NM fee schedule,42.84,40,,,percent of total billed charges,40% of total billed charges,42.84,40,,,percent of total billed charges,40% of total billed charges,96.39,90,,,percent of total billed charges,90% of total billed charges,81.4,76,,,percent of total billed charges,76% of total billed charges,42.84,40,,,percent of total billed charges,40% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of CO APG rate,85.68,80,,,percent of total billed charges,80% of total billed charges,41.55,38.8,,,percent of total billed charges,38.8% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,66.74,100,,,fee schedule,100% of APG fee schedule,214.2,200,,,fee schedule,200% of CMS fee schedule,41.55,214.2,
MA Diag Bil Tomo,60001000,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,107.1,85.68,TC,80.33,75,,,percent of total billed charges,75% of total billed charges,42.84,40,,,percent of total billed charges,40% of total billed charges,84.82,79.2,,,percent of total billed charges,79.2% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,107.1,100,,,fee schedule,100% of CO APG rates,101.75,95,,,percent of total billed charges,95% of total billed charges,85.68,80,,,percent of total billed charges,80% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,96.39,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,107.1,100,,,fee schedule,100% of NM APC rate,42.84,40,,,percent of total billed charges,40% of total billed charges,42.84,40,,,percent of total billed charges,40% of total billed charges,96.39,90,,,percent of total billed charges,90% of total billed charges,81.4,76,,,percent of total billed charges,76% of total billed charges,42.84,40,,,percent of total billed charges,40% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,85.68,80,,,percent of total billed charges,80% of total billed charges,41.55,38.8,,,percent of total billed charges,38.8% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,41.55,159.09,
MA Diag Unil Tomo,60001001,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,107.1,85.68,TC,80.33,75,,,percent of total billed charges,75% of total billed charges,42.84,40,,,percent of total billed charges,40% of total billed charges,84.82,79.2,,,percent of total billed charges,79.2% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,107.1,100,,,fee schedule,100% of CO APG rates,101.75,95,,,percent of total billed charges,95% of total billed charges,85.68,80,,,percent of total billed charges,80% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,96.39,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,107.1,100,,,fee schedule,100% of NM APC rate,42.84,40,,,percent of total billed charges,40% of total billed charges,42.84,40,,,percent of total billed charges,40% of total billed charges,96.39,90,,,percent of total billed charges,90% of total billed charges,81.4,76,,,percent of total billed charges,76% of total billed charges,42.84,40,,,percent of total billed charges,40% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,85.68,80,,,percent of total billed charges,80% of total billed charges,41.55,38.8,,,percent of total billed charges,38.8% of total billed charges,91.04,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,41.55,159.09,
Thyroxine; free,60001035,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,131.3,105.04,,98.48,75,,,percent of total billed charges,75% of total billed charges,52.52,40,,,percent of total billed charges,40% of total billed charges,103.99,79.2,,,percent of total billed charges,79.2% of total billed charges,111.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,124.74,95,,,percent of total billed charges,95% of total billed charges,105.04,80,,,percent of total billed charges,80% of total billed charges,111.61,85,,,percent of total billed charges,85% of total billed charges,118.17,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,52.52,40,,,percent of total billed charges,40% of total billed charges,52.52,40,,,percent of total billed charges,40% of total billed charges,118.17,90,,,percent of total billed charges,90% of total billed charges,99.79,76,,,percent of total billed charges,76% of total billed charges,52.52,40,,,percent of total billed charges,40% of total billed charges,111.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,105.04,80,,,percent of total billed charges,80% of total billed charges,50.94,38.8,,,percent of total billed charges,38.8% of total billed charges,111.61,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,124.74,
Acapella Vibratory PEP Therapy System,60001039,CDM,270,RC,,,OUTPATIENT,,,186.4,149.12,,139.8,75,,,percent of total billed charges,75% of total billed charges,74.56,40,,,percent of total billed charges,40% of total billed charges,147.63,79.2,,,percent of total billed charges,79.2% of total billed charges,158.44,85,,,percent of total billed charges,85% of total billed charges,186.4,100,,,fee schedule,100% of CO APG rates,177.08,95,,,percent of total billed charges,95% of total billed charges,149.12,80,,,percent of total billed charges,80% of total billed charges,158.44,85,,,percent of total billed charges,85% of total billed charges,167.76,90,,,percent of total billed charges,90% of total billed charges,186.4,100,,,fee schedule,100% of CO APG rates,186.4,100,,,fee schedule,100% of CO APG rates,186.4,100,,,fee schedule,100% of NM fee schedule,74.56,40,,,percent of total billed charges,40% of total billed charges,74.56,40,,,percent of total billed charges,40% of total billed charges,167.76,90,,,percent of total billed charges,90% of total billed charges,141.66,76,,,percent of total billed charges,76% of total billed charges,74.56,40,,,percent of total billed charges,40% of total billed charges,158.44,85,,,percent of total billed charges,85% of total billed charges,186.4,100,,,fee schedule,100% of CO APG rate,149.12,80,,,percent of total billed charges,80% of total billed charges,72.32,38.8,,,percent of total billed charges,38.8% of total billed charges,158.44,85,,,percent of total billed charges,85% of total billed charges,186.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,72.32,186.4,
Endo Bundle,60001049,CDM,270,RC,,,OUTPATIENT,,,69.4,55.52,,52.05,75,,,percent of total billed charges,75% of total billed charges,27.76,40,,,percent of total billed charges,40% of total billed charges,54.96,79.2,,,percent of total billed charges,79.2% of total billed charges,58.99,85,,,percent of total billed charges,85% of total billed charges,69.4,100,,,fee schedule,100% of CO APG rates,65.93,95,,,percent of total billed charges,95% of total billed charges,55.52,80,,,percent of total billed charges,80% of total billed charges,58.99,85,,,percent of total billed charges,85% of total billed charges,62.46,90,,,percent of total billed charges,90% of total billed charges,69.4,100,,,fee schedule,100% of CO APG rates,69.4,100,,,fee schedule,100% of CO APG rates,69.4,100,,,fee schedule,100% of NM fee schedule,27.76,40,,,percent of total billed charges,40% of total billed charges,27.76,40,,,percent of total billed charges,40% of total billed charges,62.46,90,,,percent of total billed charges,90% of total billed charges,52.74,76,,,percent of total billed charges,76% of total billed charges,27.76,40,,,percent of total billed charges,40% of total billed charges,58.99,85,,,percent of total billed charges,85% of total billed charges,69.4,100,,,fee schedule,100% of CO APG rate,55.52,80,,,percent of total billed charges,80% of total billed charges,26.93,38.8,,,percent of total billed charges,38.8% of total billed charges,58.99,85,,,percent of total billed charges,85% of total billed charges,69.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.93,69.4,
PSMC MA Stereotactic Biopsy Addl,60001044,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,2408.6,1926.88,TC,1806.45,75,,,percent of total billed charges,75% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,1907.61,79.2,,,percent of total billed charges,79.2% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,2288.17,95,,,percent of total billed charges,95% of total billed charges,1926.88,80,,,percent of total billed charges,80% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,2167.74,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,963.44,40,,,percent of total billed charges,40% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,2167.74,90,,,percent of total billed charges,90% of total billed charges,1830.54,76,,,percent of total billed charges,76% of total billed charges,963.44,40,,,percent of total billed charges,40% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,1926.88,80,,,percent of total billed charges,80% of total billed charges,934.54,38.8,,,percent of total billed charges,38.8% of total billed charges,2047.31,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,145.42,2288.17,
RT Pre Post BD Spiro Charge,60000976,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,358.8,287.04,,269.1,75,,,percent of total billed charges,75% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,284.17,79.2,,,percent of total billed charges,79.2% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,340.86,95,,,percent of total billed charges,95% of total billed charges,287.04,80,,,percent of total billed charges,80% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,143.52,40,,,percent of total billed charges,40% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,272.69,76,,,percent of total billed charges,76% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,287.04,80,,,percent of total billed charges,80% of total billed charges,139.21,38.8,,,percent of total billed charges,38.8% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,340.86,
NT Pro-BNP II,40083880,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,250.7,200.56,,188.03,75,,,percent of total billed charges,75% of total billed charges,100.28,40,,,percent of total billed charges,40% of total billed charges,198.55,79.2,,,percent of total billed charges,79.2% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,238.17,95,,,percent of total billed charges,95% of total billed charges,200.56,80,,,percent of total billed charges,80% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,225.63,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,100.28,40,,,percent of total billed charges,40% of total billed charges,100.28,40,,,percent of total billed charges,40% of total billed charges,225.63,90,,,percent of total billed charges,90% of total billed charges,190.53,76,,,percent of total billed charges,76% of total billed charges,100.28,40,,,percent of total billed charges,40% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,200.56,80,,,percent of total billed charges,80% of total billed charges,97.27,38.8,,,percent of total billed charges,38.8% of total billed charges,213.1,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,238.17,
Bill Only Tissue transglutaminase each immunoglobulin,60001002,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,49.7,39.76,,37.28,75,,,percent of total billed charges,75% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,39.36,79.2,,,percent of total billed charges,79.2% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,47.22,95,,,percent of total billed charges,95% of total billed charges,39.76,80,,,percent of total billed charges,80% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,19.88,40,,,percent of total billed charges,40% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,44.73,90,,,percent of total billed charges,90% of total billed charges,37.77,76,,,percent of total billed charges,76% of total billed charges,19.88,40,,,percent of total billed charges,40% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,39.76,80,,,percent of total billed charges,80% of total billed charges,19.28,38.8,,,percent of total billed charges,38.8% of total billed charges,42.25,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,47.22,
Bill Only Actin smooth muscle antibody,60001003,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,35.4,28.32,,26.55,75,,,percent of total billed charges,75% of total billed charges,14.16,40,,,percent of total billed charges,40% of total billed charges,28.04,79.2,,,percent of total billed charges,79.2% of total billed charges,30.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,33.63,95,,,percent of total billed charges,95% of total billed charges,28.32,80,,,percent of total billed charges,80% of total billed charges,30.09,85,,,percent of total billed charges,85% of total billed charges,31.86,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,14.16,40,,,percent of total billed charges,40% of total billed charges,14.16,40,,,percent of total billed charges,40% of total billed charges,31.86,90,,,percent of total billed charges,90% of total billed charges,26.9,76,,,percent of total billed charges,76% of total billed charges,14.16,40,,,percent of total billed charges,40% of total billed charges,30.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,28.32,80,,,percent of total billed charges,80% of total billed charges,13.74,38.8,,,percent of total billed charges,38.8% of total billed charges,30.09,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,33.63,
Arterial Line Kit,60001056,CDM,270,RC,,,OUTPATIENT,,,293.8,235.04,,220.35,75,,,percent of total billed charges,75% of total billed charges,117.52,40,,,percent of total billed charges,40% of total billed charges,232.69,79.2,,,percent of total billed charges,79.2% of total billed charges,249.73,85,,,percent of total billed charges,85% of total billed charges,293.8,100,,,fee schedule,100% of CO APG rates,279.11,95,,,percent of total billed charges,95% of total billed charges,235.04,80,,,percent of total billed charges,80% of total billed charges,249.73,85,,,percent of total billed charges,85% of total billed charges,264.42,90,,,percent of total billed charges,90% of total billed charges,293.8,100,,,fee schedule,100% of CO APG rates,293.8,100,,,fee schedule,100% of CO APG rates,293.8,100,,,fee schedule,100% of NM fee schedule,117.52,40,,,percent of total billed charges,40% of total billed charges,117.52,40,,,percent of total billed charges,40% of total billed charges,264.42,90,,,percent of total billed charges,90% of total billed charges,223.29,76,,,percent of total billed charges,76% of total billed charges,117.52,40,,,percent of total billed charges,40% of total billed charges,249.73,85,,,percent of total billed charges,85% of total billed charges,293.8,100,,,fee schedule,100% of CO APG rate,235.04,80,,,percent of total billed charges,80% of total billed charges,113.99,38.8,,,percent of total billed charges,38.8% of total billed charges,249.73,85,,,percent of total billed charges,85% of total billed charges,293.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,113.99,293.8,
Pressure Transducer Kit Tru-Wave,60001057,CDM,270,RC,,,OUTPATIENT,,,591.8,473.44,,443.85,75,,,percent of total billed charges,75% of total billed charges,236.72,40,,,percent of total billed charges,40% of total billed charges,468.71,79.2,,,percent of total billed charges,79.2% of total billed charges,503.03,85,,,percent of total billed charges,85% of total billed charges,591.8,100,,,fee schedule,100% of CO APG rates,562.21,95,,,percent of total billed charges,95% of total billed charges,473.44,80,,,percent of total billed charges,80% of total billed charges,503.03,85,,,percent of total billed charges,85% of total billed charges,532.62,90,,,percent of total billed charges,90% of total billed charges,591.8,100,,,fee schedule,100% of CO APG rates,591.8,100,,,fee schedule,100% of CO APG rates,591.8,100,,,fee schedule,100% of NM fee schedule,236.72,40,,,percent of total billed charges,40% of total billed charges,236.72,40,,,percent of total billed charges,40% of total billed charges,532.62,90,,,percent of total billed charges,90% of total billed charges,449.77,76,,,percent of total billed charges,76% of total billed charges,236.72,40,,,percent of total billed charges,40% of total billed charges,503.03,85,,,percent of total billed charges,85% of total billed charges,591.8,100,,,fee schedule,100% of CO APG rate,473.44,80,,,percent of total billed charges,80% of total billed charges,229.62,38.8,,,percent of total billed charges,38.8% of total billed charges,503.03,85,,,percent of total billed charges,85% of total billed charges,591.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,229.62,591.8,
"HSV 1 IgG, Type Spec LC",40086695,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,151.24,
"HSV 2 IgG, Type Spec LC",40086696,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,159.2,127.36,,119.4,75,,,percent of total billed charges,75% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,126.09,79.2,,,percent of total billed charges,79.2% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,151.24,95,,,percent of total billed charges,95% of total billed charges,127.36,80,,,percent of total billed charges,80% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,63.68,40,,,percent of total billed charges,40% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,143.28,90,,,percent of total billed charges,90% of total billed charges,120.99,76,,,percent of total billed charges,76% of total billed charges,63.68,40,,,percent of total billed charges,40% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,127.36,80,,,percent of total billed charges,80% of total billed charges,61.77,38.8,,,percent of total billed charges,38.8% of total billed charges,135.32,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,151.24,
PSMC Omnipaque 240,60001059,CDM,255,RC,,,OUTPATIENT,,,1.01,0.808,,0.76,75,,,percent of total billed charges,75% of total billed charges,0.4,40,,,percent of total billed charges,40% of total billed charges,0.8,79.2,,,percent of total billed charges,79.2% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,1.01,100,,,fee schedule,100% of CO APG rates,0.96,95,,,percent of total billed charges,95% of total billed charges,0.81,80,,,percent of total billed charges,80% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,0.91,90,,,percent of total billed charges,90% of total billed charges,1.01,100,,,fee schedule,100% of CO APG rates,1.01,100,,,fee schedule,100% of CO APG rates,1.01,100,,,fee schedule,100% of NM fee schedule,0.4,40,,,percent of total billed charges,40% of total billed charges,0.4,40,,,percent of total billed charges,40% of total billed charges,0.91,90,,,percent of total billed charges,90% of total billed charges,0.77,76,,,percent of total billed charges,76% of total billed charges,0.4,40,,,percent of total billed charges,40% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,1.01,100,,,fee schedule,100% of CO APG rate,0.81,80,,,percent of total billed charges,80% of total billed charges,0.39,38.8,,,percent of total billed charges,38.8% of total billed charges,0.86,85,,,percent of total billed charges,85% of total billed charges,1.01,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,0.39,1.01,
HIV Ab/Ag,60001055,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,86.7,69.36,,65.03,75,,,percent of total billed charges,75% of total billed charges,34.68,40,,,percent of total billed charges,40% of total billed charges,68.67,79.2,,,percent of total billed charges,79.2% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,82.37,95,,,percent of total billed charges,95% of total billed charges,69.36,80,,,percent of total billed charges,80% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,34.68,40,,,percent of total billed charges,40% of total billed charges,34.68,40,,,percent of total billed charges,40% of total billed charges,78.03,90,,,percent of total billed charges,90% of total billed charges,65.89,76,,,percent of total billed charges,76% of total billed charges,34.68,40,,,percent of total billed charges,40% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,69.36,80,,,percent of total billed charges,80% of total billed charges,33.64,38.8,,,percent of total billed charges,38.8% of total billed charges,73.7,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,82.37,
Optison Echo Contrast Media 3mL vial,60001061,CDM,255,RC,,,OUTPATIENT,,,631.3,505.04,26,473.48,75,,,percent of total billed charges,75% of total billed charges,252.52,40,,,percent of total billed charges,40% of total billed charges,499.99,79.2,,,percent of total billed charges,79.2% of total billed charges,536.61,85,,,percent of total billed charges,85% of total billed charges,631.3,100,,,fee schedule,100% of CO APG rates,599.74,95,,,percent of total billed charges,95% of total billed charges,505.04,80,,,percent of total billed charges,80% of total billed charges,536.61,85,,,percent of total billed charges,85% of total billed charges,568.17,90,,,percent of total billed charges,90% of total billed charges,631.3,100,,,fee schedule,100% of CO APG rates,631.3,100,,,fee schedule,100% of CO APG rates,631.3,100,,,fee schedule,100% of NM fee schedule,252.52,40,,,percent of total billed charges,40% of total billed charges,252.52,40,,,percent of total billed charges,40% of total billed charges,568.17,90,,,percent of total billed charges,90% of total billed charges,479.79,76,,,percent of total billed charges,76% of total billed charges,252.52,40,,,percent of total billed charges,40% of total billed charges,536.61,85,,,percent of total billed charges,85% of total billed charges,631.3,100,,,fee schedule,100% of CO APG rate,505.04,80,,,percent of total billed charges,80% of total billed charges,244.94,38.8,,,percent of total billed charges,38.8% of total billed charges,536.61,85,,,percent of total billed charges,85% of total billed charges,631.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,244.94,631.3,
SMALL CUSHION CPAP,60001069,CDM,270,RC,,,OUTPATIENT,,,273.5,218.8,,205.13,75,,,percent of total billed charges,75% of total billed charges,109.4,40,,,percent of total billed charges,40% of total billed charges,216.61,79.2,,,percent of total billed charges,79.2% of total billed charges,232.48,85,,,percent of total billed charges,85% of total billed charges,273.5,100,,,fee schedule,100% of CO APG rates,259.83,95,,,percent of total billed charges,95% of total billed charges,218.8,80,,,percent of total billed charges,80% of total billed charges,232.48,85,,,percent of total billed charges,85% of total billed charges,246.15,90,,,percent of total billed charges,90% of total billed charges,273.5,100,,,fee schedule,100% of CO APG rates,273.5,100,,,fee schedule,100% of CO APG rates,273.5,100,,,fee schedule,100% of NM fee schedule,109.4,40,,,percent of total billed charges,40% of total billed charges,109.4,40,,,percent of total billed charges,40% of total billed charges,246.15,90,,,percent of total billed charges,90% of total billed charges,207.86,76,,,percent of total billed charges,76% of total billed charges,109.4,40,,,percent of total billed charges,40% of total billed charges,232.48,85,,,percent of total billed charges,85% of total billed charges,273.5,100,,,fee schedule,100% of CO APG rate,218.8,80,,,percent of total billed charges,80% of total billed charges,106.12,38.8,,,percent of total billed charges,38.8% of total billed charges,232.48,85,,,percent of total billed charges,85% of total billed charges,273.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,106.12,273.5,
CPAP MASK KIT MEDIUM,60001070,CDM,270,RC,,,OUTPATIENT,,,286.8,229.44,,215.1,75,,,percent of total billed charges,75% of total billed charges,114.72,40,,,percent of total billed charges,40% of total billed charges,227.15,79.2,,,percent of total billed charges,79.2% of total billed charges,243.78,85,,,percent of total billed charges,85% of total billed charges,286.8,100,,,fee schedule,100% of CO APG rates,272.46,95,,,percent of total billed charges,95% of total billed charges,229.44,80,,,percent of total billed charges,80% of total billed charges,243.78,85,,,percent of total billed charges,85% of total billed charges,258.12,90,,,percent of total billed charges,90% of total billed charges,286.8,100,,,fee schedule,100% of CO APG rates,286.8,100,,,fee schedule,100% of CO APG rates,286.8,100,,,fee schedule,100% of NM fee schedule,114.72,40,,,percent of total billed charges,40% of total billed charges,114.72,40,,,percent of total billed charges,40% of total billed charges,258.12,90,,,percent of total billed charges,90% of total billed charges,217.97,76,,,percent of total billed charges,76% of total billed charges,114.72,40,,,percent of total billed charges,40% of total billed charges,243.78,85,,,percent of total billed charges,85% of total billed charges,286.8,100,,,fee schedule,100% of CO APG rate,229.44,80,,,percent of total billed charges,80% of total billed charges,111.28,38.8,,,percent of total billed charges,38.8% of total billed charges,243.78,85,,,percent of total billed charges,85% of total billed charges,286.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,111.28,286.8,
LARGE CUSHION CPAP MASK,60001071,CDM,270,RC,,,OUTPATIENT,,,286.8,229.44,,215.1,75,,,percent of total billed charges,75% of total billed charges,114.72,40,,,percent of total billed charges,40% of total billed charges,227.15,79.2,,,percent of total billed charges,79.2% of total billed charges,243.78,85,,,percent of total billed charges,85% of total billed charges,286.8,100,,,fee schedule,100% of CO APG rates,272.46,95,,,percent of total billed charges,95% of total billed charges,229.44,80,,,percent of total billed charges,80% of total billed charges,243.78,85,,,percent of total billed charges,85% of total billed charges,258.12,90,,,percent of total billed charges,90% of total billed charges,286.8,100,,,fee schedule,100% of CO APG rates,286.8,100,,,fee schedule,100% of CO APG rates,286.8,100,,,fee schedule,100% of NM fee schedule,114.72,40,,,percent of total billed charges,40% of total billed charges,114.72,40,,,percent of total billed charges,40% of total billed charges,258.12,90,,,percent of total billed charges,90% of total billed charges,217.97,76,,,percent of total billed charges,76% of total billed charges,114.72,40,,,percent of total billed charges,40% of total billed charges,243.78,85,,,percent of total billed charges,85% of total billed charges,286.8,100,,,fee schedule,100% of CO APG rate,229.44,80,,,percent of total billed charges,80% of total billed charges,111.28,38.8,,,percent of total billed charges,38.8% of total billed charges,243.78,85,,,percent of total billed charges,85% of total billed charges,286.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,111.28,286.8,
5.5MM Alphavent and 4.75 MM,60001074,CDM,270,RC,,,OUTPATIENT,,,860.9,688.72,,645.68,75,,,percent of total billed charges,75% of total billed charges,344.36,40,,,percent of total billed charges,40% of total billed charges,681.83,79.2,,,percent of total billed charges,79.2% of total billed charges,731.77,85,,,percent of total billed charges,85% of total billed charges,860.9,100,,,fee schedule,100% of CO APG rates,817.86,95,,,percent of total billed charges,95% of total billed charges,688.72,80,,,percent of total billed charges,80% of total billed charges,731.77,85,,,percent of total billed charges,85% of total billed charges,774.81,90,,,percent of total billed charges,90% of total billed charges,860.9,100,,,fee schedule,100% of CO APG rates,860.9,100,,,fee schedule,100% of CO APG rates,860.9,100,,,fee schedule,100% of NM fee schedule,344.36,40,,,percent of total billed charges,40% of total billed charges,344.36,40,,,percent of total billed charges,40% of total billed charges,774.81,90,,,percent of total billed charges,90% of total billed charges,654.28,76,,,percent of total billed charges,76% of total billed charges,344.36,40,,,percent of total billed charges,40% of total billed charges,731.77,85,,,percent of total billed charges,85% of total billed charges,860.9,100,,,fee schedule,100% of CO APG rate,688.72,80,,,percent of total billed charges,80% of total billed charges,334.03,38.8,,,percent of total billed charges,38.8% of total billed charges,731.77,85,,,percent of total billed charges,85% of total billed charges,860.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,334.03,860.9,
Alphavent Suture Anchor 5.5MM,60001073,CDM,270,RC,,,OUTPATIENT,,,2264.9,1811.92,,1698.68,75,,,percent of total billed charges,75% of total billed charges,905.96,40,,,percent of total billed charges,40% of total billed charges,1793.8,79.2,,,percent of total billed charges,79.2% of total billed charges,1925.17,85,,,percent of total billed charges,85% of total billed charges,2264.9,100,,,fee schedule,100% of CO APG rates,2151.66,95,,,percent of total billed charges,95% of total billed charges,1811.92,80,,,percent of total billed charges,80% of total billed charges,1925.17,85,,,percent of total billed charges,85% of total billed charges,2038.41,90,,,percent of total billed charges,90% of total billed charges,2264.9,100,,,fee schedule,100% of CO APG rates,2264.9,100,,,fee schedule,100% of CO APG rates,2264.9,100,,,fee schedule,100% of NM fee schedule,905.96,40,,,percent of total billed charges,40% of total billed charges,905.96,40,,,percent of total billed charges,40% of total billed charges,2038.41,90,,,percent of total billed charges,90% of total billed charges,1721.32,76,,,percent of total billed charges,76% of total billed charges,905.96,40,,,percent of total billed charges,40% of total billed charges,1925.17,85,,,percent of total billed charges,85% of total billed charges,2264.9,100,,,fee schedule,100% of CO APG rate,1811.92,80,,,percent of total billed charges,80% of total billed charges,878.78,38.8,,,percent of total billed charges,38.8% of total billed charges,1925.17,85,,,percent of total billed charges,85% of total billed charges,2264.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,878.78,2264.9,
5.5MM Alphavent Tap,60001075,CDM,270,RC,,,OUTPATIENT,,,1128.1,902.48,,846.08,75,,,percent of total billed charges,75% of total billed charges,451.24,40,,,percent of total billed charges,40% of total billed charges,893.46,79.2,,,percent of total billed charges,79.2% of total billed charges,958.89,85,,,percent of total billed charges,85% of total billed charges,1128.1,100,,,fee schedule,100% of CO APG rates,1071.7,95,,,percent of total billed charges,95% of total billed charges,902.48,80,,,percent of total billed charges,80% of total billed charges,958.89,85,,,percent of total billed charges,85% of total billed charges,1015.29,90,,,percent of total billed charges,90% of total billed charges,1128.1,100,,,fee schedule,100% of CO APG rates,1128.1,100,,,fee schedule,100% of CO APG rates,1128.1,100,,,fee schedule,100% of NM fee schedule,451.24,40,,,percent of total billed charges,40% of total billed charges,451.24,40,,,percent of total billed charges,40% of total billed charges,1015.29,90,,,percent of total billed charges,90% of total billed charges,857.36,76,,,percent of total billed charges,76% of total billed charges,451.24,40,,,percent of total billed charges,40% of total billed charges,958.89,85,,,percent of total billed charges,85% of total billed charges,1128.1,100,,,fee schedule,100% of CO APG rate,902.48,80,,,percent of total billed charges,80% of total billed charges,437.7,38.8,,,percent of total billed charges,38.8% of total billed charges,958.89,85,,,percent of total billed charges,85% of total billed charges,1128.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,437.7,1128.1,
SUTURE VCL CR BRD UD 8X27IN 2-0,60001082,CDM,270,RC,,,OUTPATIENT,,,122.7,98.16,,92.03,75,,,percent of total billed charges,75% of total billed charges,49.08,40,,,percent of total billed charges,40% of total billed charges,97.18,79.2,,,percent of total billed charges,79.2% of total billed charges,104.3,85,,,percent of total billed charges,85% of total billed charges,122.7,100,,,fee schedule,100% of CO APG rates,116.57,95,,,percent of total billed charges,95% of total billed charges,98.16,80,,,percent of total billed charges,80% of total billed charges,104.3,85,,,percent of total billed charges,85% of total billed charges,110.43,90,,,percent of total billed charges,90% of total billed charges,122.7,100,,,fee schedule,100% of CO APG rates,122.7,100,,,fee schedule,100% of CO APG rates,122.7,100,,,fee schedule,100% of NM fee schedule,49.08,40,,,percent of total billed charges,40% of total billed charges,49.08,40,,,percent of total billed charges,40% of total billed charges,110.43,90,,,percent of total billed charges,90% of total billed charges,93.25,76,,,percent of total billed charges,76% of total billed charges,49.08,40,,,percent of total billed charges,40% of total billed charges,104.3,85,,,percent of total billed charges,85% of total billed charges,122.7,100,,,fee schedule,100% of CO APG rate,98.16,80,,,percent of total billed charges,80% of total billed charges,47.61,38.8,,,percent of total billed charges,38.8% of total billed charges,104.3,85,,,percent of total billed charges,85% of total billed charges,122.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,47.61,122.7,
SPY Minimally Invasive Surgery Kit,60001083,CDM,270,RC,,,OUTPATIENT,,,872.3,697.84,,654.23,75,,,percent of total billed charges,75% of total billed charges,348.92,40,,,percent of total billed charges,40% of total billed charges,690.86,79.2,,,percent of total billed charges,79.2% of total billed charges,741.46,85,,,percent of total billed charges,85% of total billed charges,872.3,100,,,fee schedule,100% of CO APG rates,828.69,95,,,percent of total billed charges,95% of total billed charges,697.84,80,,,percent of total billed charges,80% of total billed charges,741.46,85,,,percent of total billed charges,85% of total billed charges,785.07,90,,,percent of total billed charges,90% of total billed charges,872.3,100,,,fee schedule,100% of CO APG rates,872.3,100,,,fee schedule,100% of CO APG rates,872.3,100,,,fee schedule,100% of NM fee schedule,348.92,40,,,percent of total billed charges,40% of total billed charges,348.92,40,,,percent of total billed charges,40% of total billed charges,785.07,90,,,percent of total billed charges,90% of total billed charges,662.95,76,,,percent of total billed charges,76% of total billed charges,348.92,40,,,percent of total billed charges,40% of total billed charges,741.46,85,,,percent of total billed charges,85% of total billed charges,872.3,100,,,fee schedule,100% of CO APG rate,697.84,80,,,percent of total billed charges,80% of total billed charges,338.45,38.8,,,percent of total billed charges,38.8% of total billed charges,741.46,85,,,percent of total billed charges,85% of total billed charges,872.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,338.45,872.3,
Bill Only Analgesic Lab,40080329,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,362.8,290.24,,272.1,75,,,percent of total billed charges,75% of total billed charges,145.12,40,,,percent of total billed charges,40% of total billed charges,287.34,79.2,,,percent of total billed charges,79.2% of total billed charges,308.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,344.66,95,,,percent of total billed charges,95% of total billed charges,290.24,80,,,percent of total billed charges,80% of total billed charges,308.38,85,,,percent of total billed charges,85% of total billed charges,326.52,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,145.12,40,,,percent of total billed charges,40% of total billed charges,145.12,40,,,percent of total billed charges,40% of total billed charges,326.52,90,,,percent of total billed charges,90% of total billed charges,275.73,76,,,percent of total billed charges,76% of total billed charges,145.12,40,,,percent of total billed charges,40% of total billed charges,308.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,290.24,80,,,percent of total billed charges,80% of total billed charges,140.77,38.8,,,percent of total billed charges,38.8% of total billed charges,308.38,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,344.66,
Bill Only Analgesic Lab 2,40080329,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,258.9,207.12,,194.18,75,,,percent of total billed charges,75% of total billed charges,103.56,40,,,percent of total billed charges,40% of total billed charges,205.05,79.2,,,percent of total billed charges,79.2% of total billed charges,220.07,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,245.96,95,,,percent of total billed charges,95% of total billed charges,207.12,80,,,percent of total billed charges,80% of total billed charges,220.07,85,,,percent of total billed charges,85% of total billed charges,233.01,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,103.56,40,,,percent of total billed charges,40% of total billed charges,103.56,40,,,percent of total billed charges,40% of total billed charges,233.01,90,,,percent of total billed charges,90% of total billed charges,196.76,76,,,percent of total billed charges,76% of total billed charges,103.56,40,,,percent of total billed charges,40% of total billed charges,220.07,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,207.12,80,,,percent of total billed charges,80% of total billed charges,100.45,38.8,,,percent of total billed charges,38.8% of total billed charges,220.07,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,245.96,
Bill Only Analgesic Lab 3,40080329,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,221.7,177.36,,166.28,75,,,percent of total billed charges,75% of total billed charges,88.68,40,,,percent of total billed charges,40% of total billed charges,175.59,79.2,,,percent of total billed charges,79.2% of total billed charges,188.45,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,210.62,95,,,percent of total billed charges,95% of total billed charges,177.36,80,,,percent of total billed charges,80% of total billed charges,188.45,85,,,percent of total billed charges,85% of total billed charges,199.53,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,88.68,40,,,percent of total billed charges,40% of total billed charges,88.68,40,,,percent of total billed charges,40% of total billed charges,199.53,90,,,percent of total billed charges,90% of total billed charges,168.49,76,,,percent of total billed charges,76% of total billed charges,88.68,40,,,percent of total billed charges,40% of total billed charges,188.45,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,177.36,80,,,percent of total billed charges,80% of total billed charges,86.02,38.8,,,percent of total billed charges,38.8% of total billed charges,188.45,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,210.62,
"ECG 12-Lead, TRACING ONLY",42893005,CDM,730,RC,93005,HCPCS,OUTPATIENT,,,179.92,143.936,,134.94,75,,,percent of total billed charges,75% of total billed charges,71.97,40,,,percent of total billed charges,40% of total billed charges,142.5,79.2,,,percent of total billed charges,79.2% of total billed charges,152.93,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,170.92,95,,,percent of total billed charges,95% of total billed charges,143.94,80,,,percent of total billed charges,80% of total billed charges,152.93,85,,,percent of total billed charges,85% of total billed charges,161.93,90,,,percent of total billed charges,90% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rates,34.77,100,,,fee schedule,100% of CO APG rates,57.48,100,,,fee schedule,100% of NM APC rate,71.97,40,,,percent of total billed charges,40% of total billed charges,71.97,40,,,percent of total billed charges,40% of total billed charges,161.93,90,,,percent of total billed charges,90% of total billed charges,136.74,76,,,percent of total billed charges,76% of total billed charges,71.97,40,,,percent of total billed charges,40% of total billed charges,152.93,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of CO APG rate,143.94,80,,,percent of total billed charges,80% of total billed charges,69.81,38.8,,,percent of total billed charges,38.8% of total billed charges,152.93,85,,,percent of total billed charges,85% of total billed charges,34.77,100,,,fee schedule,100% of APG fee schedule,13.34,200,,,fee schedule,200% of CMS fee schedule,13.34,170.92,
90380 - VFC RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML,60001092,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
96380 VFC Administration of RSV monoclonal antibody w/Physic,60001096,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,22.3,17.84,,16.73,75,,,percent of total billed charges,75% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,17.66,79.2,,,percent of total billed charges,79.2% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,22.3,100,,,fee schedule,100% of CO APG rates,21.19,95,,,percent of total billed charges,95% of total billed charges,17.84,80,,,percent of total billed charges,80% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,20.07,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,22.3,100,,,fee schedule,100% of NM APC rate,8.92,40,,,percent of total billed charges,40% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,20.07,90,,,percent of total billed charges,90% of total billed charges,16.95,76,,,percent of total billed charges,76% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,17.84,80,,,percent of total billed charges,80% of total billed charges,8.65,38.8,,,percent of total billed charges,38.8% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,8.65,50.67,
90381 - INS RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML,60001091,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,1340.18,1072.144,,1005.14,75,,,percent of total billed charges,75% of total billed charges,536.07,40,,,percent of total billed charges,40% of total billed charges,1061.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1139.15,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,1273.17,95,,,percent of total billed charges,95% of total billed charges,1072.14,80,,,percent of total billed charges,80% of total billed charges,1139.15,85,,,percent of total billed charges,85% of total billed charges,1206.16,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,1340.18,100,,,fee schedule,100% of NM fee schedule,536.07,40,,,percent of total billed charges,40% of total billed charges,536.07,40,,,percent of total billed charges,40% of total billed charges,1206.16,90,,,percent of total billed charges,90% of total billed charges,1018.54,76,,,percent of total billed charges,76% of total billed charges,536.07,40,,,percent of total billed charges,40% of total billed charges,1139.15,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,1072.14,80,,,percent of total billed charges,80% of total billed charges,519.99,38.8,,,percent of total billed charges,38.8% of total billed charges,1139.15,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,1340.18,
90380 - INS RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML,60001090,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,1340.18,1072.144,,1005.14,75,,,percent of total billed charges,75% of total billed charges,536.07,40,,,percent of total billed charges,40% of total billed charges,1061.42,79.2,,,percent of total billed charges,79.2% of total billed charges,1139.15,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,1273.17,95,,,percent of total billed charges,95% of total billed charges,1072.14,80,,,percent of total billed charges,80% of total billed charges,1139.15,85,,,percent of total billed charges,85% of total billed charges,1206.16,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,1340.18,100,,,fee schedule,100% of NM fee schedule,536.07,40,,,percent of total billed charges,40% of total billed charges,536.07,40,,,percent of total billed charges,40% of total billed charges,1206.16,90,,,percent of total billed charges,90% of total billed charges,1018.54,76,,,percent of total billed charges,76% of total billed charges,536.07,40,,,percent of total billed charges,40% of total billed charges,1139.15,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,1072.14,80,,,percent of total billed charges,80% of total billed charges,519.99,38.8,,,percent of total billed charges,38.8% of total billed charges,1139.15,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,1340.18,
"VFC 90381 RSV Vaccine Pediatric 100mg (Beyfortus) > 5Kg, up",60001093,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,,,,,,,,other ,not separately reimbursable,,,,,percent of total billed charges,40% of total billed charges,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of CO APG rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.65,35.65,
96380 INS Administration of RSV monoclonal antibody w/Physic,60001095,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.8,50.67,
96381 INS Administration of RSV monoclonal antibody w/o coun,60001097,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,43.3,34.64,,32.48,75,,,percent of total billed charges,75% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,34.29,79.2,,,percent of total billed charges,79.2% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,43.3,100,,,fee schedule,100% of CO APG rates,41.14,95,,,percent of total billed charges,95% of total billed charges,34.64,80,,,percent of total billed charges,80% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,43.3,100,,,fee schedule,100% of NM APC rate,17.32,40,,,percent of total billed charges,40% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,38.97,90,,,percent of total billed charges,90% of total billed charges,32.91,76,,,percent of total billed charges,76% of total billed charges,17.32,40,,,percent of total billed charges,40% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,34.64,80,,,percent of total billed charges,80% of total billed charges,16.8,38.8,,,percent of total billed charges,38.8% of total billed charges,36.81,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,16.8,50.67,
96381 VFC Administration of RSV monoclonal antibody w/o coun,60001098,CDM,771,RC,90471,HCPCS,OUTPATIENT,,,22.3,17.84,,16.73,75,,,percent of total billed charges,75% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,17.66,79.2,,,percent of total billed charges,79.2% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,22.3,100,,,fee schedule,100% of CO APG rates,21.19,95,,,percent of total billed charges,95% of total billed charges,17.84,80,,,percent of total billed charges,80% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,20.07,90,,,percent of total billed charges,90% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rates,50.67,100,,,fee schedule,100% of CO APG rates,22.3,100,,,fee schedule,100% of NM APC rate,8.92,40,,,percent of total billed charges,40% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,20.07,90,,,percent of total billed charges,90% of total billed charges,16.95,76,,,percent of total billed charges,76% of total billed charges,8.92,40,,,percent of total billed charges,40% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of CO APG rate,17.84,80,,,percent of total billed charges,80% of total billed charges,8.65,38.8,,,percent of total billed charges,38.8% of total billed charges,18.96,85,,,percent of total billed charges,85% of total billed charges,50.67,100,,,fee schedule,100% of APG fee schedule,42,200,,,fee schedule,200% of CMS fee schedule,8.65,50.67,
94010 - Spirometry,60001394,CDM,976,RC,94060,HCPCS,OUTPATIENT,,,82.6,66.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28045 - Excision Tumor Soft Tissue Foot/Toe SubQ <1.5cm,46028045,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1052.8,842.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25071 - Exc Tumor Soft Tiss Forearm Wrist Subq 3cm,60001415,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1276.8,1021.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25118 - Synovectomy Extensor Tendon Shth Wrist 1 Cmprt,60001351,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1181.1,944.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25628 - ORIF Scaphoid Fracture,60001100,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2181.6,1745.28,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
46045 - INCISION OF RECTAL ABSCESS,60001102,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1318.2,1054.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
PFT Complete,60001545,CDM,976,RC,94060,HCPCS,OUTPATIENT,,,171.9,137.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
36597 - REPOSITION VENOUS CATHETER,60001106,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,173.1,138.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"85097 - Bone marrow, smear interpretation",60001349,CDM,971,RC,85060,HCPCS,OUTPATIENT,,,148.7,118.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24201 Removal of arm foreign body,60001627,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1224,979.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
24582 - percutaneous skeletal fixation of a humeral condylar,60001626,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2481.8,1985.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31660 Bronchoscopy w/Bronchial Thermoplasty 1 Lobe,60001385,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,541,432.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
50390 - Aspir  and/njx renal cyst/pelvis needle prq,60001350,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,271.1,216.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
94618 Six Minute Walk Test,60001389,CDM,976,RC,94060,HCPCS,OUTPATIENT,,,102.5,82,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"94618 - Pulmonary stress testing (eg, 6-minute walk test)",60001389,CDM,976,RC,94060,HCPCS,OUTPATIENT,,,102.5,82,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
01380 ANESTH ALL CLOSED PROCEDURES ON KNEE JOINT,46201380,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,163.9,131.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27043 Excision, tumor, of the hip or pelvis",60001451,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1399.3,1119.44,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27570 Manipulation Of Knee Joint Under General Anesthesia,46027570,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,471.3,377.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
94010 Spirometry,60001453,CDM,976,RC,94060,HCPCS,OUTPATIENT,,,82.6,66.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
23410 - Acute open repair of ruptured rotator cuff,46023410,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2462.6,1970.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"24341 Repair, tendon or muscle upper arm or elbow",60001462,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2273.9,1819.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27350 - Patellectomy or Hemipatellectomy,60001466,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1981,1584.8,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
27062 Excision trochanteric bursa,60001455,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1378.6,1102.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
28270 - CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX,60000128,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1013.9,811.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
26676 - PIN HAND DISLOCATION,60001340,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1571.4,1257.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27025 Fasciotomy, hip or thigh",60001463,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2810.9,2248.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"27654 Repair, secondary, Achilles tendon, with or without gr",60001556,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2160,1728,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
29851 - Arthroscopy Aid Tx Spine Fx Knee W Fixj,60001431,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2785.2,2228.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"20606 - Arthrocent, asp/inj, intermediate joint w/US",60001534,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,152.2,121.76,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
25301 - Tenodesis Wrist Extensors Fingers,60001353,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1952.4,1561.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
PFT - Complete Pre/Post Bronchodilator,60001390,CDM,976,RC,94060,HCPCS,OUTPATIENT,,,171.9,137.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Spirometry Pre/Post BD.,60001432,CDM,976,RC,94060,HCPCS,OUTPATIENT,,,118.1,94.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64463 - PVB THORACIC CONT CATHETER INFUSION W/IMG GID,60001592,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,318.2,254.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
94729 - CO/membane diffuse capacity,60001537,CDM,976,RC,94060,HCPCS,OUTPATIENT,,,170.4,136.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
20902 - Bone graft any donor area,60001533,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,803,642.4,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
54235 - Injection of corpora cavernosa with pharmacologic ag,60001338,CDM,960,RC,99157,HCPCS,OUTPATIENT,,,220.2,176.16,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"37618 Ligation, Major Artery; Extremity",60001565,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,1140.3,912.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"24579 Open Treatment Of Humeral Condylar Fracture, Medial Or",60001339,CDM,975,RC,11406,HCPCS,OUTPATIENT,,,2519.6,2015.68,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
64466 - Unilateral thoracic fascial plane block,60001555,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,191.5,153.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
93227 - ECG Monit-Report Up To 48 Hrs,60001416,CDM,985,RC,93010,HCPCS,OUTPATIENT,,,53.3,42.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
93227 - Holter Monitor 48 hour,60001416,CDM,985,RC,93010,HCPCS,OUTPATIENT,,,53.3,42.64,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Holter Monitor 48 hrs - 7 days,60001103,CDM,985,RC,93010,HCPCS,OUTPATIENT,,,66.9,53.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
Holter Monitor 8 - 15 days,60001104,CDM,985,RC,93010,HCPCS,OUTPATIENT,,,73.8,59.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
94060 - Spirometry Pre/Post Bronchodilation,60001538,CDM,976,RC,94060,HCPCS,OUTPATIENT,,,118.1,94.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Bronchoscopy,  With Balloon Occlusion, With Assessment Of Ai",60001368,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,542.4,433.92,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Bronchoscopy,  With Removal Of Foreign Body",60001369,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,504.4,403.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Bronchoscopy,  With Transbronchial Lung Biopsy(S), Each Addi",60001366,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,138.8,111.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"Bronchoscopy,  With Transbronchial Needle Aspiration Biopsy(",60001367,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,180.4,144.32,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31646 Bronchoscopy w/Therapeutic Aspiration Of Tracheobronchial Tree Subsequent,60001377,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,411.1,328.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31651 Bronchoscopy w/Balloon Occlusion When Performed Assessment Of Air Leak Airway Sizing And Insertion Of Bronchial Valve Each Addl Lobe,60001381,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,216.7,173.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31654 Bronchoscopy w/Transendoscopic Endobronchial Ultrasound (Ebus) During Bronchoscopic Diagnostic Or Therapeutic Intervention For Peripheral Lesion,60001384,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,191.3,153.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31624 Bronchoscopy w/ Bronchial Alveolar Lavage,60001358,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,385.9,308.72,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31628 Bronchoscopy  w/Transbronchial Lung Biopsy Single Lobe,60001362,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,504.4,403.52,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31605 Tracheostomy Emergency; Cricothyroid Membrane,60001355,CDM,981,RC,10060,HCPCS,OUTPATIENT,,,952.5,762,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31645 Bronchoscopy w/Therapeutic Aspiration Of Tracheobronchial Tree Initial,60001376,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,423.7,338.96,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31652 Bronchoscopy w/Endobronchial Ultrasound (Ebus) Guided Transtracheal And/Or Transbronchial Sampling One Or Two Mediastinal And/Or Hilar Lymph Nod,60001382,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,633.2,506.56,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31629 Bronchoscopy  w/Transbronchial Needle Aspiration Biopsy Trachea Main Stem And/Or Lobar Bronchus,60001363,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,536.7,429.36,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31643 Bronchoscopy w/Placement Of Catheter For Intracavitary Radioelement Application,60001375,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,487.5,390,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31653 Bronchoscopy w/Endobronchial Ultrasound (Ebus) Guided Transtracheal And/Or Transbronchial Sampling 3 Or More Mediastinal And/Or Hilar Lymph Node,60001383,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,701.3,561.04,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31661 Bronchoscopy w/Bronchial Thermoplasty 2 Or More Lobes,60001386,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,572.8,458.24,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
32557 Pleural Drainage Percutaneous w/Insertion Of Indwelling Catheter; w/Imaging Guidance,60001387,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,427.6,342.08,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31603 Tracheostomy Emergency; Transtracheal,60001354,CDM,981,RC,10060,HCPCS,OUTPATIENT,,,922.5,738,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31622 Bronchoscopy  Diagnostic w/Cell Washing When Performed,60001356,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,381.1,304.88,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31623 Bronchoscopy w/Brushing Or Protected Brushings,60001357,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,380,304,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
31625 Bronchoscopy w/Bronchial Or Endobronchial Biopsy Single Or Multiple Sites,60001359,CDM,982,RC,99211,HCPCS,OUTPATIENT,,,448.1,358.48,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
94727-Nitrogen Washout,60001391,CDM,976,RC,94060,HCPCS,OUTPATIENT,,,136.4,109.12,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
"64466 Thoracic fascial plane block, unilateral; by",60001564,CDM,964,RC,20552,HCPCS,OUTPATIENT,,,191.5,153.2,,,,,,other ,not separately reimbursable,,,,,other ,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,
MRI UE Joint w/ + w/o Cont Bil,60001557,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI UE Joint w/o Cont Bil,60001560,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI UE Joint w/o Cont Lt,60001561,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI UE Joint w/o Cont Rt,60001561,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
94010 - Spirometry,60001394,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,283.5,226.8,,212.63,75,,,percent of total billed charges,75% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,224.53,79.2,,,percent of total billed charges,79.2% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,269.33,95,,,percent of total billed charges,95% of total billed charges,226.8,80,,,percent of total billed charges,80% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,255.15,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,113.4,40,,,percent of total billed charges,40% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,255.15,90,,,percent of total billed charges,90% of total billed charges,215.46,76,,,percent of total billed charges,76% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,226.8,80,,,percent of total billed charges,80% of total billed charges,110,38.8,,,percent of total billed charges,38.8% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,269.33,
Hemoglobin A1c w/ Avg Glucose,60001532,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,97.9,78.32,,73.43,75,,,percent of total billed charges,75% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,77.54,79.2,,,percent of total billed charges,79.2% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,93.01,95,,,percent of total billed charges,95% of total billed charges,78.32,80,,,percent of total billed charges,80% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,39.16,40,,,percent of total billed charges,40% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,88.11,90,,,percent of total billed charges,90% of total billed charges,74.4,76,,,percent of total billed charges,76% of total billed charges,39.16,40,,,percent of total billed charges,40% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,78.32,80,,,percent of total billed charges,80% of total billed charges,37.99,38.8,,,percent of total billed charges,38.8% of total billed charges,83.22,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,93.01,
MRI UE Joint w/ + w/o Cont Lt,60001558,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
MRI UE Joint w/ + w/o Cont Rt,60001559,CDM,610,RC,71552,HCPCS,OUTPATIENT,,,2514.5,2011.6,TC,1885.88,75,,,percent of total billed charges,75% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,730,100,,,case rate,pays based on per visit rate,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,2388.78,95,,,percent of total billed charges,95% of total billed charges,2011.6,80,,,percent of total billed charges,80% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rates,588.01,100,,,fee schedule,100% of CO APG rates,368.43,100,,,fee schedule,100% of NM APC rate,1005.8,40,,,percent of total billed charges,40% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2263.05,90,,,percent of total billed charges,90% of total billed charges,1911.02,76,,,percent of total billed charges,76% of total billed charges,1005.8,40,,,percent of total billed charges,40% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of CO APG rate,2011.6,80,,,percent of total billed charges,80% of total billed charges,975.63,38.8,,,percent of total billed charges,38.8% of total billed charges,2137.33,85,,,percent of total billed charges,85% of total billed charges,588.01,100,,,fee schedule,100% of APG fee schedule,496.17,200,,,fee schedule,200% of CMS fee schedule,368.43,2388.78,
Hand and Convey,30099001,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,40.4,32.32,,30.3,75,,,percent of total billed charges,75% of total billed charges,16.16,40,,,percent of total billed charges,40% of total billed charges,32,79.2,,,percent of total billed charges,79.2% of total billed charges,34.34,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,38.38,95,,,percent of total billed charges,95% of total billed charges,32.32,80,,,percent of total billed charges,80% of total billed charges,34.34,85,,,percent of total billed charges,85% of total billed charges,36.36,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,16.16,40,,,percent of total billed charges,40% of total billed charges,16.16,40,,,percent of total billed charges,40% of total billed charges,36.36,90,,,percent of total billed charges,90% of total billed charges,30.7,76,,,percent of total billed charges,76% of total billed charges,16.16,40,,,percent of total billed charges,40% of total billed charges,34.34,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,32.32,80,,,percent of total billed charges,80% of total billed charges,15.68,38.8,,,percent of total billed charges,38.8% of total billed charges,34.34,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,38.38,
Aerosol Mask,60001483,CDM,270,RC,,,OUTPATIENT,,,10,8,,7.5,75,,,percent of total billed charges,75% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,7.92,79.2,,,percent of total billed charges,79.2% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,9.5,95,,,percent of total billed charges,95% of total billed charges,8,80,,,percent of total billed charges,80% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of NM fee schedule,4,40,,,percent of total billed charges,40% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,7.6,76,,,percent of total billed charges,76% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rate,8,80,,,percent of total billed charges,80% of total billed charges,3.88,38.8,,,percent of total billed charges,38.8% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.88,10,
Carbon Monoxide Diffusion,60001537,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,468,374.4,,351,75,,,percent of total billed charges,75% of total billed charges,187.2,40,,,percent of total billed charges,40% of total billed charges,370.66,79.2,,,percent of total billed charges,79.2% of total billed charges,397.8,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,444.6,95,,,percent of total billed charges,95% of total billed charges,374.4,80,,,percent of total billed charges,80% of total billed charges,397.8,85,,,percent of total billed charges,85% of total billed charges,421.2,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,187.2,40,,,percent of total billed charges,40% of total billed charges,187.2,40,,,percent of total billed charges,40% of total billed charges,421.2,90,,,percent of total billed charges,90% of total billed charges,355.68,76,,,percent of total billed charges,76% of total billed charges,187.2,40,,,percent of total billed charges,40% of total billed charges,397.8,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,374.4,80,,,percent of total billed charges,80% of total billed charges,181.58,38.8,,,percent of total billed charges,38.8% of total billed charges,397.8,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,444.6,
Medicated Aerosol Assessment,60001546,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,358.8,287.04,,269.1,75,,,percent of total billed charges,75% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,284.17,79.2,,,percent of total billed charges,79.2% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,340.86,95,,,percent of total billed charges,95% of total billed charges,287.04,80,,,percent of total billed charges,80% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,143.52,40,,,percent of total billed charges,40% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,272.69,76,,,percent of total billed charges,76% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,287.04,80,,,percent of total billed charges,80% of total billed charges,139.21,38.8,,,percent of total billed charges,38.8% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,340.86,
Metabolic Study,60001546,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,178.2,142.56,,133.65,75,,,percent of total billed charges,75% of total billed charges,71.28,40,,,percent of total billed charges,40% of total billed charges,141.13,79.2,,,percent of total billed charges,79.2% of total billed charges,151.47,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,169.29,95,,,percent of total billed charges,95% of total billed charges,142.56,80,,,percent of total billed charges,80% of total billed charges,151.47,85,,,percent of total billed charges,85% of total billed charges,160.38,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,71.28,40,,,percent of total billed charges,40% of total billed charges,71.28,40,,,percent of total billed charges,40% of total billed charges,160.38,90,,,percent of total billed charges,90% of total billed charges,135.43,76,,,percent of total billed charges,76% of total billed charges,71.28,40,,,percent of total billed charges,40% of total billed charges,151.47,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,142.56,80,,,percent of total billed charges,80% of total billed charges,69.14,38.8,,,percent of total billed charges,38.8% of total billed charges,151.47,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,169.29,
RT FVC,60001543,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,283.5,226.8,,212.63,75,,,percent of total billed charges,75% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,224.53,79.2,,,percent of total billed charges,79.2% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,269.33,95,,,percent of total billed charges,95% of total billed charges,226.8,80,,,percent of total billed charges,80% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,255.15,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,113.4,40,,,percent of total billed charges,40% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,255.15,90,,,percent of total billed charges,90% of total billed charges,215.46,76,,,percent of total billed charges,76% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,226.8,80,,,percent of total billed charges,80% of total billed charges,110,38.8,,,percent of total billed charges,38.8% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,269.33,
RT MVV,60001547,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,178.2,142.56,,133.65,75,,,percent of total billed charges,75% of total billed charges,71.28,40,,,percent of total billed charges,40% of total billed charges,141.13,79.2,,,percent of total billed charges,79.2% of total billed charges,151.47,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,169.29,95,,,percent of total billed charges,95% of total billed charges,142.56,80,,,percent of total billed charges,80% of total billed charges,151.47,85,,,percent of total billed charges,85% of total billed charges,160.38,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,178.2,100,,,fee schedule,100% of NM APC rate,71.28,40,,,percent of total billed charges,40% of total billed charges,71.28,40,,,percent of total billed charges,40% of total billed charges,160.38,90,,,percent of total billed charges,90% of total billed charges,135.43,76,,,percent of total billed charges,76% of total billed charges,71.28,40,,,percent of total billed charges,40% of total billed charges,151.47,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,142.56,80,,,percent of total billed charges,80% of total billed charges,69.14,38.8,,,percent of total billed charges,38.8% of total billed charges,151.47,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,178.2,
RT FRC,60001542,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,1591.8,1273.44,,1193.85,75,,,percent of total billed charges,75% of total billed charges,636.72,40,,,percent of total billed charges,40% of total billed charges,1260.71,79.2,,,percent of total billed charges,79.2% of total billed charges,1353.03,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,1512.21,95,,,percent of total billed charges,95% of total billed charges,1273.44,80,,,percent of total billed charges,80% of total billed charges,1353.03,85,,,percent of total billed charges,85% of total billed charges,1432.62,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,636.72,40,,,percent of total billed charges,40% of total billed charges,636.72,40,,,percent of total billed charges,40% of total billed charges,1432.62,90,,,percent of total billed charges,90% of total billed charges,1209.77,76,,,percent of total billed charges,76% of total billed charges,636.72,40,,,percent of total billed charges,40% of total billed charges,1353.03,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,1273.44,80,,,percent of total billed charges,80% of total billed charges,617.62,38.8,,,percent of total billed charges,38.8% of total billed charges,1353.03,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,1512.21,
"Vital Capacity, Total",60001551,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,81,64.8,,60.75,75,,,percent of total billed charges,75% of total billed charges,32.4,40,,,percent of total billed charges,40% of total billed charges,64.15,79.2,,,percent of total billed charges,79.2% of total billed charges,68.85,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,76.95,95,,,percent of total billed charges,95% of total billed charges,64.8,80,,,percent of total billed charges,80% of total billed charges,68.85,85,,,percent of total billed charges,85% of total billed charges,72.9,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,81,100,,,fee schedule,100% of NM APC rate,32.4,40,,,percent of total billed charges,40% of total billed charges,32.4,40,,,percent of total billed charges,40% of total billed charges,72.9,90,,,percent of total billed charges,90% of total billed charges,61.56,76,,,percent of total billed charges,76% of total billed charges,32.4,40,,,percent of total billed charges,40% of total billed charges,68.85,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,64.8,80,,,percent of total billed charges,80% of total billed charges,31.43,38.8,,,percent of total billed charges,38.8% of total billed charges,68.85,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,81,
Pulse Oximetry: Single Day,60001550,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,192.5,154,,144.38,75,,,percent of total billed charges,75% of total billed charges,77,40,,,percent of total billed charges,40% of total billed charges,152.46,79.2,,,percent of total billed charges,79.2% of total billed charges,163.63,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,182.88,95,,,percent of total billed charges,95% of total billed charges,154,80,,,percent of total billed charges,80% of total billed charges,163.63,85,,,percent of total billed charges,85% of total billed charges,173.25,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,77,40,,,percent of total billed charges,40% of total billed charges,77,40,,,percent of total billed charges,40% of total billed charges,173.25,90,,,percent of total billed charges,90% of total billed charges,146.3,76,,,percent of total billed charges,76% of total billed charges,77,40,,,percent of total billed charges,40% of total billed charges,163.63,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,154,80,,,percent of total billed charges,80% of total billed charges,74.69,38.8,,,percent of total billed charges,38.8% of total billed charges,163.63,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,191.5,
RT Methacholine Challenge,60001548,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,1593.3,1274.64,,1194.98,75,,,percent of total billed charges,75% of total billed charges,637.32,40,,,percent of total billed charges,40% of total billed charges,1261.89,79.2,,,percent of total billed charges,79.2% of total billed charges,1354.31,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,1513.64,95,,,percent of total billed charges,95% of total billed charges,1274.64,80,,,percent of total billed charges,80% of total billed charges,1354.31,85,,,percent of total billed charges,85% of total billed charges,1433.97,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,637.32,40,,,percent of total billed charges,40% of total billed charges,637.32,40,,,percent of total billed charges,40% of total billed charges,1433.97,90,,,percent of total billed charges,90% of total billed charges,1210.91,76,,,percent of total billed charges,76% of total billed charges,637.32,40,,,percent of total billed charges,40% of total billed charges,1354.31,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,1274.64,80,,,percent of total billed charges,80% of total billed charges,618.2,38.8,,,percent of total billed charges,38.8% of total billed charges,1354.31,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,1513.64,
ABG Kit  RT Charge,60001475,CDM,270,RC,,,OUTPATIENT,,,25,20,,18.75,75,,,percent of total billed charges,75% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,19.8,79.2,,,percent of total billed charges,79.2% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of CO APG rates,23.75,95,,,percent of total billed charges,95% of total billed charges,20,80,,,percent of total billed charges,80% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,22.5,90,,,percent of total billed charges,90% of total billed charges,25,100,,,fee schedule,100% of CO APG rates,25,100,,,fee schedule,100% of CO APG rates,25,100,,,fee schedule,100% of NM fee schedule,10,40,,,percent of total billed charges,40% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,22.5,90,,,percent of total billed charges,90% of total billed charges,19,76,,,percent of total billed charges,76% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of CO APG rate,20,80,,,percent of total billed charges,80% of total billed charges,9.7,38.8,,,percent of total billed charges,38.8% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,9.7,25,
Aerosol Water Trap,60001482,CDM,270,RC,,,OUTPATIENT,,,10,8,,7.5,75,,,percent of total billed charges,75% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,7.92,79.2,,,percent of total billed charges,79.2% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,9.5,95,,,percent of total billed charges,95% of total billed charges,8,80,,,percent of total billed charges,80% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of NM fee schedule,4,40,,,percent of total billed charges,40% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,7.6,76,,,percent of total billed charges,76% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rate,8,80,,,percent of total billed charges,80% of total billed charges,3.88,38.8,,,percent of total billed charges,38.8% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.88,10,
AMBU Bag,60001476,CDM,270,RC,,,OUTPATIENT,,,15,12,,11.25,75,,,percent of total billed charges,75% of total billed charges,6,40,,,percent of total billed charges,40% of total billed charges,11.88,79.2,,,percent of total billed charges,79.2% of total billed charges,12.75,85,,,percent of total billed charges,85% of total billed charges,15,100,,,fee schedule,100% of CO APG rates,14.25,95,,,percent of total billed charges,95% of total billed charges,12,80,,,percent of total billed charges,80% of total billed charges,12.75,85,,,percent of total billed charges,85% of total billed charges,13.5,90,,,percent of total billed charges,90% of total billed charges,15,100,,,fee schedule,100% of CO APG rates,15,100,,,fee schedule,100% of CO APG rates,15,100,,,fee schedule,100% of NM fee schedule,6,40,,,percent of total billed charges,40% of total billed charges,6,40,,,percent of total billed charges,40% of total billed charges,13.5,90,,,percent of total billed charges,90% of total billed charges,11.4,76,,,percent of total billed charges,76% of total billed charges,6,40,,,percent of total billed charges,40% of total billed charges,12.75,85,,,percent of total billed charges,85% of total billed charges,15,100,,,fee schedule,100% of CO APG rate,12,80,,,percent of total billed charges,80% of total billed charges,5.82,38.8,,,percent of total billed charges,38.8% of total billed charges,12.75,85,,,percent of total billed charges,85% of total billed charges,15,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,5.82,15,
ET Tube #7.5,60001478,CDM,270,RC,,,OUTPATIENT,,,10,8,,7.5,75,,,percent of total billed charges,75% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,7.92,79.2,,,percent of total billed charges,79.2% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,9.5,95,,,percent of total billed charges,95% of total billed charges,8,80,,,percent of total billed charges,80% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of NM fee schedule,4,40,,,percent of total billed charges,40% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,7.6,76,,,percent of total billed charges,76% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rate,8,80,,,percent of total billed charges,80% of total billed charges,3.88,38.8,,,percent of total billed charges,38.8% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.88,10,
Heat/Moisture Exchanger,60001479,CDM,270,RC,,,OUTPATIENT,,,10,8,,7.5,75,,,percent of total billed charges,75% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,7.92,79.2,,,percent of total billed charges,79.2% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,9.5,95,,,percent of total billed charges,95% of total billed charges,8,80,,,percent of total billed charges,80% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of NM fee schedule,4,40,,,percent of total billed charges,40% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,7.6,76,,,percent of total billed charges,76% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rate,8,80,,,percent of total billed charges,80% of total billed charges,3.88,38.8,,,percent of total billed charges,38.8% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.88,10,
Inline Suction Catheter,60001480,CDM,270,RC,,,OUTPATIENT,,,10,8,,7.5,75,,,percent of total billed charges,75% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,7.92,79.2,,,percent of total billed charges,79.2% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,9.5,95,,,percent of total billed charges,95% of total billed charges,8,80,,,percent of total billed charges,80% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of NM fee schedule,4,40,,,percent of total billed charges,40% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,7.6,76,,,percent of total billed charges,76% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rate,8,80,,,percent of total billed charges,80% of total billed charges,3.88,38.8,,,percent of total billed charges,38.8% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.88,10,
Demonstration and/or evaluation of patient utilization of an,60001474,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,135,108,,101.25,75,,,percent of total billed charges,75% of total billed charges,54,40,,,percent of total billed charges,40% of total billed charges,106.92,79.2,,,percent of total billed charges,79.2% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,128.25,95,,,percent of total billed charges,95% of total billed charges,108,80,,,percent of total billed charges,80% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,121.5,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,135,100,,,fee schedule,100% of NM APC rate,54,40,,,percent of total billed charges,40% of total billed charges,54,40,,,percent of total billed charges,40% of total billed charges,121.5,90,,,percent of total billed charges,90% of total billed charges,102.6,76,,,percent of total billed charges,76% of total billed charges,54,40,,,percent of total billed charges,40% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,108,80,,,percent of total billed charges,80% of total billed charges,52.38,38.8,,,percent of total billed charges,38.8% of total billed charges,114.75,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,135,
"Aero, Large Volume Heated",60001535,CDM,270,RC,,,OUTPATIENT,,,25,20,,18.75,75,,,percent of total billed charges,75% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,19.8,79.2,,,percent of total billed charges,79.2% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of CO APG rates,23.75,95,,,percent of total billed charges,95% of total billed charges,20,80,,,percent of total billed charges,80% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,22.5,90,,,percent of total billed charges,90% of total billed charges,25,100,,,fee schedule,100% of CO APG rates,25,100,,,fee schedule,100% of CO APG rates,25,100,,,fee schedule,100% of NM fee schedule,10,40,,,percent of total billed charges,40% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,22.5,90,,,percent of total billed charges,90% of total billed charges,19,76,,,percent of total billed charges,76% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of CO APG rate,20,80,,,percent of total billed charges,80% of total billed charges,9.7,38.8,,,percent of total billed charges,38.8% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,9.7,25,
Aerosol Treatment with Peak Flow Charge,60001539,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,81,64.8,,60.75,75,,,percent of total billed charges,75% of total billed charges,32.4,40,,,percent of total billed charges,40% of total billed charges,64.15,79.2,,,percent of total billed charges,79.2% of total billed charges,68.85,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,76.95,95,,,percent of total billed charges,95% of total billed charges,64.8,80,,,percent of total billed charges,80% of total billed charges,68.85,85,,,percent of total billed charges,85% of total billed charges,72.9,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,81,100,,,fee schedule,100% of NM APC rate,32.4,40,,,percent of total billed charges,40% of total billed charges,32.4,40,,,percent of total billed charges,40% of total billed charges,72.9,90,,,percent of total billed charges,90% of total billed charges,61.56,76,,,percent of total billed charges,76% of total billed charges,32.4,40,,,percent of total billed charges,40% of total billed charges,68.85,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,64.8,80,,,percent of total billed charges,80% of total billed charges,31.43,38.8,,,percent of total billed charges,38.8% of total billed charges,68.85,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,81,
RT Airway Resistance,60001541,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,468.3,374.64,,351.23,75,,,percent of total billed charges,75% of total billed charges,187.32,40,,,percent of total billed charges,40% of total billed charges,370.89,79.2,,,percent of total billed charges,79.2% of total billed charges,398.06,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,444.89,95,,,percent of total billed charges,95% of total billed charges,374.64,80,,,percent of total billed charges,80% of total billed charges,398.06,85,,,percent of total billed charges,85% of total billed charges,421.47,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,187.32,40,,,percent of total billed charges,40% of total billed charges,187.32,40,,,percent of total billed charges,40% of total billed charges,421.47,90,,,percent of total billed charges,90% of total billed charges,355.91,76,,,percent of total billed charges,76% of total billed charges,187.32,40,,,percent of total billed charges,40% of total billed charges,398.06,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,374.64,80,,,percent of total billed charges,80% of total billed charges,181.7,38.8,,,percent of total billed charges,38.8% of total billed charges,398.06,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,444.89,
"Aero Large Volume, Cool Charge",60001540,CDM,270,RC,,,OUTPATIENT,,,25,20,,18.75,75,,,percent of total billed charges,75% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,19.8,79.2,,,percent of total billed charges,79.2% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of CO APG rates,23.75,95,,,percent of total billed charges,95% of total billed charges,20,80,,,percent of total billed charges,80% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,22.5,90,,,percent of total billed charges,90% of total billed charges,25,100,,,fee schedule,100% of CO APG rates,25,100,,,fee schedule,100% of CO APG rates,25,100,,,fee schedule,100% of NM fee schedule,10,40,,,percent of total billed charges,40% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,22.5,90,,,percent of total billed charges,90% of total billed charges,19,76,,,percent of total billed charges,76% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of CO APG rate,20,80,,,percent of total billed charges,80% of total billed charges,9.7,38.8,,,percent of total billed charges,38.8% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,9.7,25,
Apolipoprotein B LC,60001341,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,26.2,20.96,,19.65,75,,,percent of total billed charges,75% of total billed charges,10.48,40,,,percent of total billed charges,40% of total billed charges,20.75,79.2,,,percent of total billed charges,79.2% of total billed charges,22.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,24.89,95,,,percent of total billed charges,95% of total billed charges,20.96,80,,,percent of total billed charges,80% of total billed charges,22.27,85,,,percent of total billed charges,85% of total billed charges,23.58,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,10.48,40,,,percent of total billed charges,40% of total billed charges,10.48,40,,,percent of total billed charges,40% of total billed charges,23.58,90,,,percent of total billed charges,90% of total billed charges,19.91,76,,,percent of total billed charges,76% of total billed charges,10.48,40,,,percent of total billed charges,40% of total billed charges,22.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,20.96,80,,,percent of total billed charges,80% of total billed charges,10.17,38.8,,,percent of total billed charges,38.8% of total billed charges,22.27,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,33.06,
Plethysmography TR Only,60001549,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,897,717.6,,672.75,75,,,percent of total billed charges,75% of total billed charges,358.8,40,,,percent of total billed charges,40% of total billed charges,710.42,79.2,,,percent of total billed charges,79.2% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,852.15,95,,,percent of total billed charges,95% of total billed charges,717.6,80,,,percent of total billed charges,80% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,807.3,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,358.8,40,,,percent of total billed charges,40% of total billed charges,358.8,40,,,percent of total billed charges,40% of total billed charges,807.3,90,,,percent of total billed charges,90% of total billed charges,681.72,76,,,percent of total billed charges,76% of total billed charges,358.8,40,,,percent of total billed charges,40% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,717.6,80,,,percent of total billed charges,80% of total billed charges,348.04,38.8,,,percent of total billed charges,38.8% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,852.15,
Sputum Collection,60001552,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,514.1,411.28,,385.58,75,,,percent of total billed charges,75% of total billed charges,205.64,40,,,percent of total billed charges,40% of total billed charges,407.17,79.2,,,percent of total billed charges,79.2% of total billed charges,436.99,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,488.4,95,,,percent of total billed charges,95% of total billed charges,411.28,80,,,percent of total billed charges,80% of total billed charges,436.99,85,,,percent of total billed charges,85% of total billed charges,462.69,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,205.64,40,,,percent of total billed charges,40% of total billed charges,205.64,40,,,percent of total billed charges,40% of total billed charges,462.69,90,,,percent of total billed charges,90% of total billed charges,390.72,76,,,percent of total billed charges,76% of total billed charges,205.64,40,,,percent of total billed charges,40% of total billed charges,436.99,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,411.28,80,,,percent of total billed charges,80% of total billed charges,199.47,38.8,,,percent of total billed charges,38.8% of total billed charges,436.99,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,488.4,
Lipoprotein (a) LC,60001342,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,37.2,29.76,,27.9,75,,,percent of total billed charges,75% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,29.46,79.2,,,percent of total billed charges,79.2% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,35.34,95,,,percent of total billed charges,95% of total billed charges,29.76,80,,,percent of total billed charges,80% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,33.48,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,14.88,40,,,percent of total billed charges,40% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,33.48,90,,,percent of total billed charges,90% of total billed charges,28.27,76,,,percent of total billed charges,76% of total billed charges,14.88,40,,,percent of total billed charges,40% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,29.76,80,,,percent of total billed charges,80% of total billed charges,14.43,38.8,,,percent of total billed charges,38.8% of total billed charges,31.62,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,35.34,
Opiates Screen Urine,40080361,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,111.4,89.12,,83.55,75,,,percent of total billed charges,75% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,88.23,79.2,,,percent of total billed charges,79.2% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,105.83,95,,,percent of total billed charges,95% of total billed charges,89.12,80,,,percent of total billed charges,80% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,44.56,40,,,percent of total billed charges,40% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,100.26,90,,,percent of total billed charges,90% of total billed charges,84.66,76,,,percent of total billed charges,76% of total billed charges,44.56,40,,,percent of total billed charges,40% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,89.12,80,,,percent of total billed charges,80% of total billed charges,43.22,38.8,,,percent of total billed charges,38.8% of total billed charges,94.69,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,105.83,
2.3 M PROFYLE HAND LOCK PLATE STRAIGHT BAR 4H,50658,CDM,278,RC,,,OUTPATIENT,,,617.6,494.08,,463.2,75,,,percent of total billed charges,75% of total billed charges,247.04,40,,,percent of total billed charges,40% of total billed charges,489.14,79.2,,,percent of total billed charges,79.2% of total billed charges,524.96,85,,,percent of total billed charges,85% of total billed charges,617.6,100,,,fee schedule,100% of CO APG rates,586.72,95,,,percent of total billed charges,95% of total billed charges,494.08,80,,,percent of total billed charges,80% of total billed charges,524.96,85,,,percent of total billed charges,85% of total billed charges,555.84,90,,,percent of total billed charges,90% of total billed charges,617.6,100,,,fee schedule,100% of CO APG rates,617.6,100,,,fee schedule,100% of CO APG rates,617.6,100,,,fee schedule,100% of NM fee schedule,247.04,40,,,percent of total billed charges,40% of total billed charges,247.04,40,,,percent of total billed charges,40% of total billed charges,555.84,90,,,percent of total billed charges,90% of total billed charges,469.38,76,,,percent of total billed charges,76% of total billed charges,247.04,40,,,percent of total billed charges,40% of total billed charges,524.96,85,,,percent of total billed charges,85% of total billed charges,617.6,100,,,fee schedule,100% of CO APG rate,494.08,80,,,percent of total billed charges,80% of total billed charges,239.63,38.8,,,percent of total billed charges,38.8% of total billed charges,524.96,85,,,percent of total billed charges,85% of total billed charges,617.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,239.63,617.6,
"2.3 M PROFYLE HAND LOCK PLATE,STRAI,4H",50660,CDM,278,RC,,,OUTPATIENT,,,589.3,471.44,,441.98,75,,,percent of total billed charges,75% of total billed charges,235.72,40,,,percent of total billed charges,40% of total billed charges,466.73,79.2,,,percent of total billed charges,79.2% of total billed charges,500.91,85,,,percent of total billed charges,85% of total billed charges,589.3,100,,,fee schedule,100% of CO APG rates,559.84,95,,,percent of total billed charges,95% of total billed charges,471.44,80,,,percent of total billed charges,80% of total billed charges,500.91,85,,,percent of total billed charges,85% of total billed charges,530.37,90,,,percent of total billed charges,90% of total billed charges,589.3,100,,,fee schedule,100% of CO APG rates,589.3,100,,,fee schedule,100% of CO APG rates,589.3,100,,,fee schedule,100% of NM fee schedule,235.72,40,,,percent of total billed charges,40% of total billed charges,235.72,40,,,percent of total billed charges,40% of total billed charges,530.37,90,,,percent of total billed charges,90% of total billed charges,447.87,76,,,percent of total billed charges,76% of total billed charges,235.72,40,,,percent of total billed charges,40% of total billed charges,500.91,85,,,percent of total billed charges,85% of total billed charges,589.3,100,,,fee schedule,100% of CO APG rate,471.44,80,,,percent of total billed charges,80% of total billed charges,228.65,38.8,,,percent of total billed charges,38.8% of total billed charges,500.91,85,,,percent of total billed charges,85% of total billed charges,589.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,228.65,589.3,
"Isolation Disposable BP Unit, adult, white",60001528,CDM,270,RC,,,OUTPATIENT,,,67.35,53.88,,50.51,75,,,percent of total billed charges,75% of total billed charges,26.94,40,,,percent of total billed charges,40% of total billed charges,53.34,79.2,,,percent of total billed charges,79.2% of total billed charges,57.25,85,,,percent of total billed charges,85% of total billed charges,67.35,100,,,fee schedule,100% of CO APG rates,63.98,95,,,percent of total billed charges,95% of total billed charges,53.88,80,,,percent of total billed charges,80% of total billed charges,57.25,85,,,percent of total billed charges,85% of total billed charges,60.62,90,,,percent of total billed charges,90% of total billed charges,67.35,100,,,fee schedule,100% of CO APG rates,67.35,100,,,fee schedule,100% of CO APG rates,67.35,100,,,fee schedule,100% of NM fee schedule,26.94,40,,,percent of total billed charges,40% of total billed charges,26.94,40,,,percent of total billed charges,40% of total billed charges,60.62,90,,,percent of total billed charges,90% of total billed charges,51.19,76,,,percent of total billed charges,76% of total billed charges,26.94,40,,,percent of total billed charges,40% of total billed charges,57.25,85,,,percent of total billed charges,85% of total billed charges,67.35,100,,,fee schedule,100% of CO APG rate,53.88,80,,,percent of total billed charges,80% of total billed charges,26.13,38.8,,,percent of total billed charges,38.8% of total billed charges,57.25,85,,,percent of total billed charges,85% of total billed charges,67.35,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.13,67.35,
BIOPATCH,7774150,CDM,270,RC,,,OUTPATIENT,,,51.2,40.96,,38.4,75,,,percent of total billed charges,75% of total billed charges,20.48,40,,,percent of total billed charges,40% of total billed charges,40.55,79.2,,,percent of total billed charges,79.2% of total billed charges,43.52,85,,,percent of total billed charges,85% of total billed charges,51.2,100,,,fee schedule,100% of CO APG rates,48.64,95,,,percent of total billed charges,95% of total billed charges,40.96,80,,,percent of total billed charges,80% of total billed charges,43.52,85,,,percent of total billed charges,85% of total billed charges,46.08,90,,,percent of total billed charges,90% of total billed charges,51.2,100,,,fee schedule,100% of CO APG rates,51.2,100,,,fee schedule,100% of CO APG rates,51.2,100,,,fee schedule,100% of NM fee schedule,20.48,40,,,percent of total billed charges,40% of total billed charges,20.48,40,,,percent of total billed charges,40% of total billed charges,46.08,90,,,percent of total billed charges,90% of total billed charges,38.91,76,,,percent of total billed charges,76% of total billed charges,20.48,40,,,percent of total billed charges,40% of total billed charges,43.52,85,,,percent of total billed charges,85% of total billed charges,51.2,100,,,fee schedule,100% of CO APG rate,40.96,80,,,percent of total billed charges,80% of total billed charges,19.87,38.8,,,percent of total billed charges,38.8% of total billed charges,43.52,85,,,percent of total billed charges,85% of total billed charges,51.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,19.87,51.2,
MONSELS SOLUTION 8ML,50445,CDM,270,RC,,,OUTPATIENT,,,89,71.2,,66.75,75,,,percent of total billed charges,75% of total billed charges,35.6,40,,,percent of total billed charges,40% of total billed charges,70.49,79.2,,,percent of total billed charges,79.2% of total billed charges,75.65,85,,,percent of total billed charges,85% of total billed charges,89,100,,,fee schedule,100% of CO APG rates,84.55,95,,,percent of total billed charges,95% of total billed charges,71.2,80,,,percent of total billed charges,80% of total billed charges,75.65,85,,,percent of total billed charges,85% of total billed charges,80.1,90,,,percent of total billed charges,90% of total billed charges,89,100,,,fee schedule,100% of CO APG rates,89,100,,,fee schedule,100% of CO APG rates,89,100,,,fee schedule,100% of NM fee schedule,35.6,40,,,percent of total billed charges,40% of total billed charges,35.6,40,,,percent of total billed charges,40% of total billed charges,80.1,90,,,percent of total billed charges,90% of total billed charges,67.64,76,,,percent of total billed charges,76% of total billed charges,35.6,40,,,percent of total billed charges,40% of total billed charges,75.65,85,,,percent of total billed charges,85% of total billed charges,89,100,,,fee schedule,100% of CO APG rate,71.2,80,,,percent of total billed charges,80% of total billed charges,34.53,38.8,,,percent of total billed charges,38.8% of total billed charges,75.65,85,,,percent of total billed charges,85% of total billed charges,89,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,34.53,89,
"SPO2 Probe, PEDS (Blue)",60001484,CDM,270,RC,,,OUTPATIENT,,,85.35,68.28,,64.01,75,,,percent of total billed charges,75% of total billed charges,34.14,40,,,percent of total billed charges,40% of total billed charges,67.6,79.2,,,percent of total billed charges,79.2% of total billed charges,72.55,85,,,percent of total billed charges,85% of total billed charges,85.35,100,,,fee schedule,100% of CO APG rates,81.08,95,,,percent of total billed charges,95% of total billed charges,68.28,80,,,percent of total billed charges,80% of total billed charges,72.55,85,,,percent of total billed charges,85% of total billed charges,76.82,90,,,percent of total billed charges,90% of total billed charges,85.35,100,,,fee schedule,100% of CO APG rates,85.35,100,,,fee schedule,100% of CO APG rates,85.35,100,,,fee schedule,100% of NM fee schedule,34.14,40,,,percent of total billed charges,40% of total billed charges,34.14,40,,,percent of total billed charges,40% of total billed charges,76.82,90,,,percent of total billed charges,90% of total billed charges,64.87,76,,,percent of total billed charges,76% of total billed charges,34.14,40,,,percent of total billed charges,40% of total billed charges,72.55,85,,,percent of total billed charges,85% of total billed charges,85.35,100,,,fee schedule,100% of CO APG rate,68.28,80,,,percent of total billed charges,80% of total billed charges,33.12,38.8,,,percent of total billed charges,38.8% of total billed charges,72.55,85,,,percent of total billed charges,85% of total billed charges,85.35,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,33.12,85.35,
"SPO2 PROBE, PEDS (BLUE)",60001485,CDM,270,RC,,,OUTPATIENT,,,60.25,48.2,,45.19,75,,,percent of total billed charges,75% of total billed charges,24.1,40,,,percent of total billed charges,40% of total billed charges,47.72,79.2,,,percent of total billed charges,79.2% of total billed charges,51.21,85,,,percent of total billed charges,85% of total billed charges,60.25,100,,,fee schedule,100% of CO APG rates,57.24,95,,,percent of total billed charges,95% of total billed charges,48.2,80,,,percent of total billed charges,80% of total billed charges,51.21,85,,,percent of total billed charges,85% of total billed charges,54.23,90,,,percent of total billed charges,90% of total billed charges,60.25,100,,,fee schedule,100% of CO APG rates,60.25,100,,,fee schedule,100% of CO APG rates,60.25,100,,,fee schedule,100% of NM fee schedule,24.1,40,,,percent of total billed charges,40% of total billed charges,24.1,40,,,percent of total billed charges,40% of total billed charges,54.23,90,,,percent of total billed charges,90% of total billed charges,45.79,76,,,percent of total billed charges,76% of total billed charges,24.1,40,,,percent of total billed charges,40% of total billed charges,51.21,85,,,percent of total billed charges,85% of total billed charges,60.25,100,,,fee schedule,100% of CO APG rate,48.2,80,,,percent of total billed charges,80% of total billed charges,23.38,38.8,,,percent of total billed charges,38.8% of total billed charges,51.21,85,,,percent of total billed charges,85% of total billed charges,60.25,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,23.38,60.25,
CO-AXIAL HIGH FLOW TIP,51068,CDM,270,RC,,,OUTPATIENT,,,62.4,49.92,,46.8,75,,,percent of total billed charges,75% of total billed charges,24.96,40,,,percent of total billed charges,40% of total billed charges,49.42,79.2,,,percent of total billed charges,79.2% of total billed charges,53.04,85,,,percent of total billed charges,85% of total billed charges,62.4,100,,,fee schedule,100% of CO APG rates,59.28,95,,,percent of total billed charges,95% of total billed charges,49.92,80,,,percent of total billed charges,80% of total billed charges,53.04,85,,,percent of total billed charges,85% of total billed charges,56.16,90,,,percent of total billed charges,90% of total billed charges,62.4,100,,,fee schedule,100% of CO APG rates,62.4,100,,,fee schedule,100% of CO APG rates,62.4,100,,,fee schedule,100% of NM fee schedule,24.96,40,,,percent of total billed charges,40% of total billed charges,24.96,40,,,percent of total billed charges,40% of total billed charges,56.16,90,,,percent of total billed charges,90% of total billed charges,47.42,76,,,percent of total billed charges,76% of total billed charges,24.96,40,,,percent of total billed charges,40% of total billed charges,53.04,85,,,percent of total billed charges,85% of total billed charges,62.4,100,,,fee schedule,100% of CO APG rate,49.92,80,,,percent of total billed charges,80% of total billed charges,24.21,38.8,,,percent of total billed charges,38.8% of total billed charges,53.04,85,,,percent of total billed charges,85% of total billed charges,62.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,24.21,62.4,
Bronchial Challenge Test,60001536,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,358.8,287.04,,269.1,75,,,percent of total billed charges,75% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,284.17,79.2,,,percent of total billed charges,79.2% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,340.86,95,,,percent of total billed charges,95% of total billed charges,287.04,80,,,percent of total billed charges,80% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,143.52,40,,,percent of total billed charges,40% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,272.69,76,,,percent of total billed charges,76% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,287.04,80,,,percent of total billed charges,80% of total billed charges,139.21,38.8,,,percent of total billed charges,38.8% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,340.86,
Wrap SPU Vest,60001553,CDM,270,RC,,,OUTPATIENT,,,25,20,,18.75,75,,,percent of total billed charges,75% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,19.8,79.2,,,percent of total billed charges,79.2% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of CO APG rates,23.75,95,,,percent of total billed charges,95% of total billed charges,20,80,,,percent of total billed charges,80% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,22.5,90,,,percent of total billed charges,90% of total billed charges,25,100,,,fee schedule,100% of CO APG rates,25,100,,,fee schedule,100% of CO APG rates,25,100,,,fee schedule,100% of NM fee schedule,10,40,,,percent of total billed charges,40% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,22.5,90,,,percent of total billed charges,90% of total billed charges,19,76,,,percent of total billed charges,76% of total billed charges,10,40,,,percent of total billed charges,40% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of CO APG rate,20,80,,,percent of total billed charges,80% of total billed charges,9.7,38.8,,,percent of total billed charges,38.8% of total billed charges,21.25,85,,,percent of total billed charges,85% of total billed charges,25,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,9.7,25,
K wire 1.25x150MM,60001459,CDM,270,RC,,,OUTPATIENT,,,93.9,75.12,,70.43,75,,,percent of total billed charges,75% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,74.37,79.2,,,percent of total billed charges,79.2% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rates,89.21,95,,,percent of total billed charges,95% of total billed charges,75.12,80,,,percent of total billed charges,80% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,84.51,90,,,percent of total billed charges,90% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rates,93.9,100,,,fee schedule,100% of CO APG rates,93.9,100,,,fee schedule,100% of NM fee schedule,37.56,40,,,percent of total billed charges,40% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,84.51,90,,,percent of total billed charges,90% of total billed charges,71.36,76,,,percent of total billed charges,76% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rate,75.12,80,,,percent of total billed charges,80% of total billed charges,36.43,38.8,,,percent of total billed charges,38.8% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,36.43,93.9,
K-Wire 1.6x150,60001454,CDM,270,RC,,,OUTPATIENT,,,93.9,75.12,,70.43,75,,,percent of total billed charges,75% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,74.37,79.2,,,percent of total billed charges,79.2% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rates,89.21,95,,,percent of total billed charges,95% of total billed charges,75.12,80,,,percent of total billed charges,80% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,84.51,90,,,percent of total billed charges,90% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rates,93.9,100,,,fee schedule,100% of CO APG rates,93.9,100,,,fee schedule,100% of NM fee schedule,37.56,40,,,percent of total billed charges,40% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,84.51,90,,,percent of total billed charges,90% of total billed charges,71.36,76,,,percent of total billed charges,76% of total billed charges,37.56,40,,,percent of total billed charges,40% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of CO APG rate,75.12,80,,,percent of total billed charges,80% of total billed charges,36.43,38.8,,,percent of total billed charges,38.8% of total billed charges,79.82,85,,,percent of total billed charges,85% of total billed charges,93.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,36.43,93.9,
PFT Complete,60001545,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,897,717.6,,672.75,75,,,percent of total billed charges,75% of total billed charges,358.8,40,,,percent of total billed charges,40% of total billed charges,710.42,79.2,,,percent of total billed charges,79.2% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,852.15,95,,,percent of total billed charges,95% of total billed charges,717.6,80,,,percent of total billed charges,80% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,807.3,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,358.8,40,,,percent of total billed charges,40% of total billed charges,358.8,40,,,percent of total billed charges,40% of total billed charges,807.3,90,,,percent of total billed charges,90% of total billed charges,681.72,76,,,percent of total billed charges,76% of total billed charges,358.8,40,,,percent of total billed charges,40% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,717.6,80,,,percent of total billed charges,80% of total billed charges,348.04,38.8,,,percent of total billed charges,38.8% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,852.15,
Vent. Circuit Non Heated Supply Charge,60001481,CDM,270,RC,,,OUTPATIENT,,,10,8,,7.5,75,,,percent of total billed charges,75% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,7.92,79.2,,,percent of total billed charges,79.2% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,9.5,95,,,percent of total billed charges,95% of total billed charges,8,80,,,percent of total billed charges,80% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of CO APG rates,10,100,,,fee schedule,100% of NM fee schedule,4,40,,,percent of total billed charges,40% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,9,90,,,percent of total billed charges,90% of total billed charges,7.6,76,,,percent of total billed charges,76% of total billed charges,4,40,,,percent of total billed charges,40% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of CO APG rate,8,80,,,percent of total billed charges,80% of total billed charges,3.88,38.8,,,percent of total billed charges,38.8% of total billed charges,8.5,85,,,percent of total billed charges,85% of total billed charges,10,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,3.88,10,
"85097 - Bone marrow, smear interpretation",60001349,CDM,310,RC,88175,HCPCS,OUTPATIENT,,,2482.6,1986.08,,1861.95,75,,,percent of total billed charges,75% of total billed charges,993.04,40,,,percent of total billed charges,40% of total billed charges,1966.22,79.2,,,percent of total billed charges,79.2% of total billed charges,2110.21,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,2358.47,95,,,percent of total billed charges,95% of total billed charges,1986.08,80,,,percent of total billed charges,80% of total billed charges,2110.21,85,,,percent of total billed charges,85% of total billed charges,2234.34,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,993.04,40,,,percent of total billed charges,40% of total billed charges,993.04,40,,,percent of total billed charges,40% of total billed charges,2234.34,90,,,percent of total billed charges,90% of total billed charges,1886.78,76,,,percent of total billed charges,76% of total billed charges,993.04,40,,,percent of total billed charges,40% of total billed charges,2110.21,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,1986.08,80,,,percent of total billed charges,80% of total billed charges,963.25,38.8,,,percent of total billed charges,38.8% of total billed charges,2110.21,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,2358.47,
50390 - Aspir  and/njx renal cyst/pelvis needle prq,60001350,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2091.4,1673.12,,1568.55,75,,,percent of total billed charges,75% of total billed charges,836.56,40,,,percent of total billed charges,40% of total billed charges,1656.39,79.2,,,percent of total billed charges,79.2% of total billed charges,1777.69,85,,,percent of total billed charges,85% of total billed charges,2091.4,100,,,fee schedule,100% of CO APG rates,1986.83,95,,,percent of total billed charges,95% of total billed charges,1673.12,80,,,percent of total billed charges,80% of total billed charges,1777.69,85,,,percent of total billed charges,85% of total billed charges,1882.26,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,836.56,40,,,percent of total billed charges,40% of total billed charges,836.56,40,,,percent of total billed charges,40% of total billed charges,1882.26,90,,,percent of total billed charges,90% of total billed charges,1589.46,76,,,percent of total billed charges,76% of total billed charges,836.56,40,,,percent of total billed charges,40% of total billed charges,1777.69,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1673.12,80,,,percent of total billed charges,80% of total billed charges,811.46,38.8,,,percent of total billed charges,38.8% of total billed charges,1777.69,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
HYPERINFLATION SYSTEM MASK W/ MANOMETER (INFANT - NEONATAL),30578,CDM,270,RC,,,OUTPATIENT,,,79,63.2,,59.25,75,,,percent of total billed charges,75% of total billed charges,31.6,40,,,percent of total billed charges,40% of total billed charges,62.57,79.2,,,percent of total billed charges,79.2% of total billed charges,67.15,85,,,percent of total billed charges,85% of total billed charges,79,100,,,fee schedule,100% of CO APG rates,75.05,95,,,percent of total billed charges,95% of total billed charges,63.2,80,,,percent of total billed charges,80% of total billed charges,67.15,85,,,percent of total billed charges,85% of total billed charges,71.1,90,,,percent of total billed charges,90% of total billed charges,79,100,,,fee schedule,100% of CO APG rates,79,100,,,fee schedule,100% of CO APG rates,79,100,,,fee schedule,100% of NM fee schedule,31.6,40,,,percent of total billed charges,40% of total billed charges,31.6,40,,,percent of total billed charges,40% of total billed charges,71.1,90,,,percent of total billed charges,90% of total billed charges,60.04,76,,,percent of total billed charges,76% of total billed charges,31.6,40,,,percent of total billed charges,40% of total billed charges,67.15,85,,,percent of total billed charges,85% of total billed charges,79,100,,,fee schedule,100% of CO APG rate,63.2,80,,,percent of total billed charges,80% of total billed charges,30.65,38.8,,,percent of total billed charges,38.8% of total billed charges,67.15,85,,,percent of total billed charges,85% of total billed charges,79,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,30.65,79,
94618 Six Minute Walk Test,60001389,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,354.3,283.44,,265.73,75,,,percent of total billed charges,75% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,280.61,79.2,,,percent of total billed charges,79.2% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,336.59,95,,,percent of total billed charges,95% of total billed charges,283.44,80,,,percent of total billed charges,80% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,141.72,40,,,percent of total billed charges,40% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,269.27,76,,,percent of total billed charges,76% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,283.44,80,,,percent of total billed charges,80% of total billed charges,137.47,38.8,,,percent of total billed charges,38.8% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,336.59,
"94618 - Pulmonary stress testing (eg, 6-minute walk test)",60001389,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,354.3,283.44,,265.73,75,,,percent of total billed charges,75% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,280.61,79.2,,,percent of total billed charges,79.2% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,336.59,95,,,percent of total billed charges,95% of total billed charges,283.44,80,,,percent of total billed charges,80% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,141.72,40,,,percent of total billed charges,40% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,318.87,90,,,percent of total billed charges,90% of total billed charges,269.27,76,,,percent of total billed charges,76% of total billed charges,141.72,40,,,percent of total billed charges,40% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,283.44,80,,,percent of total billed charges,80% of total billed charges,137.47,38.8,,,percent of total billed charges,38.8% of total billed charges,301.16,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,336.59,
"SPO2 PROBE, PED (NELLCOR, WHITE CORD)",60001486,CDM,270,RC,,,OUTPATIENT,,,74.68,59.744,,56.01,75,,,percent of total billed charges,75% of total billed charges,29.87,40,,,percent of total billed charges,40% of total billed charges,59.15,79.2,,,percent of total billed charges,79.2% of total billed charges,63.48,85,,,percent of total billed charges,85% of total billed charges,74.68,100,,,fee schedule,100% of CO APG rates,70.95,95,,,percent of total billed charges,95% of total billed charges,59.74,80,,,percent of total billed charges,80% of total billed charges,63.48,85,,,percent of total billed charges,85% of total billed charges,67.21,90,,,percent of total billed charges,90% of total billed charges,74.68,100,,,fee schedule,100% of CO APG rates,74.68,100,,,fee schedule,100% of CO APG rates,74.68,100,,,fee schedule,100% of NM fee schedule,29.87,40,,,percent of total billed charges,40% of total billed charges,29.87,40,,,percent of total billed charges,40% of total billed charges,67.21,90,,,percent of total billed charges,90% of total billed charges,56.76,76,,,percent of total billed charges,76% of total billed charges,29.87,40,,,percent of total billed charges,40% of total billed charges,63.48,85,,,percent of total billed charges,85% of total billed charges,74.68,100,,,fee schedule,100% of CO APG rate,59.74,80,,,percent of total billed charges,80% of total billed charges,28.98,38.8,,,percent of total billed charges,38.8% of total billed charges,63.48,85,,,percent of total billed charges,85% of total billed charges,74.68,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,28.98,74.68,
"SPO2 PROBE, ADULT (NELLCOR, WHITE CORD)",60001487,CDM,270,RC,,,OUTPATIENT,,,74.3,59.44,,55.73,75,,,percent of total billed charges,75% of total billed charges,29.72,40,,,percent of total billed charges,40% of total billed charges,58.85,79.2,,,percent of total billed charges,79.2% of total billed charges,63.16,85,,,percent of total billed charges,85% of total billed charges,74.3,100,,,fee schedule,100% of CO APG rates,70.59,95,,,percent of total billed charges,95% of total billed charges,59.44,80,,,percent of total billed charges,80% of total billed charges,63.16,85,,,percent of total billed charges,85% of total billed charges,66.87,90,,,percent of total billed charges,90% of total billed charges,74.3,100,,,fee schedule,100% of CO APG rates,74.3,100,,,fee schedule,100% of CO APG rates,74.3,100,,,fee schedule,100% of NM fee schedule,29.72,40,,,percent of total billed charges,40% of total billed charges,29.72,40,,,percent of total billed charges,40% of total billed charges,66.87,90,,,percent of total billed charges,90% of total billed charges,56.47,76,,,percent of total billed charges,76% of total billed charges,29.72,40,,,percent of total billed charges,40% of total billed charges,63.16,85,,,percent of total billed charges,85% of total billed charges,74.3,100,,,fee schedule,100% of CO APG rate,59.44,80,,,percent of total billed charges,80% of total billed charges,28.83,38.8,,,percent of total billed charges,38.8% of total billed charges,63.16,85,,,percent of total billed charges,85% of total billed charges,74.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,28.83,74.3,
95070 - Inhalation bronchial challenge testing,60001393,CDM,924,RC,,,OUTPATIENT,,,1593.3,1274.64,,1194.98,75,,,percent of total billed charges,75% of total billed charges,637.32,40,,,percent of total billed charges,40% of total billed charges,1261.89,79.2,,,percent of total billed charges,79.2% of total billed charges,1354.31,85,,,percent of total billed charges,85% of total billed charges,1593.3,100,,,fee schedule,100% of CO APG rates,1513.64,95,,,percent of total billed charges,95% of total billed charges,1274.64,80,,,percent of total billed charges,80% of total billed charges,1354.31,85,,,percent of total billed charges,85% of total billed charges,1433.97,90,,,percent of total billed charges,90% of total billed charges,1593.3,100,,,fee schedule,100% of CO APG rates,1593.3,100,,,fee schedule,100% of CO APG rates,1593.3,100,,,fee schedule,100% of NM fee schedule,637.32,40,,,percent of total billed charges,40% of total billed charges,637.32,40,,,percent of total billed charges,40% of total billed charges,1433.97,90,,,percent of total billed charges,90% of total billed charges,1210.91,76,,,percent of total billed charges,76% of total billed charges,637.32,40,,,percent of total billed charges,40% of total billed charges,1354.31,85,,,percent of total billed charges,85% of total billed charges,1593.3,100,,,fee schedule,100% of CO APG rate,1274.64,80,,,percent of total billed charges,80% of total billed charges,618.2,38.8,,,percent of total billed charges,38.8% of total billed charges,1354.31,85,,,percent of total billed charges,85% of total billed charges,1593.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,618.2,1593.3,
94010 Spirometry,60001453,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,283.5,226.8,,212.63,75,,,percent of total billed charges,75% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,224.53,79.2,,,percent of total billed charges,79.2% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,269.33,95,,,percent of total billed charges,95% of total billed charges,226.8,80,,,percent of total billed charges,80% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,255.15,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,113.4,40,,,percent of total billed charges,40% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,255.15,90,,,percent of total billed charges,90% of total billed charges,215.46,76,,,percent of total billed charges,76% of total billed charges,113.4,40,,,percent of total billed charges,40% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,226.8,80,,,percent of total billed charges,80% of total billed charges,110,38.8,,,percent of total billed charges,38.8% of total billed charges,240.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,269.33,
INDWELLING SLIT CATHETER SET,46052695,CDM,270,RC,,,OUTPATIENT,,,330.7,264.56,,248.03,75,,,percent of total billed charges,75% of total billed charges,132.28,40,,,percent of total billed charges,40% of total billed charges,261.91,79.2,,,percent of total billed charges,79.2% of total billed charges,281.1,85,,,percent of total billed charges,85% of total billed charges,330.7,100,,,fee schedule,100% of CO APG rates,314.17,95,,,percent of total billed charges,95% of total billed charges,264.56,80,,,percent of total billed charges,80% of total billed charges,281.1,85,,,percent of total billed charges,85% of total billed charges,297.63,90,,,percent of total billed charges,90% of total billed charges,330.7,100,,,fee schedule,100% of CO APG rates,330.7,100,,,fee schedule,100% of CO APG rates,330.7,100,,,fee schedule,100% of NM fee schedule,132.28,40,,,percent of total billed charges,40% of total billed charges,132.28,40,,,percent of total billed charges,40% of total billed charges,297.63,90,,,percent of total billed charges,90% of total billed charges,251.33,76,,,percent of total billed charges,76% of total billed charges,132.28,40,,,percent of total billed charges,40% of total billed charges,281.1,85,,,percent of total billed charges,85% of total billed charges,330.7,100,,,fee schedule,100% of CO APG rate,264.56,80,,,percent of total billed charges,80% of total billed charges,128.31,38.8,,,percent of total billed charges,38.8% of total billed charges,281.1,85,,,percent of total billed charges,85% of total billed charges,330.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,128.31,330.7,
"20606 - Arthrocent, asp/inj, intermediate joint w/US",60001534,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,2077,1661.6,,1557.75,75,,,percent of total billed charges,75% of total billed charges,830.8,40,,,percent of total billed charges,40% of total billed charges,1644.98,79.2,,,percent of total billed charges,79.2% of total billed charges,1765.45,85,,,percent of total billed charges,85% of total billed charges,2077,100,,,fee schedule,100% of CO APG rates,1973.15,95,,,percent of total billed charges,95% of total billed charges,1661.6,80,,,percent of total billed charges,80% of total billed charges,1765.45,85,,,percent of total billed charges,85% of total billed charges,1869.3,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,830.8,40,,,percent of total billed charges,40% of total billed charges,830.8,40,,,percent of total billed charges,40% of total billed charges,1869.3,90,,,percent of total billed charges,90% of total billed charges,1578.52,76,,,percent of total billed charges,76% of total billed charges,830.8,40,,,percent of total billed charges,40% of total billed charges,1765.45,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1661.6,80,,,percent of total billed charges,80% of total billed charges,805.88,38.8,,,percent of total billed charges,38.8% of total billed charges,1765.45,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
PFT - Complete Pre/Post Bronchodilator,60001390,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,897,717.6,,672.75,75,,,percent of total billed charges,75% of total billed charges,358.8,40,,,percent of total billed charges,40% of total billed charges,710.42,79.2,,,percent of total billed charges,79.2% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,852.15,95,,,percent of total billed charges,95% of total billed charges,717.6,80,,,percent of total billed charges,80% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,807.3,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,358.8,40,,,percent of total billed charges,40% of total billed charges,358.8,40,,,percent of total billed charges,40% of total billed charges,807.3,90,,,percent of total billed charges,90% of total billed charges,681.72,76,,,percent of total billed charges,76% of total billed charges,358.8,40,,,percent of total billed charges,40% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,717.6,80,,,percent of total billed charges,80% of total billed charges,348.04,38.8,,,percent of total billed charges,38.8% of total billed charges,762.45,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,852.15,
NMR Lipoprof+Graph LC,60001473,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,22,17.6,,16.5,75,,,percent of total billed charges,75% of total billed charges,8.8,40,,,percent of total billed charges,40% of total billed charges,17.42,79.2,,,percent of total billed charges,79.2% of total billed charges,18.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,20.9,95,,,percent of total billed charges,95% of total billed charges,17.6,80,,,percent of total billed charges,80% of total billed charges,18.7,85,,,percent of total billed charges,85% of total billed charges,19.8,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,8.8,40,,,percent of total billed charges,40% of total billed charges,8.8,40,,,percent of total billed charges,40% of total billed charges,19.8,90,,,percent of total billed charges,90% of total billed charges,16.72,76,,,percent of total billed charges,76% of total billed charges,8.8,40,,,percent of total billed charges,40% of total billed charges,18.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,17.6,80,,,percent of total billed charges,80% of total billed charges,8.54,38.8,,,percent of total billed charges,38.8% of total billed charges,18.7,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,20.9,
Spirometry Pre/Post BD.,60001432,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,358.8,287.04,,269.1,75,,,percent of total billed charges,75% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,284.17,79.2,,,percent of total billed charges,79.2% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,340.86,95,,,percent of total billed charges,95% of total billed charges,287.04,80,,,percent of total billed charges,80% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,143.52,40,,,percent of total billed charges,40% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,272.69,76,,,percent of total billed charges,76% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,287.04,80,,,percent of total billed charges,80% of total billed charges,139.21,38.8,,,percent of total billed charges,38.8% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,340.86,
64463 - PVB THORACIC CONT CATHETER INFUSION W/IMG GID,60001592,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,1935.9,1548.72,,1451.93,75,,,percent of total billed charges,75% of total billed charges,774.36,40,,,percent of total billed charges,40% of total billed charges,1533.23,79.2,,,percent of total billed charges,79.2% of total billed charges,1645.52,85,,,percent of total billed charges,85% of total billed charges,1935.9,100,,,fee schedule,100% of CO APG rates,1839.11,95,,,percent of total billed charges,95% of total billed charges,1548.72,80,,,percent of total billed charges,80% of total billed charges,1645.52,85,,,percent of total billed charges,85% of total billed charges,1742.31,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,1854.88,100,,,fee schedule,100% of NM APC rate,774.36,40,,,percent of total billed charges,40% of total billed charges,774.36,40,,,percent of total billed charges,40% of total billed charges,1742.31,90,,,percent of total billed charges,90% of total billed charges,1471.28,76,,,percent of total billed charges,76% of total billed charges,774.36,40,,,percent of total billed charges,40% of total billed charges,1645.52,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,1548.72,80,,,percent of total billed charges,80% of total billed charges,751.13,38.8,,,percent of total billed charges,38.8% of total billed charges,1645.52,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,466.76,2713.28,
94729 - CO/membane diffuse capacity,60001537,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,467.1,373.68,,350.33,75,,,percent of total billed charges,75% of total billed charges,186.84,40,,,percent of total billed charges,40% of total billed charges,369.94,79.2,,,percent of total billed charges,79.2% of total billed charges,397.04,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,443.75,95,,,percent of total billed charges,95% of total billed charges,373.68,80,,,percent of total billed charges,80% of total billed charges,397.04,85,,,percent of total billed charges,85% of total billed charges,420.39,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,186.84,40,,,percent of total billed charges,40% of total billed charges,186.84,40,,,percent of total billed charges,40% of total billed charges,420.39,90,,,percent of total billed charges,90% of total billed charges,355,76,,,percent of total billed charges,76% of total billed charges,186.84,40,,,percent of total billed charges,40% of total billed charges,397.04,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,373.68,80,,,percent of total billed charges,80% of total billed charges,181.23,38.8,,,percent of total billed charges,38.8% of total billed charges,397.04,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,443.75,
MuSk Antibodies Test,60001105,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,1158.3,926.64,,868.73,75,,,percent of total billed charges,75% of total billed charges,463.32,40,,,percent of total billed charges,40% of total billed charges,917.37,79.2,,,percent of total billed charges,79.2% of total billed charges,984.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,1100.39,95,,,percent of total billed charges,95% of total billed charges,926.64,80,,,percent of total billed charges,80% of total billed charges,984.56,85,,,percent of total billed charges,85% of total billed charges,1042.47,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,463.32,40,,,percent of total billed charges,40% of total billed charges,463.32,40,,,percent of total billed charges,40% of total billed charges,1042.47,90,,,percent of total billed charges,90% of total billed charges,880.31,76,,,percent of total billed charges,76% of total billed charges,463.32,40,,,percent of total billed charges,40% of total billed charges,984.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,926.64,80,,,percent of total billed charges,80% of total billed charges,449.42,38.8,,,percent of total billed charges,38.8% of total billed charges,984.56,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,1100.39,
54235 - Injection of corpora cavernosa with pharmacologic ag,60001338,CDM,761,RC,55250,HCPCS,OUTPATIENT,,,734.7,587.76,,551.03,75,,,percent of total billed charges,75% of total billed charges,293.88,40,,,percent of total billed charges,40% of total billed charges,581.88,79.2,,,percent of total billed charges,79.2% of total billed charges,624.5,85,,,percent of total billed charges,85% of total billed charges,734.7,100,,,fee schedule,100% of CO APG rates,697.97,95,,,percent of total billed charges,95% of total billed charges,587.76,80,,,percent of total billed charges,80% of total billed charges,624.5,85,,,percent of total billed charges,85% of total billed charges,661.23,90,,,percent of total billed charges,90% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rates,2713.28,100,,,fee schedule,100% of CO APG rates,734.7,100,,,fee schedule,100% of NM APC rate,293.88,40,,,percent of total billed charges,40% of total billed charges,293.88,40,,,percent of total billed charges,40% of total billed charges,661.23,90,,,percent of total billed charges,90% of total billed charges,558.37,76,,,percent of total billed charges,76% of total billed charges,293.88,40,,,percent of total billed charges,40% of total billed charges,624.5,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of CO APG rate,587.76,80,,,percent of total billed charges,80% of total billed charges,285.06,38.8,,,percent of total billed charges,38.8% of total billed charges,624.5,85,,,percent of total billed charges,85% of total billed charges,2713.28,100,,,fee schedule,100% of APG fee schedule,466.76,200,,,fee schedule,200% of CMS fee schedule,285.06,2713.28,
Hepatitis B Virus Screen and Diagnosis LC,60001577,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,41.5,33.2,,31.13,75,,,percent of total billed charges,75% of total billed charges,16.6,40,,,percent of total billed charges,40% of total billed charges,32.87,79.2,,,percent of total billed charges,79.2% of total billed charges,35.28,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,39.43,95,,,percent of total billed charges,95% of total billed charges,33.2,80,,,percent of total billed charges,80% of total billed charges,35.28,85,,,percent of total billed charges,85% of total billed charges,37.35,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,16.6,40,,,percent of total billed charges,40% of total billed charges,16.6,40,,,percent of total billed charges,40% of total billed charges,37.35,90,,,percent of total billed charges,90% of total billed charges,31.54,76,,,percent of total billed charges,76% of total billed charges,16.6,40,,,percent of total billed charges,40% of total billed charges,35.28,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,33.2,80,,,percent of total billed charges,80% of total billed charges,16.1,38.8,,,percent of total billed charges,38.8% of total billed charges,35.28,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,39.43,
64466 - Unilateral thoracic fascial plane block,60001555,CDM,370,RC,99152,HCPCS,OUTPATIENT,,,885.5,708.4,,664.13,75,,,percent of total billed charges,75% of total billed charges,354.2,40,,,percent of total billed charges,40% of total billed charges,701.32,79.2,,,percent of total billed charges,79.2% of total billed charges,752.68,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rates,841.23,95,,,percent of total billed charges,95% of total billed charges,708.4,80,,,percent of total billed charges,80% of total billed charges,752.68,85,,,percent of total billed charges,85% of total billed charges,796.95,90,,,percent of total billed charges,90% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rates,31.51,100,,,fee schedule,100% of CO APG rates,885.5,100,,,fee schedule,100% of NM fee schedule,354.2,40,,,percent of total billed charges,40% of total billed charges,354.2,40,,,percent of total billed charges,40% of total billed charges,796.95,90,,,percent of total billed charges,90% of total billed charges,672.98,76,,,percent of total billed charges,76% of total billed charges,354.2,40,,,percent of total billed charges,40% of total billed charges,752.68,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of CO APG rate,708.4,80,,,percent of total billed charges,80% of total billed charges,343.57,38.8,,,percent of total billed charges,38.8% of total billed charges,752.68,85,,,percent of total billed charges,85% of total billed charges,31.51,100,,,fee schedule,100% of APG fee schedule,24.88,200,,,fee schedule,200% of CMS fee schedule,24.88,885.5,
"SpO2 Sensor Nellcor Finger, Neonatal/Adult",60001488,CDM,270,RC,,,OUTPATIENT,,,97.43,77.944,,73.07,75,,,percent of total billed charges,75% of total billed charges,38.97,40,,,percent of total billed charges,40% of total billed charges,77.16,79.2,,,percent of total billed charges,79.2% of total billed charges,82.82,85,,,percent of total billed charges,85% of total billed charges,97.43,100,,,fee schedule,100% of CO APG rates,92.56,95,,,percent of total billed charges,95% of total billed charges,77.94,80,,,percent of total billed charges,80% of total billed charges,82.82,85,,,percent of total billed charges,85% of total billed charges,87.69,90,,,percent of total billed charges,90% of total billed charges,97.43,100,,,fee schedule,100% of CO APG rates,97.43,100,,,fee schedule,100% of CO APG rates,97.43,100,,,fee schedule,100% of NM fee schedule,38.97,40,,,percent of total billed charges,40% of total billed charges,38.97,40,,,percent of total billed charges,40% of total billed charges,87.69,90,,,percent of total billed charges,90% of total billed charges,74.05,76,,,percent of total billed charges,76% of total billed charges,38.97,40,,,percent of total billed charges,40% of total billed charges,82.82,85,,,percent of total billed charges,85% of total billed charges,97.43,100,,,fee schedule,100% of CO APG rate,77.94,80,,,percent of total billed charges,80% of total billed charges,37.8,38.8,,,percent of total billed charges,38.8% of total billed charges,82.82,85,,,percent of total billed charges,85% of total billed charges,97.43,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,37.8,97.43,
Breast Biopsy Kit (HOLOGIC),60001101,CDM,270,RC,,,OUTPATIENT,,,230.4,184.32,,172.8,75,,,percent of total billed charges,75% of total billed charges,92.16,40,,,percent of total billed charges,40% of total billed charges,182.48,79.2,,,percent of total billed charges,79.2% of total billed charges,195.84,85,,,percent of total billed charges,85% of total billed charges,230.4,100,,,fee schedule,100% of CO APG rates,218.88,95,,,percent of total billed charges,95% of total billed charges,184.32,80,,,percent of total billed charges,80% of total billed charges,195.84,85,,,percent of total billed charges,85% of total billed charges,207.36,90,,,percent of total billed charges,90% of total billed charges,230.4,100,,,fee schedule,100% of CO APG rates,230.4,100,,,fee schedule,100% of CO APG rates,230.4,100,,,fee schedule,100% of NM fee schedule,92.16,40,,,percent of total billed charges,40% of total billed charges,92.16,40,,,percent of total billed charges,40% of total billed charges,207.36,90,,,percent of total billed charges,90% of total billed charges,175.1,76,,,percent of total billed charges,76% of total billed charges,92.16,40,,,percent of total billed charges,40% of total billed charges,195.84,85,,,percent of total billed charges,85% of total billed charges,230.4,100,,,fee schedule,100% of CO APG rate,184.32,80,,,percent of total billed charges,80% of total billed charges,89.4,38.8,,,percent of total billed charges,38.8% of total billed charges,195.84,85,,,percent of total billed charges,85% of total billed charges,230.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,89.4,230.4,
Myasthenia Gravis Profile LC,28579995,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,1180.6,944.48,,885.45,75,,,percent of total billed charges,75% of total billed charges,472.24,40,,,percent of total billed charges,40% of total billed charges,935.04,79.2,,,percent of total billed charges,79.2% of total billed charges,1003.51,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,1121.57,95,,,percent of total billed charges,95% of total billed charges,944.48,80,,,percent of total billed charges,80% of total billed charges,1003.51,85,,,percent of total billed charges,85% of total billed charges,1062.54,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,472.24,40,,,percent of total billed charges,40% of total billed charges,472.24,40,,,percent of total billed charges,40% of total billed charges,1062.54,90,,,percent of total billed charges,90% of total billed charges,897.26,76,,,percent of total billed charges,76% of total billed charges,472.24,40,,,percent of total billed charges,40% of total billed charges,1003.51,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,944.48,80,,,percent of total billed charges,80% of total billed charges,458.07,38.8,,,percent of total billed charges,38.8% of total billed charges,1003.51,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,1121.57,
94060 - Spirometry Pre/Post Bronchodilation,60001538,CDM,410,RC,94640,HCPCS,OUTPATIENT,,,358.8,287.04,,269.1,75,,,percent of total billed charges,75% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,284.17,79.2,,,percent of total billed charges,79.2% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,340.86,95,,,percent of total billed charges,95% of total billed charges,287.04,80,,,percent of total billed charges,80% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,191.5,100,,,fee schedule,100% of NM APC rate,143.52,40,,,percent of total billed charges,40% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,322.92,90,,,percent of total billed charges,90% of total billed charges,272.69,76,,,percent of total billed charges,76% of total billed charges,143.52,40,,,percent of total billed charges,40% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,287.04,80,,,percent of total billed charges,80% of total billed charges,139.21,38.8,,,percent of total billed charges,38.8% of total billed charges,304.98,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,19.04,200,,,fee schedule,200% of CMS fee schedule,19.04,340.86,
SecurMark? for Eviva?  Biopsy Site Marker 13cm,60001108,CDM,270,RC,,,OUTPATIENT,,,457.4,365.92,,343.05,75,,,percent of total billed charges,75% of total billed charges,182.96,40,,,percent of total billed charges,40% of total billed charges,362.26,79.2,,,percent of total billed charges,79.2% of total billed charges,388.79,85,,,percent of total billed charges,85% of total billed charges,457.4,100,,,fee schedule,100% of CO APG rates,434.53,95,,,percent of total billed charges,95% of total billed charges,365.92,80,,,percent of total billed charges,80% of total billed charges,388.79,85,,,percent of total billed charges,85% of total billed charges,411.66,90,,,percent of total billed charges,90% of total billed charges,457.4,100,,,fee schedule,100% of CO APG rates,457.4,100,,,fee schedule,100% of CO APG rates,457.4,100,,,fee schedule,100% of NM fee schedule,182.96,40,,,percent of total billed charges,40% of total billed charges,182.96,40,,,percent of total billed charges,40% of total billed charges,411.66,90,,,percent of total billed charges,90% of total billed charges,347.62,76,,,percent of total billed charges,76% of total billed charges,182.96,40,,,percent of total billed charges,40% of total billed charges,388.79,85,,,percent of total billed charges,85% of total billed charges,457.4,100,,,fee schedule,100% of CO APG rate,365.92,80,,,percent of total billed charges,80% of total billed charges,177.47,38.8,,,percent of total billed charges,38.8% of total billed charges,388.79,85,,,percent of total billed charges,85% of total billed charges,457.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,177.47,457.4,
EVIVA Needle Guide 9G,60001109,CDM,270,RC,,,OUTPATIENT,,,54.3,43.44,,40.73,75,,,percent of total billed charges,75% of total billed charges,21.72,40,,,percent of total billed charges,40% of total billed charges,43.01,79.2,,,percent of total billed charges,79.2% of total billed charges,46.16,85,,,percent of total billed charges,85% of total billed charges,54.3,100,,,fee schedule,100% of CO APG rates,51.59,95,,,percent of total billed charges,95% of total billed charges,43.44,80,,,percent of total billed charges,80% of total billed charges,46.16,85,,,percent of total billed charges,85% of total billed charges,48.87,90,,,percent of total billed charges,90% of total billed charges,54.3,100,,,fee schedule,100% of CO APG rates,54.3,100,,,fee schedule,100% of CO APG rates,54.3,100,,,fee schedule,100% of NM fee schedule,21.72,40,,,percent of total billed charges,40% of total billed charges,21.72,40,,,percent of total billed charges,40% of total billed charges,48.87,90,,,percent of total billed charges,90% of total billed charges,41.27,76,,,percent of total billed charges,76% of total billed charges,21.72,40,,,percent of total billed charges,40% of total billed charges,46.16,85,,,percent of total billed charges,85% of total billed charges,54.3,100,,,fee schedule,100% of CO APG rate,43.44,80,,,percent of total billed charges,80% of total billed charges,21.07,38.8,,,percent of total billed charges,38.8% of total billed charges,46.16,85,,,percent of total billed charges,85% of total billed charges,54.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,21.07,54.3,
"Counterbore drill, short, 5.5mmX185mm",60001111,CDM,270,RC,,,OUTPATIENT,,,1666.8,1333.44,,1250.1,75,,,percent of total billed charges,75% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1320.11,79.2,,,percent of total billed charges,79.2% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rates,1583.46,95,,,percent of total billed charges,95% of total billed charges,1333.44,80,,,percent of total billed charges,80% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1500.12,90,,,percent of total billed charges,90% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rates,1666.8,100,,,fee schedule,100% of CO APG rates,1666.8,100,,,fee schedule,100% of NM fee schedule,666.72,40,,,percent of total billed charges,40% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1500.12,90,,,percent of total billed charges,90% of total billed charges,1266.77,76,,,percent of total billed charges,76% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rate,1333.44,80,,,percent of total billed charges,80% of total billed charges,646.72,38.8,,,percent of total billed charges,38.8% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,646.72,1666.8,
"K-wire, 3 ? 285mm",60001112,CDM,270,RC,,,OUTPATIENT,,,1179.4,943.52,,884.55,75,,,percent of total billed charges,75% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,934.08,79.2,,,percent of total billed charges,79.2% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rates,1120.43,95,,,percent of total billed charges,95% of total billed charges,943.52,80,,,percent of total billed charges,80% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1061.46,90,,,percent of total billed charges,90% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rates,1179.4,100,,,fee schedule,100% of CO APG rates,1179.4,100,,,fee schedule,100% of NM fee schedule,471.76,40,,,percent of total billed charges,40% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,1061.46,90,,,percent of total billed charges,90% of total billed charges,896.34,76,,,percent of total billed charges,76% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rate,943.52,80,,,percent of total billed charges,80% of total billed charges,457.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,457.61,1179.4,
"Freehand drill, 4.2 ? 185mm",60001122,CDM,270,RC,,,OUTPATIENT,,,1666.8,1333.44,,1250.1,75,,,percent of total billed charges,75% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1320.11,79.2,,,percent of total billed charges,79.2% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rates,1583.46,95,,,percent of total billed charges,95% of total billed charges,1333.44,80,,,percent of total billed charges,80% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1500.12,90,,,percent of total billed charges,90% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rates,1666.8,100,,,fee schedule,100% of CO APG rates,1666.8,100,,,fee schedule,100% of NM fee schedule,666.72,40,,,percent of total billed charges,40% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1500.12,90,,,percent of total billed charges,90% of total billed charges,1266.77,76,,,percent of total billed charges,76% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rate,1333.44,80,,,percent of total billed charges,80% of total billed charges,646.72,38.8,,,percent of total billed charges,38.8% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,646.72,1666.8,
"Freehand drill, 4.2 ? 130mm",60001113,CDM,270,RC,,,OUTPATIENT,,,1666.8,1333.44,,1250.1,75,,,percent of total billed charges,75% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1320.11,79.2,,,percent of total billed charges,79.2% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rates,1583.46,95,,,percent of total billed charges,95% of total billed charges,1333.44,80,,,percent of total billed charges,80% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1500.12,90,,,percent of total billed charges,90% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rates,1666.8,100,,,fee schedule,100% of CO APG rates,1666.8,100,,,fee schedule,100% of NM fee schedule,666.72,40,,,percent of total billed charges,40% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1500.12,90,,,percent of total billed charges,90% of total billed charges,1266.77,76,,,percent of total billed charges,76% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rate,1333.44,80,,,percent of total billed charges,80% of total billed charges,646.72,38.8,,,percent of total billed charges,38.8% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,646.72,1666.8,
"Locking Drill, 4.2 dia. x 360 mm",60001114,CDM,270,RC,,,OUTPATIENT,,,1666.8,1333.44,,1250.1,75,,,percent of total billed charges,75% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1320.11,79.2,,,percent of total billed charges,79.2% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rates,1583.46,95,,,percent of total billed charges,95% of total billed charges,1333.44,80,,,percent of total billed charges,80% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1500.12,90,,,percent of total billed charges,90% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rates,1666.8,100,,,fee schedule,100% of CO APG rates,1666.8,100,,,fee schedule,100% of NM fee schedule,666.72,40,,,percent of total billed charges,40% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1500.12,90,,,percent of total billed charges,90% of total billed charges,1266.77,76,,,percent of total billed charges,76% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rate,1333.44,80,,,percent of total billed charges,80% of total billed charges,646.72,38.8,,,percent of total billed charges,38.8% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,646.72,1666.8,
"Counterbore drill, long,5.5 ? 255mm",60001116,CDM,270,RC,,,OUTPATIENT,,,1666.8,1333.44,,1250.1,75,,,percent of total billed charges,75% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1320.11,79.2,,,percent of total billed charges,79.2% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rates,1583.46,95,,,percent of total billed charges,95% of total billed charges,1333.44,80,,,percent of total billed charges,80% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1500.12,90,,,percent of total billed charges,90% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rates,1666.8,100,,,fee schedule,100% of CO APG rates,1666.8,100,,,fee schedule,100% of NM fee schedule,666.72,40,,,percent of total billed charges,40% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1500.12,90,,,percent of total billed charges,90% of total billed charges,1266.77,76,,,percent of total billed charges,76% of total billed charges,666.72,40,,,percent of total billed charges,40% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of CO APG rate,1333.44,80,,,percent of total billed charges,80% of total billed charges,646.72,38.8,,,percent of total billed charges,38.8% of total billed charges,1416.78,85,,,percent of total billed charges,85% of total billed charges,1666.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,646.72,1666.8,
"K-Wire, 3.2 dia. x 400 mm, Drill-Tip, Recon",60001121,CDM,270,RC,,,OUTPATIENT,,,1179.4,943.52,,884.55,75,,,percent of total billed charges,75% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,934.08,79.2,,,percent of total billed charges,79.2% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rates,1120.43,95,,,percent of total billed charges,95% of total billed charges,943.52,80,,,percent of total billed charges,80% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1061.46,90,,,percent of total billed charges,90% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rates,1179.4,100,,,fee schedule,100% of CO APG rates,1179.4,100,,,fee schedule,100% of NM fee schedule,471.76,40,,,percent of total billed charges,40% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,1061.46,90,,,percent of total billed charges,90% of total billed charges,896.34,76,,,percent of total billed charges,76% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rate,943.52,80,,,percent of total billed charges,80% of total billed charges,457.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,457.61,1179.4,
"Nail Insertion Sleeve, 8 to 13 mm",60001117,CDM,270,RC,,,OUTPATIENT,,,473.2,378.56,,354.9,75,,,percent of total billed charges,75% of total billed charges,189.28,40,,,percent of total billed charges,40% of total billed charges,374.77,79.2,,,percent of total billed charges,79.2% of total billed charges,402.22,85,,,percent of total billed charges,85% of total billed charges,473.2,100,,,fee schedule,100% of CO APG rates,449.54,95,,,percent of total billed charges,95% of total billed charges,378.56,80,,,percent of total billed charges,80% of total billed charges,402.22,85,,,percent of total billed charges,85% of total billed charges,425.88,90,,,percent of total billed charges,90% of total billed charges,473.2,100,,,fee schedule,100% of CO APG rates,473.2,100,,,fee schedule,100% of CO APG rates,473.2,100,,,fee schedule,100% of NM fee schedule,189.28,40,,,percent of total billed charges,40% of total billed charges,189.28,40,,,percent of total billed charges,40% of total billed charges,425.88,90,,,percent of total billed charges,90% of total billed charges,359.63,76,,,percent of total billed charges,76% of total billed charges,189.28,40,,,percent of total billed charges,40% of total billed charges,402.22,85,,,percent of total billed charges,85% of total billed charges,473.2,100,,,fee schedule,100% of CO APG rate,378.56,80,,,percent of total billed charges,80% of total billed charges,183.6,38.8,,,percent of total billed charges,38.8% of total billed charges,402.22,85,,,percent of total billed charges,85% of total billed charges,473.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.6,473.2,
"Nail Insertion Sleeve, 8 to 11 mm",60001118,CDM,270,RC,,,OUTPATIENT,,,473.2,378.56,,354.9,75,,,percent of total billed charges,75% of total billed charges,189.28,40,,,percent of total billed charges,40% of total billed charges,374.77,79.2,,,percent of total billed charges,79.2% of total billed charges,402.22,85,,,percent of total billed charges,85% of total billed charges,473.2,100,,,fee schedule,100% of CO APG rates,449.54,95,,,percent of total billed charges,95% of total billed charges,378.56,80,,,percent of total billed charges,80% of total billed charges,402.22,85,,,percent of total billed charges,85% of total billed charges,425.88,90,,,percent of total billed charges,90% of total billed charges,473.2,100,,,fee schedule,100% of CO APG rates,473.2,100,,,fee schedule,100% of CO APG rates,473.2,100,,,fee schedule,100% of NM fee schedule,189.28,40,,,percent of total billed charges,40% of total billed charges,189.28,40,,,percent of total billed charges,40% of total billed charges,425.88,90,,,percent of total billed charges,90% of total billed charges,359.63,76,,,percent of total billed charges,76% of total billed charges,189.28,40,,,percent of total billed charges,40% of total billed charges,402.22,85,,,percent of total billed charges,85% of total billed charges,473.2,100,,,fee schedule,100% of CO APG rate,378.56,80,,,percent of total billed charges,80% of total billed charges,183.6,38.8,,,percent of total billed charges,38.8% of total billed charges,402.22,85,,,percent of total billed charges,85% of total billed charges,473.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.6,473.2,
"Fixation K-wire,3 X 285mm",60001119,CDM,270,RC,,,OUTPATIENT,,,1179.4,943.52,,884.55,75,,,percent of total billed charges,75% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,934.08,79.2,,,percent of total billed charges,79.2% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rates,1120.43,95,,,percent of total billed charges,95% of total billed charges,943.52,80,,,percent of total billed charges,80% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1061.46,90,,,percent of total billed charges,90% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rates,1179.4,100,,,fee schedule,100% of CO APG rates,1179.4,100,,,fee schedule,100% of NM fee schedule,471.76,40,,,percent of total billed charges,40% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,1061.46,90,,,percent of total billed charges,90% of total billed charges,896.34,76,,,percent of total billed charges,76% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rate,943.52,80,,,percent of total billed charges,80% of total billed charges,457.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,457.61,1179.4,
"Guide Pin for Cannulated Cutter, 4.0 x 400mm",60001120,CDM,270,RC,,,OUTPATIENT,,,1179.4,943.52,,884.55,75,,,percent of total billed charges,75% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,934.08,79.2,,,percent of total billed charges,79.2% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rates,1120.43,95,,,percent of total billed charges,95% of total billed charges,943.52,80,,,percent of total billed charges,80% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1061.46,90,,,percent of total billed charges,90% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rates,1179.4,100,,,fee schedule,100% of CO APG rates,1179.4,100,,,fee schedule,100% of NM fee schedule,471.76,40,,,percent of total billed charges,40% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,1061.46,90,,,percent of total billed charges,90% of total billed charges,896.34,76,,,percent of total billed charges,76% of total billed charges,471.76,40,,,percent of total billed charges,40% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of CO APG rate,943.52,80,,,percent of total billed charges,80% of total billed charges,457.61,38.8,,,percent of total billed charges,38.8% of total billed charges,1002.49,85,,,percent of total billed charges,85% of total billed charges,1179.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,457.61,1179.4,
"Locking Screw IMN Screw, 5 X 32.5mm",60001164,CDM,278,RC,,,OUTPATIENT,,,643.8,515.04,,482.85,75,,,percent of total billed charges,75% of total billed charges,257.52,40,,,percent of total billed charges,40% of total billed charges,509.89,79.2,,,percent of total billed charges,79.2% of total billed charges,547.23,85,,,percent of total billed charges,85% of total billed charges,643.8,100,,,fee schedule,100% of CO APG rates,611.61,95,,,percent of total billed charges,95% of total billed charges,515.04,80,,,percent of total billed charges,80% of total billed charges,547.23,85,,,percent of total billed charges,85% of total billed charges,579.42,90,,,percent of total billed charges,90% of total billed charges,643.8,100,,,fee schedule,100% of CO APG rates,643.8,100,,,fee schedule,100% of CO APG rates,643.8,100,,,fee schedule,100% of NM fee schedule,257.52,40,,,percent of total billed charges,40% of total billed charges,257.52,40,,,percent of total billed charges,40% of total billed charges,579.42,90,,,percent of total billed charges,90% of total billed charges,489.29,76,,,percent of total billed charges,76% of total billed charges,257.52,40,,,percent of total billed charges,40% of total billed charges,547.23,85,,,percent of total billed charges,85% of total billed charges,643.8,100,,,fee schedule,100% of CO APG rate,515.04,80,,,percent of total billed charges,80% of total billed charges,249.79,38.8,,,percent of total billed charges,38.8% of total billed charges,547.23,85,,,percent of total billed charges,85% of total billed charges,643.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,249.79,643.8,
"Tibial Nail, 9 x 375mm,T2 Alpha Tibial Nail System",60002010,CDM,278,RC,,,OUTPATIENT,,,1703.5,1362.8,,1277.63,75,,,percent of total billed charges,75% of total billed charges,681.4,40,,,percent of total billed charges,40% of total billed charges,1349.17,79.2,,,percent of total billed charges,79.2% of total billed charges,1447.98,85,,,percent of total billed charges,85% of total billed charges,1703.5,100,,,fee schedule,100% of CO APG rates,1618.33,95,,,percent of total billed charges,95% of total billed charges,1362.8,80,,,percent of total billed charges,80% of total billed charges,1447.98,85,,,percent of total billed charges,85% of total billed charges,1533.15,90,,,percent of total billed charges,90% of total billed charges,1703.5,100,,,fee schedule,100% of CO APG rates,1703.5,100,,,fee schedule,100% of CO APG rates,1703.5,100,,,fee schedule,100% of NM fee schedule,681.4,40,,,percent of total billed charges,40% of total billed charges,681.4,40,,,percent of total billed charges,40% of total billed charges,1533.15,90,,,percent of total billed charges,90% of total billed charges,1294.66,76,,,percent of total billed charges,76% of total billed charges,681.4,40,,,percent of total billed charges,40% of total billed charges,1447.98,85,,,percent of total billed charges,85% of total billed charges,1703.5,100,,,fee schedule,100% of CO APG rate,1362.8,80,,,percent of total billed charges,80% of total billed charges,660.96,38.8,,,percent of total billed charges,38.8% of total billed charges,1447.98,85,,,percent of total billed charges,85% of total billed charges,1703.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,660.96,1703.5,
"Locking Screw IMN Screw, 5 X 45mm",60001169,CDM,278,RC,,,OUTPATIENT,,,643.8,515.04,,482.85,75,,,percent of total billed charges,75% of total billed charges,257.52,40,,,percent of total billed charges,40% of total billed charges,509.89,79.2,,,percent of total billed charges,79.2% of total billed charges,547.23,85,,,percent of total billed charges,85% of total billed charges,643.8,100,,,fee schedule,100% of CO APG rates,611.61,95,,,percent of total billed charges,95% of total billed charges,515.04,80,,,percent of total billed charges,80% of total billed charges,547.23,85,,,percent of total billed charges,85% of total billed charges,579.42,90,,,percent of total billed charges,90% of total billed charges,643.8,100,,,fee schedule,100% of CO APG rates,643.8,100,,,fee schedule,100% of CO APG rates,643.8,100,,,fee schedule,100% of NM fee schedule,257.52,40,,,percent of total billed charges,40% of total billed charges,257.52,40,,,percent of total billed charges,40% of total billed charges,579.42,90,,,percent of total billed charges,90% of total billed charges,489.29,76,,,percent of total billed charges,76% of total billed charges,257.52,40,,,percent of total billed charges,40% of total billed charges,547.23,85,,,percent of total billed charges,85% of total billed charges,643.8,100,,,fee schedule,100% of CO APG rate,515.04,80,,,percent of total billed charges,80% of total billed charges,249.79,38.8,,,percent of total billed charges,38.8% of total billed charges,547.23,85,,,percent of total billed charges,85% of total billed charges,643.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,249.79,643.8,
"Tibial Nail, 11x 330mm,T2 Alpha Tibial Nail System",60001586,CDM,278,RC,,,OUTPATIENT,,,1419.6,1135.68,,1064.7,75,,,percent of total billed charges,75% of total billed charges,567.84,40,,,percent of total billed charges,40% of total billed charges,1124.32,79.2,,,percent of total billed charges,79.2% of total billed charges,1206.66,85,,,percent of total billed charges,85% of total billed charges,1419.6,100,,,fee schedule,100% of CO APG rates,1348.62,95,,,percent of total billed charges,95% of total billed charges,1135.68,80,,,percent of total billed charges,80% of total billed charges,1206.66,85,,,percent of total billed charges,85% of total billed charges,1277.64,90,,,percent of total billed charges,90% of total billed charges,1419.6,100,,,fee schedule,100% of CO APG rates,1419.6,100,,,fee schedule,100% of CO APG rates,1419.6,100,,,fee schedule,100% of NM fee schedule,567.84,40,,,percent of total billed charges,40% of total billed charges,567.84,40,,,percent of total billed charges,40% of total billed charges,1277.64,90,,,percent of total billed charges,90% of total billed charges,1078.9,76,,,percent of total billed charges,76% of total billed charges,567.84,40,,,percent of total billed charges,40% of total billed charges,1206.66,85,,,percent of total billed charges,85% of total billed charges,1419.6,100,,,fee schedule,100% of CO APG rate,1135.68,80,,,percent of total billed charges,80% of total billed charges,550.8,38.8,,,percent of total billed charges,38.8% of total billed charges,1206.66,85,,,percent of total billed charges,85% of total billed charges,1419.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,550.8,1419.6,
"Retrograde Femoral Nail, 10 x 300 mm, T2 Alpha Femur",60001215,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 10 x 320 mm, T2 Alpha Femur",60001216,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 10 x 340 mm, T2 Alpha Femur",60001217,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 11 x 300 mm, T2 Alpha Femur",60001222,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 11 x 360 mm, T2 Alpha Femur",60001225,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 11 x 380 mm, T2 Alpha Femur",60001226,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 11 x 400 mm, T2 Alpha Femur",60001227,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 10 x 360 mm, T2 Alpha Femur",60001218,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 10 x 380 mm, T2 Alpha Femur",60001219,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 10 x 400 mm, T2 Alpha Femur",60001220,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 10 x 420 mm, T2 Alpha Femur",60001221,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 11 x 320 mm, T2 Alpha Femur",60001223,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 11 x 340 mm, T2 Alpha Femur",60001224,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 11 x 420 mm, T2 Alpha Femur",60001228,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 12 x 340 mm, T2 Alpha Femur",60001231,CDM,278,RC,,,OUTPATIENT,,,2087,1669.6,,1565.25,75,,,percent of total billed charges,75% of total billed charges,834.8,40,,,percent of total billed charges,40% of total billed charges,1652.9,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,2087,100,,,fee schedule,100% of CO APG rates,1982.65,95,,,percent of total billed charges,95% of total billed charges,1669.6,80,,,percent of total billed charges,80% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,1878.3,90,,,percent of total billed charges,90% of total billed charges,2087,100,,,fee schedule,100% of CO APG rates,2087,100,,,fee schedule,100% of CO APG rates,2087,100,,,fee schedule,100% of NM fee schedule,834.8,40,,,percent of total billed charges,40% of total billed charges,834.8,40,,,percent of total billed charges,40% of total billed charges,1878.3,90,,,percent of total billed charges,90% of total billed charges,1586.12,76,,,percent of total billed charges,76% of total billed charges,834.8,40,,,percent of total billed charges,40% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,2087,100,,,fee schedule,100% of CO APG rate,1669.6,80,,,percent of total billed charges,80% of total billed charges,809.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,2087,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.76,2087,
"Retrograde Femoral Nail, 12 x 380 mm, T2 Alpha Femur",60001233,CDM,278,RC,,,OUTPATIENT,,,2087,1669.6,,1565.25,75,,,percent of total billed charges,75% of total billed charges,834.8,40,,,percent of total billed charges,40% of total billed charges,1652.9,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,2087,100,,,fee schedule,100% of CO APG rates,1982.65,95,,,percent of total billed charges,95% of total billed charges,1669.6,80,,,percent of total billed charges,80% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,1878.3,90,,,percent of total billed charges,90% of total billed charges,2087,100,,,fee schedule,100% of CO APG rates,2087,100,,,fee schedule,100% of CO APG rates,2087,100,,,fee schedule,100% of NM fee schedule,834.8,40,,,percent of total billed charges,40% of total billed charges,834.8,40,,,percent of total billed charges,40% of total billed charges,1878.3,90,,,percent of total billed charges,90% of total billed charges,1586.12,76,,,percent of total billed charges,76% of total billed charges,834.8,40,,,percent of total billed charges,40% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,2087,100,,,fee schedule,100% of CO APG rate,1669.6,80,,,percent of total billed charges,80% of total billed charges,809.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,2087,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.76,2087,
"Retrograde Femoral Nail, 12 x 320 mm, T2 Alpha Femur",60001230,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 12 x 420mm, T2 Alpha Femur",60001235,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 12 x 300 mm, T2 Alpha Femur",60001229,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 12 x 360 mm, T2 Alpha Femur",60001232,CDM,278,RC,,,OUTPATIENT,,,2087,1669.6,,1565.25,75,,,percent of total billed charges,75% of total billed charges,834.8,40,,,percent of total billed charges,40% of total billed charges,1652.9,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,2087,100,,,fee schedule,100% of CO APG rates,1982.65,95,,,percent of total billed charges,95% of total billed charges,1669.6,80,,,percent of total billed charges,80% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,1878.3,90,,,percent of total billed charges,90% of total billed charges,2087,100,,,fee schedule,100% of CO APG rates,2087,100,,,fee schedule,100% of CO APG rates,2087,100,,,fee schedule,100% of NM fee schedule,834.8,40,,,percent of total billed charges,40% of total billed charges,834.8,40,,,percent of total billed charges,40% of total billed charges,1878.3,90,,,percent of total billed charges,90% of total billed charges,1586.12,76,,,percent of total billed charges,76% of total billed charges,834.8,40,,,percent of total billed charges,40% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,2087,100,,,fee schedule,100% of CO APG rate,1669.6,80,,,percent of total billed charges,80% of total billed charges,809.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.95,85,,,percent of total billed charges,85% of total billed charges,2087,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.76,2087,
"Retrograde Femoral Nail, 12 x 400 mm, T2 Alpha Femur",60001234,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 13 x 320mm, T2 Alpha Femur",60001237,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 13 x 340mm, T2 Alpha Femur",60001238,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 13 x 360mm, T2 Alpha Femur",60001239,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 13 x 420mm, T2 Alpha Femur",60001242,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 13 x 300mm, T2 Alpha Femur",60001236,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 13 x 380mm, T2 Alpha Femur",60001240,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
"Retrograde Femoral Nail, 13 x 400mm, T2 Alpha Femur",60001241,CDM,278,RC,,,OUTPATIENT,,,2086.2,1668.96,,1564.65,75,,,percent of total billed charges,75% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1652.27,79.2,,,percent of total billed charges,79.2% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,1981.89,95,,,percent of total billed charges,95% of total billed charges,1668.96,80,,,percent of total billed charges,80% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of CO APG rates,2086.2,100,,,fee schedule,100% of NM fee schedule,834.48,40,,,percent of total billed charges,40% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1877.58,90,,,percent of total billed charges,90% of total billed charges,1585.51,76,,,percent of total billed charges,76% of total billed charges,834.48,40,,,percent of total billed charges,40% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of CO APG rate,1668.96,80,,,percent of total billed charges,80% of total billed charges,809.45,38.8,,,percent of total billed charges,38.8% of total billed charges,1773.27,85,,,percent of total billed charges,85% of total billed charges,2086.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,809.45,2086.2,
90656 Fluarix Trivalent,60001344,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,46.8,37.44,,35.1,75,,,percent of total billed charges,75% of total billed charges,18.72,40,,,percent of total billed charges,40% of total billed charges,37.07,79.2,,,percent of total billed charges,79.2% of total billed charges,39.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,44.46,95,,,percent of total billed charges,95% of total billed charges,37.44,80,,,percent of total billed charges,80% of total billed charges,39.78,85,,,percent of total billed charges,85% of total billed charges,42.12,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,46.8,100,,,fee schedule,100% of NM fee schedule,18.72,40,,,percent of total billed charges,40% of total billed charges,18.72,40,,,percent of total billed charges,40% of total billed charges,42.12,90,,,percent of total billed charges,90% of total billed charges,35.57,76,,,percent of total billed charges,76% of total billed charges,18.72,40,,,percent of total billed charges,40% of total billed charges,39.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,37.44,80,,,percent of total billed charges,80% of total billed charges,18.16,38.8,,,percent of total billed charges,38.8% of total billed charges,39.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.16,46.8,
Biomet Bone Cement,60001427,CDM,278,RC,,,OUTPATIENT,,,598.9,479.12,,449.18,75,,,percent of total billed charges,75% of total billed charges,239.56,40,,,percent of total billed charges,40% of total billed charges,474.33,79.2,,,percent of total billed charges,79.2% of total billed charges,509.07,85,,,percent of total billed charges,85% of total billed charges,598.9,100,,,fee schedule,100% of CO APG rates,568.96,95,,,percent of total billed charges,95% of total billed charges,479.12,80,,,percent of total billed charges,80% of total billed charges,509.07,85,,,percent of total billed charges,85% of total billed charges,539.01,90,,,percent of total billed charges,90% of total billed charges,598.9,100,,,fee schedule,100% of CO APG rates,598.9,100,,,fee schedule,100% of CO APG rates,598.9,100,,,fee schedule,100% of NM fee schedule,239.56,40,,,percent of total billed charges,40% of total billed charges,239.56,40,,,percent of total billed charges,40% of total billed charges,539.01,90,,,percent of total billed charges,90% of total billed charges,455.16,76,,,percent of total billed charges,76% of total billed charges,239.56,40,,,percent of total billed charges,40% of total billed charges,509.07,85,,,percent of total billed charges,85% of total billed charges,598.9,100,,,fee schedule,100% of CO APG rate,479.12,80,,,percent of total billed charges,80% of total billed charges,232.37,38.8,,,percent of total billed charges,38.8% of total billed charges,509.07,85,,,percent of total billed charges,85% of total billed charges,598.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,232.37,598.9,
Radiology Procedure Pack,60001418,CDM,270,RC,,,OUTPATIENT,,,91.9,73.52,,68.93,75,,,percent of total billed charges,75% of total billed charges,36.76,40,,,percent of total billed charges,40% of total billed charges,72.78,79.2,,,percent of total billed charges,79.2% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,91.9,100,,,fee schedule,100% of CO APG rates,87.31,95,,,percent of total billed charges,95% of total billed charges,73.52,80,,,percent of total billed charges,80% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,82.71,90,,,percent of total billed charges,90% of total billed charges,91.9,100,,,fee schedule,100% of CO APG rates,91.9,100,,,fee schedule,100% of CO APG rates,91.9,100,,,fee schedule,100% of NM fee schedule,36.76,40,,,percent of total billed charges,40% of total billed charges,36.76,40,,,percent of total billed charges,40% of total billed charges,82.71,90,,,percent of total billed charges,90% of total billed charges,69.84,76,,,percent of total billed charges,76% of total billed charges,36.76,40,,,percent of total billed charges,40% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,91.9,100,,,fee schedule,100% of CO APG rate,73.52,80,,,percent of total billed charges,80% of total billed charges,35.66,38.8,,,percent of total billed charges,38.8% of total billed charges,78.12,85,,,percent of total billed charges,85% of total billed charges,91.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,35.66,91.9,
BIOSTEON INTERFERENCE SCREW 8X28MM,60001417,CDM,278,RC,,,OUTPATIENT,,,1089.9,871.92,,817.43,75,,,percent of total billed charges,75% of total billed charges,435.96,40,,,percent of total billed charges,40% of total billed charges,863.2,79.2,,,percent of total billed charges,79.2% of total billed charges,926.42,85,,,percent of total billed charges,85% of total billed charges,1089.9,100,,,fee schedule,100% of CO APG rates,1035.41,95,,,percent of total billed charges,95% of total billed charges,871.92,80,,,percent of total billed charges,80% of total billed charges,926.42,85,,,percent of total billed charges,85% of total billed charges,980.91,90,,,percent of total billed charges,90% of total billed charges,1089.9,100,,,fee schedule,100% of CO APG rates,1089.9,100,,,fee schedule,100% of CO APG rates,1089.9,100,,,fee schedule,100% of NM fee schedule,435.96,40,,,percent of total billed charges,40% of total billed charges,435.96,40,,,percent of total billed charges,40% of total billed charges,980.91,90,,,percent of total billed charges,90% of total billed charges,828.32,76,,,percent of total billed charges,76% of total billed charges,435.96,40,,,percent of total billed charges,40% of total billed charges,926.42,85,,,percent of total billed charges,85% of total billed charges,1089.9,100,,,fee schedule,100% of CO APG rate,871.92,80,,,percent of total billed charges,80% of total billed charges,422.88,38.8,,,percent of total billed charges,38.8% of total billed charges,926.42,85,,,percent of total billed charges,85% of total billed charges,1089.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,422.88,1089.9,
Transfixing Pin Apex 5-6MM 300-40MM,60001420,CDM,278,RC,,,OUTPATIENT,,,452.7,362.16,,339.53,75,,,percent of total billed charges,75% of total billed charges,181.08,40,,,percent of total billed charges,40% of total billed charges,358.54,79.2,,,percent of total billed charges,79.2% of total billed charges,384.8,85,,,percent of total billed charges,85% of total billed charges,452.7,100,,,fee schedule,100% of CO APG rates,430.07,95,,,percent of total billed charges,95% of total billed charges,362.16,80,,,percent of total billed charges,80% of total billed charges,384.8,85,,,percent of total billed charges,85% of total billed charges,407.43,90,,,percent of total billed charges,90% of total billed charges,452.7,100,,,fee schedule,100% of CO APG rates,452.7,100,,,fee schedule,100% of CO APG rates,452.7,100,,,fee schedule,100% of NM fee schedule,181.08,40,,,percent of total billed charges,40% of total billed charges,181.08,40,,,percent of total billed charges,40% of total billed charges,407.43,90,,,percent of total billed charges,90% of total billed charges,344.05,76,,,percent of total billed charges,76% of total billed charges,181.08,40,,,percent of total billed charges,40% of total billed charges,384.8,85,,,percent of total billed charges,85% of total billed charges,452.7,100,,,fee schedule,100% of CO APG rate,362.16,80,,,percent of total billed charges,80% of total billed charges,175.65,38.8,,,percent of total billed charges,38.8% of total billed charges,384.8,85,,,percent of total billed charges,85% of total billed charges,452.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,175.65,452.7,
Pin to Rod Coupling Inverted,60001419,CDM,278,RC,,,OUTPATIENT,,,1349.9,1079.92,,1012.43,75,,,percent of total billed charges,75% of total billed charges,539.96,40,,,percent of total billed charges,40% of total billed charges,1069.12,79.2,,,percent of total billed charges,79.2% of total billed charges,1147.42,85,,,percent of total billed charges,85% of total billed charges,1349.9,100,,,fee schedule,100% of CO APG rates,1282.41,95,,,percent of total billed charges,95% of total billed charges,1079.92,80,,,percent of total billed charges,80% of total billed charges,1147.42,85,,,percent of total billed charges,85% of total billed charges,1214.91,90,,,percent of total billed charges,90% of total billed charges,1349.9,100,,,fee schedule,100% of CO APG rates,1349.9,100,,,fee schedule,100% of CO APG rates,1349.9,100,,,fee schedule,100% of NM fee schedule,539.96,40,,,percent of total billed charges,40% of total billed charges,539.96,40,,,percent of total billed charges,40% of total billed charges,1214.91,90,,,percent of total billed charges,90% of total billed charges,1025.92,76,,,percent of total billed charges,76% of total billed charges,539.96,40,,,percent of total billed charges,40% of total billed charges,1147.42,85,,,percent of total billed charges,85% of total billed charges,1349.9,100,,,fee schedule,100% of CO APG rate,1079.92,80,,,percent of total billed charges,80% of total billed charges,523.76,38.8,,,percent of total billed charges,38.8% of total billed charges,1147.42,85,,,percent of total billed charges,85% of total billed charges,1349.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,523.76,1349.9,
Compression Shoulder Wrap w Gel Bags,60001422,CDM,270,RC,,,OUTPATIENT,,,214.3,171.44,,160.73,75,,,percent of total billed charges,75% of total billed charges,85.72,40,,,percent of total billed charges,40% of total billed charges,169.73,79.2,,,percent of total billed charges,79.2% of total billed charges,182.16,85,,,percent of total billed charges,85% of total billed charges,214.3,100,,,fee schedule,100% of CO APG rates,203.59,95,,,percent of total billed charges,95% of total billed charges,171.44,80,,,percent of total billed charges,80% of total billed charges,182.16,85,,,percent of total billed charges,85% of total billed charges,192.87,90,,,percent of total billed charges,90% of total billed charges,214.3,100,,,fee schedule,100% of CO APG rates,214.3,100,,,fee schedule,100% of CO APG rates,214.3,100,,,fee schedule,100% of NM fee schedule,85.72,40,,,percent of total billed charges,40% of total billed charges,85.72,40,,,percent of total billed charges,40% of total billed charges,192.87,90,,,percent of total billed charges,90% of total billed charges,162.87,76,,,percent of total billed charges,76% of total billed charges,85.72,40,,,percent of total billed charges,40% of total billed charges,182.16,85,,,percent of total billed charges,85% of total billed charges,214.3,100,,,fee schedule,100% of CO APG rate,171.44,80,,,percent of total billed charges,80% of total billed charges,83.15,38.8,,,percent of total billed charges,38.8% of total billed charges,182.16,85,,,percent of total billed charges,85% of total billed charges,214.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,83.15,214.3,
Compression Knee Wraps with Gel Bags,60001421,CDM,270,RC,,,OUTPATIENT,,,191.1,152.88,,143.33,75,,,percent of total billed charges,75% of total billed charges,76.44,40,,,percent of total billed charges,40% of total billed charges,151.35,79.2,,,percent of total billed charges,79.2% of total billed charges,162.44,85,,,percent of total billed charges,85% of total billed charges,191.1,100,,,fee schedule,100% of CO APG rates,181.55,95,,,percent of total billed charges,95% of total billed charges,152.88,80,,,percent of total billed charges,80% of total billed charges,162.44,85,,,percent of total billed charges,85% of total billed charges,171.99,90,,,percent of total billed charges,90% of total billed charges,191.1,100,,,fee schedule,100% of CO APG rates,191.1,100,,,fee schedule,100% of CO APG rates,191.1,100,,,fee schedule,100% of NM fee schedule,76.44,40,,,percent of total billed charges,40% of total billed charges,76.44,40,,,percent of total billed charges,40% of total billed charges,171.99,90,,,percent of total billed charges,90% of total billed charges,145.24,76,,,percent of total billed charges,76% of total billed charges,76.44,40,,,percent of total billed charges,40% of total billed charges,162.44,85,,,percent of total billed charges,85% of total billed charges,191.1,100,,,fee schedule,100% of CO APG rate,152.88,80,,,percent of total billed charges,80% of total billed charges,74.15,38.8,,,percent of total billed charges,38.8% of total billed charges,162.44,85,,,percent of total billed charges,85% of total billed charges,191.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,74.15,191.1,
"Protectors, Leg Spar Ball Joint Hana Table",60001429,CDM,270,RC,,,OUTPATIENT,,,56,44.8,,42,75,,,percent of total billed charges,75% of total billed charges,22.4,40,,,percent of total billed charges,40% of total billed charges,44.35,79.2,,,percent of total billed charges,79.2% of total billed charges,47.6,85,,,percent of total billed charges,85% of total billed charges,56,100,,,fee schedule,100% of CO APG rates,53.2,95,,,percent of total billed charges,95% of total billed charges,44.8,80,,,percent of total billed charges,80% of total billed charges,47.6,85,,,percent of total billed charges,85% of total billed charges,50.4,90,,,percent of total billed charges,90% of total billed charges,56,100,,,fee schedule,100% of CO APG rates,56,100,,,fee schedule,100% of CO APG rates,56,100,,,fee schedule,100% of NM fee schedule,22.4,40,,,percent of total billed charges,40% of total billed charges,22.4,40,,,percent of total billed charges,40% of total billed charges,50.4,90,,,percent of total billed charges,90% of total billed charges,42.56,76,,,percent of total billed charges,76% of total billed charges,22.4,40,,,percent of total billed charges,40% of total billed charges,47.6,85,,,percent of total billed charges,85% of total billed charges,56,100,,,fee schedule,100% of CO APG rate,44.8,80,,,percent of total billed charges,80% of total billed charges,21.73,38.8,,,percent of total billed charges,38.8% of total billed charges,47.6,85,,,percent of total billed charges,85% of total billed charges,56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,21.73,56,
Cytology Brushes with Covered Sheath,60001425,CDM,270,RC,,,OUTPATIENT,,,85.4,68.32,,64.05,75,,,percent of total billed charges,75% of total billed charges,34.16,40,,,percent of total billed charges,40% of total billed charges,67.64,79.2,,,percent of total billed charges,79.2% of total billed charges,72.59,85,,,percent of total billed charges,85% of total billed charges,85.4,100,,,fee schedule,100% of CO APG rates,81.13,95,,,percent of total billed charges,95% of total billed charges,68.32,80,,,percent of total billed charges,80% of total billed charges,72.59,85,,,percent of total billed charges,85% of total billed charges,76.86,90,,,percent of total billed charges,90% of total billed charges,85.4,100,,,fee schedule,100% of CO APG rates,85.4,100,,,fee schedule,100% of CO APG rates,85.4,100,,,fee schedule,100% of NM fee schedule,34.16,40,,,percent of total billed charges,40% of total billed charges,34.16,40,,,percent of total billed charges,40% of total billed charges,76.86,90,,,percent of total billed charges,90% of total billed charges,64.9,76,,,percent of total billed charges,76% of total billed charges,34.16,40,,,percent of total billed charges,40% of total billed charges,72.59,85,,,percent of total billed charges,85% of total billed charges,85.4,100,,,fee schedule,100% of CO APG rate,68.32,80,,,percent of total billed charges,80% of total billed charges,33.14,38.8,,,percent of total billed charges,38.8% of total billed charges,72.59,85,,,percent of total billed charges,85% of total billed charges,85.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,33.14,85.4,
"Aspiration Needle, 21G 700mm",60001426,CDM,270,RC,,,OUTPATIENT,,,551.9,441.52,,413.93,75,,,percent of total billed charges,75% of total billed charges,220.76,40,,,percent of total billed charges,40% of total billed charges,437.1,79.2,,,percent of total billed charges,79.2% of total billed charges,469.12,85,,,percent of total billed charges,85% of total billed charges,551.9,100,,,fee schedule,100% of CO APG rates,524.31,95,,,percent of total billed charges,95% of total billed charges,441.52,80,,,percent of total billed charges,80% of total billed charges,469.12,85,,,percent of total billed charges,85% of total billed charges,496.71,90,,,percent of total billed charges,90% of total billed charges,551.9,100,,,fee schedule,100% of CO APG rates,551.9,100,,,fee schedule,100% of CO APG rates,551.9,100,,,fee schedule,100% of NM fee schedule,220.76,40,,,percent of total billed charges,40% of total billed charges,220.76,40,,,percent of total billed charges,40% of total billed charges,496.71,90,,,percent of total billed charges,90% of total billed charges,419.44,76,,,percent of total billed charges,76% of total billed charges,220.76,40,,,percent of total billed charges,40% of total billed charges,469.12,85,,,percent of total billed charges,85% of total billed charges,551.9,100,,,fee schedule,100% of CO APG rate,441.52,80,,,percent of total billed charges,80% of total billed charges,214.14,38.8,,,percent of total billed charges,38.8% of total billed charges,469.12,85,,,percent of total billed charges,85% of total billed charges,551.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,214.14,551.9,
Microbiolgy Brush,60001424,CDM,270,RC,,,OUTPATIENT,,,99.9,79.92,,74.93,75,,,percent of total billed charges,75% of total billed charges,39.96,40,,,percent of total billed charges,40% of total billed charges,79.12,79.2,,,percent of total billed charges,79.2% of total billed charges,84.92,85,,,percent of total billed charges,85% of total billed charges,99.9,100,,,fee schedule,100% of CO APG rates,94.91,95,,,percent of total billed charges,95% of total billed charges,79.92,80,,,percent of total billed charges,80% of total billed charges,84.92,85,,,percent of total billed charges,85% of total billed charges,89.91,90,,,percent of total billed charges,90% of total billed charges,99.9,100,,,fee schedule,100% of CO APG rates,99.9,100,,,fee schedule,100% of CO APG rates,99.9,100,,,fee schedule,100% of NM fee schedule,39.96,40,,,percent of total billed charges,40% of total billed charges,39.96,40,,,percent of total billed charges,40% of total billed charges,89.91,90,,,percent of total billed charges,90% of total billed charges,75.92,76,,,percent of total billed charges,76% of total billed charges,39.96,40,,,percent of total billed charges,40% of total billed charges,84.92,85,,,percent of total billed charges,85% of total billed charges,99.9,100,,,fee schedule,100% of CO APG rate,79.92,80,,,percent of total billed charges,80% of total billed charges,38.76,38.8,,,percent of total billed charges,38.8% of total billed charges,84.92,85,,,percent of total billed charges,85% of total billed charges,99.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,38.76,99.9,
"Bioposy Forceps, 100 cm",60001423,CDM,270,RC,,,OUTPATIENT,,,256.8,205.44,,192.6,75,,,percent of total billed charges,75% of total billed charges,102.72,40,,,percent of total billed charges,40% of total billed charges,203.39,79.2,,,percent of total billed charges,79.2% of total billed charges,218.28,85,,,percent of total billed charges,85% of total billed charges,256.8,100,,,fee schedule,100% of CO APG rates,243.96,95,,,percent of total billed charges,95% of total billed charges,205.44,80,,,percent of total billed charges,80% of total billed charges,218.28,85,,,percent of total billed charges,85% of total billed charges,231.12,90,,,percent of total billed charges,90% of total billed charges,256.8,100,,,fee schedule,100% of CO APG rates,256.8,100,,,fee schedule,100% of CO APG rates,256.8,100,,,fee schedule,100% of NM fee schedule,102.72,40,,,percent of total billed charges,40% of total billed charges,102.72,40,,,percent of total billed charges,40% of total billed charges,231.12,90,,,percent of total billed charges,90% of total billed charges,195.17,76,,,percent of total billed charges,76% of total billed charges,102.72,40,,,percent of total billed charges,40% of total billed charges,218.28,85,,,percent of total billed charges,85% of total billed charges,256.8,100,,,fee schedule,100% of CO APG rate,205.44,80,,,percent of total billed charges,80% of total billed charges,99.64,38.8,,,percent of total billed charges,38.8% of total billed charges,218.28,85,,,percent of total billed charges,85% of total billed charges,256.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,99.64,256.8,
Disposable Boot Liner Hana Table,60001428,CDM,270,RC,,,OUTPATIENT,,,68.2,54.56,,51.15,75,,,percent of total billed charges,75% of total billed charges,27.28,40,,,percent of total billed charges,40% of total billed charges,54.01,79.2,,,percent of total billed charges,79.2% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,68.2,100,,,fee schedule,100% of CO APG rates,64.79,95,,,percent of total billed charges,95% of total billed charges,54.56,80,,,percent of total billed charges,80% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,61.38,90,,,percent of total billed charges,90% of total billed charges,68.2,100,,,fee schedule,100% of CO APG rates,68.2,100,,,fee schedule,100% of CO APG rates,68.2,100,,,fee schedule,100% of NM fee schedule,27.28,40,,,percent of total billed charges,40% of total billed charges,27.28,40,,,percent of total billed charges,40% of total billed charges,61.38,90,,,percent of total billed charges,90% of total billed charges,51.83,76,,,percent of total billed charges,76% of total billed charges,27.28,40,,,percent of total billed charges,40% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,68.2,100,,,fee schedule,100% of CO APG rate,54.56,80,,,percent of total billed charges,80% of total billed charges,26.46,38.8,,,percent of total billed charges,38.8% of total billed charges,57.97,85,,,percent of total billed charges,85% of total billed charges,68.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,26.46,68.2,
ROI Drape Kit,60001433,CDM,270,RC,,,OUTPATIENT,,,198,158.4,,148.5,75,,,percent of total billed charges,75% of total billed charges,79.2,40,,,percent of total billed charges,40% of total billed charges,156.82,79.2,,,percent of total billed charges,79.2% of total billed charges,168.3,85,,,percent of total billed charges,85% of total billed charges,198,100,,,fee schedule,100% of CO APG rates,188.1,95,,,percent of total billed charges,95% of total billed charges,158.4,80,,,percent of total billed charges,80% of total billed charges,168.3,85,,,percent of total billed charges,85% of total billed charges,178.2,90,,,percent of total billed charges,90% of total billed charges,198,100,,,fee schedule,100% of CO APG rates,198,100,,,fee schedule,100% of CO APG rates,198,100,,,fee schedule,100% of NM fee schedule,79.2,40,,,percent of total billed charges,40% of total billed charges,79.2,40,,,percent of total billed charges,40% of total billed charges,178.2,90,,,percent of total billed charges,90% of total billed charges,150.48,76,,,percent of total billed charges,76% of total billed charges,79.2,40,,,percent of total billed charges,40% of total billed charges,168.3,85,,,percent of total billed charges,85% of total billed charges,198,100,,,fee schedule,100% of CO APG rate,158.4,80,,,percent of total billed charges,80% of total billed charges,76.82,38.8,,,percent of total billed charges,38.8% of total billed charges,168.3,85,,,percent of total billed charges,85% of total billed charges,198,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,76.82,198,
Vizadisc Knee Tracking Kit,60001434,CDM,270,RC,,,OUTPATIENT,,,797.2,637.76,,597.9,75,,,percent of total billed charges,75% of total billed charges,318.88,40,,,percent of total billed charges,40% of total billed charges,631.38,79.2,,,percent of total billed charges,79.2% of total billed charges,677.62,85,,,percent of total billed charges,85% of total billed charges,797.2,100,,,fee schedule,100% of CO APG rates,757.34,95,,,percent of total billed charges,95% of total billed charges,637.76,80,,,percent of total billed charges,80% of total billed charges,677.62,85,,,percent of total billed charges,85% of total billed charges,717.48,90,,,percent of total billed charges,90% of total billed charges,797.2,100,,,fee schedule,100% of CO APG rates,797.2,100,,,fee schedule,100% of CO APG rates,797.2,100,,,fee schedule,100% of NM fee schedule,318.88,40,,,percent of total billed charges,40% of total billed charges,318.88,40,,,percent of total billed charges,40% of total billed charges,717.48,90,,,percent of total billed charges,90% of total billed charges,605.87,76,,,percent of total billed charges,76% of total billed charges,318.88,40,,,percent of total billed charges,40% of total billed charges,677.62,85,,,percent of total billed charges,85% of total billed charges,797.2,100,,,fee schedule,100% of CO APG rate,637.76,80,,,percent of total billed charges,80% of total billed charges,309.31,38.8,,,percent of total billed charges,38.8% of total billed charges,677.62,85,,,percent of total billed charges,85% of total billed charges,797.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,309.31,797.2,
MAKO Ball Burr,60001438,CDM,270,RC,,,OUTPATIENT,,,303.1,242.48,,227.33,75,,,percent of total billed charges,75% of total billed charges,121.24,40,,,percent of total billed charges,40% of total billed charges,240.06,79.2,,,percent of total billed charges,79.2% of total billed charges,257.64,85,,,percent of total billed charges,85% of total billed charges,303.1,100,,,fee schedule,100% of CO APG rates,287.95,95,,,percent of total billed charges,95% of total billed charges,242.48,80,,,percent of total billed charges,80% of total billed charges,257.64,85,,,percent of total billed charges,85% of total billed charges,272.79,90,,,percent of total billed charges,90% of total billed charges,303.1,100,,,fee schedule,100% of CO APG rates,303.1,100,,,fee schedule,100% of CO APG rates,303.1,100,,,fee schedule,100% of NM fee schedule,121.24,40,,,percent of total billed charges,40% of total billed charges,121.24,40,,,percent of total billed charges,40% of total billed charges,272.79,90,,,percent of total billed charges,90% of total billed charges,230.36,76,,,percent of total billed charges,76% of total billed charges,121.24,40,,,percent of total billed charges,40% of total billed charges,257.64,85,,,percent of total billed charges,85% of total billed charges,303.1,100,,,fee schedule,100% of CO APG rate,242.48,80,,,percent of total billed charges,80% of total billed charges,117.6,38.8,,,percent of total billed charges,38.8% of total billed charges,257.64,85,,,percent of total billed charges,85% of total billed charges,303.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,117.6,303.1,
Bone Pin 4x110,60001435,CDM,278,RC,,,OUTPATIENT,,,471.7,377.36,,353.78,75,,,percent of total billed charges,75% of total billed charges,188.68,40,,,percent of total billed charges,40% of total billed charges,373.59,79.2,,,percent of total billed charges,79.2% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,471.7,100,,,fee schedule,100% of CO APG rates,448.12,95,,,percent of total billed charges,95% of total billed charges,377.36,80,,,percent of total billed charges,80% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,424.53,90,,,percent of total billed charges,90% of total billed charges,471.7,100,,,fee schedule,100% of CO APG rates,471.7,100,,,fee schedule,100% of CO APG rates,471.7,100,,,fee schedule,100% of NM fee schedule,188.68,40,,,percent of total billed charges,40% of total billed charges,188.68,40,,,percent of total billed charges,40% of total billed charges,424.53,90,,,percent of total billed charges,90% of total billed charges,358.49,76,,,percent of total billed charges,76% of total billed charges,188.68,40,,,percent of total billed charges,40% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,471.7,100,,,fee schedule,100% of CO APG rate,377.36,80,,,percent of total billed charges,80% of total billed charges,183.02,38.8,,,percent of total billed charges,38.8% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,471.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.02,471.7,
Femoral/Tibial Checkpoint Kit,60001437,CDM,270,RC,,,OUTPATIENT,,,393.5,314.8,,295.13,75,,,percent of total billed charges,75% of total billed charges,157.4,40,,,percent of total billed charges,40% of total billed charges,311.65,79.2,,,percent of total billed charges,79.2% of total billed charges,334.48,85,,,percent of total billed charges,85% of total billed charges,393.5,100,,,fee schedule,100% of CO APG rates,373.83,95,,,percent of total billed charges,95% of total billed charges,314.8,80,,,percent of total billed charges,80% of total billed charges,334.48,85,,,percent of total billed charges,85% of total billed charges,354.15,90,,,percent of total billed charges,90% of total billed charges,393.5,100,,,fee schedule,100% of CO APG rates,393.5,100,,,fee schedule,100% of CO APG rates,393.5,100,,,fee schedule,100% of NM fee schedule,157.4,40,,,percent of total billed charges,40% of total billed charges,157.4,40,,,percent of total billed charges,40% of total billed charges,354.15,90,,,percent of total billed charges,90% of total billed charges,299.06,76,,,percent of total billed charges,76% of total billed charges,157.4,40,,,percent of total billed charges,40% of total billed charges,334.48,85,,,percent of total billed charges,85% of total billed charges,393.5,100,,,fee schedule,100% of CO APG rate,314.8,80,,,percent of total billed charges,80% of total billed charges,152.68,38.8,,,percent of total billed charges,38.8% of total billed charges,334.48,85,,,percent of total billed charges,85% of total billed charges,393.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,152.68,393.5,
DeMayo Leg Pad,60001440,CDM,270,RC,,,OUTPATIENT,,,146.6,117.28,,109.95,75,,,percent of total billed charges,75% of total billed charges,58.64,40,,,percent of total billed charges,40% of total billed charges,116.11,79.2,,,percent of total billed charges,79.2% of total billed charges,124.61,85,,,percent of total billed charges,85% of total billed charges,146.6,100,,,fee schedule,100% of CO APG rates,139.27,95,,,percent of total billed charges,95% of total billed charges,117.28,80,,,percent of total billed charges,80% of total billed charges,124.61,85,,,percent of total billed charges,85% of total billed charges,131.94,90,,,percent of total billed charges,90% of total billed charges,146.6,100,,,fee schedule,100% of CO APG rates,146.6,100,,,fee schedule,100% of CO APG rates,146.6,100,,,fee schedule,100% of NM fee schedule,58.64,40,,,percent of total billed charges,40% of total billed charges,58.64,40,,,percent of total billed charges,40% of total billed charges,131.94,90,,,percent of total billed charges,90% of total billed charges,111.42,76,,,percent of total billed charges,76% of total billed charges,58.64,40,,,percent of total billed charges,40% of total billed charges,124.61,85,,,percent of total billed charges,85% of total billed charges,146.6,100,,,fee schedule,100% of CO APG rate,117.28,80,,,percent of total billed charges,80% of total billed charges,56.88,38.8,,,percent of total billed charges,38.8% of total billed charges,124.61,85,,,percent of total billed charges,85% of total billed charges,146.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,56.88,146.6,
Bone Pin 4 x 140,60001436,CDM,278,RC,,,OUTPATIENT,,,471.7,377.36,,353.78,75,,,percent of total billed charges,75% of total billed charges,188.68,40,,,percent of total billed charges,40% of total billed charges,373.59,79.2,,,percent of total billed charges,79.2% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,471.7,100,,,fee schedule,100% of CO APG rates,448.12,95,,,percent of total billed charges,95% of total billed charges,377.36,80,,,percent of total billed charges,80% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,424.53,90,,,percent of total billed charges,90% of total billed charges,471.7,100,,,fee schedule,100% of CO APG rates,471.7,100,,,fee schedule,100% of CO APG rates,471.7,100,,,fee schedule,100% of NM fee schedule,188.68,40,,,percent of total billed charges,40% of total billed charges,188.68,40,,,percent of total billed charges,40% of total billed charges,424.53,90,,,percent of total billed charges,90% of total billed charges,358.49,76,,,percent of total billed charges,76% of total billed charges,188.68,40,,,percent of total billed charges,40% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,471.7,100,,,fee schedule,100% of CO APG rate,377.36,80,,,percent of total billed charges,80% of total billed charges,183.02,38.8,,,percent of total billed charges,38.8% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,471.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.02,471.7,
MICS Irrigation Clip,60001439,CDM,270,RC,,,OUTPATIENT,,,469.3,375.44,,351.98,75,,,percent of total billed charges,75% of total billed charges,187.72,40,,,percent of total billed charges,40% of total billed charges,371.69,79.2,,,percent of total billed charges,79.2% of total billed charges,398.91,85,,,percent of total billed charges,85% of total billed charges,469.3,100,,,fee schedule,100% of CO APG rates,445.84,95,,,percent of total billed charges,95% of total billed charges,375.44,80,,,percent of total billed charges,80% of total billed charges,398.91,85,,,percent of total billed charges,85% of total billed charges,422.37,90,,,percent of total billed charges,90% of total billed charges,469.3,100,,,fee schedule,100% of CO APG rates,469.3,100,,,fee schedule,100% of CO APG rates,469.3,100,,,fee schedule,100% of NM fee schedule,187.72,40,,,percent of total billed charges,40% of total billed charges,187.72,40,,,percent of total billed charges,40% of total billed charges,422.37,90,,,percent of total billed charges,90% of total billed charges,356.67,76,,,percent of total billed charges,76% of total billed charges,187.72,40,,,percent of total billed charges,40% of total billed charges,398.91,85,,,percent of total billed charges,85% of total billed charges,469.3,100,,,fee schedule,100% of CO APG rate,375.44,80,,,percent of total billed charges,80% of total billed charges,182.09,38.8,,,percent of total billed charges,38.8% of total billed charges,398.91,85,,,percent of total billed charges,85% of total billed charges,469.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.09,469.3,
High Flow Irrigation Tube,60001441,CDM,270,RC,,,OUTPATIENT,,,469.3,375.44,,351.98,75,,,percent of total billed charges,75% of total billed charges,187.72,40,,,percent of total billed charges,40% of total billed charges,371.69,79.2,,,percent of total billed charges,79.2% of total billed charges,398.91,85,,,percent of total billed charges,85% of total billed charges,469.3,100,,,fee schedule,100% of CO APG rates,445.84,95,,,percent of total billed charges,95% of total billed charges,375.44,80,,,percent of total billed charges,80% of total billed charges,398.91,85,,,percent of total billed charges,85% of total billed charges,422.37,90,,,percent of total billed charges,90% of total billed charges,469.3,100,,,fee schedule,100% of CO APG rates,469.3,100,,,fee schedule,100% of CO APG rates,469.3,100,,,fee schedule,100% of NM fee schedule,187.72,40,,,percent of total billed charges,40% of total billed charges,187.72,40,,,percent of total billed charges,40% of total billed charges,422.37,90,,,percent of total billed charges,90% of total billed charges,356.67,76,,,percent of total billed charges,76% of total billed charges,187.72,40,,,percent of total billed charges,40% of total billed charges,398.91,85,,,percent of total billed charges,85% of total billed charges,469.3,100,,,fee schedule,100% of CO APG rate,375.44,80,,,percent of total billed charges,80% of total billed charges,182.09,38.8,,,percent of total billed charges,38.8% of total billed charges,398.91,85,,,percent of total billed charges,85% of total billed charges,469.3,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.09,469.3,
Leg Positioner Kit,60001442,CDM,270,RC,,,OUTPATIENT,,,151.5,121.2,,113.63,75,,,percent of total billed charges,75% of total billed charges,60.6,40,,,percent of total billed charges,40% of total billed charges,119.99,79.2,,,percent of total billed charges,79.2% of total billed charges,128.78,85,,,percent of total billed charges,85% of total billed charges,151.5,100,,,fee schedule,100% of CO APG rates,143.93,95,,,percent of total billed charges,95% of total billed charges,121.2,80,,,percent of total billed charges,80% of total billed charges,128.78,85,,,percent of total billed charges,85% of total billed charges,136.35,90,,,percent of total billed charges,90% of total billed charges,151.5,100,,,fee schedule,100% of CO APG rates,151.5,100,,,fee schedule,100% of CO APG rates,151.5,100,,,fee schedule,100% of NM fee schedule,60.6,40,,,percent of total billed charges,40% of total billed charges,60.6,40,,,percent of total billed charges,40% of total billed charges,136.35,90,,,percent of total billed charges,90% of total billed charges,115.14,76,,,percent of total billed charges,76% of total billed charges,60.6,40,,,percent of total billed charges,40% of total billed charges,128.78,85,,,percent of total billed charges,85% of total billed charges,151.5,100,,,fee schedule,100% of CO APG rate,121.2,80,,,percent of total billed charges,80% of total billed charges,58.78,38.8,,,percent of total billed charges,38.8% of total billed charges,128.78,85,,,percent of total billed charges,85% of total billed charges,151.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,58.78,151.5,
Bone Pin 3.2x140,60001443,CDM,278,RC,,,OUTPATIENT,,,471.7,377.36,,353.78,75,,,percent of total billed charges,75% of total billed charges,188.68,40,,,percent of total billed charges,40% of total billed charges,373.59,79.2,,,percent of total billed charges,79.2% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,471.7,100,,,fee schedule,100% of CO APG rates,448.12,95,,,percent of total billed charges,95% of total billed charges,377.36,80,,,percent of total billed charges,80% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,424.53,90,,,percent of total billed charges,90% of total billed charges,471.7,100,,,fee schedule,100% of CO APG rates,471.7,100,,,fee schedule,100% of CO APG rates,471.7,100,,,fee schedule,100% of NM fee schedule,188.68,40,,,percent of total billed charges,40% of total billed charges,188.68,40,,,percent of total billed charges,40% of total billed charges,424.53,90,,,percent of total billed charges,90% of total billed charges,358.49,76,,,percent of total billed charges,76% of total billed charges,188.68,40,,,percent of total billed charges,40% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,471.7,100,,,fee schedule,100% of CO APG rate,377.36,80,,,percent of total billed charges,80% of total billed charges,183.02,38.8,,,percent of total billed charges,38.8% of total billed charges,400.95,85,,,percent of total billed charges,85% of total billed charges,471.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,183.02,471.7,
Bone Pin 3.2x110,60001444,CDM,278,RC,,,OUTPATIENT,,,471.4,377.12,,353.55,75,,,percent of total billed charges,75% of total billed charges,188.56,40,,,percent of total billed charges,40% of total billed charges,373.35,79.2,,,percent of total billed charges,79.2% of total billed charges,400.69,85,,,percent of total billed charges,85% of total billed charges,471.4,100,,,fee schedule,100% of CO APG rates,447.83,95,,,percent of total billed charges,95% of total billed charges,377.12,80,,,percent of total billed charges,80% of total billed charges,400.69,85,,,percent of total billed charges,85% of total billed charges,424.26,90,,,percent of total billed charges,90% of total billed charges,471.4,100,,,fee schedule,100% of CO APG rates,471.4,100,,,fee schedule,100% of CO APG rates,471.4,100,,,fee schedule,100% of NM fee schedule,188.56,40,,,percent of total billed charges,40% of total billed charges,188.56,40,,,percent of total billed charges,40% of total billed charges,424.26,90,,,percent of total billed charges,90% of total billed charges,358.26,76,,,percent of total billed charges,76% of total billed charges,188.56,40,,,percent of total billed charges,40% of total billed charges,400.69,85,,,percent of total billed charges,85% of total billed charges,471.4,100,,,fee schedule,100% of CO APG rate,377.12,80,,,percent of total billed charges,80% of total billed charges,182.9,38.8,,,percent of total billed charges,38.8% of total billed charges,400.69,85,,,percent of total billed charges,85% of total billed charges,471.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.9,471.4,
Vizadisc Hip Kit,60001445,CDM,270,RC,,,OUTPATIENT,,,797.2,637.76,,597.9,75,,,percent of total billed charges,75% of total billed charges,318.88,40,,,percent of total billed charges,40% of total billed charges,631.38,79.2,,,percent of total billed charges,79.2% of total billed charges,677.62,85,,,percent of total billed charges,85% of total billed charges,797.2,100,,,fee schedule,100% of CO APG rates,757.34,95,,,percent of total billed charges,95% of total billed charges,637.76,80,,,percent of total billed charges,80% of total billed charges,677.62,85,,,percent of total billed charges,85% of total billed charges,717.48,90,,,percent of total billed charges,90% of total billed charges,797.2,100,,,fee schedule,100% of CO APG rates,797.2,100,,,fee schedule,100% of CO APG rates,797.2,100,,,fee schedule,100% of NM fee schedule,318.88,40,,,percent of total billed charges,40% of total billed charges,318.88,40,,,percent of total billed charges,40% of total billed charges,717.48,90,,,percent of total billed charges,90% of total billed charges,605.87,76,,,percent of total billed charges,76% of total billed charges,318.88,40,,,percent of total billed charges,40% of total billed charges,677.62,85,,,percent of total billed charges,85% of total billed charges,797.2,100,,,fee schedule,100% of CO APG rate,637.76,80,,,percent of total billed charges,80% of total billed charges,309.31,38.8,,,percent of total billed charges,38.8% of total billed charges,677.62,85,,,percent of total billed charges,85% of total billed charges,797.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,309.31,797.2,
Bone Pin 4x170,60001446,CDM,278,RC,,,OUTPATIENT,,,527.9,422.32,,395.93,75,,,percent of total billed charges,75% of total billed charges,211.16,40,,,percent of total billed charges,40% of total billed charges,418.1,79.2,,,percent of total billed charges,79.2% of total billed charges,448.72,85,,,percent of total billed charges,85% of total billed charges,527.9,100,,,fee schedule,100% of CO APG rates,501.51,95,,,percent of total billed charges,95% of total billed charges,422.32,80,,,percent of total billed charges,80% of total billed charges,448.72,85,,,percent of total billed charges,85% of total billed charges,475.11,90,,,percent of total billed charges,90% of total billed charges,527.9,100,,,fee schedule,100% of CO APG rates,527.9,100,,,fee schedule,100% of CO APG rates,527.9,100,,,fee schedule,100% of NM fee schedule,211.16,40,,,percent of total billed charges,40% of total billed charges,211.16,40,,,percent of total billed charges,40% of total billed charges,475.11,90,,,percent of total billed charges,90% of total billed charges,401.2,76,,,percent of total billed charges,76% of total billed charges,211.16,40,,,percent of total billed charges,40% of total billed charges,448.72,85,,,percent of total billed charges,85% of total billed charges,527.9,100,,,fee schedule,100% of CO APG rate,422.32,80,,,percent of total billed charges,80% of total billed charges,204.83,38.8,,,percent of total billed charges,38.8% of total billed charges,448.72,85,,,percent of total billed charges,85% of total billed charges,527.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,204.83,527.9,
Tibial Check Point,60001447,CDM,270,RC,,,OUTPATIENT,,,207.7,166.16,,155.78,75,,,percent of total billed charges,75% of total billed charges,83.08,40,,,percent of total billed charges,40% of total billed charges,164.5,79.2,,,percent of total billed charges,79.2% of total billed charges,176.55,85,,,percent of total billed charges,85% of total billed charges,207.7,100,,,fee schedule,100% of CO APG rates,197.32,95,,,percent of total billed charges,95% of total billed charges,166.16,80,,,percent of total billed charges,80% of total billed charges,176.55,85,,,percent of total billed charges,85% of total billed charges,186.93,90,,,percent of total billed charges,90% of total billed charges,207.7,100,,,fee schedule,100% of CO APG rates,207.7,100,,,fee schedule,100% of CO APG rates,207.7,100,,,fee schedule,100% of NM fee schedule,83.08,40,,,percent of total billed charges,40% of total billed charges,83.08,40,,,percent of total billed charges,40% of total billed charges,186.93,90,,,percent of total billed charges,90% of total billed charges,157.85,76,,,percent of total billed charges,76% of total billed charges,83.08,40,,,percent of total billed charges,40% of total billed charges,176.55,85,,,percent of total billed charges,85% of total billed charges,207.7,100,,,fee schedule,100% of CO APG rate,166.16,80,,,percent of total billed charges,80% of total billed charges,80.59,38.8,,,percent of total billed charges,38.8% of total billed charges,176.55,85,,,percent of total billed charges,85% of total billed charges,207.7,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,80.59,207.7,
Checkpoint 3.5 Hex Impaction,60001448,CDM,270,RC,,,OUTPATIENT,,,457,365.6,,342.75,75,,,percent of total billed charges,75% of total billed charges,182.8,40,,,percent of total billed charges,40% of total billed charges,361.94,79.2,,,percent of total billed charges,79.2% of total billed charges,388.45,85,,,percent of total billed charges,85% of total billed charges,457,100,,,fee schedule,100% of CO APG rates,434.15,95,,,percent of total billed charges,95% of total billed charges,365.6,80,,,percent of total billed charges,80% of total billed charges,388.45,85,,,percent of total billed charges,85% of total billed charges,411.3,90,,,percent of total billed charges,90% of total billed charges,457,100,,,fee schedule,100% of CO APG rates,457,100,,,fee schedule,100% of CO APG rates,457,100,,,fee schedule,100% of NM fee schedule,182.8,40,,,percent of total billed charges,40% of total billed charges,182.8,40,,,percent of total billed charges,40% of total billed charges,411.3,90,,,percent of total billed charges,90% of total billed charges,347.32,76,,,percent of total billed charges,76% of total billed charges,182.8,40,,,percent of total billed charges,40% of total billed charges,388.45,85,,,percent of total billed charges,85% of total billed charges,457,100,,,fee schedule,100% of CO APG rate,365.6,80,,,percent of total billed charges,80% of total billed charges,177.32,38.8,,,percent of total billed charges,38.8% of total billed charges,388.45,85,,,percent of total billed charges,85% of total billed charges,457,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,177.32,457,
"Sagittal Blade, Standard (MAKO)",60001449,CDM,270,RC,,,OUTPATIENT,,,1141.9,913.52,,856.43,75,,,percent of total billed charges,75% of total billed charges,456.76,40,,,percent of total billed charges,40% of total billed charges,904.38,79.2,,,percent of total billed charges,79.2% of total billed charges,970.62,85,,,percent of total billed charges,85% of total billed charges,1141.9,100,,,fee schedule,100% of CO APG rates,1084.81,95,,,percent of total billed charges,95% of total billed charges,913.52,80,,,percent of total billed charges,80% of total billed charges,970.62,85,,,percent of total billed charges,85% of total billed charges,1027.71,90,,,percent of total billed charges,90% of total billed charges,1141.9,100,,,fee schedule,100% of CO APG rates,1141.9,100,,,fee schedule,100% of CO APG rates,1141.9,100,,,fee schedule,100% of NM fee schedule,456.76,40,,,percent of total billed charges,40% of total billed charges,456.76,40,,,percent of total billed charges,40% of total billed charges,1027.71,90,,,percent of total billed charges,90% of total billed charges,867.84,76,,,percent of total billed charges,76% of total billed charges,456.76,40,,,percent of total billed charges,40% of total billed charges,970.62,85,,,percent of total billed charges,85% of total billed charges,1141.9,100,,,fee schedule,100% of CO APG rate,913.52,80,,,percent of total billed charges,80% of total billed charges,443.06,38.8,,,percent of total billed charges,38.8% of total billed charges,970.62,85,,,percent of total billed charges,85% of total billed charges,1141.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,443.06,1141.9,
"Sagittal Blade, Narrow",60001450,CDM,270,RC,,,OUTPATIENT,,,1141.9,913.52,,856.43,75,,,percent of total billed charges,75% of total billed charges,456.76,40,,,percent of total billed charges,40% of total billed charges,904.38,79.2,,,percent of total billed charges,79.2% of total billed charges,970.62,85,,,percent of total billed charges,85% of total billed charges,1141.9,100,,,fee schedule,100% of CO APG rates,1084.81,95,,,percent of total billed charges,95% of total billed charges,913.52,80,,,percent of total billed charges,80% of total billed charges,970.62,85,,,percent of total billed charges,85% of total billed charges,1027.71,90,,,percent of total billed charges,90% of total billed charges,1141.9,100,,,fee schedule,100% of CO APG rates,1141.9,100,,,fee schedule,100% of CO APG rates,1141.9,100,,,fee schedule,100% of NM fee schedule,456.76,40,,,percent of total billed charges,40% of total billed charges,456.76,40,,,percent of total billed charges,40% of total billed charges,1027.71,90,,,percent of total billed charges,90% of total billed charges,867.84,76,,,percent of total billed charges,76% of total billed charges,456.76,40,,,percent of total billed charges,40% of total billed charges,970.62,85,,,percent of total billed charges,85% of total billed charges,1141.9,100,,,fee schedule,100% of CO APG rate,913.52,80,,,percent of total billed charges,80% of total billed charges,443.06,38.8,,,percent of total billed charges,38.8% of total billed charges,970.62,85,,,percent of total billed charges,85% of total billed charges,1141.9,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,443.06,1141.9,
Silver Foam Dressing Acticoat,60001460,CDM,270,RC,,,OUTPATIENT,,,221.2,176.96,,165.9,75,,,percent of total billed charges,75% of total billed charges,88.48,40,,,percent of total billed charges,40% of total billed charges,175.19,79.2,,,percent of total billed charges,79.2% of total billed charges,188.02,85,,,percent of total billed charges,85% of total billed charges,221.2,100,,,fee schedule,100% of CO APG rates,210.14,95,,,percent of total billed charges,95% of total billed charges,176.96,80,,,percent of total billed charges,80% of total billed charges,188.02,85,,,percent of total billed charges,85% of total billed charges,199.08,90,,,percent of total billed charges,90% of total billed charges,221.2,100,,,fee schedule,100% of CO APG rates,221.2,100,,,fee schedule,100% of CO APG rates,221.2,100,,,fee schedule,100% of NM fee schedule,88.48,40,,,percent of total billed charges,40% of total billed charges,88.48,40,,,percent of total billed charges,40% of total billed charges,199.08,90,,,percent of total billed charges,90% of total billed charges,168.11,76,,,percent of total billed charges,76% of total billed charges,88.48,40,,,percent of total billed charges,40% of total billed charges,188.02,85,,,percent of total billed charges,85% of total billed charges,221.2,100,,,fee schedule,100% of CO APG rate,176.96,80,,,percent of total billed charges,80% of total billed charges,85.83,38.8,,,percent of total billed charges,38.8% of total billed charges,188.02,85,,,percent of total billed charges,85% of total billed charges,221.2,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,85.83,221.2,
Stryker XBraid TT 2.0mm,60001461,CDM,270,RC,,,OUTPATIENT,,,539.1,431.28,,404.33,75,,,percent of total billed charges,75% of total billed charges,215.64,40,,,percent of total billed charges,40% of total billed charges,426.97,79.2,,,percent of total billed charges,79.2% of total billed charges,458.24,85,,,percent of total billed charges,85% of total billed charges,539.1,100,,,fee schedule,100% of CO APG rates,512.15,95,,,percent of total billed charges,95% of total billed charges,431.28,80,,,percent of total billed charges,80% of total billed charges,458.24,85,,,percent of total billed charges,85% of total billed charges,485.19,90,,,percent of total billed charges,90% of total billed charges,539.1,100,,,fee schedule,100% of CO APG rates,539.1,100,,,fee schedule,100% of CO APG rates,539.1,100,,,fee schedule,100% of NM fee schedule,215.64,40,,,percent of total billed charges,40% of total billed charges,215.64,40,,,percent of total billed charges,40% of total billed charges,485.19,90,,,percent of total billed charges,90% of total billed charges,409.72,76,,,percent of total billed charges,76% of total billed charges,215.64,40,,,percent of total billed charges,40% of total billed charges,458.24,85,,,percent of total billed charges,85% of total billed charges,539.1,100,,,fee schedule,100% of CO APG rate,431.28,80,,,percent of total billed charges,80% of total billed charges,209.17,38.8,,,percent of total billed charges,38.8% of total billed charges,458.24,85,,,percent of total billed charges,85% of total billed charges,539.1,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,209.17,539.1,
"Implant Deliveru System, PEC Repair",60001464,CDM,270,RC,,,OUTPATIENT,,,1627.5,1302,,1220.63,75,,,percent of total billed charges,75% of total billed charges,651,40,,,percent of total billed charges,40% of total billed charges,1288.98,79.2,,,percent of total billed charges,79.2% of total billed charges,1383.38,85,,,percent of total billed charges,85% of total billed charges,1627.5,100,,,fee schedule,100% of CO APG rates,1546.13,95,,,percent of total billed charges,95% of total billed charges,1302,80,,,percent of total billed charges,80% of total billed charges,1383.38,85,,,percent of total billed charges,85% of total billed charges,1464.75,90,,,percent of total billed charges,90% of total billed charges,1627.5,100,,,fee schedule,100% of CO APG rates,1627.5,100,,,fee schedule,100% of CO APG rates,1627.5,100,,,fee schedule,100% of NM fee schedule,651,40,,,percent of total billed charges,40% of total billed charges,651,40,,,percent of total billed charges,40% of total billed charges,1464.75,90,,,percent of total billed charges,90% of total billed charges,1236.9,76,,,percent of total billed charges,76% of total billed charges,651,40,,,percent of total billed charges,40% of total billed charges,1383.38,85,,,percent of total billed charges,85% of total billed charges,1627.5,100,,,fee schedule,100% of CO APG rate,1302,80,,,percent of total billed charges,80% of total billed charges,631.47,38.8,,,percent of total billed charges,38.8% of total billed charges,1383.38,85,,,percent of total billed charges,85% of total billed charges,1627.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,631.47,1627.5,
"Drill Bit, 3.1 dia x 216, short, locking, Titanium",60001468,CDM,270,RC,,,OUTPATIENT,,,630,504,,472.5,75,,,percent of total billed charges,75% of total billed charges,252,40,,,percent of total billed charges,40% of total billed charges,498.96,79.2,,,percent of total billed charges,79.2% of total billed charges,535.5,85,,,percent of total billed charges,85% of total billed charges,630,100,,,fee schedule,100% of CO APG rates,598.5,95,,,percent of total billed charges,95% of total billed charges,504,80,,,percent of total billed charges,80% of total billed charges,535.5,85,,,percent of total billed charges,85% of total billed charges,567,90,,,percent of total billed charges,90% of total billed charges,630,100,,,fee schedule,100% of CO APG rates,630,100,,,fee schedule,100% of CO APG rates,630,100,,,fee schedule,100% of NM fee schedule,252,40,,,percent of total billed charges,40% of total billed charges,252,40,,,percent of total billed charges,40% of total billed charges,567,90,,,percent of total billed charges,90% of total billed charges,478.8,76,,,percent of total billed charges,76% of total billed charges,252,40,,,percent of total billed charges,40% of total billed charges,535.5,85,,,percent of total billed charges,85% of total billed charges,630,100,,,fee schedule,100% of CO APG rate,504,80,,,percent of total billed charges,80% of total billed charges,244.44,38.8,,,percent of total billed charges,38.8% of total billed charges,535.5,85,,,percent of total billed charges,85% of total billed charges,630,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,244.44,630,
"Cortex Screw, 3.5dia x 80mm, self tapping, Titanium",60001470,CDM,270,RC,,,OUTPATIENT,,,903,722.4,,677.25,75,,,percent of total billed charges,75% of total billed charges,361.2,40,,,percent of total billed charges,40% of total billed charges,715.18,79.2,,,percent of total billed charges,79.2% of total billed charges,767.55,85,,,percent of total billed charges,85% of total billed charges,903,100,,,fee schedule,100% of CO APG rates,857.85,95,,,percent of total billed charges,95% of total billed charges,722.4,80,,,percent of total billed charges,80% of total billed charges,767.55,85,,,percent of total billed charges,85% of total billed charges,812.7,90,,,percent of total billed charges,90% of total billed charges,903,100,,,fee schedule,100% of CO APG rates,903,100,,,fee schedule,100% of CO APG rates,903,100,,,fee schedule,100% of NM fee schedule,361.2,40,,,percent of total billed charges,40% of total billed charges,361.2,40,,,percent of total billed charges,40% of total billed charges,812.7,90,,,percent of total billed charges,90% of total billed charges,686.28,76,,,percent of total billed charges,76% of total billed charges,361.2,40,,,percent of total billed charges,40% of total billed charges,767.55,85,,,percent of total billed charges,85% of total billed charges,903,100,,,fee schedule,100% of CO APG rate,722.4,80,,,percent of total billed charges,80% of total billed charges,350.36,38.8,,,percent of total billed charges,38.8% of total billed charges,767.55,85,,,percent of total billed charges,85% of total billed charges,903,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,350.36,903,
"Cortex Screw, 3.5dia x 44mm, self tapping, Titanium",60001469,CDM,270,RC,,,OUTPATIENT,,,903,722.4,,677.25,75,,,percent of total billed charges,75% of total billed charges,361.2,40,,,percent of total billed charges,40% of total billed charges,715.18,79.2,,,percent of total billed charges,79.2% of total billed charges,767.55,85,,,percent of total billed charges,85% of total billed charges,903,100,,,fee schedule,100% of CO APG rates,857.85,95,,,percent of total billed charges,95% of total billed charges,722.4,80,,,percent of total billed charges,80% of total billed charges,767.55,85,,,percent of total billed charges,85% of total billed charges,812.7,90,,,percent of total billed charges,90% of total billed charges,903,100,,,fee schedule,100% of CO APG rates,903,100,,,fee schedule,100% of CO APG rates,903,100,,,fee schedule,100% of NM fee schedule,361.2,40,,,percent of total billed charges,40% of total billed charges,361.2,40,,,percent of total billed charges,40% of total billed charges,812.7,90,,,percent of total billed charges,90% of total billed charges,686.28,76,,,percent of total billed charges,76% of total billed charges,361.2,40,,,percent of total billed charges,40% of total billed charges,767.55,85,,,percent of total billed charges,85% of total billed charges,903,100,,,fee schedule,100% of CO APG rate,722.4,80,,,percent of total billed charges,80% of total billed charges,350.36,38.8,,,percent of total billed charges,38.8% of total billed charges,767.55,85,,,percent of total billed charges,85% of total billed charges,903,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,350.36,903,
NMR LIPO-83704,60001472,CDM,301,RC,82270,HCPCS,OUTPATIENT,,,72.1,57.68,,54.08,75,,,percent of total billed charges,75% of total billed charges,28.84,40,,,percent of total billed charges,40% of total billed charges,57.1,79.2,,,percent of total billed charges,79.2% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,68.5,95,,,percent of total billed charges,95% of total billed charges,57.68,80,,,percent of total billed charges,80% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,64.89,90,,,percent of total billed charges,90% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rates,6.44,100,,,fee schedule,100% of CO APG rates,4.12,100,,,fee schedule,100% of NM fee schedule,28.84,40,,,percent of total billed charges,40% of total billed charges,28.84,40,,,percent of total billed charges,40% of total billed charges,64.89,90,,,percent of total billed charges,90% of total billed charges,54.8,76,,,percent of total billed charges,76% of total billed charges,28.84,40,,,percent of total billed charges,40% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of CO APG rate,57.68,80,,,percent of total billed charges,80% of total billed charges,27.97,38.8,,,percent of total billed charges,38.8% of total billed charges,61.29,85,,,percent of total billed charges,85% of total billed charges,6.44,100,,,fee schedule,100% of APG fee schedule,8.76,200,,,fee schedule,200% of CMS fee schedule,4.12,68.5,
"ARS Decompression Kit, 10 gauge",60001477,CDM,270,RC,,,OUTPATIENT,,,100.06,80.048,,75.05,75,,,percent of total billed charges,75% of total billed charges,40.02,40,,,percent of total billed charges,40% of total billed charges,79.25,79.2,,,percent of total billed charges,79.2% of total billed charges,85.05,85,,,percent of total billed charges,85% of total billed charges,100.06,100,,,fee schedule,100% of CO APG rates,95.06,95,,,percent of total billed charges,95% of total billed charges,80.05,80,,,percent of total billed charges,80% of total billed charges,85.05,85,,,percent of total billed charges,85% of total billed charges,90.05,90,,,percent of total billed charges,90% of total billed charges,100.06,100,,,fee schedule,100% of CO APG rates,100.06,100,,,fee schedule,100% of CO APG rates,100.06,100,,,fee schedule,100% of NM fee schedule,40.02,40,,,percent of total billed charges,40% of total billed charges,40.02,40,,,percent of total billed charges,40% of total billed charges,90.05,90,,,percent of total billed charges,90% of total billed charges,76.05,76,,,percent of total billed charges,76% of total billed charges,40.02,40,,,percent of total billed charges,40% of total billed charges,85.05,85,,,percent of total billed charges,85% of total billed charges,100.06,100,,,fee schedule,100% of CO APG rate,80.05,80,,,percent of total billed charges,80% of total billed charges,38.82,38.8,,,percent of total billed charges,38.8% of total billed charges,85.05,85,,,percent of total billed charges,85% of total billed charges,100.06,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,38.82,100.06,
"K-Wire, 2dia x 234mm, Titanium",60001500,CDM,278,RC,,,OUTPATIENT,,,181.6,145.28,,136.2,75,,,percent of total billed charges,75% of total billed charges,72.64,40,,,percent of total billed charges,40% of total billed charges,143.83,79.2,,,percent of total billed charges,79.2% of total billed charges,154.36,85,,,percent of total billed charges,85% of total billed charges,181.6,100,,,fee schedule,100% of CO APG rates,172.52,95,,,percent of total billed charges,95% of total billed charges,145.28,80,,,percent of total billed charges,80% of total billed charges,154.36,85,,,percent of total billed charges,85% of total billed charges,163.44,90,,,percent of total billed charges,90% of total billed charges,181.6,100,,,fee schedule,100% of CO APG rates,181.6,100,,,fee schedule,100% of CO APG rates,181.6,100,,,fee schedule,100% of NM fee schedule,72.64,40,,,percent of total billed charges,40% of total billed charges,72.64,40,,,percent of total billed charges,40% of total billed charges,163.44,90,,,percent of total billed charges,90% of total billed charges,138.02,76,,,percent of total billed charges,76% of total billed charges,72.64,40,,,percent of total billed charges,40% of total billed charges,154.36,85,,,percent of total billed charges,85% of total billed charges,181.6,100,,,fee schedule,100% of CO APG rate,145.28,80,,,percent of total billed charges,80% of total billed charges,70.46,38.8,,,percent of total billed charges,38.8% of total billed charges,154.36,85,,,percent of total billed charges,85% of total billed charges,181.6,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,70.46,181.6,
"Drill Sleeve, 3.1dia, Locking",60001501,CDM,271,RC,,,OUTPATIENT,,,322.42,257.936,,241.82,75,,,percent of total billed charges,75% of total billed charges,128.97,40,,,percent of total billed charges,40% of total billed charges,255.36,79.2,,,percent of total billed charges,79.2% of total billed charges,274.06,85,,,percent of total billed charges,85% of total billed charges,322.42,100,,,fee schedule,100% of CO APG rates,306.3,95,,,percent of total billed charges,95% of total billed charges,257.94,80,,,percent of total billed charges,80% of total billed charges,274.06,85,,,percent of total billed charges,85% of total billed charges,290.18,90,,,percent of total billed charges,90% of total billed charges,322.42,100,,,fee schedule,100% of CO APG rates,322.42,100,,,fee schedule,100% of CO APG rates,322.42,100,,,fee schedule,100% of NM fee schedule,128.97,40,,,percent of total billed charges,40% of total billed charges,128.97,40,,,percent of total billed charges,40% of total billed charges,290.18,90,,,percent of total billed charges,90% of total billed charges,245.04,76,,,percent of total billed charges,76% of total billed charges,128.97,40,,,percent of total billed charges,40% of total billed charges,274.06,85,,,percent of total billed charges,85% of total billed charges,322.42,100,,,fee schedule,100% of CO APG rate,257.94,80,,,percent of total billed charges,80% of total billed charges,125.1,38.8,,,percent of total billed charges,38.8% of total billed charges,274.06,85,,,percent of total billed charges,85% of total billed charges,322.42,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,125.1,322.42,
31605 Tracheostomy Emergency; Cricothyroid Membrane,60001355,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,698,558.4,,523.5,75,,,percent of total billed charges,75% of total billed charges,279.2,40,,,percent of total billed charges,40% of total billed charges,552.82,79.2,,,percent of total billed charges,79.2% of total billed charges,593.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,663.1,95,,,percent of total billed charges,95% of total billed charges,558.4,80,,,percent of total billed charges,80% of total billed charges,593.3,85,,,percent of total billed charges,85% of total billed charges,628.2,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,279.2,40,,,percent of total billed charges,40% of total billed charges,279.2,40,,,percent of total billed charges,40% of total billed charges,628.2,90,,,percent of total billed charges,90% of total billed charges,530.48,76,,,percent of total billed charges,76% of total billed charges,279.2,40,,,percent of total billed charges,40% of total billed charges,593.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,558.4,80,,,percent of total billed charges,80% of total billed charges,270.82,38.8,,,percent of total billed charges,38.8% of total billed charges,593.3,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,663.1,
Proximal Lateral Tibial Plate 2 holes 95mm LT ver.,60001525,CDM,278,RC,,,OUTPATIENT,,,566.83,453.464,,425.12,75,,,percent of total billed charges,75% of total billed charges,226.73,40,,,percent of total billed charges,40% of total billed charges,448.93,79.2,,,percent of total billed charges,79.2% of total billed charges,481.81,85,,,percent of total billed charges,85% of total billed charges,566.83,100,,,fee schedule,100% of CO APG rates,538.49,95,,,percent of total billed charges,95% of total billed charges,453.46,80,,,percent of total billed charges,80% of total billed charges,481.81,85,,,percent of total billed charges,85% of total billed charges,510.15,90,,,percent of total billed charges,90% of total billed charges,566.83,100,,,fee schedule,100% of CO APG rates,566.83,100,,,fee schedule,100% of CO APG rates,566.83,100,,,fee schedule,100% of NM fee schedule,226.73,40,,,percent of total billed charges,40% of total billed charges,226.73,40,,,percent of total billed charges,40% of total billed charges,510.15,90,,,percent of total billed charges,90% of total billed charges,430.79,76,,,percent of total billed charges,76% of total billed charges,226.73,40,,,percent of total billed charges,40% of total billed charges,481.81,85,,,percent of total billed charges,85% of total billed charges,566.83,100,,,fee schedule,100% of CO APG rate,453.46,80,,,percent of total billed charges,80% of total billed charges,219.93,38.8,,,percent of total billed charges,38.8% of total billed charges,481.81,85,,,percent of total billed charges,85% of total billed charges,566.83,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,219.93,566.83,
Fluted Headless Pin 3,60001526,CDM,278,RC,,,OUTPATIENT,,,577.71,462.168,,433.28,75,,,percent of total billed charges,75% of total billed charges,231.08,40,,,percent of total billed charges,40% of total billed charges,457.55,79.2,,,percent of total billed charges,79.2% of total billed charges,491.05,85,,,percent of total billed charges,85% of total billed charges,577.71,100,,,fee schedule,100% of CO APG rates,548.82,95,,,percent of total billed charges,95% of total billed charges,462.17,80,,,percent of total billed charges,80% of total billed charges,491.05,85,,,percent of total billed charges,85% of total billed charges,519.94,90,,,percent of total billed charges,90% of total billed charges,577.71,100,,,fee schedule,100% of CO APG rates,577.71,100,,,fee schedule,100% of CO APG rates,577.71,100,,,fee schedule,100% of NM fee schedule,231.08,40,,,percent of total billed charges,40% of total billed charges,231.08,40,,,percent of total billed charges,40% of total billed charges,519.94,90,,,percent of total billed charges,90% of total billed charges,439.06,76,,,percent of total billed charges,76% of total billed charges,231.08,40,,,percent of total billed charges,40% of total billed charges,491.05,85,,,percent of total billed charges,85% of total billed charges,577.71,100,,,fee schedule,100% of CO APG rate,462.17,80,,,percent of total billed charges,80% of total billed charges,224.15,38.8,,,percent of total billed charges,38.8% of total billed charges,491.05,85,,,percent of total billed charges,85% of total billed charges,577.71,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,224.15,577.71,
"Cortex Screw, 3.5dia x 42mm self-tapping, Titanium",60001511,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 38mm self-tapping, Titanium",60001512,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 36mm self-tapping, Titanium",60001513,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 32mm self-tapping, Titanium",60001515,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 22mm self-tapping, Titanium",60001520,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 26mm self-tapping, Titanium",60001518,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 24mm self-tapping, Titanium",60001519,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 34mm self-tapping, Titanium",60001514,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 30mm self-tapping, Titanium",60001516,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 28mm self-tapping, Titanium",60001517,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 16mm self-tapping, Titanium",60001523,CDM,270,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 20mm self-tapping, Titanium",60001521,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 18mm self-tapping, Titanium",60001522,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Intramedullary Nail, 10dia x 420mm Long Titanium RT version",60001498,CDM,278,RC,,,OUTPATIENT,,,3762.48,3009.984,,2821.86,75,,,percent of total billed charges,75% of total billed charges,1504.99,40,,,percent of total billed charges,40% of total billed charges,2979.88,79.2,,,percent of total billed charges,79.2% of total billed charges,3198.11,85,,,percent of total billed charges,85% of total billed charges,3762.48,100,,,fee schedule,100% of CO APG rates,3574.36,95,,,percent of total billed charges,95% of total billed charges,3009.98,80,,,percent of total billed charges,80% of total billed charges,3198.11,85,,,percent of total billed charges,85% of total billed charges,3386.23,90,,,percent of total billed charges,90% of total billed charges,3762.48,100,,,fee schedule,100% of CO APG rates,3762.48,100,,,fee schedule,100% of CO APG rates,3762.48,100,,,fee schedule,100% of NM fee schedule,1504.99,40,,,percent of total billed charges,40% of total billed charges,1504.99,40,,,percent of total billed charges,40% of total billed charges,3386.23,90,,,percent of total billed charges,90% of total billed charges,2859.48,76,,,percent of total billed charges,76% of total billed charges,1504.99,40,,,percent of total billed charges,40% of total billed charges,3198.11,85,,,percent of total billed charges,85% of total billed charges,3762.48,100,,,fee schedule,100% of CO APG rate,3009.98,80,,,percent of total billed charges,80% of total billed charges,1459.84,38.8,,,percent of total billed charges,38.8% of total billed charges,3198.11,85,,,percent of total billed charges,85% of total billed charges,3762.48,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1459.84,3762.48,
"Cortex Screw, 3.5dia x 50mm self-tapping, Titanium",60001508,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 95mm self-tapping, Titanium",60001502,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 70mm self-tapping, Titanium",60001504,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 65mm self-tapping, Titanium",60001505,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 60mm self-tapping, Titanium",60001506,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"3.5dia x 55mm self-tapping, Titanium",60001507,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 48mm self-tapping, Titanium",60001509,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 46mm self-tapping, Titanium",60001510,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
"Cortex Screw, 3.5dia x 75mm self-tapping, Titanium",60001503,CDM,278,RC,,,OUTPATIENT,,,780.57,624.456,,585.43,75,,,percent of total billed charges,75% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,618.21,79.2,,,percent of total billed charges,79.2% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,741.54,95,,,percent of total billed charges,95% of total billed charges,624.46,80,,,percent of total billed charges,80% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of CO APG rates,780.57,100,,,fee schedule,100% of NM fee schedule,312.23,40,,,percent of total billed charges,40% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,702.51,90,,,percent of total billed charges,90% of total billed charges,593.23,76,,,percent of total billed charges,76% of total billed charges,312.23,40,,,percent of total billed charges,40% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of CO APG rate,624.46,80,,,percent of total billed charges,80% of total billed charges,302.86,38.8,,,percent of total billed charges,38.8% of total billed charges,663.48,85,,,percent of total billed charges,85% of total billed charges,780.57,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,302.86,780.57,
31603 Tracheostomy Emergency; Transtracheal,60001354,CDM,450,RC,10060,HCPCS,OUTPATIENT,,,4359,3487.2,,3269.25,75,,,percent of total billed charges,75% of total billed charges,1743.6,40,,,percent of total billed charges,40% of total billed charges,3452.33,79.2,,,percent of total billed charges,79.2% of total billed charges,3705.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,4141.05,95,,,percent of total billed charges,95% of total billed charges,3487.2,80,,,percent of total billed charges,80% of total billed charges,3705.15,85,,,percent of total billed charges,85% of total billed charges,3923.1,90,,,percent of total billed charges,90% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rates,215.49,100,,,fee schedule,100% of CO APG rates,180.58,100,,,fee schedule,100% of NM APC rate,1743.6,40,,,percent of total billed charges,40% of total billed charges,1743.6,40,,,percent of total billed charges,40% of total billed charges,3923.1,90,,,percent of total billed charges,90% of total billed charges,3312.84,76,,,percent of total billed charges,76% of total billed charges,1743.6,40,,,percent of total billed charges,40% of total billed charges,3705.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of CO APG rate,3487.2,80,,,percent of total billed charges,80% of total billed charges,1691.29,38.8,,,percent of total billed charges,38.8% of total billed charges,3705.15,85,,,percent of total billed charges,85% of total billed charges,215.49,100,,,fee schedule,100% of APG fee schedule,217.66,200,,,fee schedule,200% of CMS fee schedule,180.58,4141.05,
"Drill Bit, 3.1dia x 238mm",60001524,CDM,270,RC,,,OUTPATIENT,,,439.4,351.52,,329.55,75,,,percent of total billed charges,75% of total billed charges,175.76,40,,,percent of total billed charges,40% of total billed charges,348,79.2,,,percent of total billed charges,79.2% of total billed charges,373.49,85,,,percent of total billed charges,85% of total billed charges,439.4,100,,,fee schedule,100% of CO APG rates,417.43,95,,,percent of total billed charges,95% of total billed charges,351.52,80,,,percent of total billed charges,80% of total billed charges,373.49,85,,,percent of total billed charges,85% of total billed charges,395.46,90,,,percent of total billed charges,90% of total billed charges,439.4,100,,,fee schedule,100% of CO APG rates,439.4,100,,,fee schedule,100% of CO APG rates,439.4,100,,,fee schedule,100% of NM fee schedule,175.76,40,,,percent of total billed charges,40% of total billed charges,175.76,40,,,percent of total billed charges,40% of total billed charges,395.46,90,,,percent of total billed charges,90% of total billed charges,333.94,76,,,percent of total billed charges,76% of total billed charges,175.76,40,,,percent of total billed charges,40% of total billed charges,373.49,85,,,percent of total billed charges,85% of total billed charges,439.4,100,,,fee schedule,100% of CO APG rate,351.52,80,,,percent of total billed charges,80% of total billed charges,170.49,38.8,,,percent of total billed charges,38.8% of total billed charges,373.49,85,,,percent of total billed charges,85% of total billed charges,439.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,170.49,439.4,
94727-Nitrogen Washout,60001391,CDM,460,RC,94618,HCPCS,OUTPATIENT,,,446,356.8,,334.5,75,,,percent of total billed charges,75% of total billed charges,178.4,40,,,percent of total billed charges,40% of total billed charges,353.23,79.2,,,percent of total billed charges,79.2% of total billed charges,379.1,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,423.7,95,,,percent of total billed charges,95% of total billed charges,356.8,80,,,percent of total billed charges,80% of total billed charges,379.1,85,,,percent of total billed charges,85% of total billed charges,401.4,90,,,percent of total billed charges,90% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rates,68.59,100,,,fee schedule,100% of CO APG rates,116.11,100,,,fee schedule,100% of NM APC rate,178.4,40,,,percent of total billed charges,40% of total billed charges,178.4,40,,,percent of total billed charges,40% of total billed charges,401.4,90,,,percent of total billed charges,90% of total billed charges,338.96,76,,,percent of total billed charges,76% of total billed charges,178.4,40,,,percent of total billed charges,40% of total billed charges,379.1,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of CO APG rate,356.8,80,,,percent of total billed charges,80% of total billed charges,173.05,38.8,,,percent of total billed charges,38.8% of total billed charges,379.1,85,,,percent of total billed charges,85% of total billed charges,68.59,100,,,fee schedule,100% of APG fee schedule,69.18,200,,,fee schedule,200% of CMS fee schedule,68.59,423.7,
US Elastography Liver,60001456,CDM,320,RC,77080,HCPCS,OUTPATIENT,,,917.25,733.8,,687.94,75,,,percent of total billed charges,75% of total billed charges,366.9,40,,,percent of total billed charges,40% of total billed charges,726.46,79.2,,,percent of total billed charges,79.2% of total billed charges,779.66,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,871.39,95,,,percent of total billed charges,95% of total billed charges,733.8,80,,,percent of total billed charges,80% of total billed charges,779.66,85,,,percent of total billed charges,85% of total billed charges,825.53,90,,,percent of total billed charges,90% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rates,104.58,100,,,fee schedule,100% of CO APG rates,106.88,100,,,fee schedule,100% of NM APC rate,366.9,40,,,percent of total billed charges,40% of total billed charges,366.9,40,,,percent of total billed charges,40% of total billed charges,825.53,90,,,percent of total billed charges,90% of total billed charges,697.11,76,,,percent of total billed charges,76% of total billed charges,366.9,40,,,percent of total billed charges,40% of total billed charges,779.66,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of CO APG rate,733.8,80,,,percent of total billed charges,80% of total billed charges,355.89,38.8,,,percent of total billed charges,38.8% of total billed charges,779.66,85,,,percent of total billed charges,85% of total billed charges,104.58,100,,,fee schedule,100% of APG fee schedule,80.16,200,,,fee schedule,200% of CMS fee schedule,80.16,871.39,
"87506 - GI Panel by PCR, 6-11 Targets",60001531,CDM,306,RC,87804,HCPCS,OUTPATIENT,,,789,631.2,,591.75,75,,,percent of total billed charges,75% of total billed charges,315.6,40,,,percent of total billed charges,40% of total billed charges,624.89,79.2,,,percent of total billed charges,79.2% of total billed charges,670.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,749.55,95,,,percent of total billed charges,95% of total billed charges,631.2,80,,,percent of total billed charges,80% of total billed charges,670.65,85,,,percent of total billed charges,85% of total billed charges,710.1,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.56,100,,,fee schedule,100% of NM fee schedule,315.6,40,,,percent of total billed charges,40% of total billed charges,315.6,40,,,percent of total billed charges,40% of total billed charges,710.1,90,,,percent of total billed charges,90% of total billed charges,599.64,76,,,percent of total billed charges,76% of total billed charges,315.6,40,,,percent of total billed charges,40% of total billed charges,670.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,631.2,80,,,percent of total billed charges,80% of total billed charges,306.13,38.8,,,percent of total billed charges,38.8% of total billed charges,670.65,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.1,200,,,fee schedule,200% of CMS fee schedule,9.49,749.55,
"Scorpion Needle, Knee",60001563,CDM,270,RC,,,OUTPATIENT,,,1170,936,,877.5,75,,,percent of total billed charges,75% of total billed charges,468,40,,,percent of total billed charges,40% of total billed charges,926.64,79.2,,,percent of total billed charges,79.2% of total billed charges,994.5,85,,,percent of total billed charges,85% of total billed charges,1170,100,,,fee schedule,100% of CO APG rates,1111.5,95,,,percent of total billed charges,95% of total billed charges,936,80,,,percent of total billed charges,80% of total billed charges,994.5,85,,,percent of total billed charges,85% of total billed charges,1053,90,,,percent of total billed charges,90% of total billed charges,1170,100,,,fee schedule,100% of CO APG rates,1170,100,,,fee schedule,100% of CO APG rates,1170,100,,,fee schedule,100% of NM fee schedule,468,40,,,percent of total billed charges,40% of total billed charges,468,40,,,percent of total billed charges,40% of total billed charges,1053,90,,,percent of total billed charges,90% of total billed charges,889.2,76,,,percent of total billed charges,76% of total billed charges,468,40,,,percent of total billed charges,40% of total billed charges,994.5,85,,,percent of total billed charges,85% of total billed charges,1170,100,,,fee schedule,100% of CO APG rate,936,80,,,percent of total billed charges,80% of total billed charges,453.96,38.8,,,percent of total billed charges,38.8% of total billed charges,994.5,85,,,percent of total billed charges,85% of total billed charges,1170,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,453.96,1170,
"GAMMA 4 Guide Wire, Ball-Tipped, T2 3X1000mm",60001568,CDM,272,RC,,,OUTPATIENT,,,447.97,358.376,,335.98,75,,,percent of total billed charges,75% of total billed charges,179.19,40,,,percent of total billed charges,40% of total billed charges,354.79,79.2,,,percent of total billed charges,79.2% of total billed charges,380.77,85,,,percent of total billed charges,85% of total billed charges,447.97,100,,,fee schedule,100% of CO APG rates,425.57,95,,,percent of total billed charges,95% of total billed charges,358.38,80,,,percent of total billed charges,80% of total billed charges,380.77,85,,,percent of total billed charges,85% of total billed charges,403.17,90,,,percent of total billed charges,90% of total billed charges,447.97,100,,,fee schedule,100% of CO APG rates,447.97,100,,,fee schedule,100% of CO APG rates,447.97,100,,,fee schedule,100% of NM fee schedule,179.19,40,,,percent of total billed charges,40% of total billed charges,179.19,40,,,percent of total billed charges,40% of total billed charges,403.17,90,,,percent of total billed charges,90% of total billed charges,340.46,76,,,percent of total billed charges,76% of total billed charges,179.19,40,,,percent of total billed charges,40% of total billed charges,380.77,85,,,percent of total billed charges,85% of total billed charges,447.97,100,,,fee schedule,100% of CO APG rate,358.38,80,,,percent of total billed charges,80% of total billed charges,173.81,38.8,,,percent of total billed charges,38.8% of total billed charges,380.77,85,,,percent of total billed charges,85% of total billed charges,447.97,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,173.81,447.97,
"GAMMA 4 Precision Pin, Tapered 3.2X450mm",60001566,CDM,278,RC,,,OUTPATIENT,,,483.71,386.968,,362.78,75,,,percent of total billed charges,75% of total billed charges,193.48,40,,,percent of total billed charges,40% of total billed charges,383.1,79.2,,,percent of total billed charges,79.2% of total billed charges,411.15,85,,,percent of total billed charges,85% of total billed charges,483.71,100,,,fee schedule,100% of CO APG rates,459.52,95,,,percent of total billed charges,95% of total billed charges,386.97,80,,,percent of total billed charges,80% of total billed charges,411.15,85,,,percent of total billed charges,85% of total billed charges,435.34,90,,,percent of total billed charges,90% of total billed charges,483.71,100,,,fee schedule,100% of CO APG rates,483.71,100,,,fee schedule,100% of CO APG rates,483.71,100,,,fee schedule,100% of NM fee schedule,193.48,40,,,percent of total billed charges,40% of total billed charges,193.48,40,,,percent of total billed charges,40% of total billed charges,435.34,90,,,percent of total billed charges,90% of total billed charges,367.62,76,,,percent of total billed charges,76% of total billed charges,193.48,40,,,percent of total billed charges,40% of total billed charges,411.15,85,,,percent of total billed charges,85% of total billed charges,483.71,100,,,fee schedule,100% of CO APG rate,386.97,80,,,percent of total billed charges,80% of total billed charges,187.68,38.8,,,percent of total billed charges,38.8% of total billed charges,411.15,85,,,percent of total billed charges,85% of total billed charges,483.71,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,187.68,483.71,
"Gamma 4 Guide Wire, Ball-Tipped T2 3x800mm",60001567,CDM,272,RC,,,OUTPATIENT,,,429.91,343.928,,322.43,75,,,percent of total billed charges,75% of total billed charges,171.96,40,,,percent of total billed charges,40% of total billed charges,340.49,79.2,,,percent of total billed charges,79.2% of total billed charges,365.42,85,,,percent of total billed charges,85% of total billed charges,429.91,100,,,fee schedule,100% of CO APG rates,408.41,95,,,percent of total billed charges,95% of total billed charges,343.93,80,,,percent of total billed charges,80% of total billed charges,365.42,85,,,percent of total billed charges,85% of total billed charges,386.92,90,,,percent of total billed charges,90% of total billed charges,429.91,100,,,fee schedule,100% of CO APG rates,429.91,100,,,fee schedule,100% of CO APG rates,429.91,100,,,fee schedule,100% of NM fee schedule,171.96,40,,,percent of total billed charges,40% of total billed charges,171.96,40,,,percent of total billed charges,40% of total billed charges,386.92,90,,,percent of total billed charges,90% of total billed charges,326.73,76,,,percent of total billed charges,76% of total billed charges,171.96,40,,,percent of total billed charges,40% of total billed charges,365.42,85,,,percent of total billed charges,85% of total billed charges,429.91,100,,,fee schedule,100% of CO APG rate,343.93,80,,,percent of total billed charges,80% of total billed charges,166.81,38.8,,,percent of total billed charges,38.8% of total billed charges,365.42,85,,,percent of total billed charges,85% of total billed charges,429.91,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,166.81,429.91,
"GAMMA 4 Counterbore Drill, Short IMN Instruments 5.5X185mm",60001569,CDM,272,RC,,,OUTPATIENT,,,465.99,372.792,,349.49,75,,,percent of total billed charges,75% of total billed charges,186.4,40,,,percent of total billed charges,40% of total billed charges,369.06,79.2,,,percent of total billed charges,79.2% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,465.99,100,,,fee schedule,100% of CO APG rates,442.69,95,,,percent of total billed charges,95% of total billed charges,372.79,80,,,percent of total billed charges,80% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,419.39,90,,,percent of total billed charges,90% of total billed charges,465.99,100,,,fee schedule,100% of CO APG rates,465.99,100,,,fee schedule,100% of CO APG rates,465.99,100,,,fee schedule,100% of NM fee schedule,186.4,40,,,percent of total billed charges,40% of total billed charges,186.4,40,,,percent of total billed charges,40% of total billed charges,419.39,90,,,percent of total billed charges,90% of total billed charges,354.15,76,,,percent of total billed charges,76% of total billed charges,186.4,40,,,percent of total billed charges,40% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,465.99,100,,,fee schedule,100% of CO APG rate,372.79,80,,,percent of total billed charges,80% of total billed charges,180.8,38.8,,,percent of total billed charges,38.8% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,465.99,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,180.8,465.99,
"GAMMA 4 Counterbore Drill, Long IMN Instruments 5.5X255mm",60001570,CDM,272,RC,,,OUTPATIENT,,,465.99,372.792,,349.49,75,,,percent of total billed charges,75% of total billed charges,186.4,40,,,percent of total billed charges,40% of total billed charges,369.06,79.2,,,percent of total billed charges,79.2% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,465.99,100,,,fee schedule,100% of CO APG rates,442.69,95,,,percent of total billed charges,95% of total billed charges,372.79,80,,,percent of total billed charges,80% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,419.39,90,,,percent of total billed charges,90% of total billed charges,465.99,100,,,fee schedule,100% of CO APG rates,465.99,100,,,fee schedule,100% of CO APG rates,465.99,100,,,fee schedule,100% of NM fee schedule,186.4,40,,,percent of total billed charges,40% of total billed charges,186.4,40,,,percent of total billed charges,40% of total billed charges,419.39,90,,,percent of total billed charges,90% of total billed charges,354.15,76,,,percent of total billed charges,76% of total billed charges,186.4,40,,,percent of total billed charges,40% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,465.99,100,,,fee schedule,100% of CO APG rate,372.79,80,,,percent of total billed charges,80% of total billed charges,180.8,38.8,,,percent of total billed charges,38.8% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,465.99,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,180.8,465.99,
"GAMMA 4 Counterbore Drill, Manual 5.5X280mm",60001571,CDM,272,RC,,,OUTPATIENT,,,465.99,372.792,,349.49,75,,,percent of total billed charges,75% of total billed charges,186.4,40,,,percent of total billed charges,40% of total billed charges,369.06,79.2,,,percent of total billed charges,79.2% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,465.99,100,,,fee schedule,100% of CO APG rates,442.69,95,,,percent of total billed charges,95% of total billed charges,372.79,80,,,percent of total billed charges,80% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,419.39,90,,,percent of total billed charges,90% of total billed charges,465.99,100,,,fee schedule,100% of CO APG rates,465.99,100,,,fee schedule,100% of CO APG rates,465.99,100,,,fee schedule,100% of NM fee schedule,186.4,40,,,percent of total billed charges,40% of total billed charges,186.4,40,,,percent of total billed charges,40% of total billed charges,419.39,90,,,percent of total billed charges,90% of total billed charges,354.15,76,,,percent of total billed charges,76% of total billed charges,186.4,40,,,percent of total billed charges,40% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,465.99,100,,,fee schedule,100% of CO APG rate,372.79,80,,,percent of total billed charges,80% of total billed charges,180.8,38.8,,,percent of total billed charges,38.8% of total billed charges,396.09,85,,,percent of total billed charges,85% of total billed charges,465.99,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,180.8,465.99,
GAMMA 4 Trochanteric Nail 11X170mm 125',60001573,CDM,278,RC,,,OUTPATIENT,,,2672.07,2137.656,,2004.05,75,,,percent of total billed charges,75% of total billed charges,1068.83,40,,,percent of total billed charges,40% of total billed charges,2116.28,79.2,,,percent of total billed charges,79.2% of total billed charges,2271.26,85,,,percent of total billed charges,85% of total billed charges,2672.07,100,,,fee schedule,100% of CO APG rates,2538.47,95,,,percent of total billed charges,95% of total billed charges,2137.66,80,,,percent of total billed charges,80% of total billed charges,2271.26,85,,,percent of total billed charges,85% of total billed charges,2404.86,90,,,percent of total billed charges,90% of total billed charges,2672.07,100,,,fee schedule,100% of CO APG rates,2672.07,100,,,fee schedule,100% of CO APG rates,2672.07,100,,,fee schedule,100% of NM fee schedule,1068.83,40,,,percent of total billed charges,40% of total billed charges,1068.83,40,,,percent of total billed charges,40% of total billed charges,2404.86,90,,,percent of total billed charges,90% of total billed charges,2030.77,76,,,percent of total billed charges,76% of total billed charges,1068.83,40,,,percent of total billed charges,40% of total billed charges,2271.26,85,,,percent of total billed charges,85% of total billed charges,2672.07,100,,,fee schedule,100% of CO APG rate,2137.66,80,,,percent of total billed charges,80% of total billed charges,1036.76,38.8,,,percent of total billed charges,38.8% of total billed charges,2271.26,85,,,percent of total billed charges,85% of total billed charges,2672.07,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1036.76,2672.07,
GAMMA 4 Trochanteric Nail 12X170mm 125',60001574,CDM,278,RC,,,OUTPATIENT,,,2771.39,2217.112,,2078.54,75,,,percent of total billed charges,75% of total billed charges,1108.56,40,,,percent of total billed charges,40% of total billed charges,2194.94,79.2,,,percent of total billed charges,79.2% of total billed charges,2355.68,85,,,percent of total billed charges,85% of total billed charges,2771.39,100,,,fee schedule,100% of CO APG rates,2632.82,95,,,percent of total billed charges,95% of total billed charges,2217.11,80,,,percent of total billed charges,80% of total billed charges,2355.68,85,,,percent of total billed charges,85% of total billed charges,2494.25,90,,,percent of total billed charges,90% of total billed charges,2771.39,100,,,fee schedule,100% of CO APG rates,2771.39,100,,,fee schedule,100% of CO APG rates,2771.39,100,,,fee schedule,100% of NM fee schedule,1108.56,40,,,percent of total billed charges,40% of total billed charges,1108.56,40,,,percent of total billed charges,40% of total billed charges,2494.25,90,,,percent of total billed charges,90% of total billed charges,2106.26,76,,,percent of total billed charges,76% of total billed charges,1108.56,40,,,percent of total billed charges,40% of total billed charges,2355.68,85,,,percent of total billed charges,85% of total billed charges,2771.39,100,,,fee schedule,100% of CO APG rate,2217.11,80,,,percent of total billed charges,80% of total billed charges,1075.3,38.8,,,percent of total billed charges,38.8% of total billed charges,2355.68,85,,,percent of total billed charges,85% of total billed charges,2771.39,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1075.3,2771.39,
GAMMA 4 Trochanteric Nail 10X170mm 125',60001572,CDM,278,RC,,,OUTPATIENT,,,2672.07,2137.656,,2004.05,75,,,percent of total billed charges,75% of total billed charges,1068.83,40,,,percent of total billed charges,40% of total billed charges,2116.28,79.2,,,percent of total billed charges,79.2% of total billed charges,2271.26,85,,,percent of total billed charges,85% of total billed charges,2672.07,100,,,fee schedule,100% of CO APG rates,2538.47,95,,,percent of total billed charges,95% of total billed charges,2137.66,80,,,percent of total billed charges,80% of total billed charges,2271.26,85,,,percent of total billed charges,85% of total billed charges,2404.86,90,,,percent of total billed charges,90% of total billed charges,2672.07,100,,,fee schedule,100% of CO APG rates,2672.07,100,,,fee schedule,100% of CO APG rates,2672.07,100,,,fee schedule,100% of NM fee schedule,1068.83,40,,,percent of total billed charges,40% of total billed charges,1068.83,40,,,percent of total billed charges,40% of total billed charges,2404.86,90,,,percent of total billed charges,90% of total billed charges,2030.77,76,,,percent of total billed charges,76% of total billed charges,1068.83,40,,,percent of total billed charges,40% of total billed charges,2271.26,85,,,percent of total billed charges,85% of total billed charges,2672.07,100,,,fee schedule,100% of CO APG rate,2137.66,80,,,percent of total billed charges,80% of total billed charges,1036.76,38.8,,,percent of total billed charges,38.8% of total billed charges,2271.26,85,,,percent of total billed charges,85% of total billed charges,2672.07,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1036.76,2672.07,
GAMMA 4 Lag Screw 10.5X80mm,60001575,CDM,278,RC,,,OUTPATIENT,,,1191.27,953.016,,893.45,75,,,percent of total billed charges,75% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,943.49,79.2,,,percent of total billed charges,79.2% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1131.71,95,,,percent of total billed charges,95% of total billed charges,953.02,80,,,percent of total billed charges,80% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of NM fee schedule,476.51,40,,,percent of total billed charges,40% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,905.37,76,,,percent of total billed charges,76% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rate,953.02,80,,,percent of total billed charges,80% of total billed charges,462.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,462.21,1191.27,
GAMMA 4 Lag Screw 10.5X85mm,60001576,CDM,278,RC,,,OUTPATIENT,,,1191.27,953.016,,893.45,75,,,percent of total billed charges,75% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,943.49,79.2,,,percent of total billed charges,79.2% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1131.71,95,,,percent of total billed charges,95% of total billed charges,953.02,80,,,percent of total billed charges,80% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of NM fee schedule,476.51,40,,,percent of total billed charges,40% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,905.37,76,,,percent of total billed charges,76% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rate,953.02,80,,,percent of total billed charges,80% of total billed charges,462.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,462.21,1191.27,
"GAMMA 4 Long Nail, RIGHT, 10X380mm 125'",60001588,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, RIGHT, 10X400mm 125'",60001589,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, RIGHT, 10X360mm 125'",60001587,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, RIGHT, 11X320mm 125'",60001591,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, RIGHT, 10X420mm 125'",60001590,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, RIGHT, 11X360mm 125'",60001594,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, RIGHT, 11X380mm 125'",60001595,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, RIGHT, 11X340mm 125'",60001593,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, RIGHT, 11X400mm 125'",60001596,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, RIGHT, 11X420mm 125'",60001597,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, RIGHT, 12X320mm 125'",60001598,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
"GAMMA 4 Long Nail, RIGHT, 12X380mm 125'",60001601,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
"GAMMA 4 Long Nail, RIGHT, 12X340mm 125'",60001599,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
"GAMMA 4 Long Nail, RIGHT, 12X400mm 125'",60001602,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
"GAMMA 4 Long Nail, RIGHT, 12X360mm 125'",60001600,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
"GAMMA 4 Long Nail, RIGHT, 12X420mm 125'",60001604,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
GAMMA 4 Lag Screw 10.5X90mm,60001578,CDM,278,RC,,,OUTPATIENT,,,1191.27,953.016,,893.45,75,,,percent of total billed charges,75% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,943.49,79.2,,,percent of total billed charges,79.2% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1131.71,95,,,percent of total billed charges,95% of total billed charges,953.02,80,,,percent of total billed charges,80% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of NM fee schedule,476.51,40,,,percent of total billed charges,40% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,905.37,76,,,percent of total billed charges,76% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rate,953.02,80,,,percent of total billed charges,80% of total billed charges,462.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,462.21,1191.27,
GAMMA 4 Lag Screw 10.5X105mm,60001581,CDM,278,RC,,,OUTPATIENT,,,1191.27,953.016,,893.45,75,,,percent of total billed charges,75% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,943.49,79.2,,,percent of total billed charges,79.2% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1131.71,95,,,percent of total billed charges,95% of total billed charges,953.02,80,,,percent of total billed charges,80% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of NM fee schedule,476.51,40,,,percent of total billed charges,40% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,905.37,76,,,percent of total billed charges,76% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rate,953.02,80,,,percent of total billed charges,80% of total billed charges,462.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,462.21,1191.27,
GAMMA 4 Lag Screw 10.5X95mm,60001579,CDM,278,RC,,,OUTPATIENT,,,1191.27,953.016,,893.45,75,,,percent of total billed charges,75% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,943.49,79.2,,,percent of total billed charges,79.2% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1131.71,95,,,percent of total billed charges,95% of total billed charges,953.02,80,,,percent of total billed charges,80% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of NM fee schedule,476.51,40,,,percent of total billed charges,40% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,905.37,76,,,percent of total billed charges,76% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rate,953.02,80,,,percent of total billed charges,80% of total billed charges,462.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,462.21,1191.27,
GAMMA 4 Lag Screw 10.5X110mm,60001582,CDM,278,RC,,,OUTPATIENT,,,1191.27,953.016,,893.45,75,,,percent of total billed charges,75% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,943.49,79.2,,,percent of total billed charges,79.2% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1131.71,95,,,percent of total billed charges,95% of total billed charges,953.02,80,,,percent of total billed charges,80% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of NM fee schedule,476.51,40,,,percent of total billed charges,40% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,905.37,76,,,percent of total billed charges,76% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rate,953.02,80,,,percent of total billed charges,80% of total billed charges,462.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,462.21,1191.27,
"GAMMA 4 Long Nail, RIGHT, 10X320mm 125'",60001583,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
GAMMA 4 Lag Screw 10.5X100mm,60001580,CDM,278,RC,,,OUTPATIENT,,,1191.27,953.016,,893.45,75,,,percent of total billed charges,75% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,943.49,79.2,,,percent of total billed charges,79.2% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1131.71,95,,,percent of total billed charges,95% of total billed charges,953.02,80,,,percent of total billed charges,80% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of CO APG rates,1191.27,100,,,fee schedule,100% of NM fee schedule,476.51,40,,,percent of total billed charges,40% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1072.14,90,,,percent of total billed charges,90% of total billed charges,905.37,76,,,percent of total billed charges,76% of total billed charges,476.51,40,,,percent of total billed charges,40% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of CO APG rate,953.02,80,,,percent of total billed charges,80% of total billed charges,462.21,38.8,,,percent of total billed charges,38.8% of total billed charges,1012.58,85,,,percent of total billed charges,85% of total billed charges,1191.27,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,462.21,1191.27,
"GAMMA 4 Long Nail, RIGHT, 10X340mm 125'",60001584,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
CO2 Sampling Line Microstream Adult,60001585,CDM,270,RC,,,OUTPATIENT,,,63.97,51.176,,47.98,75,,,percent of total billed charges,75% of total billed charges,25.59,40,,,percent of total billed charges,40% of total billed charges,50.66,79.2,,,percent of total billed charges,79.2% of total billed charges,54.37,85,,,percent of total billed charges,85% of total billed charges,63.97,100,,,fee schedule,100% of CO APG rates,60.77,95,,,percent of total billed charges,95% of total billed charges,51.18,80,,,percent of total billed charges,80% of total billed charges,54.37,85,,,percent of total billed charges,85% of total billed charges,57.57,90,,,percent of total billed charges,90% of total billed charges,63.97,100,,,fee schedule,100% of CO APG rates,63.97,100,,,fee schedule,100% of CO APG rates,63.97,100,,,fee schedule,100% of NM fee schedule,25.59,40,,,percent of total billed charges,40% of total billed charges,25.59,40,,,percent of total billed charges,40% of total billed charges,57.57,90,,,percent of total billed charges,90% of total billed charges,48.62,76,,,percent of total billed charges,76% of total billed charges,25.59,40,,,percent of total billed charges,40% of total billed charges,54.37,85,,,percent of total billed charges,85% of total billed charges,63.97,100,,,fee schedule,100% of CO APG rate,51.18,80,,,percent of total billed charges,80% of total billed charges,24.82,38.8,,,percent of total billed charges,38.8% of total billed charges,54.37,85,,,percent of total billed charges,85% of total billed charges,63.97,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,24.82,63.97,
"GAMMA 4 Long Nail, LEFT, 10X320mm 125'",60001605,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
Compression Foot and Ankle Wraps with (24) 3+ Hour Gels,60001603,CDM,270,RC,,,OUTPATIENT,,,206.04,164.832,,154.53,75,,,percent of total billed charges,75% of total billed charges,82.42,40,,,percent of total billed charges,40% of total billed charges,163.18,79.2,,,percent of total billed charges,79.2% of total billed charges,175.13,85,,,percent of total billed charges,85% of total billed charges,206.04,100,,,fee schedule,100% of CO APG rates,195.74,95,,,percent of total billed charges,95% of total billed charges,164.83,80,,,percent of total billed charges,80% of total billed charges,175.13,85,,,percent of total billed charges,85% of total billed charges,185.44,90,,,percent of total billed charges,90% of total billed charges,206.04,100,,,fee schedule,100% of CO APG rates,206.04,100,,,fee schedule,100% of CO APG rates,206.04,100,,,fee schedule,100% of NM fee schedule,82.42,40,,,percent of total billed charges,40% of total billed charges,82.42,40,,,percent of total billed charges,40% of total billed charges,185.44,90,,,percent of total billed charges,90% of total billed charges,156.59,76,,,percent of total billed charges,76% of total billed charges,82.42,40,,,percent of total billed charges,40% of total billed charges,175.13,85,,,percent of total billed charges,85% of total billed charges,206.04,100,,,fee schedule,100% of CO APG rate,164.83,80,,,percent of total billed charges,80% of total billed charges,79.94,38.8,,,percent of total billed charges,38.8% of total billed charges,175.13,85,,,percent of total billed charges,85% of total billed charges,206.04,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,79.94,206.04,
"GAMMA 4 Long Nail, LEFT, 10X360mm 125'",60001607,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, LEFT, 10X340mm 125'",60001606,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, LEFT, 10X380mm 125'",60001608,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, LEFT, 10X400mm 125'",60001609,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, LEFT, 10X420mm 125'",60001610,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, LEFT, 11X320mm 125'",60001611,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, LEFT, 11X340mm 125'",60001612,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, LEFT, 11X360mm 125'",60001613,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, LEFT, 11X380mm 125'",60001614,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, LEFT, 12X400mm 125'",60001621,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
"GAMMA 4 Long Nail, LEFT, 11X400mm 125'",60001615,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, LEFT, 11X420mm 125'",60001616,CDM,278,RC,,,OUTPATIENT,,,3610.56,2888.448,,2707.92,75,,,percent of total billed charges,75% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,2859.56,79.2,,,percent of total billed charges,79.2% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3430.03,95,,,percent of total billed charges,95% of total billed charges,2888.45,80,,,percent of total billed charges,80% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of CO APG rates,3610.56,100,,,fee schedule,100% of NM fee schedule,1444.22,40,,,percent of total billed charges,40% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3249.5,90,,,percent of total billed charges,90% of total billed charges,2744.03,76,,,percent of total billed charges,76% of total billed charges,1444.22,40,,,percent of total billed charges,40% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of CO APG rate,2888.45,80,,,percent of total billed charges,80% of total billed charges,1400.9,38.8,,,percent of total billed charges,38.8% of total billed charges,3068.98,85,,,percent of total billed charges,85% of total billed charges,3610.56,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1400.9,3610.56,
"GAMMA 4 Long Nail, LEFT, 12X320mm 125'",60001617,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
"GAMMA 4 Long Nail, LEFT, 12X340mm 125'",60001618,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
"GAMMA 4 Long Nail, LEFT, 12X360mm 125'",60001619,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
"GAMMA 4 Long Nail, LEFT, 12X380mm 125'",60001620,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
"GAMMA 4 Long Nail, LEFT, 12X420mm 125'",60001622,CDM,278,RC,,,OUTPATIENT,,,3744.46,2995.568,,2808.35,75,,,percent of total billed charges,75% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,2965.61,79.2,,,percent of total billed charges,79.2% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3557.24,95,,,percent of total billed charges,95% of total billed charges,2995.57,80,,,percent of total billed charges,80% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of CO APG rates,3744.46,100,,,fee schedule,100% of NM fee schedule,1497.78,40,,,percent of total billed charges,40% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3370.01,90,,,percent of total billed charges,90% of total billed charges,2845.79,76,,,percent of total billed charges,76% of total billed charges,1497.78,40,,,percent of total billed charges,40% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of CO APG rate,2995.57,80,,,percent of total billed charges,80% of total billed charges,1452.85,38.8,,,percent of total billed charges,38.8% of total billed charges,3182.79,85,,,percent of total billed charges,85% of total billed charges,3744.46,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1452.85,3744.46,
GAMMA 4 Threaded Guide Wire,60001623,CDM,272,RC,,,OUTPATIENT,,,4485.03,3588.024,,3363.77,75,,,percent of total billed charges,75% of total billed charges,1794.01,40,,,percent of total billed charges,40% of total billed charges,3552.14,79.2,,,percent of total billed charges,79.2% of total billed charges,3812.28,85,,,percent of total billed charges,85% of total billed charges,4485.03,100,,,fee schedule,100% of CO APG rates,4260.78,95,,,percent of total billed charges,95% of total billed charges,3588.02,80,,,percent of total billed charges,80% of total billed charges,3812.28,85,,,percent of total billed charges,85% of total billed charges,4036.53,90,,,percent of total billed charges,90% of total billed charges,4485.03,100,,,fee schedule,100% of CO APG rates,4485.03,100,,,fee schedule,100% of CO APG rates,4485.03,100,,,fee schedule,100% of NM fee schedule,1794.01,40,,,percent of total billed charges,40% of total billed charges,1794.01,40,,,percent of total billed charges,40% of total billed charges,4036.53,90,,,percent of total billed charges,90% of total billed charges,3408.62,76,,,percent of total billed charges,76% of total billed charges,1794.01,40,,,percent of total billed charges,40% of total billed charges,3812.28,85,,,percent of total billed charges,85% of total billed charges,4485.03,100,,,fee schedule,100% of CO APG rate,3588.02,80,,,percent of total billed charges,80% of total billed charges,1740.19,38.8,,,percent of total billed charges,38.8% of total billed charges,3812.28,85,,,percent of total billed charges,85% of total billed charges,4485.03,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1740.19,4485.03,
"Skin Closure Zip Strip Medical 1 x 9cm, Plastic, Translucen",60001624,CDM,276,RC,,,OUTPATIENT,,,328.35,262.68,,246.26,75,,,percent of total billed charges,75% of total billed charges,131.34,40,,,percent of total billed charges,40% of total billed charges,260.05,79.2,,,percent of total billed charges,79.2% of total billed charges,279.1,85,,,percent of total billed charges,85% of total billed charges,328.35,100,,,fee schedule,100% of CO APG rates,311.93,95,,,percent of total billed charges,95% of total billed charges,262.68,80,,,percent of total billed charges,80% of total billed charges,279.1,85,,,percent of total billed charges,85% of total billed charges,295.52,90,,,percent of total billed charges,90% of total billed charges,328.35,100,,,fee schedule,100% of CO APG rates,328.35,100,,,fee schedule,100% of CO APG rates,328.35,100,,,fee schedule,100% of NM fee schedule,131.34,40,,,percent of total billed charges,40% of total billed charges,131.34,40,,,percent of total billed charges,40% of total billed charges,295.52,90,,,percent of total billed charges,90% of total billed charges,249.55,76,,,percent of total billed charges,76% of total billed charges,131.34,40,,,percent of total billed charges,40% of total billed charges,279.1,85,,,percent of total billed charges,85% of total billed charges,328.35,100,,,fee schedule,100% of CO APG rate,262.68,80,,,percent of total billed charges,80% of total billed charges,127.4,38.8,,,percent of total billed charges,38.8% of total billed charges,279.1,85,,,percent of total billed charges,85% of total billed charges,328.35,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,127.4,328.35,
"Proximal Lateral Tibia Plate #10 LEFT, TITANIUM",60001630,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,1222.2,3150,
"Proximal Lateral Tibia Plate #8 LEFT, TITANIUM",60001631,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
Proximal Lateral Tibia Plate #14 LEFT,60001628,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
"Proximal Lateral Tibia Plate #12 LEFT, TITANIUM",60001629,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
"Proximal Lateral Tibia Plate #6 LEFT, TITANIUM",60001632,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
"Proximal Lateral Tibia Plate #4 LEFT, TITANIUM",60001633,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
"Proximal Lateral Tibia Plate #14, RIGHT, TITANIUM",60001634,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
"Proximal Lateral Tibia Plate #12, RIGHT, TITANIUM",60001635,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
"Proximal Lateral Tibia Plate #8, RIGHT, TITANIUM",60001637,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
"Proximal Lateral Tibia Plate #2, RIGHT, TITANIUM",60001640,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
"Proximal Lateral Tibia Plate #10, RIGHT, TITANIUM",60001636,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
"Proximal Lateral Tibia Plate #6, RIGHT, TITANIUM",60001638,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
"Proximal Lateral Tibia Plate #4, RIGHT, TITANIUM",60001639,CDM,278,RC,,,OUTPATIENT,,,3150,2520,,2362.5,75,,,percent of total billed charges,75% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2494.8,79.2,,,percent of total billed charges,79.2% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,2992.5,95,,,percent of total billed charges,95% of total billed charges,2520,80,,,percent of total billed charges,80% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of CO APG rates,3150,100,,,fee schedule,100% of NM fee schedule,1260,40,,,percent of total billed charges,40% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2835,90,,,percent of total billed charges,90% of total billed charges,2394,76,,,percent of total billed charges,76% of total billed charges,1260,40,,,percent of total billed charges,40% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of CO APG rate,2520,80,,,percent of total billed charges,80% of total billed charges,1222.2,38.8,,,percent of total billed charges,38.8% of total billed charges,2677.5,85,,,percent of total billed charges,85% of total billed charges,3150,100,,,fee schedule,100% of APG fee schedule,6300,200,,,percent of total billed charges,200% of total billed charges,1222.2,6300,
HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,1,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,205244.8,100,MS-DRG,164195.84,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,109903.47,100,,,case rate,100% of CO IPPS rate,109903.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,198570.74,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,205244.8,
HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,2,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,92736.81,100,MS-DRG,74189.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,57317.6,100,,,case rate,100% of CO IPPS rate,57317.6,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,95052.72,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,95052.72,
"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",3,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,161479.95,100,MS-DRG,129183.96,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,89188.29,100,,,case rate,100% of CO IPPS rate,89188.29,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,142772.74,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,161479.95,
"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",4,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,111337.8,100,MS-DRG,89070.24,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,56756.21,100,,,case rate,100% of CO IPPS rate,56756.21,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,96877.14,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,111337.8,
LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,5,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,78390.9,100,MS-DRG,62712.72,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,50753.76,100,,,case rate,100% of CO IPPS rate,50753.76,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,80476.39,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,80476.39,
LIVER TRANSPLANT WITHOUT MCC,6,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,36634.68,100,MS-DRG,29307.744,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,24114.2,100,,,case rate,100% of CO IPPS rate,24114.2,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,33929.61,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,36634.68,
LUNG TRANSPLANT,7,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,92905.71,100,MS-DRG,74324.568,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,46554.47,100,,,case rate,100% of CO IPPS rate,46554.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,86122.5,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,92905.71,
SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,8,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,39852.12,100,MS-DRG,31881.696,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,24923.53,100,,,case rate,100% of CO IPPS rate,24923.53,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,39445.21,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,39852.12,
PANCREAS TRANSPLANT,10,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,36458.21,100,MS-DRG,29166.568,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,18866.69,100,,,case rate,100% of CO IPPS rate,18866.69,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,29255.67,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,36458.21,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",11,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,39053.82,100,MS-DRG,31243.056,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,22536.47,100,,,case rate,100% of CO IPPS rate,22536.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,36440.49,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,39053.82,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",12,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,30333.11,100,MS-DRG,24266.488,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12715.41,100,,,case rate,100% of CO IPPS rate,12715.41,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,27581.52,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,30333.11,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",13,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20341.49,100,MS-DRG,16273.192,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9505.57,100,,,case rate,100% of CO IPPS rate,9505.57,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,19953.66,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20341.49,
ALLOGENEIC BONE MARROW TRANSPLANT,14,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,86804.86,100,MS-DRG,69443.888,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,57823.73,100,,,case rate,100% of CO IPPS rate,57823.73,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,78966.62,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,86804.86,
AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,16,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,46784.6,100,MS-DRG,37427.68,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,30361.09,100,,,case rate,100% of CO IPPS rate,30361.09,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,42925.44,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,46784.6,
AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,17,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,46784.6,100,MS-DRG,37427.68,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,25718.54,100,,,case rate,100% of CO IPPS rate,25718.54,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,30831.06,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,46784.6,
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,18,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,279046.61,100,MS-DRG,223237.288,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,109145.89,100,,,case rate,100% of CO IPPS rate,109145.89,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,255004.39,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,279046.61,
SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,19,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,60542.77,100,MS-DRG,48434.216,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,27724.32,100,,,case rate,100% of CO IPPS rate,27724.32,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,50334.6,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,60542.77,
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,20,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,64018.48,100,MS-DRG,51214.784,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,47550.05,100,,,case rate,100% of CO IPPS rate,47550.05,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,65634.78,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,65634.78,
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,21,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,46514.96,100,MS-DRG,37211.968,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,34828.21,100,,,case rate,100% of CO IPPS rate,34828.21,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,47897.81,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,47897.81,
INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,22,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,26332.53,100,MS-DRG,21066.024,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,27716.14,100,,,case rate,100% of CO IPPS rate,27716.14,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,30749.22,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,30749.22,
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,23,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,42935.49,100,MS-DRG,34348.392,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,24383.2,100,,,case rate,100% of CO IPPS rate,24383.2,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,40435.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,42935.49,
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,24,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,28696.37,100,MS-DRG,22957.096,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,22230.92,100,,,case rate,100% of CO IPPS rate,22230.92,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,27858.78,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,28696.37,
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,25,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,33446.78,100,MS-DRG,26757.424,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,23962.16,100,,,case rate,100% of CO IPPS rate,23962.16,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,32033.23,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,33446.78,
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,26,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22366.78,100,MS-DRG,17893.424,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,17541.29,100,,,case rate,100% of CO IPPS rate,17541.29,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21330.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,22366.78,
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,27,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18426.78,100,MS-DRG,14741.424,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,14877.04,100,,,case rate,100% of CO IPPS rate,14877.04,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17605.05,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,18426.78,
SPINAL PROCEDURES WITH MCC,28,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,45641.68,100,MS-DRG,36513.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,16809.44,100,,,case rate,100% of CO IPPS rate,16809.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,41465.76,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,45641.68,
SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,29,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,25965.19,100,MS-DRG,20772.152,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,16336.65,100,,,case rate,100% of CO IPPS rate,16336.65,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,24111.17,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,25965.19,
SPINAL PROCEDURES WITHOUT CC/MCC,30,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17564.11,100,MS-DRG,14051.288,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9940.06,100,,,case rate,100% of CO IPPS rate,9940.06,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16517.17,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17564.11,
VENTRICULAR SHUNT PROCEDURES WITH MCC,31,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,31179.13,100,MS-DRG,24943.304,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12978.86,100,,,case rate,100% of CO IPPS rate,12978.86,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,29073.66,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,31179.13,
VENTRICULAR SHUNT PROCEDURES WITH CC,32,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16312.88,100,MS-DRG,13050.304,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8813.77,100,,,case rate,100% of CO IPPS rate,8813.77,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14494.5,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16312.88,
VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,33,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12291.84,100,MS-DRG,9833.472,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7924.91,100,,,case rate,100% of CO IPPS rate,7924.91,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11982.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12291.84,
CAROTID ARTERY STENT PROCEDURES WITH MCC,34,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,29549.2,100,MS-DRG,23639.36,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,21691.46,100,,,case rate,100% of CO IPPS rate,21691.46,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,28215.77,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,29549.2,
CAROTID ARTERY STENT PROCEDURES WITH CC,35,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17416.41,100,MS-DRG,13933.128,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9793.28,100,,,case rate,100% of CO IPPS rate,9793.28,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16112.21,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17416.41,
CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,36,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13695.31,100,MS-DRG,10956.248,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6475.54,100,,,case rate,100% of CO IPPS rate,6475.54,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13268.34,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13695.31,
EXTRACRANIAL PROCEDURES WITH MCC,37,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,25566.79,100,MS-DRG,20453.432,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9712.87,100,,,case rate,100% of CO IPPS rate,9712.87,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,23796.52,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,25566.79,
EXTRACRANIAL PROCEDURES WITH CC,38,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12117.64,100,MS-DRG,9694.112,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7157.98,100,,,case rate,100% of CO IPPS rate,7157.98,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11538.45,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12117.64,
EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,39,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8641.93,100,MS-DRG,6913.544,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6172.92,100,,,case rate,100% of CO IPPS rate,6172.92,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8132.3,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8641.93,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",40,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,29163.69,100,MS-DRG,23330.952,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,18949.44,100,,,case rate,100% of CO IPPS rate,18949.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,26727.16,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,29163.69,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",41,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16895.32,100,MS-DRG,13516.256,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8279.29,100,,,case rate,100% of CO IPPS rate,8279.29,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16495.3,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16895.32,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",42,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13177.25,100,MS-DRG,10541.8,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6699.22,100,,,case rate,100% of CO IPPS rate,6699.22,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13049.63,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13177.25,
SPINAL DISORDERS AND INJURIES WITH CC/MCC,52,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14727.64,100,MS-DRG,11782.112,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9023.71,100,,,case rate,100% of CO IPPS rate,9023.71,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12560.02,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14727.64,
SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,53,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7451.3,100,MS-DRG,5961.04,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4863.01,100,,,case rate,100% of CO IPPS rate,4863.01,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7215.85,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7451.3,
NERVOUS SYSTEM NEOPLASMS WITH MCC,54,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11160.29,100,MS-DRG,8928.232,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4744.01,100,,,case rate,100% of CO IPPS rate,4744.01,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9785.29,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11160.29,
NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,55,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8128.42,100,MS-DRG,6502.736,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4082.34,100,,,case rate,100% of CO IPPS rate,4082.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7113.56,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4082.34,8128.42,
DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,56,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18132.16,100,MS-DRG,14505.728,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4220.05,100,,,case rate,100% of CO IPPS rate,4220.05,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15738.29,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4220.05,18132.16,
DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,57,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10324.88,100,MS-DRG,8259.904,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3004,100,,,case rate,100% of CO IPPS rate,3004,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9182.08,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3004,10324.88,
MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,58,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13087.11,100,MS-DRG,10469.688,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4476.48,100,,,case rate,100% of CO IPPS rate,4476.48,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12171.99,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4476.48,13087.11,
MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,59,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8991.85,100,MS-DRG,7193.48,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3852.23,100,,,case rate,100% of CO IPPS rate,3852.23,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8067.39,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3852.23,8991.85,
MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,60,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6796.91,100,MS-DRG,5437.528,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2842.9,100,,,case rate,100% of CO IPPS rate,2842.9,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6393.95,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2842.9,6796.91,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",61,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,21228.41,100,MS-DRG,16982.728,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13978.53,100,,,case rate,100% of CO IPPS rate,13978.53,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20689.49,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,21228.41,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",62,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14176.26,100,MS-DRG,11341.008,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10055.55,100,,,case rate,100% of CO IPPS rate,10055.55,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13525.85,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14176.26,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",63,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11261.02,100,MS-DRG,9008.816,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7903.57,100,,,case rate,100% of CO IPPS rate,7903.57,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11153.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11261.02,
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,64,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15170.72,100,MS-DRG,12136.576,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7566.15,100,,,case rate,100% of CO IPPS rate,7566.15,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13912.46,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15170.72,
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,65,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7698.21,100,MS-DRG,6158.568,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5681.7,100,,,case rate,100% of CO IPPS rate,5681.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7170.7,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7698.21,
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,66,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5207.13,100,MS-DRG,4165.704,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4422.68,100,,,case rate,100% of CO IPPS rate,4422.68,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4927.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4422.68,5207.13,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,67,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10731.6,100,MS-DRG,8585.28,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7650.65,100,,,case rate,100% of CO IPPS rate,7650.65,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9976.48,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10731.6,
NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,68,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6596.95,100,MS-DRG,5277.56,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4986.69,100,,,case rate,100% of CO IPPS rate,4986.69,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6375.6,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,6596.95,
TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,69,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6049.35,100,MS-DRG,4839.48,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3811.88,100,,,case rate,100% of CO IPPS rate,3811.88,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5629.18,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3811.88,6049.35,
NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC,70,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13553.67,100,MS-DRG,10842.936,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10913.13,100,,,case rate,100% of CO IPPS rate,10913.13,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12164.23,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13553.67,
NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC,71,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8042.07,100,MS-DRG,6433.656,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6586.06,100,,,case rate,100% of CO IPPS rate,6586.06,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7541.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8042.07,
NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,72,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5930.44,100,MS-DRG,4744.352,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4403.96,100,,,case rate,100% of CO IPPS rate,4403.96,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5446.46,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4403.96,5930.44,
CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,73,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11459.46,100,MS-DRG,9167.568,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2796.7,100,,,case rate,100% of CO IPPS rate,2796.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10577.56,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2796.7,11459.46,
CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,74,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7772.44,100,MS-DRG,6217.952,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2445.83,100,,,case rate,100% of CO IPPS rate,2445.83,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7221.5,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2445.83,7772.44,
VIRAL MENINGITIS WITH CC/MCC,75,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14495.12,100,MS-DRG,11596.096,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2512.21,100,,,case rate,100% of CO IPPS rate,2512.21,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12875.38,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2512.21,14495.12,
VIRAL MENINGITIS WITHOUT CC/MCC,76,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6987.02,100,MS-DRG,5589.616,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1769.83,100,,,case rate,100% of CO IPPS rate,1769.83,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6965.4,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1769.83,6987.02,
HYPERTENSIVE ENCEPHALOPATHY WITH MCC,77,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11443.56,100,MS-DRG,9154.848,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3709.25,100,,,case rate,100% of CO IPPS rate,3709.25,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11035.43,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3709.25,11443.56,
HYPERTENSIVE ENCEPHALOPATHY WITH CC,78,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7702,100,MS-DRG,6161.6,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2990.55,100,,,case rate,100% of CO IPPS rate,2990.55,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7004.2,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2990.55,7702,
HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC,79,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5610.82,100,MS-DRG,4488.656,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2217.48,100,,,case rate,100% of CO IPPS rate,2217.48,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5177.66,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2217.48,5610.82,
NONTRAUMATIC STUPOR AND COMA WITH MCC,80,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16728.69,100,MS-DRG,13382.952,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4768.28,100,,,case rate,100% of CO IPPS rate,4768.28,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14390.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16728.69,
NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,81,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6888.55,100,MS-DRG,5510.84,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3503.7,100,,,case rate,100% of CO IPPS rate,3503.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6338.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3503.7,6888.55,
TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,82,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17255.84,100,MS-DRG,13804.672,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13152.83,100,,,case rate,100% of CO IPPS rate,13152.83,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15981.69,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17255.84,
TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,83,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10273.37,100,MS-DRG,8218.696,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9834.5,100,,,case rate,100% of CO IPPS rate,9834.5,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9511.55,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10273.37,
TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,84,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6965.81,100,MS-DRG,5572.648,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7816.44,100,,,case rate,100% of CO IPPS rate,7816.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6465.91,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7816.44,
TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,85,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17214.19,100,MS-DRG,13771.352,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6496.01,100,,,case rate,100% of CO IPPS rate,6496.01,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16478.36,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17214.19,
TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,86,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9975.72,100,MS-DRG,7980.576,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4663.02,100,,,case rate,100% of CO IPPS rate,4663.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9169.38,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9975.72,
TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,87,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6712.08,100,MS-DRG,5369.664,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3984.97,100,,,case rate,100% of CO IPPS rate,3984.97,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6154.78,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3984.97,6712.08,
CONCUSSION WITH MCC,88,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11617,100,MS-DRG,9293.6,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3358.09,100,,,case rate,100% of CO IPPS rate,3358.09,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11120.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3358.09,11617,
CONCUSSION WITH CC,89,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8709.34,100,MS-DRG,6967.472,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3084.12,100,,,case rate,100% of CO IPPS rate,3084.12,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8238.12,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3084.12,8709.34,
CONCUSSION WITHOUT CC/MCC,90,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7080.18,100,MS-DRG,5664.144,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2506.94,100,,,case rate,100% of CO IPPS rate,2506.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5806.97,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2506.94,7080.18,
OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,91,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13551.4,100,MS-DRG,10841.12,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4763.02,100,,,case rate,100% of CO IPPS rate,4763.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12186.81,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13551.4,
OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,92,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7771.68,100,MS-DRG,6217.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3502.24,100,,,case rate,100% of CO IPPS rate,3502.24,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7014.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3502.24,7771.68,
OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,93,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5865.31,100,MS-DRG,4692.248,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3106.93,100,,,case rate,100% of CO IPPS rate,3106.93,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5395.66,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3106.93,5865.31,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,94,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,27438.33,100,MS-DRG,21950.664,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13953.97,100,,,case rate,100% of CO IPPS rate,13953.97,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,25211.04,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,27438.33,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,95,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18057.93,100,MS-DRG,14446.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10679.8,100,,,case rate,100% of CO IPPS rate,10679.8,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18038.22,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,18057.93,
BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,96,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16509.05,100,MS-DRG,13207.24,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8036.31,100,,,case rate,100% of CO IPPS rate,8036.31,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16115.74,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16509.05,
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,97,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,27545.88,100,MS-DRG,22036.704,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9537.44,100,,,case rate,100% of CO IPPS rate,9537.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,27431.25,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,27545.88,
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,98,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16318.18,100,MS-DRG,13054.544,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6997.75,100,,,case rate,100% of CO IPPS rate,6997.75,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14704.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16318.18,
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,99,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9999.19,100,MS-DRG,7999.352,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5476.74,100,,,case rate,100% of CO IPPS rate,5476.74,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9866.42,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9999.19,
SEIZURES WITH MCC,100,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15015.46,100,MS-DRG,12012.368,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2782.67,100,,,case rate,100% of CO IPPS rate,2782.67,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13552.66,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2782.67,15015.46,
SEIZURES WITHOUT MCC,101,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6889.31,100,MS-DRG,5511.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2363.67,100,,,case rate,100% of CO IPPS rate,2363.67,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6360.08,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2363.67,6889.31,
HEADACHES WITH MCC,102,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9138.79,100,MS-DRG,7311.032,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2518.64,100,,,case rate,100% of CO IPPS rate,2518.64,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8112.54,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2518.64,9138.79,
HEADACHES WITHOUT MCC,103,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6380.34,100,MS-DRG,5104.272,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1934.45,100,,,case rate,100% of CO IPPS rate,1934.45,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5873.29,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1934.45,6380.34,
ORBITAL PROCEDURES WITH CC/MCC,113,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18990.29,100,MS-DRG,15192.232,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3860.12,100,,,case rate,100% of CO IPPS rate,3860.12,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15840.59,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3860.12,18990.29,
ORBITAL PROCEDURES WITHOUT CC/MCC,114,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9329.65,100,MS-DRG,7463.72,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2858.69,100,,,case rate,100% of CO IPPS rate,2858.69,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9191.25,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2858.69,9329.65,
EXTRAOCULAR PROCEDURES EXCEPT ORBIT,115,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11848.77,100,MS-DRG,9479.016,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3687.32,100,,,case rate,100% of CO IPPS rate,3687.32,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10717.25,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3687.32,11848.77,
INTRAOCULAR PROCEDURES WITH CC/MCC,116,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13866.48,100,MS-DRG,11093.184,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4207.48,100,,,case rate,100% of CO IPPS rate,4207.48,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13309.26,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4207.48,13866.48,
INTRAOCULAR PROCEDURES WITHOUT CC/MCC,117,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9076.68,100,MS-DRG,7261.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3115.99,100,,,case rate,100% of CO IPPS rate,3115.99,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7004.2,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3115.99,9076.68,
ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,121,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9703.81,100,MS-DRG,7763.048,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2072.75,100,,,case rate,100% of CO IPPS rate,2072.75,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8644.49,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2072.75,9703.81,
ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,122,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5638.84,100,MS-DRG,4511.072,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1477.15,100,,,case rate,100% of CO IPPS rate,1477.15,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4873.59,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1477.15,5638.84,
NEUROLOGICAL EYE DISORDERS,123,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6089.5,100,MS-DRG,4871.6,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2494.66,100,,,case rate,100% of CO IPPS rate,2494.66,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5600.26,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2494.66,6089.5,
OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,124,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10012.07,100,MS-DRG,8009.656,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3116.87,100,,,case rate,100% of CO IPPS rate,3116.87,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9881.94,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3116.87,10012.07,
OTHER DISORDERS OF THE EYE WITHOUT MCC,125,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6040.27,100,MS-DRG,4832.216,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1709.01,100,,,case rate,100% of CO IPPS rate,1709.01,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6082.12,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1709.01,6082.12,
SINUS AND MASTOID PROCEDURES WITH CC/MCC,135,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20087.01,100,MS-DRG,16069.608,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3090.55,100,,,case rate,100% of CO IPPS rate,3090.55,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17289.69,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3090.55,20087.01,
SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,136,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7112.74,100,MS-DRG,5690.192,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2288.82,100,,,case rate,100% of CO IPPS rate,2288.82,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8185.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2288.82,8185.92,
MOUTH PROCEDURES WITH CC/MCC,137,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11396.6,100,MS-DRG,9117.28,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4311.86,100,,,case rate,100% of CO IPPS rate,4311.86,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10579.68,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4311.86,11396.6,
MOUTH PROCEDURES WITHOUT CC/MCC,138,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6556.81,100,MS-DRG,5245.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2890.85,100,,,case rate,100% of CO IPPS rate,2890.85,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6238.74,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2890.85,6556.81,
SALIVARY GLAND PROCEDURES,139,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8995.64,100,MS-DRG,7196.512,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3107.51,100,,,case rate,100% of CO IPPS rate,3107.51,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8871.66,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3107.51,8995.64,
MAJOR HEAD AND NECK PROCEDURES WITH MCC,140,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,28615.33,100,MS-DRG,22892.264,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7313.53,100,,,case rate,100% of CO IPPS rate,7313.53,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,29322.7,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,29322.7,
MAJOR HEAD AND NECK PROCEDURES WITH CC,141,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15691.06,100,MS-DRG,12552.848,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4739.33,100,,,case rate,100% of CO IPPS rate,4739.33,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15750.99,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15750.99,
MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,142,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11701.83,100,MS-DRG,9361.464,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4550.74,100,,,case rate,100% of CO IPPS rate,4550.74,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12005.49,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4550.74,12005.49,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",143,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,25188.09,100,MS-DRG,20150.472,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5678.19,100,,,case rate,100% of CO IPPS rate,5678.19,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,22382.69,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,25188.09,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",144,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13106.81,100,MS-DRG,10485.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3411.89,100,,,case rate,100% of CO IPPS rate,3411.89,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12764.61,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3411.89,13106.81,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",145,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9248.61,100,MS-DRG,7398.888,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2132.98,100,,,case rate,100% of CO IPPS rate,2132.98,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8521.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2132.98,9248.61,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",146,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15988.71,100,MS-DRG,12790.968,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8668.46,100,,,case rate,100% of CO IPPS rate,8668.46,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14210.18,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15988.71,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",147,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9359.95,100,MS-DRG,7487.96,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5816.49,100,,,case rate,100% of CO IPPS rate,5816.49,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8544.31,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9359.95,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",148,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6738.59,100,MS-DRG,5390.872,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4646.35,100,,,case rate,100% of CO IPPS rate,4646.35,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5768.17,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,6738.59,
DYSEQUILIBRIUM,149,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5640.36,100,MS-DRG,4512.288,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2072.16,100,,,case rate,100% of CO IPPS rate,2072.16,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5326.53,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2072.16,5640.36,
EPISTAXIS WITH MCC,150,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9956.02,100,MS-DRG,7964.816,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4225.02,100,,,case rate,100% of CO IPPS rate,4225.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9730.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4225.02,9956.02,
EPISTAXIS WITHOUT MCC,151,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5837.28,100,MS-DRG,4669.824,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2012.81,100,,,case rate,100% of CO IPPS rate,2012.81,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5439.41,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2012.81,5837.28,
OTITIS MEDIA AND URI WITH MCC,152,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8999.43,100,MS-DRG,7199.544,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1945.85,100,,,case rate,100% of CO IPPS rate,1945.85,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8449.77,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1945.85,8999.43,
OTITIS MEDIA AND URI WITHOUT MCC,153,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5565.38,100,MS-DRG,4452.304,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1829.48,100,,,case rate,100% of CO IPPS rate,1829.48,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4871.48,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1829.48,5565.38,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",154,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11650.33,100,MS-DRG,9320.264,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3453.7,100,,,case rate,100% of CO IPPS rate,3453.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10602.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3453.7,11650.33,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",155,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7169.55,100,MS-DRG,5735.64,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2541.15,100,,,case rate,100% of CO IPPS rate,2541.15,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6485.66,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2541.15,7169.55,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",156,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4964.76,100,MS-DRG,3971.808,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2079.76,100,,,case rate,100% of CO IPPS rate,2079.76,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4809.39,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2079.76,4964.76,
DENTAL AND ORAL DISEASES WITH MCC,157,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12928.82,100,MS-DRG,10343.056,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2984.71,100,,,case rate,100% of CO IPPS rate,2984.71,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11794.55,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2984.71,12928.82,
DENTAL AND ORAL DISEASES WITH CC,158,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7108.2,100,MS-DRG,5686.56,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2196.43,100,,,case rate,100% of CO IPPS rate,2196.43,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6554.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2196.43,7108.2,
DENTAL AND ORAL DISEASES WITHOUT CC/MCC,159,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5113.96,100,MS-DRG,4091.168,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1754.33,100,,,case rate,100% of CO IPPS rate,1754.33,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5290.54,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1754.33,5290.54,
MAJOR CHEST PROCEDURES WITH MCC,163,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,35700.81,100,MS-DRG,28560.648,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,23485.85,100,,,case rate,100% of CO IPPS rate,23485.85,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,34172.3,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,35700.81,
MAJOR CHEST PROCEDURES WITH CC,164,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,19316.73,100,MS-DRG,15453.384,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12440.27,100,,,case rate,100% of CO IPPS rate,12440.27,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18220.95,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,19316.73,
MAJOR CHEST PROCEDURES WITHOUT CC/MCC,165,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14211.85,100,MS-DRG,11369.48,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9185.99,100,,,case rate,100% of CO IPPS rate,9185.99,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13594.28,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14211.85,
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,166,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,30733.78,100,MS-DRG,24587.024,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10211.69,100,,,case rate,100% of CO IPPS rate,10211.69,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,25862.22,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,30733.78,
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,167,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13783.17,100,MS-DRG,11026.536,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6976.4,100,,,case rate,100% of CO IPPS rate,6976.4,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13412.26,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13783.17,
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,168,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10268.07,100,MS-DRG,8214.456,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7009.73,100,,,case rate,100% of CO IPPS rate,7009.73,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10001.17,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10268.07,
ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,173,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,23290.05,100,MS-DRG,8501.056,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,23290.05,
PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,175,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10626.32,100,MS-DRG,4941.88,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10844.42,100,,,case rate,100% of CO IPPS rate,10844.42,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9854.42,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10844.42,
PULMONARY EMBOLISM WITHOUT MCC,176,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6177.35,100,MS-DRG,10278.824,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7803.28,100,,,case rate,100% of CO IPPS rate,7803.28,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5768.17,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7803.28,
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,177,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12848.53,100,MS-DRG,5978.616,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9314.34,100,,,case rate,100% of CO IPPS rate,9314.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12557.19,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12848.53,
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,178,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7473.27,100,MS-DRG,4624.984,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6098.94,100,,,case rate,100% of CO IPPS rate,6098.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7668.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7668.79,
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,179,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5781.23,100,MS-DRG,10532.104,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4087.89,100,,,case rate,100% of CO IPPS rate,4087.89,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5541,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4087.89,5781.23,
RESPIRATORY NEOPLASMS WITH MCC,180,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13165.13,100,MS-DRG,6671.784,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8538.34,100,,,case rate,100% of CO IPPS rate,8538.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11950.46,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13165.13,
RESPIRATORY NEOPLASMS WITH CC,181,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8339.73,100,MS-DRG,4598.936,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6122.33,100,,,case rate,100% of CO IPPS rate,6122.33,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7998.25,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8339.73,
RESPIRATORY NEOPLASMS WITHOUT CC/MCC,182,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5748.67,100,MS-DRG,9540.208,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3521.24,100,,,case rate,100% of CO IPPS rate,3521.24,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6261.31,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3521.24,6261.31,
MAJOR CHEST TRAUMA WITH MCC,183,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11925.26,100,MS-DRG,6373.672,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5771.76,100,,,case rate,100% of CO IPPS rate,5771.76,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10598.02,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11925.26,
MAJOR CHEST TRAUMA WITH CC,184,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7967.09,100,MS-DRG,4578.936,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3686.15,100,,,case rate,100% of CO IPPS rate,3686.15,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7373.89,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3686.15,7967.09,
MAJOR CHEST TRAUMA WITHOUT CC/MCC,185,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5723.67,100,MS-DRG,9404.488,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3260.14,100,,,case rate,100% of CO IPPS rate,3260.14,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5326.53,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3260.14,5723.67,
PLEURAL EFFUSION WITH MCC,186,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11755.61,100,MS-DRG,6036.784,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6048.07,100,,,case rate,100% of CO IPPS rate,6048.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10771.57,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11755.61,
PLEURAL EFFUSION WITH CC,187,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7545.98,100,MS-DRG,4523.192,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4477.35,100,,,case rate,100% of CO IPPS rate,4477.35,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7378.82,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4477.35,7545.98,
PLEURAL EFFUSION WITHOUT CC/MCC,188,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5653.99,100,MS-DRG,7464.936,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3145.23,100,,,case rate,100% of CO IPPS rate,3145.23,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5107.82,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3145.23,5653.99,
PULMONARY EDEMA AND RESPIRATORY FAILURE,189,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9331.17,100,MS-DRG,6677.24,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5848.07,100,,,case rate,100% of CO IPPS rate,5848.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8515.39,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9331.17,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,190,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8346.55,100,MS-DRG,5144.264,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5229.08,100,,,case rate,100% of CO IPPS rate,5229.08,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7658.2,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8346.55,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,191,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6430.33,100,MS-DRG,3888.792,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3908.07,100,,,case rate,100% of CO IPPS rate,3908.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6096.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3908.07,6430.33,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,192,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4860.99,100,MS-DRG,8038.136,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3132.95,100,,,case rate,100% of CO IPPS rate,3132.95,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4600.57,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3132.95,4860.99,
SIMPLE PNEUMONIA AND PLEURISY WITH MCC,193,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10047.67,100,MS-DRG,4981.872,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6517.64,100,,,case rate,100% of CO IPPS rate,6517.64,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9162.33,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10047.67,
SIMPLE PNEUMONIA AND PLEURISY WITH CC,194,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6227.34,100,MS-DRG,3790.632,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3987.02,100,,,case rate,100% of CO IPPS rate,3987.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5927.61,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3987.02,6227.34,
SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,195,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4738.29,100,MS-DRG,11484.608,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2489.98,100,,,case rate,100% of CO IPPS rate,2489.98,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4527.9,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2489.98,4772,
INTERSTITIAL LUNG DISEASE WITH MCC,196,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14355.76,100,MS-DRG,6044.056,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6805.06,100,,,case rate,100% of CO IPPS rate,6805.06,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12259.47,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14355.76,
INTERSTITIAL LUNG DISEASE WITH CC,197,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7555.07,100,MS-DRG,4715.272,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5053.65,100,,,case rate,100% of CO IPPS rate,5053.65,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6939.3,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7555.07,
INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,198,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5894.09,100,MS-DRG,10749.624,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3321.83,100,,,case rate,100% of CO IPPS rate,3321.83,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5015.4,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3321.83,5894.09,
PNEUMOTHORAX WITH MCC,199,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13437.03,100,MS-DRG,6525.76,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7550.07,100,,,case rate,100% of CO IPPS rate,7550.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12406.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13437.03,
PNEUMOTHORAX WITH CC,200,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8157.2,100,MS-DRG,4278.4,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4497.82,100,,,case rate,100% of CO IPPS rate,4497.82,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7562.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4497.82,8157.2,
PNEUMOTHORAX WITHOUT CC/MCC,201,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5348,100,MS-DRG,5801.688,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,14392.83,100,,,case rate,100% of CO ipps rate,2930.91,100,,,case rate,100% of CO IPPS rate,2930.91,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,14392.83,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5135.33,100,,,case rate,100% of CMS IPPS rate,14392.83,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,2930.91,14392.83,
BRONCHITIS AND ASTHMA WITH CC/MCC,202,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7252.11,100,MS-DRG,4210.536,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,17145.34,100,,,case rate,100% of CO ipps rate,2861.9,100,,,case rate,100% of CO IPPS rate,2861.9,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,17145.34,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6531.52,100,,,case rate,100% of CMS IPPS rate,17145.34,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,2861.9,17145.34,
BRONCHITIS AND ASTHMA WITHOUT CC/MCC,203,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5263.17,100,MS-DRG,4986.112,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,28714.37,100,,,case rate,100% of CO ipps rate,2547.88,100,,,case rate,100% of CO IPPS rate,2547.88,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,28714.37,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4706.39,100,,,case rate,100% of CMS IPPS rate,28714.37,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,2547.88,28714.37,
RESPIRATORY SIGNS AND SYMPTOMS,204,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6232.64,100,MS-DRG,10968.968,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,54942.31,100,,,case rate,100% of CO ipps rate,2408.7,100,,,case rate,100% of CO IPPS rate,2408.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,54942.31,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5710.32,100,,,case rate,100% of CMS IPPS rate,54942.31,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,2408.7,54942.31,
OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,205,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13711.21,100,MS-DRG,5535.08,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4722.96,100,,,case rate,100% of CO IPPS rate,4722.96,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12564.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13711.21,
OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,206,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6918.85,100,MS-DRG,41856.952,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3984.97,100,,,case rate,100% of CO IPPS rate,3984.97,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6302.94,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3984.97,6918.85,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,207,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,52321.19,100,MS-DRG,16382.864,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,31206.39,100,,,case rate,100% of CO IPPS rate,31206.39,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,46322.42,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,52321.19,
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,208,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20478.58,100,MS-DRG,61893.52,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13335.57,100,,,case rate,100% of CO IPPS rate,13335.57,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18343.71,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20478.58,
CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,212,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,81577.28,100,MS-DRG,58806.352,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,20194.28,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,20194.28,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,20194.28,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,81577.28,
OTHER HEART ASSIST SYSTEM IMPLANT,215,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,77366.9,100,MS-DRG,38568.624,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,37545.38,100,,,case rate,100% of CO IPPS rate,37545.38,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,72689.08,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,77366.9,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,216,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,73507.94,100,MS-DRG,34517.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,42272.14,100,,,case rate,100% of CO IPPS rate,42272.14,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,68729.1,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,73507.94,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,217,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,48210.78,100,MS-DRG,46723.704,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,30811.37,100,,,case rate,100% of CO IPPS rate,30811.37,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,44790.78,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,48210.78,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,218,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,43146.81,100,MS-DRG,31778.08,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,23023.59,100,,,case rate,100% of CO IPPS rate,23023.59,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,41897.53,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,43146.81,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,219,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,58404.63,100,MS-DRG,28166.8,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,32229.16,100,,,case rate,100% of CO IPPS rate,32229.16,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,57345.16,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,58404.63,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,220,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,39722.6,100,MS-DRG,30530.488,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,23535.56,100,,,case rate,100% of CO IPPS rate,23535.56,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,38344.63,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,39722.6,
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,221,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,35208.5,100,MS-DRG,19265.832,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8726.18,100,,,case rate,100% of CO ipps rate,18050.34,100,,,case rate,100% of CO IPPS rate,18050.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,8726.18,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,33381.44,100,,,case rate,100% of CMS IPPS rate,8726.18,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,35208.5,
OTHER CARDIOTHORACIC PROCEDURES WITH MCC,228,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,38163.11,100,MS-DRG,49171.616,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,26233.14,100,,,case rate,100% of CO IPPS rate,26233.14,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,34769.16,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,38163.11,
OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,229,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,24082.29,100,MS-DRG,36043.76,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,16220.28,100,,,case rate,100% of CO IPPS rate,16220.28,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,23287.85,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,24082.29,
CORONARY BYPASS WITH PTCA WITH MCC,231,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,61464.52,100,MS-DRG,47259.336,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8369.06,100,,,case rate,100% of CO ipps rate,34713.01,100,,,case rate,100% of CO IPPS rate,34713.01,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,8369.06,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,59214.03,100,,,case rate,100% of CMS IPPS rate,8369.06,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,61464.52,
CORONARY BYPASS WITH PTCA WITHOUT MCC,232,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,45054.7,100,MS-DRG,31495.112,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,15945.53,100,,,case rate,100% of CO ipps rate,29428.95,100,,,case rate,100% of CO IPPS rate,29428.95,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,15945.53,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,41326.78,100,,,case rate,100% of CMS IPPS rate,15945.53,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,45054.7,
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,233,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,59074.17,100,MS-DRG,35631.728,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,32553.07,100,,,case rate,100% of CO ipps rate,28585.41,100,,,case rate,100% of CO IPPS rate,28585.41,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,32553.07,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,54640.27,100,,,case rate,100% of CMS IPPS rate,32553.07,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,59074.17,
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,234,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,39368.89,100,MS-DRG,24486.44,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,56178.12,100,,,case rate,100% of CO ipps rate,25605.97,100,,,case rate,100% of CO IPPS rate,25605.97,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,56178.12,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,36589.35,100,,,case rate,100% of CMS IPPS rate,56178.12,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,56178.12,
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,235,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,44539.66,100,MS-DRG,29125.36,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,26469.1,100,,,case rate,100% of CO IPPS rate,26469.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,42259.45,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,44539.66,
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,236,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,30608.05,100,MS-DRG,17021.504,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,22959.26,100,,,case rate,100% of CO IPPS rate,22959.26,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,28773.11,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,30608.05,
AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,239,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,36406.7,100,MS-DRG,8421.08,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,19745.91,100,,,case rate,100% of CO IPPS rate,19745.91,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,32806.46,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,36406.7,
AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,240,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,21276.88,100,MS-DRG,20935.144,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9963.45,100,,,case rate,100% of CO IPPS rate,9963.45,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,19148.68,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,21276.88,
AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,241,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10526.35,100,MS-DRG,13800.432,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8292.83,100,,,case rate,100% of CO ipps rate,7039.56,100,,,case rate,100% of CO IPPS rate,7039.56,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,8292.83,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10927.49,100,,,case rate,100% of CMS IPPS rate,8292.83,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,10927.49,
PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,242,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,26168.93,100,MS-DRG,11085.304,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11647.37,100,,,case rate,100% of CO ipps rate,12377.41,100,,,case rate,100% of CO IPPS rate,12377.41,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,11647.37,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,24505.54,100,,,case rate,100% of CMS IPPS rate,11647.37,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,26168.93,
PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,243,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17250.54,100,MS-DRG,27456.656,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,23297.57,100,,,case rate,100% of CO ipps rate,11064,100,,,case rate,100% of CO IPPS rate,11064,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,23297.57,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16536.92,100,,,case rate,100% of CMS IPPS rate,23297.57,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,23297.57,
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,244,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13856.63,100,MS-DRG,14243.968,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,48638.35,100,,,case rate,100% of CO ipps rate,9938.3,100,,,case rate,100% of CO IPPS rate,9938.3,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,48638.35,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13412.26,100,,,case rate,100% of CMS IPPS rate,48638.35,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,48638.35,
AICD GENERATOR PROCEDURES,245,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,34320.82,100,MS-DRG,9615.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,14722.66,100,,,case rate,100% of CO IPPS rate,14722.66,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,34400.18,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,34400.18,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,250,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17804.96,100,MS-DRG,20321.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10056.13,100,,,case rate,100% of CO IPPS rate,10056.13,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17070.98,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17804.96,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,251,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12019.18,100,MS-DRG,15457.624,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6848.34,100,,,case rate,100% of CO IPPS rate,6848.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11466.49,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12019.18,
OTHER VASCULAR PROCEDURES WITH MCC,252,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,25401.68,100,MS-DRG,10513.32,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11247.33,100,,,case rate,100% of CO IPPS rate,11247.33,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,23586.98,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,25401.68,
OTHER VASCULAR PROCEDURES WITH CC,253,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,19322.03,100,MS-DRG,16647.048,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8931.02,100,,,case rate,100% of CO IPPS rate,8931.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18865.07,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,19322.03,
OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,254,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13141.65,100,MS-DRG,9935.272,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6358.58,100,,,case rate,100% of CO IPPS rate,6358.58,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12900.07,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13141.65,
UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,255,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20808.81,100,MS-DRG,6004.664,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11194.11,100,,,case rate,100% of CO IPPS rate,11194.11,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18100.31,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20808.81,
UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,256,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12419.09,100,MS-DRG,16411.952,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6726.12,100,,,case rate,100% of CO IPPS rate,6726.12,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11515.17,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12419.09,
UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,257,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7505.83,100,MS-DRG,11310.104,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4599.57,100,,,case rate,100% of CO IPPS rate,4599.57,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7398.58,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4599.57,7505.83,
CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,258,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20514.94,100,MS-DRG,20087.456,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9771.35,100,,,case rate,100% of CO IPPS rate,9771.35,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20115.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20514.94,
CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,259,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14137.63,100,MS-DRG,11402.2,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8340.1,100,,,case rate,100% of CO IPPS rate,8340.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14068.38,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14137.63,
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,260,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,25109.32,100,MS-DRG,9969.2,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10145.02,100,,,case rate,100% of CO IPPS rate,10145.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,24682.62,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,25109.32,
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,261,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14252.75,100,MS-DRG,17118.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9531.46,100,,,case rate,100% of CO ipps rate,6193.97,100,,,case rate,100% of CO IPPS rate,6193.97,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,9531.46,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13480.69,100,,,case rate,100% of CMS IPPS rate,9531.46,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,14252.75,
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,262,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12461.5,100,MS-DRG,19789.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12462.54,100,,,case rate,100% of CO ipps rate,5076.46,100,,,case rate,100% of CO IPPS rate,5076.46,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,12462.54,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11829.82,100,,,case rate,100% of CMS IPPS rate,12462.54,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,12462.54,
VEIN LIGATION AND STRIPPING,263,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,21398.06,100,MS-DRG,21413.816,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,20012.9,100,,,case rate,100% of CO ipps rate,3625.33,100,,,case rate,100% of CO IPPS rate,3625.33,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,20012.9,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,19655.23,100,,,case rate,100% of CMS IPPS rate,20012.9,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3625.33,21398.06,
OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,264,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,24736.68,100,MS-DRG,37846.368,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,46691.12,100,,,case rate,100% of CO ipps rate,8509.69,100,,,case rate,100% of CO IPPS rate,8509.69,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,46691.12,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,23349.93,100,,,case rate,100% of CMS IPPS rate,46691.12,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,46691.12,
AICD LEAD PROCEDURES,265,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,26767.27,100,MS-DRG,29570.104,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11029.79,100,,,case rate,100% of CO IPPS rate,11029.79,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,23860.72,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,26767.27,
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,266,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,47307.96,100,MS-DRG,41534,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,33802.51,100,,,case rate,100% of CO IPPS rate,33802.51,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,46567.94,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,47307.96,
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,267,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,36962.63,100,MS-DRG,25197.792,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,22389.1,100,,,case rate,100% of CO IPPS rate,22389.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,36408.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,36962.63,
AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,268,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,51917.5,100,MS-DRG,30640.768,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,18121.39,100,,,case rate,100% of CO IPPS rate,18121.39,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,48826.24,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,51917.5,
AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,269,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,31497.24,100,MS-DRG,20941.808,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7456.5,100,,,case rate,100% of CO IPPS rate,7456.5,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,30169.3,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,31497.24,
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,270,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,38300.96,100,MS-DRG,14781.416,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,29336.56,100,,,case rate,100% of CO IPPS rate,29336.56,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,36069.39,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,38300.96,
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,271,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,26177.26,100,MS-DRG,23612.704,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12909.85,100,,,case rate,100% of CO IPPS rate,12909.85,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,24578.21,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,26177.26,
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,272,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18476.77,100,MS-DRG,19636.656,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9217.56,100,,,case rate,100% of CO IPPS rate,9217.56,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18317.6,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,18476.77,
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,273,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,29515.88,100,MS-DRG,9612.92,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35536.08,100,,,case rate,100% of CO IPPS rate,35536.08,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,28311.72,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,35536.08,
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,274,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,24545.82,100,MS-DRG,5532.048,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,25410.65,100,,,case rate,100% of CO IPPS rate,25410.65,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,23701.27,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,25410.65,
CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,275,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,53289.15,100,MS-DRG,4351.112,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,53289.15,
CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,276,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,47036.05,100,MS-DRG,11945.104,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,47036.05,
CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,277,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,36221.9,100,MS-DRG,4481.992,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,36221.9,
ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,278,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,33783.07,100,MS-DRG,2961.128,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,33783.07,
ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,279,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,24241.34,100,MS-DRG,13061.208,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,24241.34,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",280,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12016.15,100,MS-DRG,6553.632,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10552.32,100,,,case rate,100% of CO IPPS rate,10552.32,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11333.15,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12016.15,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",281,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6915.06,100,MS-DRG,15711.504,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9538.02,100,,,case rate,100% of CO IPPS rate,9538.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6480.72,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9538.02,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",282,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5438.89,100,MS-DRG,8953.68,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7741.29,100,,,case rate,100% of CO IPPS rate,7741.29,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5056.32,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7741.29,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",283,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14931.38,100,MS-DRG,6211.888,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9226.33,100,,,case rate,100% of CO IPPS rate,9226.33,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13535.72,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14931.38,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",284,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5602.49,100,MS-DRG,7779.408,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7675.5,100,,,case rate,100% of CO IPPS rate,7675.5,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5188.25,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7675.5,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",285,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3701.41,100,MS-DRG,5189.704,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6405.95,100,,,case rate,100% of CO IPPS rate,6405.95,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,3822.4,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3701.41,6405.95,
"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",286,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16326.51,100,MS-DRG,3402.24,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5961.23,100,,,case rate,100% of CO IPPS rate,5961.23,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14963.66,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16326.51,
"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",287,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8192.04,100,MS-DRG,6626.944,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5215.34,100,,,case rate,100% of CO IPPS rate,5215.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7761.91,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8192.04,
ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,288,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,19639.38,100,MS-DRG,3826.384,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11932.69,100,,,case rate,100% of CO IPPS rate,11932.69,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,19023.81,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,19639.38,
ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,289,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11192.1,100,MS-DRG,9714.112,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9809.94,100,,,case rate,100% of CO IPPS rate,9809.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11338.09,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11338.09,
ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,290,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7764.86,100,MS-DRG,4414.736,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4557.47,100,,,case rate,100% of CO IPPS rate,4557.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8506.21,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4557.47,8506.21,
HEART FAILURE AND SHOCK WITH MCC,291,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9724.26,100,MS-DRG,2659.384,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5478.79,100,,,case rate,100% of CO IPPS rate,5478.79,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9028.99,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9724.26,
HEART FAILURE AND SHOCK WITH CC,292,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6487.13,100,MS-DRG,9550.512,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3614.22,100,,,case rate,100% of CO IPPS rate,3614.22,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6087.05,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3614.22,6487.13,
HEART FAILURE AND SHOCK WITHOUT CC/MCC,293,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4252.8,100,MS-DRG,6465.168,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2422.15,100,,,case rate,100% of CO IPPS rate,2422.15,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,3952.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2422.15,4772,
DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC,294,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8283.68,100,MS-DRG,4300.824,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3669.48,100,,,case rate,100% of CO IPPS rate,3669.48,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8145,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3669.48,8283.68,
DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC,295,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4782.98,100,MS-DRG,6792.968,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2739.1,100,,,case rate,100% of CO IPPS rate,2739.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6248.61,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2739.1,6248.61,
"CARDIAC ARREST, UNEXPLAINED WITH MCC",296,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12142.64,100,MS-DRG,3987.56,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8625.18,100,,,case rate,100% of CO IPPS rate,8625.18,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11558.21,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12142.64,
"CARDIAC ARREST, UNEXPLAINED WITH CC",297,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5518.42,100,MS-DRG,6962.024,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5922.05,100,,,case rate,100% of CO IPPS rate,5922.05,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4489.1,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4489.1,5922.05,
"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",298,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3324.23,100,MS-DRG,4565.608,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4838.75,100,,,case rate,100% of CO IPPS rate,4838.75,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,3446.37,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3324.23,4838.75,
PERIPHERAL VASCULAR DISORDERS WITH MCC,299,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11938.14,100,MS-DRG,9311.776,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6079.94,100,,,case rate,100% of CO IPPS rate,6079.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10850.59,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11938.14,
PERIPHERAL VASCULAR DISORDERS WITH CC,300,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8081.46,100,MS-DRG,5711.4,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4060.41,100,,,case rate,100% of CO IPPS rate,4060.41,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7274.41,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4060.41,8081.46,
PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,301,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5376.03,100,MS-DRG,7284.368,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2645.24,100,,,case rate,100% of CO IPPS rate,2645.24,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5052.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2645.24,5376.03,
ATHEROSCLEROSIS WITH MCC,302,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8491.21,100,MS-DRG,4512.288,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3634.69,100,,,case rate,100% of CO IPPS rate,3634.69,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8506.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3634.69,8506.92,
ATHEROSCLEROSIS WITHOUT MCC,303,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4984.45,100,MS-DRG,3350.736,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2870.68,100,,,case rate,100% of CO IPPS rate,2870.68,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4769.89,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2870.68,4984.45,
HYPERTENSION WITH MCC,304,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8702.53,100,MS-DRG,4229.928,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3503.11,100,,,case rate,100% of CO IPPS rate,3503.11,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7750.62,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3503.11,8702.53,
HYPERTENSION WITHOUT MCC,305,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5707.01,100,MS-DRG,5232.12,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2609.57,100,,,case rate,100% of CO IPPS rate,2609.57,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5260.21,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2609.57,5707.01,
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,306,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11639.72,100,MS-DRG,4384.44,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9567.55,100,,,case rate,100% of CO IPPS rate,9567.55,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10411.77,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11639.72,
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,307,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7139.25,100,MS-DRG,12684.936,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8358.52,100,,,case rate,100% of CO IPPS rate,8358.52,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6429.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8358.52,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,308,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9105.46,100,MS-DRG,5861.064,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4653.08,100,,,case rate,100% of CO IPPS rate,4653.08,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8272.69,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9105.46,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,309,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5640.36,100,MS-DRG,4197.208,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3205.17,100,,,case rate,100% of CO IPPS rate,3205.17,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5203.77,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3205.17,5640.36,
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,310,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4188.42,100,MS-DRG,26429.624,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2223.62,100,,,case rate,100% of CO IPPS rate,2223.62,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,3888.72,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2223.62,4772,
ANGINA PECTORIS,311,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5287.41,100,MS-DRG,13487.776,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2793.19,100,,,case rate,100% of CO IPPS rate,2793.19,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4713.45,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2793.19,5287.41,
SYNCOPE AND COLLAPSE,312,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6540.15,100,MS-DRG,30774.68,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2324.49,100,,,case rate,100% of CO IPPS rate,2324.49,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6015.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2324.49,6540.15,
CHEST PAIN,313,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5480.55,100,MS-DRG,15132.248,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2289.7,100,,,case rate,100% of CO IPPS rate,2289.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5103.59,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2289.7,5480.55,
OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,314,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15856.17,100,MS-DRG,9678.36,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6372.62,100,,,case rate,100% of CO IPPS rate,6372.62,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14692.74,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15856.17,
OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,315,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7326.33,100,MS-DRG,27368.192,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4726.76,100,,,case rate,100% of CO IPPS rate,4726.76,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6832.77,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7326.33,
OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,316,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5246.51,100,MS-DRG,14373.032,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4646.06,100,,,case rate,100% of CO IPPS rate,4646.06,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4811.51,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,5246.51,
CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,317,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,319,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,33037.03,100,MS-DRG,21980.352,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,31111.07,100,,,case rate,100% of CO IPPS rate,31111.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,30383.06,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,33037.03,
OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,320,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16859.72,100,MS-DRG,12600.104,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,23021.83,100,,,case rate,100% of CO IPPS rate,23021.83,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17435.73,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,23021.83,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,321,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,21772.98,100,MS-DRG,9725.624,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,21772.98,
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,322,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,13810.43,100,MS-DRG,21661.64,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13810.43,
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,323,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,31356.36,100,MS-DRG,12756.432,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,31356.36,
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,324,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,22484.18,100,MS-DRG,9066.984,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,22484.18,
CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,325,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,20027.93,100,MS-DRG,16604.632,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20027.93,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",326,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,38468.35,100,MS-DRG,9334.8,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,15538.43,100,,,case rate,100% of CO IPPS rate,15538.43,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,36113.13,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,38468.35,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",327,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18915.31,100,MS-DRG,7803.04,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12684.13,100,,,case rate,100% of CO IPPS rate,12684.13,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18069.97,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,18915.31,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",328,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12097.95,100,MS-DRG,15445.504,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7128.44,100,,,case rate,100% of CO IPPS rate,7128.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11695.07,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12097.95,
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,329,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,34210.24,100,MS-DRG,7885.44,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13641.7,100,,,case rate,100% of CO IPPS rate,13641.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,32617.38,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,34210.24,
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,330,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17966.29,100,MS-DRG,5912.568,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11430.07,100,,,case rate,100% of CO IPPS rate,11430.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17322.85,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17966.29,
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,331,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12663.73,100,MS-DRG,14542.08,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7480.48,100,,,case rate,100% of CO IPPS rate,7480.48,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12055.58,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12663.73,
RECTAL RESECTION WITH MCC,332,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,27475.44,100,MS-DRG,8819.768,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12946.98,100,,,case rate,100% of CO IPPS rate,12946.98,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,28645.42,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,28645.42,
RECTAL RESECTION WITH CC,333,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15750.13,100,MS-DRG,6719.656,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9585.68,100,,,case rate,100% of CO IPPS rate,9585.68,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15754.52,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15754.52,
RECTAL RESECTION WITHOUT CC/MCC,334,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12157.03,100,MS-DRG,17718.92,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8272.27,100,,,case rate,100% of CO IPPS rate,8272.27,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12095.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12157.03,
PERITONEAL ADHESIOLYSIS WITH MCC,335,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,27077.05,100,MS-DRG,10408.496,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13397.26,100,,,case rate,100% of CO IPPS rate,13397.26,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,25989.21,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,27077.05,
PERITONEAL ADHESIOLYSIS WITH CC,336,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15945.54,100,MS-DRG,8256.264,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9939.76,100,,,case rate,100% of CO IPPS rate,9939.76,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15005.99,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15945.54,
PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,337,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11333.73,100,MS-DRG,25925.496,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6564.13,100,,,case rate,100% of CO IPPS rate,6564.13,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11115.15,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11333.73,
MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,344,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20755.79,100,MS-DRG,13310.848,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9155.87,100,,,case rate,100% of CO IPPS rate,9155.87,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18572.29,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20755.79,
MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,345,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11668.5,100,MS-DRG,7762.44,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6308.59,100,,,case rate,100% of CO IPPS rate,6308.59,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10945.83,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11668.5,
MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,346,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9753.8,100,MS-DRG,10009.8,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5364.75,100,,,case rate,100% of CO IPPS rate,5364.75,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8823.69,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9753.8,
ANAL AND STOMAL PROCEDURES WITH MCC,347,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,19306.88,100,MS-DRG,5988.304,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7962.63,100,,,case rate,100% of CO IPPS rate,7962.63,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17907,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,19306.88,
ANAL AND STOMAL PROCEDURES WITH CC,348,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9856.8,100,MS-DRG,4506.224,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4594.89,100,,,case rate,100% of CO IPPS rate,4594.89,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9742.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4594.89,9856.8,
ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,349,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7390.71,100,MS-DRG,10589.664,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2819.51,100,,,case rate,100% of CO IPPS rate,2819.51,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7035.25,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2819.51,7390.71,
INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,350,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18177.6,100,MS-DRG,6315.504,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3347.85,100,,,case rate,100% of CO IPPS rate,3347.85,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16628.64,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3347.85,18177.6,
INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,351,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11024.71,100,MS-DRG,4341.416,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2549.34,100,,,case rate,100% of CO IPPS rate,2549.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10372.26,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2549.34,11024.71,
INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,352,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8399.57,100,MS-DRG,12718.264,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2299.93,100,,,case rate,100% of CO IPPS rate,2299.93,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7775.32,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2299.93,8399.57,
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,353,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22148.65,100,MS-DRG,7260.736,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7780.47,100,,,case rate,100% of CO IPPS rate,7780.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20232.33,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,22148.65,
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,354,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13010.62,100,MS-DRG,5401.168,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3958.36,100,,,case rate,100% of CO IPPS rate,3958.36,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12360.36,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3958.36,13010.62,
HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,355,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10320.33,100,MS-DRG,10847.784,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3454.87,100,,,case rate,100% of CO IPPS rate,3454.87,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9681.58,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3454.87,10320.33,
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,356,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,32406.87,100,MS-DRG,5961.04,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,17284.58,100,,,case rate,100% of CO IPPS rate,17284.58,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,29789.74,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,32406.87,
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,357,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16638.56,100,MS-DRG,3836.688,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10098.82,100,,,case rate,100% of CO IPPS rate,10098.82,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15846.94,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16638.56,
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,358,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9703.05,100,MS-DRG,11806.352,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5543.4,100,,,case rate,100% of CO IPPS rate,5543.4,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9786.7,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9786.7,
MAJOR ESOPHAGEAL DISORDERS WITH MCC,368,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12512.25,100,MS-DRG,6501.52,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4607.47,100,,,case rate,100% of CO IPPS rate,4607.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12375.88,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4607.47,12512.25,
MAJOR ESOPHAGEAL DISORDERS WITH CC,369,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7485.38,100,MS-DRG,4587.424,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3245.23,100,,,case rate,100% of CO IPPS rate,3245.23,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7210.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3245.23,7485.38,
MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,370,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5632.78,100,MS-DRG,8471.976,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2551.97,100,,,case rate,100% of CO IPPS rate,2551.97,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5282.08,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2551.97,5632.78,
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,371,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13237.08,100,MS-DRG,5306.04,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5515.63,100,,,case rate,100% of CO IPPS rate,5515.63,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11935.65,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13237.08,
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,372,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7894.38,100,MS-DRG,9494.16,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3868.89,100,,,case rate,100% of CO IPPS rate,3868.89,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7181.99,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3868.89,7894.38,
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,373,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5426.77,100,MS-DRG,5887.12,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2978.57,100,,,case rate,100% of CO IPPS rate,2978.57,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5121.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2978.57,5426.77,
DIGESTIVE MALIGNANCY WITH MCC,374,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15897.83,100,MS-DRG,4145.096,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7877.25,100,,,case rate,100% of CO IPPS rate,7877.25,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14062.73,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15897.83,
DIGESTIVE MALIGNANCY WITH CC,375,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9075.92,100,MS-DRG,8807.048,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5499.25,100,,,case rate,100% of CO IPPS rate,5499.25,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8498.45,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9075.92,
DIGESTIVE MALIGNANCY WITHOUT CC/MCC,376,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6751.46,100,MS-DRG,4825.544,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3830.59,100,,,case rate,100% of CO IPPS rate,3830.59,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6192.88,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3830.59,6751.46,
GASTROINTESTINAL HEMORRHAGE WITH MCC,377,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13559.73,100,MS-DRG,3387.096,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5754.8,100,,,case rate,100% of CO IPPS rate,5754.8,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12543.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13559.73,
GASTROINTESTINAL HEMORRHAGE WITH CC,378,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7451.3,100,MS-DRG,7729.72,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3101.08,100,,,case rate,100% of CO IPPS rate,3101.08,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6949.18,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3101.08,7451.3,
GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,379,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4795.86,100,MS-DRG,4760.104,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2242.33,100,,,case rate,100% of CO IPPS rate,2242.33,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4471.46,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2242.33,4795.86,
COMPLICATED PEPTIC ULCER WITH MCC,380,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14757.94,100,MS-DRG,9813.48,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6196.31,100,,,case rate,100% of CO IPPS rate,6196.31,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13433.43,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14757.94,
COMPLICATED PEPTIC ULCER WITH CC,381,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8126.9,100,MS-DRG,5676.864,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3652.52,100,,,case rate,100% of CO IPPS rate,3652.52,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7446.55,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3652.52,8126.9,
COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,382,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5734.28,100,MS-DRG,3923.336,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2625.36,100,,,case rate,100% of CO IPPS rate,2625.36,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5430.94,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2625.36,5734.28,
UNCOMPLICATED PEPTIC ULCER WITH MCC,383,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10589.97,100,MS-DRG,33357.104,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3637.61,100,,,case rate,100% of CO IPPS rate,3637.61,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9594.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3637.61,10589.97,
UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,384,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6632.55,100,MS-DRG,17495.336,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2610.74,100,,,case rate,100% of CO IPPS rate,2610.74,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6360.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2610.74,6632.55,
INFLAMMATORY BOWEL DISEASE WITH MCC,385,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11867.7,100,MS-DRG,13033.336,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5161.54,100,,,case rate,100% of CO IPPS rate,5161.54,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11490.48,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11867.7,
INFLAMMATORY BOWEL DISEASE WITH CC,386,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7358.9,100,MS-DRG,22553.552,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3636.73,100,,,case rate,100% of CO IPPS rate,3636.73,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6983.04,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3636.73,7358.9,
INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,387,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5181.37,100,MS-DRG,11859.672,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2897.87,100,,,case rate,100% of CO IPPS rate,2897.87,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4879.24,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2897.87,5181.37,
GASTROINTESTINAL OBSTRUCTION WITH MCC,388,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11008.81,100,MS-DRG,9483.856,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4655.13,100,,,case rate,100% of CO IPPS rate,4655.13,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10352.51,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11008.81,
GASTROINTESTINAL OBSTRUCTION WITH CC,389,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6031.93,100,MS-DRG,17453.528,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2716.59,100,,,case rate,100% of CO IPPS rate,2716.59,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5694.09,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2716.59,6031.93,
GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,390,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4233.87,100,MS-DRG,12394.096,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1840.3,100,,,case rate,100% of CO IPPS rate,1840.3,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,3989.6,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1840.3,4772,
"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",391,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9662.15,100,MS-DRG,9146.968,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2366.01,100,,,case rate,100% of CO IPPS rate,2366.01,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9058.62,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2366.01,9662.15,
"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",392,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5950.13,100,MS-DRG,21359.888,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2089.41,100,,,case rate,100% of CO IPPS rate,2089.41,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5556.52,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2089.41,5950.13,
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,393,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12266.85,100,MS-DRG,11971.768,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3870.35,100,,,case rate,100% of CO IPPS rate,3870.35,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11367.72,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3870.35,12266.85,
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,394,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7096.08,100,MS-DRG,8114.48,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2956.93,100,,,case rate,100% of CO IPPS rate,2956.93,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6652.87,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2956.93,7096.08,
OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,395,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4904.17,100,MS-DRG,14044.016,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2520.39,100,,,case rate,100% of CO IPPS rate,2520.39,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4549.77,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2520.39,4904.17,
APPENDIX PROCEDURES WITH MCC,397,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,17015.75,100,MS-DRG,9904.976,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17015.75,
APPENDIX PROCEDURES WITH CC,398,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,11461.73,100,MS-DRG,7956.944,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11461.73,
APPENDIX PROCEDURES WITHOUT CC/MCC,399,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,8430.62,100,MS-DRG,19394.288,case rate,100% of  CMS ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8430.62,
SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,402,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8784.05,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,8784.05,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,8784.05,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,8784.05,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",405,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,41696.38,100,MS-DRG,8549.528,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13703.1,100,,,case rate,100% of CO IPPS rate,13703.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,39098.1,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,41696.38,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",406,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,21869.17,100,MS-DRG,23696.928,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9948.54,100,,,case rate,100% of CO IPPS rate,9948.54,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20669.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,21869.17,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",407,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16291.67,100,MS-DRG,12647.368,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8927.22,100,,,case rate,100% of CO IPPS rate,8927.22,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15702.31,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16291.67,
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,408,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,28191.94,100,MS-DRG,9706.232,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13958.94,100,,,case rate,100% of CO IPPS rate,13958.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,25888.32,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,28191.94,
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,409,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14824.59,100,MS-DRG,11609.424,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10586.82,100,,,case rate,100% of CO IPPS rate,10586.82,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15037.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15037.03,
BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,410,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11854.82,100,MS-DRG,6247.032,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8067.89,100,,,case rate,100% of CO IPPS rate,8067.89,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11977.27,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11977.27,
CHOLECYSTECTOMY WITH C.D.E. WITH MCC,411,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,21816.91,100,MS-DRG,4056.632,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6059.06,100,,,case rate,100% of CO ipps rate,6779.33,100,,,case rate,100% of CO IPPS rate,6779.33,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,6059.06,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,23833.2,100,,,case rate,100% of CMS IPPS rate,6059.06,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,23833.2,
CHOLECYSTECTOMY WITH C.D.E. WITH CC,412,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15492.62,100,MS-DRG,10663.584,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6437.36,100,,,case rate,100% of CO ipps rate,6657.41,100,,,case rate,100% of CO IPPS rate,6657.41,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,6437.36,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16196.16,100,,,case rate,100% of CMS IPPS rate,6437.36,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,16196.16,
CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,413,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11433.71,100,MS-DRG,6669.36,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9115.76,100,,,case rate,100% of CO ipps rate,6342.79,100,,,case rate,100% of CO IPPS rate,6342.79,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,9115.76,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11431.92,100,,,case rate,100% of CMS IPPS rate,9115.76,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,11433.71,
CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,414,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,26699.86,100,MS-DRG,5035.8,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,17261.8,100,,,case rate,100% of CO ipps rate,9551.47,100,,,case rate,100% of CO IPPS rate,9551.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,17261.8,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,24937.31,100,,,case rate,100% of CMS IPPS rate,17261.8,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,26699.86,
CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,415,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14964.71,100,MS-DRG,10111.592,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7053.3,100,,,case rate,100% of CO IPPS rate,7053.3,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14110,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14964.71,
CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,416,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10143.1,100,MS-DRG,5181.824,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5224.7,100,,,case rate,100% of CO IPPS rate,5224.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9710.5,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10143.1,
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,417,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17555.02,100,MS-DRG,3730.04,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6403.03,100,,,case rate,100% of CO IPPS rate,6403.03,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16774.67,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17555.02,
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,418,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12381.22,100,MS-DRG,11077.432,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4828.51,100,,,case rate,100% of CO IPPS rate,4828.51,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11718.36,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12381.22,
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,419,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9946.18,100,MS-DRG,5765.328,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4389.05,100,,,case rate,100% of CO IPPS rate,4389.05,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9206.78,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4389.05,9946.18,
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,420,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,24242.86,100,MS-DRG,4330.512,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12908.68,100,,,case rate,100% of CO IPPS rate,12908.68,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,23007.77,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,24242.86,
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,421,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12948.51,100,MS-DRG,9895.888,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4382.85,100,,,case rate,100% of CO ipps rate,10130.99,100,,,case rate,100% of CO IPPS rate,10130.99,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,4382.85,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12780.84,100,,,case rate,100% of CMS IPPS rate,4382.85,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4382.85,12948.51,
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,422,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10686.91,100,MS-DRG,6585.136,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5449.27,100,,,case rate,100% of CO ipps rate,8018.77,100,,,case rate,100% of CO IPPS rate,8018.77,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5449.27,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9775.41,100,,,case rate,100% of CMS IPPS rate,5449.27,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,10686.91,
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,423,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,29621.16,100,MS-DRG,4856.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8069.81,100,,,case rate,100% of CO ipps rate,16789.85,100,,,case rate,100% of CO IPPS rate,16789.85,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,8069.81,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,27739.55,100,,,case rate,100% of CMS IPPS rate,8069.81,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,29621.16,
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,424,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15809.21,100,MS-DRG,51075.424,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,22504.98,100,,,case rate,100% of CO ipps rate,11381.24,100,,,case rate,100% of CO IPPS rate,11381.24,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,22504.98,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16710.47,100,,,case rate,100% of CMS IPPS rate,22504.98,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,22504.98,
OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,425,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12132.79,100,MS-DRG,36811.456,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8911.72,100,,,case rate,100% of CO IPPS rate,8911.72,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10092.88,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12132.79,
MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,426,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,427,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,428,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,429,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,430,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,432,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14511.78,100,MS-DRG,11335.552,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7901.13,100,,,case rate,100% of CO ipps rate,7249.49,100,,,case rate,100% of CO IPPS rate,7249.49,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,7901.13,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13321.25,100,,,case rate,100% of CMS IPPS rate,7901.13,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,14511.78,
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,433,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7808.79,100,MS-DRG,31426.648,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11952.97,100,,,case rate,100% of CO ipps rate,3911.87,100,,,case rate,100% of CO IPPS rate,3911.87,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,11952.97,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7335.79,100,,,case rate,100% of CMS IPPS rate,11952.97,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3911.87,11952.97,
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,434,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5070.79,100,MS-DRG,21124.192,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,27321.18,100,,,case rate,100% of CO ipps rate,2285.9,100,,,case rate,100% of CO IPPS rate,2285.9,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,27321.18,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4428.42,100,,,case rate,100% of CMS IPPS rate,27321.18,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,2285.9,27321.18,
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,435,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13329.48,100,MS-DRG,16175.64,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6174.38,100,,,case rate,100% of CO IPPS rate,6174.38,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12333.55,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13329.48,
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,436,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8336.7,100,MS-DRG,20175.928,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4595.48,100,,,case rate,100% of CO IPPS rate,4595.48,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7763.32,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4595.48,8336.7,
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,437,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6294.75,100,MS-DRG,11401.6,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3636.44,100,,,case rate,100% of CO IPPS rate,3636.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5967.82,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3636.44,6294.75,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,438,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12639.49,100,MS-DRG,29805.208,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5524.98,100,,,case rate,100% of CO IPPS rate,5524.98,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11692.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12639.49,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,439,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6477.28,100,MS-DRG,17907.36,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4075.61,100,,,case rate,100% of CO IPPS rate,4075.61,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6136.44,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4075.61,6477.28,
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,440,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4662.55,100,MS-DRG,14909.264,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3234.11,100,,,case rate,100% of CO IPPS rate,3234.11,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4278.15,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3234.11,4772,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",441,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13846.79,100,MS-DRG,26071.528,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6067.53,100,,,case rate,100% of CO ipps rate,5116.22,100,,,case rate,100% of CO IPPS rate,5116.22,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,6067.53,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13367.81,100,,,case rate,100% of CMS IPPS rate,6067.53,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,13846.79,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",442,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7206.66,100,MS-DRG,12995.168,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8004.17,100,,,case rate,100% of CO ipps rate,3716.56,100,,,case rate,100% of CO IPPS rate,3716.56,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,8004.17,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6674.03,100,,,case rate,100% of CMS IPPS rate,8004.17,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3716.56,8004.17,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",443,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5413.14,100,MS-DRG,7131.072,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10950.07,100,,,case rate,100% of CO ipps rate,3068.04,100,,,case rate,100% of CO IPPS rate,3068.04,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,10950.07,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4599.15,100,,,case rate,100% of CMS IPPS rate,10950.07,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3068.04,10950.07,
DISORDERS OF THE BILIARY TRACT WITH MCC,444,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12369.86,100,MS-DRG,20413.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,20220.4,100,,,case rate,100% of CO ipps rate,3547.85,100,,,case rate,100% of CO IPPS rate,3547.85,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,20220.4,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11744.46,100,,,case rate,100% of CMS IPPS rate,20220.4,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3547.85,20220.4,
DISORDERS OF THE BILIARY TRACT WITH CC,445,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8231.42,100,MS-DRG,14443.312,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2686.47,100,,,case rate,100% of CO IPPS rate,2686.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7757.68,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2686.47,8231.42,
DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,446,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6070.56,100,MS-DRG,11294.352,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2054.03,100,,,case rate,100% of CO IPPS rate,2054.03,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5726.54,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2054.03,6070.56,
MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,447,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,448,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,450,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,451,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5597.49,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5597.49,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5597.49,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,5597.49,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",456,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,63844.28,100,MS-DRG,19959.008,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,22239.69,100,,,case rate,100% of CO IPPS rate,22239.69,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,59609.11,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,63844.28,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",457,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,46014.32,100,MS-DRG,12168.688,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,17670.24,100,,,case rate,100% of CO IPPS rate,17670.24,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,42589.62,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,46014.32,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",458,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,34317.79,100,MS-DRG,9360.856,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13937.01,100,,,case rate,100% of CO IPPS rate,13937.01,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,33956.42,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,34317.79,
BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,461,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,51643.32,100,MS-DRG,12764.312,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5349.05,100,,,case rate,100% of CO ipps rate,24142.56,100,,,case rate,100% of CO IPPS rate,24142.56,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5349.05,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,45259.24,100,,,case rate,100% of CMS IPPS rate,5349.05,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,51643.32,
BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,462,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,21557.88,100,MS-DRG,7499.472,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6080.23,100,,,case rate,100% of CO ipps rate,17545.09,100,,,case rate,100% of CO IPPS rate,17545.09,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,6080.23,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21063.41,100,,,case rate,100% of CMS IPPS rate,6080.23,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,21557.88,
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,463,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,42896.86,100,MS-DRG,20977.56,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8295.66,100,,,case rate,100% of CO ipps rate,25034.05,100,,,case rate,100% of CO IPPS rate,25034.05,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,8295.66,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,36979.49,100,,,case rate,100% of CMS IPPS rate,8295.66,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,42896.86,
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,464,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22732.6,100,MS-DRG,14552.384,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,18048.73,100,,,case rate,100% of CO ipps rate,11404.34,100,,,case rate,100% of CO IPPS rate,11404.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,18048.73,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21074.7,100,,,case rate,100% of CMS IPPS rate,18048.73,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,22732.6,
WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,465,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14169.44,100,MS-DRG,11325.856,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6446.59,100,,,case rate,100% of CO IPPS rate,6446.59,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14058.5,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14169.44,
REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,466,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,39283.31,100,MS-DRG,21699.208,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,26519.39,100,,,case rate,100% of CO IPPS rate,26519.39,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,37004.18,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,39283.31,
REVISION OF HIP OR KNEE REPLACEMENT WITH CC,467,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,26405.24,100,MS-DRG,12042.664,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,18121.98,100,,,case rate,100% of CO IPPS rate,18121.98,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,25580.72,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,26405.24,
REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,468,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20219.55,100,MS-DRG,8648.904,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,14294.31,100,,,case rate,100% of CO IPPS rate,14294.31,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,19678.51,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20219.55,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,469,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,25219.91,100,MS-DRG,15820.568,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,17558.84,100,,,case rate,100% of CO IPPS rate,17558.84,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,22797.53,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,25219.91,
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,470,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14252,100,MS-DRG,7815.16,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11852.87,100,,,case rate,100% of CO IPPS rate,11852.87,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13488.45,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14252,
CERVICAL SPINAL FUSION WITH MCC,471,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,37256.51,100,MS-DRG,19648.776,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4073.02,100,,,case rate,100% of CO ipps rate,9641.82,100,,,case rate,100% of CO IPPS rate,9641.82,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,4073.02,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,35536.04,100,,,case rate,100% of CMS IPPS rate,4073.02,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4073.02,37256.51,
CERVICAL SPINAL FUSION WITH CC,472,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22384.2,100,MS-DRG,10516.952,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5069.57,100,,,case rate,100% of CO ipps rate,8290.11,100,,,case rate,100% of CO IPPS rate,8290.11,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5069.57,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21665.91,100,,,case rate,100% of CMS IPPS rate,5069.57,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,22384.2,
CERVICAL SPINAL FUSION WITHOUT CC/MCC,473,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18636.58,100,MS-DRG,8378.056,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5812.04,100,,,case rate,100% of CO ipps rate,6548.05,100,,,case rate,100% of CO IPPS rate,6548.05,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5812.04,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17885.13,100,,,case rate,100% of CMS IPPS rate,5812.04,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,18636.58,
AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,474,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,32589.41,100,MS-DRG,16250.168,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,15071.08,100,,,case rate,100% of CO ipps rate,14695.18,100,,,case rate,100% of CO IPPS rate,14695.18,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,15071.08,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,28903.63,100,,,case rate,100% of CMS IPPS rate,15071.08,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,32589.41,
AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,475,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16243.96,100,MS-DRG,10464.848,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7270.25,100,,,case rate,100% of CO IPPS rate,7270.25,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15670.57,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16243.96,
AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,476,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8913.84,100,MS-DRG,10335.176,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4584.07,100,,,case rate,100% of CO IPPS rate,4584.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8660.01,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4584.07,8913.84,
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,477,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,25516.81,100,MS-DRG,8862.184,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10799.97,100,,,case rate,100% of CO IPPS rate,10799.97,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,24006.75,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,25516.81,
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,478,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18054.14,100,MS-DRG,12916.4,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7831.93,100,,,case rate,100% of CO IPPS rate,7831.93,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16571.49,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,18054.14,
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,479,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14117.94,100,MS-DRG,8688.896,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6138.12,100,,,case rate,100% of CO IPPS rate,6138.12,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12476.06,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14117.94,
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,480,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22334.97,100,MS-DRG,8035.712,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12171.86,100,,,case rate,100% of CO IPPS rate,12171.86,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20925.13,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,22334.97,
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,481,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15715.29,100,MS-DRG,16484.656,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4313.68,100,,,case rate,100% of CO ipps rate,8764.95,100,,,case rate,100% of CO IPPS rate,8764.95,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,4313.68,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14902.98,100,,,case rate,100% of CMS IPPS rate,4313.68,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4313.68,15715.29,
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,482,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12030.54,100,MS-DRG,12080.832,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4475.31,100,,,case rate,100% of CO ipps rate,7730.77,100,,,case rate,100% of CO IPPS rate,7730.77,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,4475.31,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11613.24,100,,,case rate,100% of CMS IPPS rate,4475.31,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4475.31,12030.54,
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,483,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18815.33,100,MS-DRG,9778.336,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6291.97,100,,,case rate,100% of CO ipps rate,7297.44,100,,,case rate,100% of CO IPPS rate,7297.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,6291.97,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16632.87,100,,,case rate,100% of CMS IPPS rate,6291.97,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,18815.33,
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,485,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,24948.76,100,MS-DRG,9821.96,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13194.93,100,,,case rate,100% of CO IPPS rate,13194.93,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,22935.81,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,24948.76,
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,486,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15210.86,100,MS-DRG,6310.656,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7886.02,100,,,case rate,100% of CO IPPS rate,7886.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14716.73,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15210.86,
KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,487,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11701.07,100,MS-DRG,19156.16,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5253.94,100,,,case rate,100% of CO IPPS rate,5253.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11316.22,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11701.07,
KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,488,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15955.39,100,MS-DRG,12365.616,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6248.35,100,,,case rate,100% of CO IPPS rate,6248.35,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16009.21,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16009.21,
KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,489,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9374.34,100,MS-DRG,9054.872,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4429.69,100,,,case rate,100% of CO IPPS rate,4429.69,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9379.62,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4429.69,9379.62,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",492,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,26221.95,100,MS-DRG,22126.984,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,14572.1,100,,,case rate,100% of CO ipps rate,7324.64,100,,,case rate,100% of CO IPPS rate,7324.64,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,14572.1,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,24593.02,100,,,case rate,100% of CMS IPPS rate,14572.1,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,26221.95,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",493,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18190.48,100,MS-DRG,11928.144,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,19267.6,100,,,case rate,100% of CO ipps rate,5103.07,100,,,case rate,100% of CO IPPS rate,5103.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,19267.6,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16761.27,100,,,case rate,100% of CMS IPPS rate,19267.6,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,19267.6,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",494,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14157.32,100,MS-DRG,8673.744,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,35371.23,100,,,case rate,100% of CO ipps rate,4339.35,100,,,case rate,100% of CO IPPS rate,4339.35,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,35371.23,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13325.48,100,,,case rate,100% of CMS IPPS rate,35371.23,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4339.35,35371.23,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,495,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,27124.01,100,MS-DRG,18142.456,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13808.36,100,,,case rate,100% of CO IPPS rate,13808.36,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,26205.09,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,27124.01,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,496,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15053.33,100,MS-DRG,12798.24,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6708.28,100,,,case rate,100% of CO IPPS rate,6708.28,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14813.38,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15053.33,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,497,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10811.13,100,MS-DRG,9884.976,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4088.48,100,,,case rate,100% of CO IPPS rate,4088.48,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10735.59,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4088.48,10811.13,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,498,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,19775.71,100,MS-DRG,4907.952,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3689.36,100,,,case rate,100% of CO IPPS rate,3689.36,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18082.67,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3689.36,19775.71,
LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,499,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9768.95,100,MS-DRG,7856.968,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2732.38,100,,,case rate,100% of CO IPPS rate,2732.38,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9303.43,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2732.38,9768.95,
SOFT TISSUE PROCEDURES WITH MCC,500,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,24560.97,100,MS-DRG,4769.2,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7026.98,100,,,case rate,100% of CO IPPS rate,7026.98,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,22607.75,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,24560.97,
SOFT TISSUE PROCEDURES WITH CC,501,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13146.19,100,MS-DRG,5859.248,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5057.57,100,,,case rate,100% of CO ipps rate,3687.9,100,,,case rate,100% of CO IPPS rate,3687.9,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5057.57,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12401.28,100,,,case rate,100% of CMS IPPS rate,5057.57,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3687.9,13146.19,
SOFT TISSUE PROCEDURES WITHOUT CC/MCC,502,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10472.57,100,MS-DRG,4296.576,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8731.82,100,,,case rate,100% of CO ipps rate,2696.7,100,,,case rate,100% of CO IPPS rate,2696.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,8731.82,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9697.1,100,,,case rate,100% of CMS IPPS rate,8731.82,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,2696.7,10472.57,
FOOT PROCEDURES WITH MCC,503,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20312.71,100,MS-DRG,12023.88,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,14380.12,100,,,case rate,100% of CO ipps rate,6385.19,100,,,case rate,100% of CO IPPS rate,6385.19,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,14380.12,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17872.43,100,,,case rate,100% of CMS IPPS rate,14380.12,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,20312.71,
FOOT PROCEDURES WITH CC,504,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13081.06,100,MS-DRG,7866.056,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,36693.84,100,,,case rate,100% of CO ipps rate,4186.13,100,,,case rate,100% of CO IPPS rate,4186.13,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,36693.84,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12521.21,100,,,case rate,100% of CMS IPPS rate,36693.84,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4186.13,36693.84,
FOOT PROCEDURES WITHOUT CC/MCC,505,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12918.97,100,MS-DRG,5198.184,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2842.02,100,,,case rate,100% of CO IPPS rate,2842.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12464.77,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2842.02,12918.97,
MAJOR THUMB OR JOINT PROCEDURES,506,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11077.73,100,MS-DRG,11050.16,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4429.69,100,,,case rate,100% of CO IPPS rate,4429.69,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9946.14,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4429.69,11077.73,
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,507,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16145.5,100,MS-DRG,6608.768,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5320.02,100,,,case rate,100% of CO IPPS rate,5320.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13085.61,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16145.5,
MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,508,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10861.12,100,MS-DRG,4650.44,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3939.94,100,,,case rate,100% of CO IPPS rate,3939.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10217.05,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3939.94,10861.12,
ARTHROSCOPY,509,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10044.64,100,MS-DRG,15106.8,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3814.21,100,,,case rate,100% of CO IPPS rate,3814.21,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10708.78,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3814.21,10708.78,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",510,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20605.82,100,MS-DRG,7266.8,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5927.6,100,,,case rate,100% of CO IPPS rate,5927.6,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20375.55,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20605.82,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",511,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15101.04,100,MS-DRG,4928.552,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3740.6,100,,,case rate,100% of CO ipps rate,3929.12,100,,,case rate,100% of CO IPPS rate,3929.12,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,3740.6,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13961.85,100,,,case rate,100% of CMS IPPS rate,3740.6,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3740.6,15101.04,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",512,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12222.92,100,MS-DRG,11814.232,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5018.05,100,,,case rate,100% of CO ipps rate,3608.37,100,,,case rate,100% of CO IPPS rate,3608.37,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5018.05,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11333.86,100,,,case rate,100% of CMS IPPS rate,5018.05,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3608.37,12222.92,
"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",513,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12277.45,100,MS-DRG,7308.608,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10451.09,100,,,case rate,100% of CO ipps rate,3842.28,100,,,case rate,100% of CO IPPS rate,3842.28,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,10451.09,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11245.67,100,,,case rate,100% of CMS IPPS rate,10451.09,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3842.28,12277.45,
"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",514,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7888.32,100,MS-DRG,5579.312,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,26453.08,100,,,case rate,100% of CO ipps rate,3354.29,100,,,case rate,100% of CO IPPS rate,3354.29,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,26453.08,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7285.7,100,,,case rate,100% of CMS IPPS rate,26453.08,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3354.29,26453.08,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,515,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,23945.2,100,MS-DRG,10312.152,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13850.76,100,,,case rate,100% of CO IPPS rate,13850.76,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21996.08,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,23945.2,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,516,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15457.02,100,MS-DRG,5855.008,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7478.73,100,,,case rate,100% of CO IPPS rate,7478.73,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14348.46,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15457.02,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,517,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11318.59,100,MS-DRG,8189.008,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4984.65,100,,,case rate,100% of CO IPPS rate,4984.65,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10652.34,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11318.59,
BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,518,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,27658.73,100,MS-DRG,4979.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9234.81,100,,,case rate,100% of CO IPPS rate,9234.81,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,26298.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,27658.73,
BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,519,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14910.18,100,MS-DRG,8476.824,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5603.93,100,,,case rate,100% of CO IPPS rate,5603.93,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14105.06,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14910.18,
BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,520,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10842.18,100,MS-DRG,4995.208,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4840.21,100,,,case rate,100% of CO IPPS rate,4840.21,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10439.99,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10842.18,
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,521,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22678.07,100,MS-DRG,9432.96,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3211.27,100,,,case rate,100% of CO ipps rate,19401.18,100,,,case rate,100% of CO IPPS rate,19401.18,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,3211.27,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21300.46,100,,,case rate,100% of CMS IPPS rate,3211.27,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3211.27,22678.07,
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,522,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15997.8,100,MS-DRG,5322.4,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3888.81,100,,,case rate,100% of CO ipps rate,14408.05,100,,,case rate,100% of CO IPPS rate,14408.05,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,3888.81,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15329.81,100,,,case rate,100% of CMS IPPS rate,3888.81,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3888.81,15997.8,
FRACTURES OF FEMUR WITH MCC,533,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12356.22,100,MS-DRG,11212.552,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6459.94,100,,,case rate,100% of CO ipps rate,6468.52,100,,,case rate,100% of CO IPPS rate,6468.52,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,6459.94,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10062.55,100,,,case rate,100% of CMS IPPS rate,6459.94,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,12356.22,
FRACTURES OF FEMUR WITHOUT MCC,534,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6134.94,100,MS-DRG,6859.624,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12596.64,100,,,case rate,100% of CO ipps rate,3530.89,100,,,case rate,100% of CO IPPS rate,3530.89,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,12596.64,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5615.07,100,,,case rate,100% of CMS IPPS rate,12596.64,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3530.89,12596.64,
FRACTURES OF HIP AND PELVIS WITH MCC,535,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9821.21,100,MS-DRG,4727.384,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4733.49,100,,,case rate,100% of CO IPPS rate,4733.49,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9097.42,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9821.21,
FRACTURES OF HIP AND PELVIS WITHOUT MCC,536,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5961.5,100,MS-DRG,9214.224,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2638.52,100,,,case rate,100% of CO IPPS rate,2638.52,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5482.44,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2638.52,5961.5,
"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",537,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7324.06,100,MS-DRG,5426.616,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2945.82,100,,,case rate,100% of CO IPPS rate,2945.82,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7008.44,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2945.82,7324.06,
"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",538,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5370.72,100,MS-DRG,9463.864,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2198.18,100,,,case rate,100% of CO IPPS rate,2198.18,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4911.69,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2198.18,5370.72,
OSTEOMYELITIS WITH MCC,539,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15029.85,100,MS-DRG,6055.568,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7671.12,100,,,case rate,100% of CO IPPS rate,7671.12,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14081.07,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15029.85,
OSTEOMYELITIS WITH CC,540,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9832.57,100,MS-DRG,4547.432,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5773.22,100,,,case rate,100% of CO IPPS rate,5773.22,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9500.26,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9832.57,
OSTEOMYELITIS WITHOUT CC/MCC,541,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6497.73,100,MS-DRG,17706.192,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4048.31,100,,,case rate,100% of CO ipps rate,4410.1,100,,,case rate,100% of CO IPPS rate,4410.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,4048.31,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5770.99,100,,,case rate,100% of CMS IPPS rate,4048.31,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4048.31,6497.73,
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,542,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13812.7,100,MS-DRG,10251.56,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4624.22,100,,,case rate,100% of CO ipps rate,8123.74,100,,,case rate,100% of CO IPPS rate,8123.74,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,4624.22,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12896.54,100,,,case rate,100% of CMS IPPS rate,4624.22,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4624.22,13812.7,
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,543,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8260.96,100,MS-DRG,6905.064,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6326.55,100,,,case rate,100% of CO ipps rate,5587.26,100,,,case rate,100% of CO IPPS rate,5587.26,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,6326.55,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7682.9,100,,,case rate,100% of CMS IPPS rate,6326.55,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,8260.96,
PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,544,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5813.05,100,MS-DRG,37676.712,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,14570.68,100,,,case rate,100% of CO ipps rate,4467.41,100,,,case rate,100% of CO IPPS rate,4467.41,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,14570.68,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5489.5,100,,,case rate,100% of CMS IPPS rate,14570.68,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4467.41,14570.68,
CONNECTIVE TISSUE DISORDERS WITH MCC,545,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18883.5,100,MS-DRG,20636.424,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7956.2,100,,,case rate,100% of CO IPPS rate,7956.2,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17698.17,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,18883.5,
CONNECTIVE TISSUE DISORDERS WITH CC,546,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9083.5,100,MS-DRG,12397.12,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3317.45,100,,,case rate,100% of CO IPPS rate,3317.45,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8505.51,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3317.45,9083.5,
CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,547,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6160.69,100,MS-DRG,34435.04,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1997.6,100,,,case rate,100% of CO IPPS rate,1997.6,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6453.91,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1997.6,6453.91,
SEPTIC ARTHRITIS WITH MCC,548,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14767.79,100,MS-DRG,16051.424,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9421.36,100,,,case rate,100% of CO IPPS rate,9421.36,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13685.99,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14767.79,
SEPTIC ARTHRITIS WITH CC,549,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9135.76,100,MS-DRG,9758.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5360.37,100,,,case rate,100% of CO IPPS rate,5360.37,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8548.54,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9135.76,
SEPTIC ARTHRITIS WITHOUT CC/MCC,550,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6974.14,100,MS-DRG,20251.056,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3225.05,100,,,case rate,100% of CO IPPS rate,3225.05,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7395.76,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3225.05,7395.76,
MEDICAL BACK PROBLEMS WITH MCC,551,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12890.19,100,MS-DRG,10583,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5308.82,100,,,case rate,100% of CO ipps rate,3108.39,100,,,case rate,100% of CO IPPS rate,3108.39,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5308.82,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11805.84,100,,,case rate,100% of CMS IPPS rate,5308.82,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3108.39,12890.19,
MEDICAL BACK PROBLEMS WITHOUT MCC,552,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7318.76,100,MS-DRG,8159.928,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8264.6,100,,,case rate,100% of CO ipps rate,2166.6,100,,,case rate,100% of CO IPPS rate,2166.6,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,8264.6,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6776.33,100,,,case rate,100% of CMS IPPS rate,8264.6,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,2166.6,8264.6,
BONE DISEASES AND ARTHROPATHIES WITH MCC,553,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10236.26,100,MS-DRG,10101.296,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,16149.5,100,,,case rate,100% of CO ipps rate,12296.42,100,,,case rate,100% of CO IPPS rate,12296.42,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,16149.5,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9354.22,100,,,case rate,100% of CMS IPPS rate,16149.5,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,16149.5,
BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,554,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6224.31,100,MS-DRG,9221.496,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,26975.35,100,,,case rate,100% of CO ipps rate,4887.87,100,,,case rate,100% of CO IPPS rate,4887.87,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,26975.35,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5786.51,100,,,case rate,100% of CMS IPPS rate,26975.35,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,26975.35,
SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,555,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10596.03,100,MS-DRG,11867.552,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2990.85,100,,,case rate,100% of CO IPPS rate,2990.85,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9391.62,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2990.85,10596.03,
SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,556,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6244.01,100,MS-DRG,10203.696,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1682.7,100,,,case rate,100% of CO IPPS rate,1682.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5700.44,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1682.7,6244.01,
"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",557,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11791.2,100,MS-DRG,12664.336,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5349.84,100,,,case rate,100% of CO IPPS rate,5349.84,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10102.05,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11791.2,
"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",558,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6653,100,MS-DRG,7331.024,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2387.94,100,,,case rate,100% of CO IPPS rate,2387.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6130.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2387.94,6653,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",559,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14015.69,100,MS-DRG,4771.016,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4441.97,100,,,case rate,100% of CO IPPS rate,4441.97,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12593.18,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4441.97,14015.69,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",560,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8574.53,100,MS-DRG,13178.76,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2759.27,100,,,case rate,100% of CO IPPS rate,2759.27,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7729.46,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2759.27,8574.53,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",561,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5909.23,100,MS-DRG,6113.736,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5253.77,100,,,case rate,100% of CO ipps rate,1634.16,100,,,case rate,100% of CO IPPS rate,1634.16,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5253.77,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5574.86,100,,,case rate,100% of CMS IPPS rate,5253.77,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,1634.16,5909.23,
"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",562,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11517.78,100,MS-DRG,9697.752,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7472.72,100,,,case rate,100% of CO ipps rate,4016.26,100,,,case rate,100% of CO IPPS rate,4016.26,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,7472.72,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10320.05,100,,,case rate,100% of CMS IPPS rate,7472.72,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4016.26,11517.78,
"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",563,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6783.27,100,MS-DRG,7263.768,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11729.24,100,,,case rate,100% of CO ipps rate,2009.3,100,,,case rate,100% of CO IPPS rate,2009.3,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,11729.24,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6075.77,100,,,case rate,100% of CMS IPPS rate,11729.24,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,2009.3,11729.24,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,564,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11829.83,100,MS-DRG,3765.184,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,29626.94,100,,,case rate,100% of CO ipps rate,4505.71,100,,,case rate,100% of CO IPPS rate,4505.71,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,29626.94,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10958.53,100,,,case rate,100% of CMS IPPS rate,29626.94,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4505.71,29626.94,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,565,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7569.46,100,MS-DRG,6213.712,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2926.52,100,,,case rate,100% of CO IPPS rate,2926.52,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6966.11,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2926.52,7569.46,
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,566,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5684.29,100,MS-DRG,3772.456,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1952.87,100,,,case rate,100% of CO IPPS rate,1952.87,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5239.75,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1952.87,5684.29,
SKIN DEBRIDEMENT WITH MCC,570,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22132.74,100,MS-DRG,9013.064,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11094.12,100,,,case rate,100% of CO IPPS rate,11094.12,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20580.14,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,22132.74,
SKIN DEBRIDEMENT WITH CC,571,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12814.45,100,MS-DRG,5360.576,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5099.92,100,,,case rate,100% of CO ipps rate,6729.63,100,,,case rate,100% of CO IPPS rate,6729.63,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5099.92,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11630.87,100,,,case rate,100% of CMS IPPS rate,5099.92,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,12814.45,
SKIN DEBRIDEMENT WITHOUT CC/MCC,572,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8631.33,100,MS-DRG,9126.368,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5658.89,100,,,case rate,100% of CO ipps rate,4129.7,100,,,case rate,100% of CO IPPS rate,4129.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5658.89,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8491.4,100,,,case rate,100% of CMS IPPS rate,5658.89,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4129.7,8631.33,
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,573,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,47095.89,100,MS-DRG,5506.6,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9918.93,100,,,case rate,100% of CO ipps rate,21754.91,100,,,case rate,100% of CO IPPS rate,21754.91,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,9918.93,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,41416.38,100,,,case rate,100% of CMS IPPS rate,9918.93,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,47095.89,
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,574,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,25795.53,100,MS-DRG,9608.68,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,25054.24,100,,,case rate,100% of CO ipps rate,11557.26,100,,,case rate,100% of CO IPPS rate,11557.26,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,25054.24,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,25430.45,100,,,case rate,100% of CMS IPPS rate,25054.24,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,25795.53,
SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,575,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15496.4,100,MS-DRG,5413.896,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8309.99,100,,,case rate,100% of CO IPPS rate,8309.99,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14459.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15496.4,
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,576,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,43043.8,100,MS-DRG,13647.744,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,26750.08,100,,,case rate,100% of CO IPPS rate,26750.08,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,39853.7,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,43043.8,
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,577,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20064.28,100,MS-DRG,8913.688,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11840,100,,,case rate,100% of CO IPPS rate,11840,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18474.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20064.28,
SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,578,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12197.93,100,MS-DRG,23980.496,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8136.6,100,,,case rate,100% of CO IPPS rate,8136.6,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12081.69,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12197.93,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",579,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,25313.82,100,MS-DRG,12024.48,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7831.35,100,,,case rate,100% of CO IPPS rate,7831.35,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,22235.24,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,25313.82,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",580,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13228.75,100,MS-DRG,7037.76,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4199,100,,,case rate,100% of CO IPPS rate,4199,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12248.89,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4199,13228.75,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",581,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10199.91,100,MS-DRG,15684.24,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4202.88,100,,,case rate,100% of CO ipps rate,3181.48,100,,,case rate,100% of CO IPPS rate,3181.48,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,4202.88,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9958.13,100,,,case rate,100% of CMS IPPS rate,4202.88,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3181.48,10199.91,
MASTECTOMY FOR MALIGNANCY WITH CC/MCC,582,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12626.62,100,MS-DRG,9829.232,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5678.65,100,,,case rate,100% of CO ipps rate,3846.38,100,,,case rate,100% of CO IPPS rate,3846.38,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5678.65,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13650.01,100,,,case rate,100% of CMS IPPS rate,5678.65,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3846.38,13650.01,
MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,583,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11526.87,100,MS-DRG,9193.624,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8980.96,100,,,case rate,100% of CO ipps rate,3580.6,100,,,case rate,100% of CO IPPS rate,3580.6,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,8980.96,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10658.69,100,,,case rate,100% of CMS IPPS rate,8980.96,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3580.6,11526.87,
"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",584,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14834.44,100,MS-DRG,23180.072,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,18887.9,100,,,case rate,100% of CO ipps rate,4372.68,100,,,case rate,100% of CO IPPS rate,4372.68,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,18887.9,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15068.07,100,,,case rate,100% of CMS IPPS rate,18887.9,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4372.68,18887.9,
"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",585,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12754.62,100,MS-DRG,11278.592,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3238.21,100,,,case rate,100% of CO IPPS rate,3238.21,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12988.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3238.21,12988.96,
SKIN ULCERS WITH MCC,592,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15830.42,100,MS-DRG,6752.976,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6019.12,100,,,case rate,100% of CO IPPS rate,6019.12,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12586.12,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15830.42,
SKIN ULCERS WITH CC,593,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9163.78,100,MS-DRG,17700.136,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3044.94,100,,,case rate,100% of CO IPPS rate,3044.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8126.65,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3044.94,9163.78,
SKIN ULCERS WITHOUT CC/MCC,594,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5963.77,100,MS-DRG,9039.72,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1871,100,,,case rate,100% of CO IPPS rate,1871,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5459.86,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1871,5963.77,
MAJOR SKIN DISORDERS WITH MCC,595,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16473.45,100,MS-DRG,7489.168,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11266.33,100,,,case rate,100% of CO IPPS rate,11266.33,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15107.58,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16473.45,
MAJOR SKIN DISORDERS WITHOUT MCC,596,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7642.17,100,MS-DRG,24324.656,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3479.72,100,,,case rate,100% of CO IPPS rate,3479.72,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7702.65,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3479.72,7702.65,
MALIGNANT BREAST DISORDERS WITH MCC,597,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12122.19,100,MS-DRG,13710.76,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4314.49,100,,,case rate,100% of CO IPPS rate,4314.49,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11880.62,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4314.49,12122.19,
MALIGNANT BREAST DISORDERS WITH CC,598,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9079.71,100,MS-DRG,8460.464,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2395.54,100,,,case rate,100% of CO IPPS rate,2395.54,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7535.45,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2395.54,9079.71,
MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,599,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4706.48,100,MS-DRG,8781.6,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1404.93,100,,,case rate,100% of CO IPPS rate,1404.93,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5274.32,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1404.93,5274.32,
NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,600,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7767.14,100,MS-DRG,5449.648,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3082.95,100,,,case rate,100% of CO IPPS rate,3082.95,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7344.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3082.95,7767.14,
NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,601,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4715.57,100,MS-DRG,3771.856,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2149.06,100,,,case rate,100% of CO IPPS rate,2149.06,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4966.01,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2149.06,4966.01,
CELLULITIS WITH MCC,602,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11266.33,100,MS-DRG,7969.056,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5235.52,100,,,case rate,100% of CO IPPS rate,5235.52,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10167.67,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11266.33,
CELLULITIS WITHOUT MCC,603,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6700.72,100,MS-DRG,4734.656,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2520.1,100,,,case rate,100% of CO IPPS rate,2520.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6221.1,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2520.1,6700.72,
"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",604,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11407.96,100,MS-DRG,7896.952,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2318.94,100,,,case rate,100% of CO IPPS rate,2318.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10647.41,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2318.94,11407.96,
"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",605,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6883.25,100,MS-DRG,9967.992,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1590.89,100,,,case rate,100% of CO IPPS rate,1590.89,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6422.87,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1590.89,6883.25,
MINOR SKIN DISORDERS WITH MCC,606,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12010.85,100,MS-DRG,6433.056,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3637.32,100,,,case rate,100% of CO IPPS rate,3637.32,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10828.72,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3637.32,12010.85,
MINOR SKIN DISORDERS WITHOUT MCC,607,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6767.37,100,MS-DRG,4610.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1826.26,100,,,case rate,100% of CO IPPS rate,1826.26,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5984.05,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1826.26,6767.37,
ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,614,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17059.68,100,MS-DRG,27251.256,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8252.68,100,,,case rate,100% of CO IPPS rate,8252.68,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16578.54,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17059.68,
ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,615,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11142.11,100,MS-DRG,20955.136,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6700.68,100,,,case rate,100% of CO IPPS rate,6700.68,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10411.77,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11142.11,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",616,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,29975.62,100,MS-DRG,18204.264,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,15266.8,100,,,case rate,100% of CO IPPS rate,15266.8,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,26558.55,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,29975.62,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",617,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15030.6,100,MS-DRG,32802.088,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7612.35,100,,,case rate,100% of CO IPPS rate,7612.35,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13714.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15030.6,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",618,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8797.2,100,MS-DRG,16587.064,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7011.49,100,,,case rate,100% of CO IPPS rate,7011.49,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8274.81,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8797.2,
O.R. PROCEDURES FOR OBESITY WITH MCC,619,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,19605.3,100,MS-DRG,12771.584,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12481.5,100,,,case rate,100% of CO IPPS rate,12481.5,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20400.94,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20400.94,
O.R. PROCEDURES FOR OBESITY WITH CC,620,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12286.54,100,MS-DRG,19011.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6911.49,100,,,case rate,100% of CO IPPS rate,6911.49,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11891.91,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12286.54,
O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,621,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11492.03,100,MS-DRG,11174.376,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5774.98,100,,,case rate,100% of CO IPPS rate,5774.98,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10970.53,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11492.03,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",622,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,28975.09,100,MS-DRG,8970.04,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13053.71,100,,,case rate,100% of CO IPPS rate,13053.71,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,25546.86,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,28975.09,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",623,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14098.24,100,MS-DRG,15686.664,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6894.53,100,,,case rate,100% of CO IPPS rate,6894.53,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13295.85,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14098.24,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",624,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8441.22,100,MS-DRG,8155.08,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4915.64,100,,,case rate,100% of CO IPPS rate,4915.64,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6977.4,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8441.22,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",625,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22125.17,100,MS-DRG,6352.464,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5486.09,100,,,case rate,100% of CO IPPS rate,5486.09,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20298.65,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,22125.17,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",626,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11299.65,100,MS-DRG,18157.608,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4241.1,100,,,case rate,100% of CO IPPS rate,4241.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11423.46,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4241.1,11423.46,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",627,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9361.46,100,MS-DRG,8840.376,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3336.74,100,,,case rate,100% of CO IPPS rate,3336.74,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9001.47,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3336.74,9361.46,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",628,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,30405.82,100,MS-DRG,6432.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12727.11,100,,,case rate,100% of CO IPPS rate,12727.11,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,25714.06,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,30405.82,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",629,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17138.45,100,MS-DRG,18717.472,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7367.03,100,,,case rate,100% of CO IPPS rate,7367.03,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15830.01,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17138.45,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",630,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10575.58,100,MS-DRG,10406.072,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4637,100,,,case rate,100% of CO IPPS rate,4637,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9906.63,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10575.58,
DIABETES WITH MCC,637,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10977,100,MS-DRG,6359.736,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4126.78,100,,,case rate,100% of CO IPPS rate,4126.78,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9846.66,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4126.78,10977,
DIABETES WITH CC,638,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6812.06,100,MS-DRG,17074.824,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2635.89,100,,,case rate,100% of CO IPPS rate,2635.89,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6180.18,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2635.89,6812.06,
DIABETES WITHOUT CC/MCC,639,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4714.82,100,MS-DRG,9298.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2097.31,100,,,case rate,100% of CO IPPS rate,2097.31,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4238.64,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2097.31,4772,
"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",640,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9961.32,100,MS-DRG,5832.584,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5964.44,100,,,case rate,100% of CO IPPS rate,5964.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8926.69,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9961.32,
"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",641,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5918.32,100,MS-DRG,10372.744,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2752.84,100,,,case rate,100% of CO IPPS rate,2752.84,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5433.76,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2752.84,5918.32,
INBORN AND OTHER DISORDERS OF METABOLISM,642,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9871.19,100,MS-DRG,5590.824,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4610.1,100,,,case rate,100% of CO IPPS rate,4610.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9900.28,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4610.1,9900.28,
ENDOCRINE DISORDERS WITH MCC,643,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12459.99,100,MS-DRG,22406.92,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4863.01,100,,,case rate,100% of CO IPPS rate,4863.01,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11596.3,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12459.99,
ENDOCRINE DISORDERS WITH CC,644,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8041.32,100,MS-DRG,14434.224,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3442.88,100,,,case rate,100% of CO IPPS rate,3442.88,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7189.75,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3442.88,8041.32,
ENDOCRINE DISORDERS WITHOUT CC/MCC,645,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5763.06,100,MS-DRG,9612.92,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3021.26,100,,,case rate,100% of CO IPPS rate,3021.26,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5239.04,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3021.26,5763.06,
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,650,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,34064.07,100,MS-DRG,9093.648,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,40743.24,100,,,case rate,100% of CO IPPS rate,40743.24,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,32762.71,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,40743.24,
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,651,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,26193.92,100,MS-DRG,5458.128,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,31159.6,100,,,case rate,100% of CO IPPS rate,31159.6,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,25018.44,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,31159.6,
KIDNEY TRANSPLANT,652,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22755.33,100,MS-DRG,3687.024,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,39140.07,100,,,case rate,100% of CO IPPS rate,39140.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21765.38,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,39140.07,
MAJOR BLADDER PROCEDURES WITH MCC,653,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,41002.61,100,MS-DRG,11145.296,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,19340.66,100,,,case rate,100% of CO IPPS rate,19340.66,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,39202.52,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,41002.61,
MAJOR BLADDER PROCEDURES WITH CC,654,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20733.83,100,MS-DRG,6333.68,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11137.1,100,,,case rate,100% of CO IPPS rate,11137.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20053.84,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20733.83,
MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,655,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15964.48,100,MS-DRG,4731.632,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8107.36,100,,,case rate,100% of CO IPPS rate,8107.36,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15229.63,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15964.48,
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,656,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,23764.18,100,MS-DRG,7115.928,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13625.91,100,,,case rate,100% of CO IPPS rate,13625.91,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,23318.89,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,23764.18,
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,657,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13967.97,100,MS-DRG,4889.168,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8326.65,100,,,case rate,100% of CO IPPS rate,8326.65,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13249.29,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13967.97,
KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,658,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11212.55,100,MS-DRG,8581.648,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6707.7,100,,,case rate,100% of CO IPPS rate,6707.7,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11139.85,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11212.55,
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,659,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,19608.33,100,MS-DRG,4742.536,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10408.17,100,,,case rate,100% of CO IPPS rate,10408.17,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18180.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,19608.33,
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,660,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10193.85,100,MS-DRG,7246.8,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7043.65,100,,,case rate,100% of CO IPPS rate,7043.65,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9956.02,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10193.85,
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,661,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7940.58,100,MS-DRG,4193.576,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5041.66,100,,,case rate,100% of CO IPPS rate,5041.66,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7604.58,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7940.58,
MINOR BLADDER PROCEDURES WITH MCC,662,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22697.01,100,MS-DRG,6744.496,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8653.54,100,,,case rate,100% of CO IPPS rate,8653.54,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21438.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,22697.01,
MINOR BLADDER PROCEDURES WITH CC,663,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11050.47,100,MS-DRG,10024.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4970.91,100,,,case rate,100% of CO IPPS rate,4970.91,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10758.88,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11050.47,
MINOR BLADDER PROCEDURES WITHOUT CC/MCC,664,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8040.56,100,MS-DRG,6185.232,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2989.39,100,,,case rate,100% of CO IPPS rate,2989.39,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7948.87,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2989.39,8040.56,
PROSTATECTOMY WITH MCC,665,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,23396.84,100,MS-DRG,4291.728,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5700.71,100,,,case rate,100% of CO IPPS rate,5700.71,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21590.42,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,23396.84,
PROSTATECTOMY WITH CC,666,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13007.59,100,MS-DRG,11887.544,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4428.82,100,,,case rate,100% of CO IPPS rate,4428.82,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12148,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4428.82,13007.59,
PROSTATECTOMY WITHOUT CC/MCC,667,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7949.67,100,MS-DRG,8837.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3774.45,100,,,case rate,100% of CO IPPS rate,3774.45,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6941.41,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3774.45,7949.67,
TRANSURETHRAL PROCEDURES WITH MCC,668,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,21343.53,100,MS-DRG,12845.504,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5446.33,100,,,case rate,100% of CO IPPS rate,5446.33,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,19915.56,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,21343.53,
TRANSURETHRAL PROCEDURES WITH CC,669,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11623.06,100,MS-DRG,7478.872,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3400.48,100,,,case rate,100% of CO IPPS rate,3400.48,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11105.98,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3400.48,11623.06,
TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,670,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7290.73,100,MS-DRG,12863.072,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3001.96,100,,,case rate,100% of CO IPPS rate,3001.96,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6966.81,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3001.96,7290.73,
URETHRAL PROCEDURES WITH CC/MCC,671,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12965.93,100,MS-DRG,7200.752,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3037.63,100,,,case rate,100% of CO IPPS rate,3037.63,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12921.23,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3037.63,12965.93,
URETHRAL PROCEDURES WITHOUT CC/MCC,672,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6988.53,100,MS-DRG,8790.08,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2924.77,100,,,case rate,100% of CO IPPS rate,2924.77,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7349.19,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2924.77,7349.19,
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,673,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,28008.65,100,MS-DRG,5807.744,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8707.34,100,,,case rate,100% of CO IPPS rate,8707.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,24650.17,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,28008.65,
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,674,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18042.78,100,MS-DRG,13375.688,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6733.43,100,,,case rate,100% of CO IPPS rate,6733.43,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16723.88,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,18042.78,
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,675,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12016.15,100,MS-DRG,8617.392,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3585.27,100,,,case rate,100% of CO IPPS rate,3585.27,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11897.55,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3585.27,12016.15,
RENAL FAILURE WITH MCC,682,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11367.06,100,MS-DRG,10989.568,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11518.66,100,,,case rate,100% of CO IPPS rate,11518.66,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10487.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11518.66,
RENAL FAILURE WITH CC,683,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6822.66,100,MS-DRG,7124.408,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7285.46,100,,,case rate,100% of CO IPPS rate,7285.46,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6313.52,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7285.46,
RENAL FAILURE WITHOUT CC/MCC,684,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4608.78,100,MS-DRG,11359.792,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4714.77,100,,,case rate,100% of CO IPPS rate,4714.77,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4266.86,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4266.86,4772,
KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,686,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13931.62,100,MS-DRG,6751.768,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9591.82,100,,,case rate,100% of CO IPPS rate,9591.82,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11977.98,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13931.62,
KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,687,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7917.1,100,MS-DRG,4904.92,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6623.78,100,,,case rate,100% of CO IPPS rate,6623.78,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7335.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7917.1,
KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,688,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5914.54,100,MS-DRG,7518.864,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5157.45,100,,,case rate,100% of CO IPPS rate,5157.45,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6112.45,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,6112.45,
KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,689,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8894.91,100,MS-DRG,4428.672,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4521.8,100,,,case rate,100% of CO IPPS rate,4521.8,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8092.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4521.8,8894.91,
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,690,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6111.46,100,MS-DRG,9821.96,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2612.79,100,,,case rate,100% of CO IPPS rate,2612.79,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5612.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2612.79,6111.46,
URINARY STONES WITH MCC,693,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10727.06,100,MS-DRG,4847.968,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3310.14,100,,,case rate,100% of CO IPPS rate,3310.14,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10094.29,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3310.14,10727.06,
URINARY STONES WITHOUT MCC,694,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5928.17,100,MS-DRG,6082.832,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2303.44,100,,,case rate,100% of CO IPPS rate,2303.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5623.54,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2303.44,5928.17,
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,695,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9058.5,100,MS-DRG,3766.4,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3739.95,100,,,case rate,100% of CO IPPS rate,3739.95,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8101.26,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3739.95,9058.5,
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,696,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5241.97,100,MS-DRG,13170.28,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2246.42,100,,,case rate,100% of CO IPPS rate,2246.42,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4889.12,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2246.42,5241.97,
URETHRAL STRICTURE,697,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8430.62,100,MS-DRG,7635.8,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3612.17,100,,,case rate,100% of CO IPPS rate,3612.17,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7001.38,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3612.17,8430.62,
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,698,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12530.43,100,MS-DRG,23553.32,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6028.18,100,,,case rate,100% of CO IPPS rate,6028.18,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11305.64,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12530.43,
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,699,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7731.54,100,MS-DRG,11959.648,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4520.04,100,,,case rate,100% of CO IPPS rate,4520.04,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7140.37,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4520.04,7731.54,
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,700,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5364.66,100,MS-DRG,8268.384,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3035.29,100,,,case rate,100% of CO IPPS rate,3035.29,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5226.34,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3035.29,5364.66,
MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,707,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14859.43,100,MS-DRG,21911.888,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7875.21,100,,,case rate,100% of CO IPPS rate,7875.21,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14076.84,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14859.43,
MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,708,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11046.68,100,MS-DRG,10827.792,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6391.62,100,,,case rate,100% of CO IPPS rate,6391.62,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10474.56,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11046.68,
PENIS PROCEDURES WITH CC/MCC,709,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16056.88,100,MS-DRG,7872.72,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4858.34,100,,,case rate,100% of CO IPPS rate,4858.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17016.66,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17016.66,
PENIS PROCEDURES WITHOUT CC/MCC,710,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9348.59,100,MS-DRG,10796.888,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3524.16,100,,,case rate,100% of CO IPPS rate,3524.16,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10169.08,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3524.16,10169.08,
TESTES PROCEDURES WITH CC/MCC,711,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16078.84,100,MS-DRG,7040.792,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4517.99,100,,,case rate,100% of CO IPPS rate,4517.99,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14416.19,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4517.99,16078.84,
TESTES PROCEDURES WITHOUT CC/MCC,712,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9000.94,100,MS-DRG,11405.84,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3345.81,100,,,case rate,100% of CO IPPS rate,3345.81,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8759.49,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3345.81,9000.94,
TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,713,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10987.6,100,MS-DRG,6276.728,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4386.42,100,,,case rate,100% of CO IPPS rate,4386.42,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10454.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4386.42,10987.6,
TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,714,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7259.68,100,MS-DRG,10155.824,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3289.08,100,,,case rate,100% of CO IPPS rate,3289.08,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6760.1,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3289.08,7259.68,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,715,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16719.61,100,MS-DRG,5375.72,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8706.76,100,,,case rate,100% of CO IPPS rate,8706.76,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15755.23,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16719.61,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,716,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10771.74,100,MS-DRG,8512.568,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7146.28,100,,,case rate,100% of CO IPPS rate,7146.28,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9272.39,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10771.74,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,717,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13736.96,100,MS-DRG,15252.216,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4070.05,100,,,case rate,100% of CO IPPS rate,4070.05,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12489.47,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4070.05,13736.96,
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,718,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8905.51,100,MS-DRG,8240.512,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3014.24,100,,,case rate,100% of CO IPPS rate,3014.24,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8952.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3014.24,8952.8,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",722,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14199.74,100,MS-DRG,11224.672,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5260.37,100,,,case rate,100% of CO IPPS rate,5260.37,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11977.27,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14199.74,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",723,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8439.71,100,MS-DRG,6572.416,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4102.8,100,,,case rate,100% of CO IPPS rate,4102.8,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8130.18,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4102.8,8439.71,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",724,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6131.15,100,MS-DRG,5996.792,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2961.02,100,,,case rate,100% of CO IPPS rate,2961.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5397.78,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2961.02,6131.15,
BENIGN PROSTATIC HYPERTROPHY WITH MCC,725,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9398.58,100,MS-DRG,9037.904,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4627.93,100,,,case rate,100% of CO IPPS rate,4627.93,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8813.81,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4627.93,9398.58,
BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,726,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5535.84,100,MS-DRG,6014.36,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1815.44,100,,,case rate,100% of CO IPPS rate,1815.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5443.64,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1815.44,5535.84,
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,727,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12277.45,100,MS-DRG,3915.456,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2806.93,100,,,case rate,100% of CO IPPS rate,2806.93,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10136.62,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2806.93,12277.45,
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,728,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6059.96,100,MS-DRG,6031.328,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2176.84,100,,,case rate,100% of CO IPPS rate,2176.84,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5797.09,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2176.84,6059.96,
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,729,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7603.54,100,MS-DRG,3669.448,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3481.77,100,,,case rate,100% of CO IPPS rate,3481.77,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7603.88,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3481.77,7603.88,
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,730,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4708,100,MS-DRG,7380.712,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2580.04,100,,,case rate,100% of CO IPPS rate,2580.04,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4626.67,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2580.04,4772,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",734,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16462.85,100,MS-DRG,9354.8,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,24387.99,100,,,case rate,100% of CO ipps rate,9492.41,100,,,case rate,100% of CO IPPS rate,9492.41,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,24387.99,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15416.59,100,,,case rate,100% of CMS IPPS rate,24387.99,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,24387.99,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",735,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9544.75,100,MS-DRG,4839.48,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7029.91,100,,,case rate,100% of CO IPPS rate,7029.91,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8975.37,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9544.75,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,736,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,29441.65,100,MS-DRG,4342.632,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12299.93,100,,,case rate,100% of CO IPPS rate,12299.93,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,30090.99,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,30090.99,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,737,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14949.56,100,MS-DRG,5993.76,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8835.12,100,,,case rate,100% of CO IPPS rate,8835.12,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14275.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14949.56,
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,738,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10335.48,100,MS-DRG,10735.688,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6979.62,100,,,case rate,100% of CO IPPS rate,6979.62,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9903.81,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10335.48,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,739,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,27389.86,100,MS-DRG,6205.224,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6568.23,100,,,case rate,100% of CO IPPS rate,6568.23,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,27530.73,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,27530.73,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,740,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13534.74,100,MS-DRG,5249.088,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4651.91,100,,,case rate,100% of CO IPPS rate,4651.91,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12715.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13534.74,
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,741,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9840.9,100,MS-DRG,10600.568,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3668.02,100,,,case rate,100% of CO IPPS rate,3668.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9262.51,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3668.02,9840.9,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,742,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13496.11,100,MS-DRG,6368.824,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4557.47,100,,,case rate,100% of CO IPPS rate,4557.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12713.82,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4557.47,13496.11,
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,743,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8800.99,100,MS-DRG,5180.616,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3614.51,100,,,case rate,100% of CO IPPS rate,3614.51,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8258.58,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3614.51,8800.99,
"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",744,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14257.3,100,MS-DRG,11024.112,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3814.21,100,,,case rate,100% of CO IPPS rate,3814.21,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13392.51,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3814.21,14257.3,
"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",745,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7845.91,100,MS-DRG,36355.808,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2963.36,100,,,case rate,100% of CO IPPS rate,2963.36,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8118.89,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2963.36,8118.89,
"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",746,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12694.78,100,MS-DRG,24828.784,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4475.6,100,,,case rate,100% of CO IPPS rate,4475.6,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11029.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4475.6,12694.78,
"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",747,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6719.65,100,MS-DRG,14981.376,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3252.24,100,,,case rate,100% of CO IPPS rate,3252.24,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6904.02,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3252.24,6904.02,
FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,748,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10640.71,100,MS-DRG,25504.992,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3190.26,100,,,case rate,100% of CO IPPS rate,3190.26,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9998.35,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3190.26,10640.71,
OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,749,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,19065.27,100,MS-DRG,9027.6,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7242.77,100,,,case rate,100% of CO IPPS rate,7242.77,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17822.34,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,19065.27,
OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,750,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10300.64,100,MS-DRG,1222.144,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5139.03,100,,,case rate,100% of CO IPPS rate,5139.03,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10067.49,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10300.64,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",754,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14030.84,100,MS-DRG,8594.368,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5431.13,100,,,case rate,100% of CO IPPS rate,5431.13,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12253.83,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14030.84,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",755,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8215.52,100,MS-DRG,6034.36,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3352.82,100,,,case rate,100% of CO IPPS rate,3352.82,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7627.16,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3352.82,8215.52,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",756,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7495.99,100,MS-DRG,4915.224,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1875.97,100,,,case rate,100% of CO IPPS rate,1875.97,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7032.42,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1875.97,7495.99,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",757,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11297.38,100,MS-DRG,30020.912,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3608.08,100,,,case rate,100% of CO IPPS rate,3608.08,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9680.87,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3608.08,11297.38,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",758,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7517.95,100,MS-DRG,17073.008,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2336.19,100,,,case rate,100% of CO IPPS rate,2336.19,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6741.05,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2336.19,7517.95,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",759,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4894.32,100,MS-DRG,10844.152,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1842.05,100,,,case rate,100% of CO IPPS rate,1842.05,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4376.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1842.05,4894.32,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,760,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7539.16,100,MS-DRG,20542.504,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2705.48,100,,,case rate,100% of CO IPPS rate,2705.48,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6819.36,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2705.48,7539.16,
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,761,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4586.81,100,MS-DRG,11259.208,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1944.97,100,,,case rate,100% of CO IPPS rate,1944.97,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,3991.01,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1944.97,4772,
VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,768,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9225.89,100,MS-DRG,7334.056,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3127.98,100,,,case rate,100% of CO IPPS rate,3127.98,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8090.67,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3127.98,9225.89,
POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,769,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11693.5,100,MS-DRG,6108.888,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3190.55,100,,,case rate,100% of CO IPPS rate,3190.55,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11720.47,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3190.55,11720.47,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",770,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6049.35,100,MS-DRG,4524.408,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1901.41,100,,,case rate,100% of CO IPPS rate,1901.41,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6108.22,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1901.41,6108.22,
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,776,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5428.29,100,MS-DRG,3964.536,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1763.4,100,,,case rate,100% of CO IPPS rate,1763.4,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4918.04,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1763.4,5428.29,
ABORTION WITHOUT D&C,779,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7492.2,100,MS-DRG,13270.256,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1437.68,100,,,case rate,100% of CO IPPS rate,1437.68,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7186.22,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1437.68,7492.2,
CESAREAN SECTION WITH STERILIZATION WITH MCC,783,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13419.61,100,MS-DRG,7297.704,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4897.81,100,,,case rate,100% of CO IPPS rate,4897.81,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13614.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13614.03,
CESAREAN SECTION WITH STERILIZATION WITH CC,784,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7756.53,100,MS-DRG,6086.464,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3280.6,100,,,case rate,100% of CO IPPS rate,3280.6,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7365.42,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3280.6,7756.53,
CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,785,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6561.36,100,MS-DRG,8504.696,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2971.26,100,,,case rate,100% of CO IPPS rate,2971.26,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6434.87,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2971.26,6561.36,
CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,786,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13250.71,100,MS-DRG,5457.52,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4672.38,100,,,case rate,100% of CO IPPS rate,4672.38,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11393.83,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13250.71,
CESAREAN SECTION WITHOUT STERILIZATION WITH CC,787,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7961.03,100,MS-DRG,9452.352,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3407.79,100,,,case rate,100% of CO IPPS rate,3407.79,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7515.69,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3407.79,7961.03,
CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,788,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6475.77,100,MS-DRG,12894.584,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3076.52,100,,,case rate,100% of CO IPPS rate,3076.52,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6154.78,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3076.52,6475.77,
"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",789,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13780.14,100,MS-DRG,6024.056,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9011.14,100,,,case rate,100% of CO IPPS rate,9011.14,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12881.02,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13780.14,
"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",790,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,45444.76,100,MS-DRG,4303.24,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,19633.92,100,,,case rate,100% of CO IPPS rate,19633.92,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,42478.86,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,45444.76,
PREMATURITY WITH MAJOR PROBLEMS,791,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,31035.98,100,MS-DRG,13663.496,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9646.5,100,,,case rate,100% of CO IPPS rate,9646.5,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,29010.87,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,31035.98,
PREMATURITY WITHOUT MAJOR PROBLEMS,792,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18726.72,100,MS-DRG,7108.048,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2110.46,100,,,case rate,100% of CO IPPS rate,2110.46,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17504.87,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2110.46,18726.72,
FULL TERM NEONATE WITH MAJOR PROBLEMS,793,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,31881.24,100,MS-DRG,5496.904,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2424.78,100,,,case rate,100% of CO IPPS rate,2424.78,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,29800.32,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2424.78,31881.24,
NEONATE WITH OTHER SIGNIFICANT PROBLEMS,794,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11284.5,100,MS-DRG,36638.168,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,725.12,100,,,case rate,100% of CO IPPS rate,725.12,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10547.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,725.12,11284.5,
NORMAL NEWBORN,795,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1527.68,100,MS-DRG,13524.744,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,355.55,100,,,case rate,100% of CO IPPS rate,355.55,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,1427.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,355.55,4772,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,796,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10742.96,100,MS-DRG,7506.136,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2838.22,100,,,case rate,100% of CO IPPS rate,2838.22,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9263.22,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2838.22,10742.96,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,797,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7542.95,100,MS-DRG,27277.912,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2088.53,100,,,case rate,100% of CO IPPS rate,2088.53,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6546.33,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2088.53,7542.95,
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,798,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6144.03,100,MS-DRG,13529.584,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1911.05,100,,,case rate,100% of CO IPPS rate,1911.05,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6546.33,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1911.05,6546.33,
SPLENIC PROCEDURES WITH MCC,799,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,37526.14,100,MS-DRG,7824.848,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12084.44,100,,,case rate,100% of CO IPPS rate,12084.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,36740.32,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,37526.14,
SPLENIC PROCEDURES WITH CC,800,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,21341.26,100,MS-DRG,26592.616,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9087.16,100,,,case rate,100% of CO IPPS rate,9087.16,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18755.72,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,21341.26,
SPLENIC PROCEDURES WITHOUT CC/MCC,801,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13555.19,100,MS-DRG,14040.376,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3046.12,100,,,case rate,100% of CO ipps rate,7074.94,100,,,case rate,100% of CO IPPS rate,7074.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,3046.12,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12670.78,100,,,case rate,100% of CMS IPPS rate,3046.12,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3046.12,13555.19,
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,802,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,25678.13,100,MS-DRG,9939.512,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4467.54,100,,,case rate,100% of CO ipps rate,14481.44,100,,,case rate,100% of CO IPPS rate,14481.44,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,4467.54,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,26893.66,100,,,case rate,100% of CMS IPPS rate,4467.54,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4467.54,26893.66,
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,803,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14074.01,100,MS-DRG,19109.504,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7581.41,100,,,case rate,100% of CO ipps rate,7260.9,100,,,case rate,100% of CO IPPS rate,7260.9,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,7581.41,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14486.03,100,,,case rate,100% of CMS IPPS rate,7581.41,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,14486.03,
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,804,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9167.57,100,MS-DRG,9580.808,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,20709.5,100,,,case rate,100% of CO ipps rate,6017.66,100,,,case rate,100% of CO IPPS rate,6017.66,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,20709.5,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8902,100,,,case rate,100% of CMS IPPS rate,20709.5,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,20709.5,
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,805,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7636.11,100,MS-DRG,6118.584,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1894.39,100,,,case rate,100% of CO IPPS rate,1894.39,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7094.51,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1894.39,7636.11,
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,806,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5655.51,100,MS-DRG,4469.872,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1418.67,100,,,case rate,100% of CO IPPS rate,1418.67,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4922.98,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1418.67,5655.51,
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,807,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4955.67,100,MS-DRG,3101.096,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1260.2,100,,,case rate,100% of CO IPPS rate,1260.2,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4454.53,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1260.2,4955.67,
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,808,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16587.82,100,MS-DRG,33925.464,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6741.03,100,,,case rate,100% of CO IPPS rate,6741.03,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15104.76,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16587.82,
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,809,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9122.13,100,MS-DRG,13545.344,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4230.28,100,,,case rate,100% of CO IPPS rate,4230.28,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8576.76,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4230.28,9122.13,
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,810,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7608.08,100,MS-DRG,7254.68,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3073.59,100,,,case rate,100% of CO IPPS rate,3073.59,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6623.23,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3073.59,7608.08,
RED BLOOD CELL DISORDERS WITH MCC,811,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10630.87,100,MS-DRG,28821.192,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4003.68,100,,,case rate,100% of CO IPPS rate,4003.68,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9808.57,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4003.68,10630.87,
RED BLOOD CELL DISORDERS WITHOUT MCC,812,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6821.9,100,MS-DRG,11829.984,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2449.34,100,,,case rate,100% of CO IPPS rate,2449.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6335.39,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2449.34,6821.9,
COAGULATION DISORDERS,813,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11815.44,100,MS-DRG,7895.744,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2866,100,,,case rate,100% of CO IPPS rate,2866,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11041.78,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2866,11815.44,
RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,814,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16118.23,100,MS-DRG,18936.208,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6131.98,100,,,case rate,100% of CO IPPS rate,6131.98,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13257.05,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16118.23,
RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,815,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7530.07,100,MS-DRG,9534.152,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3343.47,100,,,case rate,100% of CO IPPS rate,3343.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7274.41,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3343.47,7530.07,
RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,816,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5379.05,100,MS-DRG,6461.528,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2156.37,100,,,case rate,100% of CO IPPS rate,2156.37,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5143.1,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2156.37,5379.05,
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,817,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17079.37,100,MS-DRG,11273.744,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3879.71,100,,,case rate,100% of CO IPPS rate,3879.71,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,22080.74,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3879.71,22080.74,
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,818,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8885.06,100,MS-DRG,7011.704,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3040.55,100,,,case rate,100% of CO IPPS rate,3040.55,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11218.16,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3040.55,11218.16,
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,819,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6871.13,100,MS-DRG,5240.6,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2519.22,100,,,case rate,100% of CO IPPS rate,2519.22,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6268.37,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2519.22,6871.13,
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,820,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,45797.71,100,MS-DRG,14808.688,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,21029.49,100,,,case rate,100% of CO IPPS rate,21029.49,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,37515.67,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,45797.71,
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,821,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16905.93,100,MS-DRG,7347.384,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3740.6,100,,,case rate,100% of CO ipps rate,8705.88,100,,,case rate,100% of CO IPPS rate,8705.88,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,3740.6,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15255.73,100,,,case rate,100% of CMS IPPS rate,3740.6,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3740.6,16905.93,
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,822,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9382.67,100,MS-DRG,4601.96,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4817.61,100,,,case rate,100% of CO ipps rate,4620.04,100,,,case rate,100% of CO IPPS rate,4620.04,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,4817.61,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8501.28,100,,,case rate,100% of CMS IPPS rate,4817.61,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4620.04,9382.67,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,823,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,34097.39,100,MS-DRG,16307.728,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6673.08,100,,,case rate,100% of CO ipps rate,15962.1,100,,,case rate,100% of CO IPPS rate,15962.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,6673.08,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,30522.75,100,,,case rate,100% of CMS IPPS rate,6673.08,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,34097.39,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,824,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16911.98,100,MS-DRG,30291.76,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,24817.8,100,,,case rate,100% of CO ipps rate,8201.51,100,,,case rate,100% of CO IPPS rate,8201.51,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,24817.8,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16158.07,100,,,case rate,100% of CMS IPPS rate,24817.8,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,24817.8,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,825,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9781.06,100,MS-DRG,12349.864,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4732.32,100,,,case rate,100% of CO IPPS rate,4732.32,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9288.61,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9781.06,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,826,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,33240.77,100,MS-DRG,10311.544,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13673.28,100,,,case rate,100% of CO IPPS rate,13673.28,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,36276.1,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,36276.1,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,827,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,17550.47,100,MS-DRG,26832.56,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9871.64,100,,,case rate,100% of CO IPPS rate,9871.64,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17176.81,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,17550.47,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,828,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12424.39,100,MS-DRG,12940.632,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6276.13,100,,,case rate,100% of CO IPPS rate,6276.13,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12269.35,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12424.39,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,829,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,23886.88,100,MS-DRG,7776.376,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7371.13,100,,,case rate,100% of CO IPPS rate,7371.13,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,22326.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,23886.88,
MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,830,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11976.01,100,MS-DRG,11161.048,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5510.66,100,,,case rate,100% of CO IPPS rate,5510.66,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10374.38,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11976.01,
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,831,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7648.23,100,MS-DRG,6092.528,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2470.69,100,,,case rate,100% of CO IPPS rate,2470.69,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8429.31,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2470.69,8429.31,
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,832,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5587.34,100,MS-DRG,5349.064,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1609.02,100,,,case rate,100% of CO IPPS rate,1609.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4942.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1609.02,5587.34,
OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,833,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3876.37,100,MS-DRG,9936.48,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1133.88,100,,,case rate,100% of CO IPPS rate,1133.88,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,3555.72,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1133.88,4772,
ACUTE LEUKEMIA WITH MCC,834,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,42406.83,100,MS-DRG,5560.528,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,28548.28,100,,,case rate,100% of CO IPPS rate,28548.28,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,39014.15,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,42406.83,
ACUTE LEUKEMIA WITH CC,835,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16931.68,100,MS-DRG,12677.664,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,19900.58,100,,,case rate,100% of CO IPPS rate,19900.58,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14795.04,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,19900.58,
ACUTE LEUKEMIA WITHOUT CC/MCC,836,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9068.35,100,MS-DRG,6577.264,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,26618.22,100,,,case rate,100% of CO IPPS rate,26618.22,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11067.88,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,26618.22,
CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,837,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,36026.49,100,MS-DRG,4185.088,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9043.88,100,,,case rate,100% of CO IPPS rate,9043.88,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,37971.42,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,37971.42,
CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,838,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14787.48,100,MS-DRG,42201.72,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6076.14,100,,,case rate,100% of CO IPPS rate,6076.14,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15691.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15691.03,
CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,839,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9869.68,100,MS-DRG,12012.968,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4894.3,100,,,case rate,100% of CO IPPS rate,4894.3,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9698.51,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9869.68,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,840,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,23670.26,100,MS-DRG,6240.368,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,11458.72,100,,,case rate,100% of CO IPPS rate,11458.72,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21919.89,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,23670.26,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,841,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11917.69,100,MS-DRG,22609.904,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8394.78,100,,,case rate,100% of CO IPPS rate,8394.78,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11251.31,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11917.69,
LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,842,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8076.91,100,MS-DRG,5784.112,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6055.67,100,,,case rate,100% of CO IPPS rate,6055.67,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7786.6,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8076.91,
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,843,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14092.18,100,MS-DRG,5492.664,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10396.77,100,,,case rate,100% of CO IPPS rate,10396.77,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13668.36,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,14092.18,
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,844,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8764.63,100,MS-DRG,5691.408,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6118.82,100,,,case rate,100% of CO IPPS rate,6118.82,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8046.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8764.63,
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,845,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6550.75,100,MS-DRG,11363.424,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3111.31,100,,,case rate,100% of CO IPPS rate,3111.31,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5965,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3111.31,6550.75,
CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,846,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18510.86,100,MS-DRG,10645.408,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5967.07,100,,,case rate,100% of CO IPPS rate,5967.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16995.5,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,18510.86,
CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,847,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9184.23,100,MS-DRG,8279.288,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4123.27,100,,,case rate,100% of CO IPPS rate,4123.27,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8593.7,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4123.27,9184.23,
CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,848,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5752.45,100,MS-DRG,10189.76,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3221.25,100,,,case rate,100% of CO IPPS rate,3221.25,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6554.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3221.25,6554.8,
RADIOTHERAPY,849,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20384.66,100,MS-DRG,7850.296,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3936.73,100,,,case rate,100% of CO IPPS rate,3936.73,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,16500.94,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3936.73,20384.66,
ACUTE LEUKEMIA WITH OTHER PROCEDURES,850,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,853,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,37864.7,100,MS-DRG,9748.04,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,19590.94,100,,,case rate,100% of CO IPPS rate,19590.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,34576.56,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,37864.7,
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,854,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15437.33,100,MS-DRG,10773.864,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10376.59,100,,,case rate,100% of CO IPPS rate,10376.59,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14502.26,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15437.33,
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,855,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12889.43,100,MS-DRG,5184.248,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7599.77,100,,,case rate,100% of CO IPPS rate,7599.77,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10777.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12889.43,
POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,856,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,33540.7,100,MS-DRG,26223.008,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,15950.4,100,,,case rate,100% of CO IPPS rate,15950.4,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,31131.6,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,33540.7,
POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,857,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16175.79,100,MS-DRG,11419.776,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5994.27,100,,,case rate,100% of CO IPPS rate,5994.27,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14879,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16175.79,
POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,858,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9720.47,100,MS-DRG,7522.496,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4208.65,100,,,case rate,100% of CO IPPS rate,4208.65,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9980,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4208.65,9980,
POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,862,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13951.31,100,MS-DRG,19729.968,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5780.53,100,,,case rate,100% of CO IPPS rate,5780.53,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12904.3,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,13951.31,
POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,863,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7615.66,100,MS-DRG,9595.952,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2612.2,100,,,case rate,100% of CO IPPS rate,2612.2,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7096.62,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2612.2,7615.66,
FEVER AND INFLAMMATORY CONDITIONS,864,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6686.33,100,MS-DRG,11400.992,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3408.09,100,,,case rate,100% of CO IPPS rate,3408.09,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5984.05,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3408.09,6686.33,
VIRAL ILLNESS WITH MCC,865,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12420.6,100,MS-DRG,22537.192,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2323.62,100,,,case rate,100% of CO IPPS rate,2323.62,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11801.6,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2323.62,12420.6,
VIRAL ILLNESS WITHOUT MCC,866,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6950.66,100,MS-DRG,12143.24,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1711.94,100,,,case rate,100% of CO IPPS rate,1711.94,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6347.38,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1711.94,6950.66,
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,867,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15847.08,100,MS-DRG,8218.096,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6556.53,100,,,case rate,100% of CO IPPS rate,6556.53,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14910.04,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15847.08,
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,868,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8221.58,100,MS-DRG,9055.472,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5034.65,100,,,case rate,100% of CO IPPS rate,5034.65,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7447.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,8221.58,
OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,869,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5231.36,100,MS-DRG,5499.936,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3599.89,100,,,case rate,100% of CO IPPS rate,3599.89,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5226.34,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3599.89,5231.36,
SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,870,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,52752.15,100,MS-DRG,10749.024,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,24412.43,100,,,case rate,100% of CO IPPS rate,24412.43,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,47909.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,52752.15,
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,871,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15016.21,100,MS-DRG,3991.8,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7176.4,100,,,case rate,100% of CO IPPS rate,7176.4,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13808.05,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15016.21,
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,872,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7800.46,100,MS-DRG,9669.88,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4355.72,100,,,case rate,100% of CO IPPS rate,4355.72,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7252.54,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4355.72,7800.46,
O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,876,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,28262.38,100,MS-DRG,5216.368,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7674.63,100,,,case rate,100% of CO IPPS rate,7674.63,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,22549.9,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,28262.38,
ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,880,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7230.14,100,MS-DRG,11056.224,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2321.28,100,,,case rate,100% of CO IPPS rate,2321.28,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6393.24,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2321.28,7230.14,
DEPRESSIVE NEUROSES,881,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6865.83,100,MS-DRG,6264,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2452.56,100,,,case rate,100% of CO IPPS rate,2452.56,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6035.55,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2452.56,6865.83,
NEUROSES EXCEPT DEPRESSIVE,882,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7114.26,100,MS-DRG,4228.112,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2757.23,100,,,case rate,100% of CO IPPS rate,2757.23,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6162.54,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2757.23,7114.26,
DISORDERS OF PERSONALITY AND IMPULSE CONTROL,883,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14204.28,100,MS-DRG,10572.696,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3744.63,100,,,case rate,100% of CO IPPS rate,3744.63,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11390.3,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3744.63,14204.28,
ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,884,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13306.76,100,MS-DRG,6128.272,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3808.07,100,,,case rate,100% of CO IPPS rate,3808.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11076.35,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3808.07,13306.76,
PSYCHOSES,885,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10349.11,100,MS-DRG,159712.632,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3404.58,100,,,case rate,100% of CO IPPS rate,3404.58,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9139.75,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3404.58,10349.11,
BEHAVIORAL AND DEVELOPMENTAL DISORDERS,886,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12737.2,100,MS-DRG,41927.848,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4758.92,100,,,case rate,100% of CO IPPS rate,4758.92,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9630.08,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,12737.2,
OTHER MENTAL DISORDER DIAGNOSES,887,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9812.87,100,MS-DRG,19483.36,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5007.16,100,,,case rate,100% of CO IPPS rate,5007.16,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9146.81,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,9812.87,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",894,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4351.26,100,MS-DRG,18371.496,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,53670.51,100,,,case rate,100% of CO ipps rate,1329.79,100,,,case rate,100% of CO IPPS rate,1329.79,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,53670.51,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4034.05,100,,,case rate,100% of CMS IPPS rate,53670.51,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,1329.79,53670.51,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",895,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12185.05,100,MS-DRG,12678.88,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2891.73,100,,,case rate,100% of CO IPPS rate,2891.73,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10996.63,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2891.73,12185.05,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",896,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13467.33,100,MS-DRG,12367.432,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3201.07,100,,,case rate,100% of CO IPPS rate,3201.07,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12385.76,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3201.07,13467.33,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",897,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6480.31,100,MS-DRG,19482.144,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2235.9,100,,,case rate,100% of CO IPPS rate,2235.9,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6005.92,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2235.9,6480.31,
WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,901,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,32778.76,100,MS-DRG,13127.864,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5413.28,100,,,case rate,100% of CO ipps rate,22483.84,100,,,case rate,100% of CO IPPS rate,22483.84,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5413.28,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,31032.12,100,,,case rate,100% of CMS IPPS rate,5413.28,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,32778.76,
WOUND DEBRIDEMENTS FOR INJURIES WITH CC,902,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14274.72,100,MS-DRG,11245.872,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,18192,100,,,case rate,100% of CO ipps rate,6297.77,100,,,case rate,100% of CO IPPS rate,6297.77,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,18192,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13981.6,100,,,case rate,100% of CMS IPPS rate,18192,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,18192,
WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,903,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9403.12,100,MS-DRG,722.4,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,28901.4,100,,,case rate,100% of CO ipps rate,3464.52,100,,,case rate,100% of CO IPPS rate,3464.52,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,28901.4,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8576.06,100,,,case rate,100% of CMS IPPS rate,28901.4,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3464.52,28901.4,
SKIN GRAFTS FOR INJURIES WITH CC/MCC,904,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,24662.46,100,MS-DRG,722.4,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,57562.14,100,,,case rate,100% of CO ipps rate,12041.16,100,,,case rate,100% of CO IPPS rate,12041.16,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,57562.14,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,25058.65,100,,,case rate,100% of CMS IPPS rate,57562.14,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,57562.14,
SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,905,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11994.94,100,MS-DRG,7583.696,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4523.84,100,,,case rate,100% of CO IPPS rate,4523.84,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11005.09,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4523.84,11994.94,
HAND PROCEDURES FOR INJURIES,906,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14251.24,100,MS-DRG,4853.416,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3432.06,100,,,case rate,100% of CO IPPS rate,3432.06,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12612.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3432.06,14251.24,
OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,907,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,28171.49,100,MS-DRG,6277.936,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13579.42,100,,,case rate,100% of CO IPPS rate,13579.42,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,27272.51,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,28171.49,
OTHER O.R. PROCEDURES FOR INJURIES WITH CC,908,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15179.05,100,MS-DRG,3806.392,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5990.76,100,,,case rate,100% of CO IPPS rate,5990.76,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14508.61,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,15179.05,
OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,909,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10272.62,100,MS-DRG,3574.928,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3552.82,100,,,case rate,100% of CO IPPS rate,3552.82,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9627.96,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3552.82,10272.62,
TRAUMATIC INJURY WITH MCC,913,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11319.34,100,MS-DRG,36901.736,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,30678.54,100,,,case rate,100% of CO ipps rate,3223.88,100,,,case rate,100% of CO IPPS rate,3223.88,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,30678.54,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10681.98,100,,,case rate,100% of CMS IPPS rate,30678.54,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,3223.88,30678.54,
TRAUMATIC INJURY WITHOUT MCC,914,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6874.92,100,MS-DRG,23498.792,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,49934.15,100,,,case rate,100% of CO ipps rate,2401.1,100,,,case rate,100% of CO IPPS rate,2401.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,49934.15,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6272.6,100,,,case rate,100% of CMS IPPS rate,49934.15,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,2401.1,49934.15,
ALLERGIC REACTIONS WITH MCC,915,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13436.28,100,MS-DRG,43823.168,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2675.36,100,,,case rate,100% of CO IPPS rate,2675.36,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12840.81,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2675.36,13436.28,
ALLERGIC REACTIONS WITHOUT MCC,916,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4989.75,100,MS-DRG,24508.256,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1860.18,100,,,case rate,100% of CO IPPS rate,1860.18,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4685.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1860.18,4989.75,
POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,917,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12087.35,100,MS-DRG,15344.32,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2763.37,100,,,case rate,100% of CO IPPS rate,2763.37,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10741.24,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2763.37,12087.35,
POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,918,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6520.46,100,MS-DRG,16567.672,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2272.74,100,,,case rate,100% of CO IPPS rate,2272.74,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5768.87,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2272.74,6520.46,
COMPLICATIONS OF TREATMENT WITH MCC,919,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13820.28,100,MS-DRG,9094.856,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3498.14,100,,,case rate,100% of CO IPPS rate,3498.14,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,12653.85,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3498.14,13820.28,
COMPLICATIONS OF TREATMENT WITH CC,920,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7830,100,MS-DRG,5791.992,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2597.29,100,,,case rate,100% of CO IPPS rate,2597.29,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7208.8,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2597.29,7830,
COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,921,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,5285.14,100,MS-DRG,41642.456,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7871.49,100,,,case rate,100% of CO ipps rate,2040.88,100,,,case rate,100% of CO IPPS rate,2040.88,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,7871.49,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5135.33,100,,,case rate,100% of CMS IPPS rate,7871.49,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,2040.88,7871.49,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",922,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,13215.87,100,MS-DRG,14568.744,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10621.88,100,,,case rate,100% of CO ipps rate,4186.43,100,,,case rate,100% of CO IPPS rate,4186.43,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,10621.88,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10976.17,100,,,case rate,100% of CMS IPPS rate,10621.88,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4186.43,13215.87,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",923,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7660.34,100,MS-DRG,17671.656,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,19916.91,100,,,case rate,100% of CO ipps rate,2590.57,100,,,case rate,100% of CO IPPS rate,2590.57,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,19916.91,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6654.28,100,,,case rate,100% of CMS IPPS rate,19916.91,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,2590.57,19916.91,
EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,927,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,199640.79,100,MS-DRG,8260.504,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,76849.19,100,,,case rate,100% of CO IPPS rate,76849.19,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,133919.42,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,199640.79,
FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,928,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,52409.81,100,MS-DRG,5121.84,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,17510.59,100,,,case rate,100% of CO IPPS rate,17510.59,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,43679.62,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,52409.81,
FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,929,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,24354.2,100,MS-DRG,8580.432,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,10776.29,100,,,case rate,100% of CO IPPS rate,10776.29,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20733.23,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,24354.2,
EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,933,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22964.37,100,MS-DRG,28723.032,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,15454.31,100,,,case rate,100% of CO ipps rate,13330.31,100,,,case rate,100% of CO IPPS rate,13330.31,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,15454.31,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21397.82,100,,,case rate,100% of CMS IPPS rate,15454.31,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,22964.37,
FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,934,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15848.6,100,MS-DRG,15063.168,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,24836.86,100,,,case rate,100% of CO ipps rate,4792.26,100,,,case rate,100% of CO IPPS rate,4792.26,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,24836.86,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13235.18,100,,,case rate,100% of CMS IPPS rate,24836.86,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,24836.86,
NON-EXTENSIVE BURNS,935,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,15459.29,100,MS-DRG,9908,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2124.21,100,,,case rate,100% of CO IPPS rate,2124.21,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,14280.03,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2124.21,15459.29,
O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,939,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,24352.68,100,MS-DRG,20460.104,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8365.54,100,,,case rate,100% of CO IPPS rate,8365.54,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21850.04,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,24352.68,
O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,940,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,16409.83,100,MS-DRG,10282.464,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6605.65,100,,,case rate,100% of CO IPPS rate,6605.65,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,15544.28,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,16409.83,
O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,941,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,14057.34,100,MS-DRG,6545.752,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3597.85,100,,,case rate,100% of CO IPPS rate,3597.85,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,13315.61,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3597.85,14057.34,
REHABILITATION WITH CC/MCC,945,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,903,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9975.73,100,,,case rate,100% of CO IPPS rate,9975.73,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10619.19,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,903,10619.19,
REHABILITATION WITHOUT CC/MCC,946,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,903,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7368.5,100,,,case rate,100% of CO IPPS rate,7368.5,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7919.94,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,903,7919.94,
SIGNS AND SYMPTOMS WITH MCC,947,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,9479.62,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4051.34,100,,,case rate,100% of CO IPPS rate,4051.34,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8576.06,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4051.34,9479.62,
SIGNS AND SYMPTOMS WITHOUT MCC,948,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6066.77,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2697,100,,,case rate,100% of CO IPPS rate,2697,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5485.97,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2697,6066.77,
AFTERCARE WITH CC/MCC,949,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7847.42,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2617.17,100,,,case rate,100% of CO IPPS rate,2617.17,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,8409.56,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2617.17,8409.56,
AFTERCARE WITHOUT CC/MCC,950,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4757.99,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,1506.39,100,,,case rate,100% of CO IPPS rate,1506.39,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,5005.52,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,1506.39,5005.52,
OTHER FACTORS INFLUENCING HEALTH STATUS,951,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4468.66,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4933.35,100,,,case rate,100% of CO ipps rate,1345.87,100,,,case rate,100% of CO IPPS rate,1345.87,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,4933.35,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,4015.71,100,,,case rate,100% of CMS IPPS rate,4933.35,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,1345.87,4933.35,
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,955,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,46127.17,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,23454.86,100,,,case rate,100% of CO IPPS rate,23454.86,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,47522.48,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,47522.48,
"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",956,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,29373.49,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,23515.68,100,,,case rate,100% of CO IPPS rate,23515.68,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,26838.63,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,29373.49,
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,957,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,54778.96,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,25469.42,100,,,case rate,100% of CO IPPS rate,25469.42,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,52281.08,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,54778.96,
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,958,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,30635.32,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,19047.39,100,,,case rate,100% of CO IPPS rate,19047.39,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,29422.88,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,30635.32,
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,959,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,19180.4,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,14563.02,100,,,case rate,100% of CO IPPS rate,14563.02,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,18122.18,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,19180.4,
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,963,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,20709.59,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,12929.73,100,,,case rate,100% of CO IPPS rate,12929.73,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,19564.93,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,20709.59,
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,964,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,11368.57,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,9235.11,100,,,case rate,100% of CO IPPS rate,9235.11,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,10332.05,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,11368.57,
OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,965,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,7239.99,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7439.25,100,,,case rate,100% of CO IPPS rate,7439.25,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6419.34,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,7439.25,
HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,969,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,52053.07,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,37137.2,100,,,case rate,100% of CO IPPS rate,37137.2,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,51131.82,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,52053.07,
HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,970,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18210.93,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,28362.03,100,,,case rate,100% of CO IPPS rate,28362.03,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,21788.66,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,28362.03,
HIV WITH MAJOR RELATED CONDITION WITH MCC,974,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,22089.57,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,32246.06,100,,,case rate,100% of CO ipps rate,8568.46,100,,,case rate,100% of CO IPPS rate,8568.46,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,32246.06,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,20269.02,100,,,case rate,100% of CMS IPPS rate,32246.06,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,32246.06,
HIV WITH MAJOR RELATED CONDITION WITH CC,975,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10325.63,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,6106.25,100,,,case rate,100% of CO IPPS rate,6106.25,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9705.56,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,10325.63,
HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,976,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,6402.3,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4660.68,100,,,case rate,100% of CO IPPS rate,4660.68,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,6510.35,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,6510.35,
HIV WITH OR WITHOUT OTHER RELATED CONDITION,977,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,10725.54,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,3816.85,100,,,case rate,100% of CO IPPS rate,3816.85,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,9170.79,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,3816.85,10725.54,
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,981,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,35903.79,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,5685,100,,,case rate,100% of CO ipps rate,14426.47,100,,,case rate,100% of CO IPPS rate,14426.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,5685,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,32314.72,100,,,case rate,100% of CMS IPPS rate,5685,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,35903.79,
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,982,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,18828.96,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,7193.24,100,,,case rate,100% of CO ipps rate,7345.1,100,,,case rate,100% of CO IPPS rate,7345.1,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,7193.24,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,17695.35,100,,,case rate,100% of CMS IPPS rate,7193.24,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4628.84,18828.96,
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,983,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12385,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,13701.17,100,,,case rate,100% of CO ipps rate,4280.57,100,,,case rate,100% of CO IPPS rate,4280.57,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,13701.17,100,,,case rate,100% of CO ipps rate,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11783.26,100,,,case rate,100% of CMS IPPS rate,13701.17,100,,,case rate,100% of CO IPPS rate,4772,100,,,per diem,pays based on per day rate,4280.57,13701.17,
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,987,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,25575.13,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,8864.36,100,,,case rate,100% of CO IPPS rate,8864.36,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,23411.31,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,25575.13,
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,988,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,12853.08,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4288.47,100,,,case rate,100% of CO IPPS rate,4288.47,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,11968.1,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4288.47,12853.08,
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,989,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,8182.19,100,MS-DRG,,case rate,100% of  CMS IPPS rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,2694.36,100,,,case rate,100% of CO IPPS rate,2694.36,100,,,case rate,100% of NM IPPS rate,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,7777.43,100,,,case rate,100% of CMS IPPS rate,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,2694.36,8182.19,
PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS,998,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
UNGROUPABLE,999,CDM,100,RC,,,INPATIENT,,,,,,,,,,other,not separately reimbursable,4772,,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4628.84,100,,,per diem,pays based on per day rate,,,,,other,not separately reimbursable,,,,,other,not separately reimbursable,4772,100,,,per diem,pays based on per day rate,4628.84,4772,
Hepatitis A vaccine,60000522,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,47.3,37.84,,35.48,75,,,percent of total billed charges,75% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,37.46,79.2,,,percent of total billed charges,79.2% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,44.94,95,,,percent of total billed charges,95% of total billed charges,37.84,80,,,percent of total billed charges,80% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,47.3,100,,,fee schedule,100% of NM fee schedule,18.92,40,,,percent of total billed charges,40% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,42.57,90,,,percent of total billed charges,90% of total billed charges,35.95,76,,,percent of total billed charges,76% of total billed charges,18.92,40,,,percent of total billed charges,40% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,37.84,80,,,percent of total billed charges,80% of total billed charges,18.35,38.8,,,percent of total billed charges,38.8% of total billed charges,40.21,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,18.35,47.3,
Cytopathology,40088175,CDM,311,RC,88175,HCPCS,OUTPATIENT,,,132.1,105.68,,99.08,75,,,percent of total billed charges,75% of total billed charges,52.84,40,,,percent of total billed charges,40% of total billed charges,104.62,79.2,,,percent of total billed charges,79.2% of total billed charges,112.29,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,125.5,95,,,percent of total billed charges,95% of total billed charges,105.68,80,,,percent of total billed charges,80% of total billed charges,112.29,85,,,percent of total billed charges,85% of total billed charges,118.89,90,,,percent of total billed charges,90% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rates,22.75,100,,,fee schedule,100% of CO APG rates,25.01,100,,,fee schedule,100% of NM fee schedule,52.84,40,,,percent of total billed charges,40% of total billed charges,52.84,40,,,percent of total billed charges,40% of total billed charges,118.89,90,,,percent of total billed charges,90% of total billed charges,100.4,76,,,percent of total billed charges,76% of total billed charges,52.84,40,,,percent of total billed charges,40% of total billed charges,112.29,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of CO APG rate,105.68,80,,,percent of total billed charges,80% of total billed charges,51.25,38.8,,,percent of total billed charges,38.8% of total billed charges,112.29,85,,,percent of total billed charges,85% of total billed charges,22.75,100,,,fee schedule,100% of APG fee schedule,53.22,200,,,fee schedule,200% of CMS fee schedule,22.75,125.5,
Intraocular lenses,460ECON0003,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,939,200,,,percent of total billed charges,200% of total billed charges,182.17,939,
Intraocular lenses,460ECON0004,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,939,200,,,percent of total billed charges,200% of total billed charges,182.17,939,
Intraocular lenses,460ECON0005,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,939,200,,,percent of total billed charges,200% of total billed charges,182.17,939,
Intraocular lenses,460ECON0006,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,939,200,,,percent of total billed charges,200% of total billed charges,182.17,939,
Intraocular lenses,460ECON0007,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,939,200,,,percent of total billed charges,200% of total billed charges,182.17,939,
Intraocular lenses,460ECON0008,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,939,200,,,percent of total billed charges,200% of total billed charges,182.17,939,
Intraocular lenses,460ECON0009,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,939,200,,,percent of total billed charges,200% of total billed charges,182.17,939,
Intraocular lenses,460ECON0010,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,939,200,,,percent of total billed charges,200% of total billed charges,182.17,939,
Intraocular lenses,460ECON0011,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,939,200,,,percent of total billed charges,200% of total billed charges,182.17,939,
Intraocular lenses,460ECON0012,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0013,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0014,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0015,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0016,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0017,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0018,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0019,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0020,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0021,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0022,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0023,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0024,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0025,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0026,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0027,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0028,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0029,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0030,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0031,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0032,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0033,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0034,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0035,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0036,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0037,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0038,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0039,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0040,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0041,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0042,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0043,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0044,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0045,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0046,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0047,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0048,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
Intraocular lenses,460ECON0049,CDM,276,RC,,,OUTPATIENT,,,469.5,375.6,,352.13,75,,,percent of total billed charges,75% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,371.84,79.2,,,percent of total billed charges,79.2% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,446.03,95,,,percent of total billed charges,95% of total billed charges,375.6,80,,,percent of total billed charges,80% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of CO APG rates,469.5,100,,,fee schedule,100% of NM fee schedule,187.8,40,,,percent of total billed charges,40% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,422.55,90,,,percent of total billed charges,90% of total billed charges,356.82,76,,,percent of total billed charges,76% of total billed charges,187.8,40,,,percent of total billed charges,40% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of CO APG rate,375.6,80,,,percent of total billed charges,80% of total billed charges,182.17,38.8,,,percent of total billed charges,38.8% of total billed charges,399.08,85,,,percent of total billed charges,85% of total billed charges,469.5,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,182.17,469.5,
radiological supervision and interpretation of a mammary ductogram,60001027,CDM,401,RC,77054,HCPCS,OUTPATIENT,,,373.1,298.48,TC,279.83,75,,,percent of total billed charges,75% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,295.5,79.2,,,percent of total billed charges,79.2% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,354.45,95,,,percent of total billed charges,95% of total billed charges,298.48,80,,,percent of total billed charges,80% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,335.79,90,,,percent of total billed charges,90% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rates,159.09,100,,,fee schedule,100% of CO APG rates,233.52,100,,,fee schedule,100% of NM APC rate,149.24,40,,,percent of total billed charges,40% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,335.79,90,,,percent of total billed charges,90% of total billed charges,283.56,76,,,percent of total billed charges,76% of total billed charges,149.24,40,,,percent of total billed charges,40% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of CO APG rate,298.48,80,,,percent of total billed charges,80% of total billed charges,144.76,38.8,,,percent of total billed charges,38.8% of total billed charges,317.14,85,,,percent of total billed charges,85% of total billed charges,159.09,100,,,fee schedule,100% of APG fee schedule,145.42,200,,,fee schedule,200% of CMS fee schedule,144.76,354.45,
Hepatitis A vaccine,60000522,CDM,636,RC,90632,HCPCS,OUTPATIENT,,,51.5,41.2,,38.63,75,,,percent of total billed charges,75% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,40.79,79.2,,,percent of total billed charges,79.2% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,48.93,95,,,percent of total billed charges,95% of total billed charges,41.2,80,,,percent of total billed charges,80% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,46.35,90,,,percent of total billed charges,90% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rates,35.65,100,,,fee schedule,100% of CO APG rates,51.5,100,,,fee schedule,100% of NM fee schedule,20.6,40,,,percent of total billed charges,40% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,46.35,90,,,percent of total billed charges,90% of total billed charges,39.14,76,,,percent of total billed charges,76% of total billed charges,20.6,40,,,percent of total billed charges,40% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of CO APG rate,41.2,80,,,percent of total billed charges,80% of total billed charges,19.98,38.8,,,percent of total billed charges,38.8% of total billed charges,43.78,85,,,percent of total billed charges,85% of total billed charges,35.65,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,19.98,51.5,
Infectious agent antigen detection,60000602,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,65.8,52.64,,49.35,75,,,percent of total billed charges,75% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,52.11,79.2,,,percent of total billed charges,79.2% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,62.51,95,,,percent of total billed charges,95% of total billed charges,52.64,80,,,percent of total billed charges,80% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,26.32,40,,,percent of total billed charges,40% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,59.22,90,,,percent of total billed charges,90% of total billed charges,50.01,76,,,percent of total billed charges,76% of total billed charges,26.32,40,,,percent of total billed charges,40% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,52.64,80,,,percent of total billed charges,80% of total billed charges,25.53,38.8,,,percent of total billed charges,38.8% of total billed charges,55.93,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,62.51,
C-Reactive Protein,60000619,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,60.42,
C-Reactive Protein,60000619,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,60.42,
C-Reactive Protein,60000619,CDM,302,RC,86140,HCPCS,OUTPATIENT,,,63.6,50.88,,47.7,75,,,percent of total billed charges,75% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,50.37,79.2,,,percent of total billed charges,79.2% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,60.42,95,,,percent of total billed charges,95% of total billed charges,50.88,80,,,percent of total billed charges,80% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rates,13.74,100,,,fee schedule,100% of CO APG rates,4.87,100,,,fee schedule,100% of NM fee schedule,25.44,40,,,percent of total billed charges,40% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,57.24,90,,,percent of total billed charges,90% of total billed charges,48.34,76,,,percent of total billed charges,76% of total billed charges,25.44,40,,,percent of total billed charges,40% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of CO APG rate,50.88,80,,,percent of total billed charges,80% of total billed charges,24.68,38.8,,,percent of total billed charges,38.8% of total billed charges,54.06,85,,,percent of total billed charges,85% of total billed charges,13.74,100,,,fee schedule,100% of APG fee schedule,10.36,200,,,fee schedule,200% of CMS fee schedule,4.87,60.42,
pharmacy,,,250,RC,,,OUTPATIENT,,,529.4,423.52,,397.05,75,,,percent of total billed charges,75% of total billed charges,211.76,40,,,percent of total billed charges,40% of total billed charges,419.28,79.2,,,percent of total billed charges,79.2% of total billed charges,449.99,85,,,percent of total billed charges,85% of total billed charges,529.4,100,,,fee schedule,100% of CO APG rates,502.93,95,,,percent of total billed charges,95% of total billed charges,423.52,80,,,percent of total billed charges,80% of total billed charges,449.99,85,,,percent of total billed charges,85% of total billed charges,476.46,90,,,percent of total billed charges,90% of total billed charges,529.4,100,,,fee schedule,100% of CO APG rates,529.4,100,,,fee schedule,100% of CO APG rates,529.4,100,,,fee schedule,100% of NM fee schedule,211.76,40,,,percent of total billed charges,40% of total billed charges,211.76,40,,,percent of total billed charges,40% of total billed charges,476.46,90,,,percent of total billed charges,90% of total billed charges,402.34,76,,,percent of total billed charges,76% of total billed charges,211.76,40,,,percent of total billed charges,40% of total billed charges,449.99,85,,,percent of total billed charges,85% of total billed charges,529.4,100,,,fee schedule,100% of CO APG rate,423.52,80,,,percent of total billed charges,80% of total billed charges,205.41,38.8,,,percent of total billed charges,38.8% of total billed charges,449.99,85,,,percent of total billed charges,85% of total billed charges,529.4,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,205.41,529.4,
Infectious agent antigen detection,60001107,CDM,300,RC,87880,HCPCS,OUTPATIENT,,,1181.6,945.28,,886.2,75,,,percent of total billed charges,75% of total billed charges,472.64,40,,,percent of total billed charges,40% of total billed charges,935.83,79.2,,,percent of total billed charges,79.2% of total billed charges,1004.36,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,1122.52,95,,,percent of total billed charges,95% of total billed charges,945.28,80,,,percent of total billed charges,80% of total billed charges,1004.36,85,,,percent of total billed charges,85% of total billed charges,1063.44,90,,,percent of total billed charges,90% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rates,9.49,100,,,fee schedule,100% of CO APG rates,15.54,100,,,fee schedule,100% of NM fee schedule,472.64,40,,,percent of total billed charges,40% of total billed charges,472.64,40,,,percent of total billed charges,40% of total billed charges,1063.44,90,,,percent of total billed charges,90% of total billed charges,898.02,76,,,percent of total billed charges,76% of total billed charges,472.64,40,,,percent of total billed charges,40% of total billed charges,1004.36,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of CO APG rate,945.28,80,,,percent of total billed charges,80% of total billed charges,458.46,38.8,,,percent of total billed charges,38.8% of total billed charges,1004.36,85,,,percent of total billed charges,85% of total billed charges,9.49,100,,,fee schedule,100% of APG fee schedule,33.06,200,,,fee schedule,200% of CMS fee schedule,9.49,1122.52,
Medical and surgical supplies,60001186,CDM,270,RC,,,OUTPATIENT,,,1137.8,910.24,,853.35,75,,,percent of total billed charges,75% of total billed charges,455.12,40,,,percent of total billed charges,40% of total billed charges,901.14,79.2,,,percent of total billed charges,79.2% of total billed charges,967.13,85,,,percent of total billed charges,85% of total billed charges,1137.8,100,,,fee schedule,100% of CO APG rates,1080.91,95,,,percent of total billed charges,95% of total billed charges,910.24,80,,,percent of total billed charges,80% of total billed charges,967.13,85,,,percent of total billed charges,85% of total billed charges,1024.02,90,,,percent of total billed charges,90% of total billed charges,1137.8,100,,,fee schedule,100% of CO APG rates,1137.8,100,,,fee schedule,100% of CO APG rates,1137.8,100,,,fee schedule,100% of NM fee schedule,455.12,40,,,percent of total billed charges,40% of total billed charges,455.12,40,,,percent of total billed charges,40% of total billed charges,1024.02,90,,,percent of total billed charges,90% of total billed charges,864.73,76,,,percent of total billed charges,76% of total billed charges,455.12,40,,,percent of total billed charges,40% of total billed charges,967.13,85,,,percent of total billed charges,85% of total billed charges,1137.8,100,,,fee schedule,100% of CO APG rate,910.24,80,,,percent of total billed charges,80% of total billed charges,441.47,38.8,,,percent of total billed charges,38.8% of total billed charges,967.13,85,,,percent of total billed charges,85% of total billed charges,1137.8,100,,,fee schedule,100% of APG fee schedule,,,,,other,not separately reimbursable,441.47,1137.8,